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Trends in sociodemographic inequalities in prenatal care in Baixada Litorânea, a region of the state of Rio de Janeiro, Brazil, 2000-2020: an ecological study

Abstract

Objective:

To analyze trends in sociodemographic inequalities in the access to and use of prenatal care in Baixada Litorânea, a region of the state of Rio de Janeiro, Brazil, 2000-2020.

Methods:

This was an ecological time-series study of the number of visits and adequacy of access to prenatal care. Absolute (differences) and relative (ratios) inequalities were calculated between extreme categories of variables; trends were estimated using joinpoint regression.

Results:

A total of 185,242 pregnant women were studied. A proportion of ≥ 7 visits increased annually by 2.4% (95%CI 1.1;3.7) between 2013 (54.4%) and 2020 (63.4%), stable for less than eight years of schooling. Adequacy of access increased 2.6% (95%CI 1.2;4.0) between 2014 and 2020, stable for women ≥ 35 years old and schooling ≥ 12 years. Absolute inequalities decreased (between 3.5% and 6.4%) for age and race/skin color, and relative inequalities decreased (between 7.7% and 20.0%) for all variables.

Conclusion:

Access and number of prenatal consultations increased, however, remained lower for adolescents, women with low level of schooling and those of Black and mixed race/skin color.

Keywords:
Prenatal Care; Healthcare Disparities; Quality of Health Care; Time Series Studies

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