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2005, Number 3

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Rev Med Inst Mex Seguro Soc 2005; 43 (3)

Perinatal Hospital Mortality: Its Relationship with Prenatal Care Quality

Aguilar BMR, Méndez MGF, Guevara AJ, Caballero LLA

Language: Spanish
References: 39
Page: 215-220
PDF size: 72.07 Kb.


ABSTRACT

Objective: Our aim was to analyze infant mortality at the Mexican Institute of Social Security (IMSS) North Veracruz, Mexico, Delegation from the perspective of prenatal care quality.
Materials and methods: We performed a retros-pective case-control study and included all cases of perinatal mortality at the IMSS at North Veracruz from July 1 to December 31, 2003. There were two controls per case matched by gender and date of birth. Prenatal care quality was evaluated by a specifically developed questionnaire.
Results: A total of 53 cases were used for the final analysis. Maternal age was similar between cases and controls (p = 0.814). There were fewer prenatal appointments (p = 0.0001), fewer test performed [blood test (p = 0.0001) and urine test (p = 0.004)], higher obstetric risk (p = 0.004), and fewer obstetric ultrasound imaging studies developed (p = 0.022) in cases of perinatal mortality vs. controls. Main variables related with perinatal mortality were the following: absent of blood test (odds ratio [OR] 4.7, 95 % confidence interval [CI 95 %] 2.2–9.9, p = 0.0001); urine test (OR 4.4, CI 95% 1.5–12.6, p = 0.004), and obstetric ultrasound studies (OR 2.3, CI 95 %, 1.1–4.8, p = 0.022), and having fewer than five prenatal appointments (OR 2.2, CI 95 % 1.1–4.4, p = 0.018).
Conclusions: There is evidence of inadequate prenatal care quality in cases of hospital perinatal mortality in Veracruz. Absence of obstetric ultrasound imaging studies and blood tests during prenatal care increases the risk of perinatal mortality 2–4 times.


REFERENCES

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  2. Wise PH. The anatomy of a disparity in infant mortality. Ann Rev Public Health 2003;24:341-362.

  3. Safe Motherhood, World Health Organization, World Bank. Health around the world. Geneva, Switzerland; Motherhood WHO; 1997.

  4. Velasco-Murrillo V, Palomares-Trejo A, Navarrete-Hernández E. Causalidad y tendencia de la mortalidad perinatal hospitalaria en el Instituto Mexicano del Seguro Social, 1998-2002. Cir Ciruj 2003;71:304-313.

  5. Vintzileos AM, Ananth CV, Smulian JC, Scorza WE, Knuppel RA. The impact of prenatal care on neonatal deaths in the presence and absence of antenatal highrisk

  6. conditions. Am J Obstet Gynecol 2002;186:1011-1016.

  7. Insler V, Larholt K, Hagay ZJ, Baly R, Bar DG, Meizner I, et al. The impact of prenatal care on the outcome of pregnancy. Eur J Obstet Gynecol Reprod Biol 1986; 23:211-223.

  8. Essén B, Bödker B, Sjöberg N-O, Langhoff-Roos J, Greisen G, Gudmundson S, et al. Are some perinatal deaths in inmigrant groups linked to suboptimal perinatal care services? BJOG 2002;109:677-682.

  9. Rasmussen KM. Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation and perinatal mortality? J Nutr 2001;131:590S-603S.

  10. Richardus JH, Graafmans WC, Veloove-Vanhorick SP, Mackenbach JP. The EuroNatal International Audit Panel, The EuroNatal Working Group. Differences in perinatal mortality and suboptimal care between 10 European regions: results of an international audit. BJOG 2003;100:97-105.

  11. Moctezuma-Hernández SL, Tena-Pérez CE, Aguayo-Godínez A, Millán- Guerrero R. Perinatal mortality 1 in Colima, Col. Case-control study. Ginecol Obstet Mex 2000;68:207-211.

  12. Rivera L, Fuentes-Román ML, Esquinca-Albores C, Abarca FJ, Hernández-Girón C. Perinatal mortality associated factors in a general hospital of Chiapas, Mexico. Rev Saude Publica 2003;37:687-692.

  13. Rosenberg TJ, Garbers S, Chavkin W, Chaisson MA. Prepregnancy weight and adverse perinatal outcomes in an ethically diverse population. Obstet Gynecol 2003;102:1022-1027.

  14. Murakami M, Ohmichi M, Takhashi T, Shibata A, Fukao A, Morisaki N, et al. Prepregnancy body mass index as an important predictor of perinatal outcomes in Japanese. Arch Gynecol Obstet 2004.

  15. Kabiru W, Raynor D. Obstetric outcomes associated with increase in BMI category during pregnancy. Am J Obstet Gynecol 2004;191:928-932.

