Assessing the effect on outcomes of public or private provision of prenatal care in Portugal.
Matern Child Health J
; 19(7): 1574-83, 2015 Jul.
Article
em En
| MEDLINE
| ID: mdl-25636645
ABSTRACT
To evaluate whether public and private prenatal care users experience similar outcomes, taking into consideration maternal pre-pregnancy social and clinical risk. We studied 7,325 women who delivered single newborns at five public maternity units in Porto, Portugal. Health behaviors and prenatal care were self-reported; pregnancy complications and delivery data were retrieved from medical files. The odds of inadequate weight gain, continuing to smoke, gestational hypertension, gestational diabetes, caesarean section, preterm birth, low birthweight, and small- and large-for-gestational-age were estimated for public and private providers using logistic regression, stratified by pre-pregnancy risk profile, adjusted for maternal characteristics. 38 % of women used private prenatal care. Among low-risk women, public care users were more likely to gain excessive weight (OR 1.26; 95 % CI 1.06-1.57) and be diagnosed with gestational diabetes (OR 1.37; 95 % CI 1.01-1.86). They were less likely to have a caesarean (OR 0.63; 95 % CI 0.51-0.78) and more likely to deliver small-for-gestational-age babies (OR 1.48; 95 % CI 1.19-1.83). Outcomes were similar in high-risk women although preterm and pre-labor caesarean were less frequent in public care users (OR 0.64 95 % CI 0.45-0.91; OR 0.69 95 % CI 0.49-0.97). The amount of care was not significantly related to risk profile in either case. Public care users experienced similar outcomes to those using private care, despite higher pre-pregnancy disadvantage. Low-risk women need further attention if narrowing inequalities in birth outcomes remains a priority.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidado Pré-Natal
/
Resultado da Gravidez
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Hospitais Privados
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Avaliação de Resultados em Cuidados de Saúde
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Hospitais Públicos
/
Serviços de Saúde Materna
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
/
Newborn
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Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
Matern Child Health J
Assunto da revista:
PERINATOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article