Análise da qualidade da assistência pré-natal na atenção primária à saúde no município de João Pessoa/PB

Prenatal quality is associated with desirable obstetric outcomes and with the health of the mother-child binomial, which assessment is important in the discovery of results that allow interventions aimed at improving prenatal care. In this context, some indexes are used to evaluate prenatal care; however, the most used present as evaluative components only information regarding gestational age at the beginning of prenatal care and number of medical visits, which does not reflect in full the quality of care. The aim of this study was to evaluate the quality of prenatal care in the city of Joao Pessoa-Paraiba and to verify whether demographic, socioeconomic, reproductive, maternal morbidity and prenatal care variables were possible determinants of prenatal adequacy. This cross-sectional epidemiological study was carried out based on interviews with 130 professionals from primary health care units and 1673 postpartum women at the maternity ward. For these, information was also collected from the Pregnant Woman's Card and medical records. Prenatal qualification was based on the prenatal IPR index, which classifies prenatal care into four categories (appropriate superior, adequate, intermediate and inadequate), based on criteria involving structure, process and results. Prenatal qualification was dichotomized (adequate, inadequate) and, through binary logistic regression, odds and confidence interval (95% CI), the risk factors associated with the outcome were verified, considered here as: "Adequate prenatal care". Prenatal care in the city of Joao Pessoa presented low prevalence of adequacy, with approximately 25%. Based on the analyses, it was observed that in the Health District where women were assisted, parity, per capita income increase, women's participation in systematic health education activities, their attendance by the multiprofessional team, and schooling were determinants of prenatal qualification. Therefore, the study demonstrated that factors such as: access, reproductive and economic inequities, educational elements and multiprofessionality in prenatal care determine its quality, and should be taken into account in the planning and development of actions aimed at the maternal-child group, specifically in the prenatal care performed in primary health care units.