  16. Forsbach G, Vásquez-Lara J, Álvarez-y-García C, Vásquez-Rosales J. Pregnancy and diabetes in Mexico. Rev Invest Clin 1998;50:227-231.

  17. Velásquez-Monroy O, Rosas-Peralta M, Lara-Esqueda A, Pastelín-Hernández G, Grupos ENSA 2000, Castillo C, et al. Prevalencia e interrelación de enfermedades

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  19. 2003;73:62-77.

  20. Secretaría de Salud. Normal oficial mexicana para la atención de la mujer durante el embarazo, parto y puerperio y recién nacido. Diario Oficial de la Federación, 1994.

  21. Coordinación de Salud Reproductiva. Manual de procedimientos para la vigilancia prenatal y puerperal en medicina familiar. México: IMSS; 2003.

  22. World Health Organization. Perinatal mortality: a listing of available information. Family and reproductive health. Geneva, Switzerland: Motherhood WHO; 1996.

  23. Wise PH. The anatomy of a disparity in infant mortality. Ann Rev Public Health 2003;24:341-362.

  24. Safe Motherhood, World Health Organization, World Bank. Health around the world. Geneva, Switzerland; Motherhood WHO; 1997.

  25. Velasco-Murrillo V, Palomares-Trejo A, Navarrete-Hernández E. Causalidad y tendencia de la mortalidad perinatal hospitalaria en el Instituto Mexicano del Seguro Social, 1998-2002. Cir Ciruj 2003;71:304-313.

  26. Vintzileos AM, Ananth CV, Smulian JC, Scorza WE, Knuppel RA. The impact of prenatal care on neonatal deaths in the presence and absence of antenatal highrisk conditions. Am J Obstet Gynecol 2002;186:1011-1016.

  27. Insler V, Larholt K, Hagay ZJ, Baly R, Bar DG, Meizner I, et al. The impact of prenatal care on the outcome of pregnancy. Eur J Obstet Gynecol Reprod Biol 1986; 23:211-223.

  28. Essén B, Bödker B, Sjöberg N-O, Langhoff-Roos J, Greisen G, Gudmundson S, et al. Are some perinatal deaths in inmigrant groups linked to suboptimal perinatal care services? BJOG 2002;109:677-682.

  29. Rasmussen KM. Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation and perinatal mortality? J Nutr 2001;131:590S-603S.

  30. Richardus JH, Graafmans WC, Veloove-Vanhorick SP, Mackenbach JP. The EuroNatal International Audit Panel, The EuroNatal Working Group. Differences in perinatal mortality and suboptimal care between 10 European regions: results of an international audit. BJOG 2003;100:97-105.

  31. Moctezuma-Hernández SL, Tena-Pérez CE, Aguayo-Godínez A, Millán- Guerrero R. Perinatal mortality 1 in Colima, Col. Case-control study. Ginecol Obstet Mex 2000;68:207-211.

  32. Rivera L, Fuentes-Román ML, Esquinca-Albores C, Abarca FJ, Hernández-Girón C. Perinatal mortality associated factors in a general hospital of Chiapas, Mexico. Rev Saude Publica 2003;37:687-692.

  33. Rosenberg TJ, Garbers S, Chavkin W, Chaisson MA. Prepregnancy weight and adverse perinatal outcomes in an ethically diverse population. Obstet Gynecol 2003;102:1022-1027.

  34. Murakami M, Ohmichi M, Takhashi T, Shibata A, Fukao A, Morisaki N, et al. Prepregnancy body mass index as an important predictor of perinatal outcomes in Japanese. Arch Gynecol Obstet 2004.

  35. Kabiru W, Raynor D. Obstetric outcomes associated with increase in BMI category during pregnancy. Am J Obstet Gynecol 2004;191:928-932.

  36. Forsbach G, Vásquez-Lara J, Álvarez-y-García C, Vásquez-Rosales J. Pregnancy and diabetes in Mexico. Rev Invest Clin 1998;50:227-231.

  37. Velásquez-Monroy O, Rosas-Peralta M, Lara-Esqueda A, Pastelín-Hernández G, Grupos ENSA 2000, Castillo C, et al. Prevalencia e interrelación de enfermedades crónicas no transmisibles y factores de riesgo cardiovascular en México: Resultados finales de la Encuesta Nacional de Salud (ENSA) 2000. Arch Cardiol Mex 2003;73:62-77.

  38. Secretaría de Salud. Normal oficial mexicana para la atención de la mujer durante el embarazo, parto y puerperio y recién nacido. Diario Oficial de la Federación, 1994.

  39. Coordinación de Salud Reproductiva. Manual de procedimientos para la vigilancia prenatal y puerperal en medicina familiar. México: IMSS; 2003.




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