Neonatal visits in the first week of life in primary care: low prevalence and related factors

Oscar, Marina Cecília Belotti; Simão, Delma Aurélia da Silva; Ribeiro, Gabriela de Cássia; Vieira, Ed Wilson Rodrigues

doi:10.1590/0034-7167-2021-0295

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (04) • 2022 • https://doi.org/10.1590/0034-7167-2021-0295 copy

Neonatal visits in the first week of life in primary care: low prevalence and related factors

Consulta neonatal durante la primera semana de vida en la atención primaria: baja prevalencia y factores relacionados

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to identify the prevalence of and factors related to access to neonatal consultation in the first week of life, in Brazil.

Methods:

a secondary data analysis from a national cross-sectional survey involving 14,133 mothers from primary care services. Pearson chi-square was used to analyze the prevalence of access to appointment and Poisson regression to analyze related factors, considering prevalence ratio (PR) and confidence intervals (95%CI).

Results:

the prevalence of healthcare visits was 63.0% in Brazil. Children of mothers, aged 30-39 years (PR=1.065; CI=1.029-1.103), and of single mothers (PR=1.021; CI=1.00-1.042) had higher prevalence of access. Children from the northern region of Brazil had a lower prevalence of healthcare visits compared to children from other regions.

Conclusions:

low prevalence of access to neonatal visits was identified in the first week of life in primary care services; the region of residence, maternal age, and marital status were identified among the related factors.

Descriptors:
Health Services Accessibility; Newborn; Pediatric Nursing; Primary Health Care; Brazil

	n	(%)
Mother's age (in years)
18-19	1,353	(9.6)
20-29	7,722	(54.2)
30-39	4,506	(31.9)
40 or more	552	(3.9)
Marital status
Married or stable union	9,862	(69.8)
Solo	3,922	(27.8)
Separated or widowed	349	(2.5)
Race or skin color (n=14,037)
Brown or mixed race	8,044	(57.3)
White
Black	1,921	(13.7)
Yellow	488	(3.5)
Indigenous	128	(0.9)
Education (n=14,127)
≥8 years of study	11,104	(78.6)
< 8 years of study	3,023	(21.4)
Poverty Line (n=11,659)
Below (1)	8,866	(76.0)
Above (2)	2,793	(24.0)
Bolsa Família program (n=13.943)
Never participated	5,637	(40.4)
Participating or has participated	8,306	(59.6)
Geographic region
North	1,522	(10.8)
Center-West	1,052	(7.4)
Northeast	5,183	(36.7)
Southeast	4,922	(34.8)
South	1,454	(10.3)

	Access to the health visit in the first week of life
	n	(%)	(95% CI)	p^ * statistical test (Pearson Chi-Square).*
Brazil	8,910	(63.0)	(62.2-63.8)
Mothers age (in years)				< 0.001
18-19	802	(59.3)	(56.6-61.9)
20-29	4,827	(62.5)	(61.4-63.6)
30-39	2,922	(64.8)	(63.4-66.2)
40 or more	359	(65.0)	(60.9-69.0)
Marital status				0.127
Married or stable union	6,164	(62.5)	(61.5-63.5)
Separated or widowed	223	(63.9)	(58.6-68.9)
Solo	2,523	(64.3)	(62.8-65.8)
Race or skin color (n=14.037)				0.003
Indigenous	72	(56.3)	(47.2-64.9)
Brow or mixed color	4,988	(62.0)	(60.9-63.1)
Yellow	307	(62.9)	(58.4-67.2)
Black	1,218	(63.4)	(61.2-65.6)
White	2,267	(65.6)	(64.0-67.2)
Education (n=14.127)				0.545
≥8 years of study	6,986	(62.9)	(62.0-63.8)
< 8 years of study	1,920	(63.5)	(61.8-65.2)
Poverty Line (n=11.659)				0.101
Below (1)	5,584	(63.0)	(62.0-64.0)
Above (2)	1,807	(64.7)	(62.9-66.5)
Bolsa Família program (n=13.943)				0.171
Participating or has participated	5,195	(62.5)	(61.5-63.6)
Never participated	3,590	(63.7)	(62.4-64.9)
Geographic region				< 0.001
North	787	(51.7)	(49.2-54.2)
Center-west	650	(61.8)	(58.8-64.7)
Northeast	3,218	(62.1)	(60.7-63.4)
Southeast	3,220	(65.4)	(64.1-66.7)
South	1,035	(71.2)	(68.8-73.5)

	Access to health visit in the first week of life
	Bivariate analysis			Multivariate analysis
	PR	(95% CI)	**p^ * PR = Prevalence Reason; CI - confidence interval; n - number of respondents;***	PR	(95% CI)	*p^ statistical test (Wald Chi-Square).*
Mother’s age (in years)
18-19	1.000			1.00
20-29	1.033	(1.004-1.063)	0.025	1.029	(0.995-1.064)	0.093
30-39	1.057	(1.026-1.089)	0.000	1.065	(1.029-1.103)	< 0.001
40 or more	1.059	(1.010-1.111)	0.018	1.055	(0.999-1.114)	0.056
Marital status of mother
Married or stable union	1.00			1.00
Solo	1.018	(1.000-1.037)	0.044	1.021	(1.000-1.042)	0.048
Separated or widowed	1.014	(0.963-1.067)	0.594	1.013	(0.957-1.072)	0.652
Race or skin color (n=14.037)
White	1.000			1.00
Black	0.978	(0.953-1.005)	0.108	0.994	(0.964-1.024)	0.685
Yellow	0.973	(0.930-1.019)	0.240	0.981	(0.932-1.032)	0.464
Brow or mixed color	0.965	(0.947-0.983)	0.000	0.995	(0.973-1.018)	0.680
Indigenous	0.911	(0.835-0.994)	0.036	0.981	(0.891-1.081)	0.705
Maternal education (n=14.127)
≥ 8 years of study	1.000
< 8 years of study	1.006	(0.987-1.026)	0.545
Poverty Line (n=11.659)
Below	1.000			1.00
Above	1.017	(0.997-1.038)	0.099	0.995	(0.971-1.018)	0.649
Bolsa Família program (n=13.943)
Participating or has participated	1.011	(0.995-1.028)	0.170	0.999	(0.979-1.020)	0.949
Never participated	1.000			1.00
Geographic region
North	1.00			1.00
Center-west	1.106	(1.064-1.150)	0.000	1.087	(1.040-1.135)	< 0.001
Northeast	1.109	(1.078-1.141)	0.000	1.100	(1.065-1.136)	< 0.001
Southeast	1.147	(1.115-1.180)	0.000	1.131	(1.094-1.169)	< 0.001
South	1.215	(1.174-1.257)	0.000	1.189	(1.142-1.238)	< 0.001

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[1] Corresponding author: Ed Wilson Rodrigues Vieira E-mail: edwilsonvieira@ufmg.br