Inconsistencies in the completeness of the pregnant woman's card: a systematic review

The pregnant woman's card is one of the instruments used to evaluate prenatal care. It is an important source of data for epidemiological survey, being essential to ensure the flow of information and contribute to the continuity of care. Objective: Analyze studies that focused on the evaluation of the completeness of the pregnant woman's card.

Methods

A systematic review was carried out in the Scielo, Virtual Health Library, EMBASE, and Web of Science databases and the checklist based on the Preferred Reporting Items for Systematic Reviews (PRISMA) guideline was used.

Results

Forty-three studies were identified, resulting in seven analyzed. The studies showed methodological differences, especially regarding the fields of the pregnant woman's card selected for analysis, method of presentation and interpretation of results, ranging from relative frequency with different categories to classification by Romero & Cunha score. This divergence limited the comparison of findings. Even so, all studies observed poor completeness in important fields of the maternity card.

Conclusion

It is extremely important that professionals and managers value the full completion of the pregnant woman's card, favoring the assessment of care and decision-making during prenatal care.

Keywords:
Prenatal care; Data accuracy; Delivery of health care; Quality of health care; Systematic review

AUTHORS	Santos et al.	Coelho et al.	Santos Neto et al.	Carvalho et al.	Carrilho	Cristofaro	Zago
Study type	Cross-sectional	Cross-sectional	Cross-sectional	Cross-sectional	Cross-sectional	Cross-sectional	Cross-sectional
Study Place	Teresina, Piauí	Santa Cruz, RN	Great Vitória, ES	São Paulo, SP	Belo Horizonte, MG	Rio de Janeiro, RJ	Florianópolis, SC
Data Collect	Oct. – Nov. 2014	July- Nov. 2011	Apr. - Sept. 2010	Feb. 2001	Oct.2012 - Jan. 2013	Jan. – May 2017	Feb. 2008
Type of health facility	Maternity public of reference state	Federal University Hospital	Public Maternity or affiliated to the SUS	Private Maternity	Federal University Hospital	Municipal Public Maternity	Federal University Hospital
Sample Size	241	81	1006	19	185	805	115
Eligibility criteria	Pregnant women, older than 18 years	Puerperal women, older than 18 years, prenatal care performed in basic health units	Puerperal women, prenatal care carried out in public units located in Great Vitória	Puerperal women from the second day of the puerperium	Puerperal women, low-risk prenatal care carried out in the metropolitan region of Belo Horizonte	Puerperal women prenatal care in the family health units of the municipality of Rio de Janeiro	Puerperal women, pre-natal care in Florianópolis
Exclusion Criteria	Not available	Risk and/or psychiatric disease pregnancy	Pre-natal care, complete or partial in the private system or outside the Great Victory	Not available	Preterm delivery	Not in good clinical condition and giving birth before 37 weeks	Preterm delivery
Criterion for evaluation of completeness	Relative frequency	Relative frequency and classification by Romero & Cunha criteria	Relative frequency and classification by Romero & Cunha criteria	Relative frequency	Relative frequency	Relative frequency and classification by Romero & Cunha criteria	Relative frequency
Evaluated Card Model	Not available	Not available	Not available	Not available	Standardized by the Ministry of Health, a model of Belo Horizonte and the health insurance plan	Not available	Card from the Municipality secretariat

Authors	Santos et al.	Coelho et al.	Santos Neto et al.	Carvalho et al.	Carrilho	Cristofaro	Zago
	Percentage of incompleteness
Access, bond, identification
Type of health unit	NA	NA	46,7%	0%	NA	22,46%	NA
Professional who made the first consultation	34%	NA	NA	NA	NA	NA	NA
Professional who made the sixth consultation	63,50	NA	NA	NA	NA	NA	NA
Name	NA	NA	NA	37%	NA	0,53%	NA
Age	6,60%	43,20%	23,90%	16%	NA	33,42%	NA
Marital status	11,6%	NA	45,60%	NA	NA	18,69%	NA
Identification (name, age and address and/or telephone number)	NA	NA	NA	NA	20,50%	NA	NA
Schooling	14,10%	NA	45,30%	NA	NA	23,51%	NA
FAMILY, PERSONAL AND OBSTETRIC HISTORY
Family history of diabetes mellitus	10,30%	NA	NA	NA	NA	NA	NA
Personal history	NA	NA	76,90%	21%	39,5%	21,05%	NA
Personal history Hypertension	12,80%	NA	NA	NA	NA	NA	NA
Personal history of diabetes mellitus	12,50%	NA	NA	NA	NA	NA	NA
Obstetric history	NA	NA	NA	NA	4,3%	13,91%	2,6%
Number of pregnancies	8,30%	NA	NA	NA	NA	NA	NA
Number of abortions	34%	NA	46%	NA	NA	NA	NA
Number of deliveries	24,10%	NA	27,20%	NA	NA	NA	NA
Number of vaginal deliveries	43,20%	NA	49,40%	NA	NA	NA	NA
Number of caesarean deliveries	60,60%	NA	72,90%	NA	NA	NA	NA
Number of children born alive	61,80%	NA	53,20%	NA	NA	NA	NA
Number of stillbirths	79,30%	NA	90,00%	NA	NA	NA	NA
Number of children living	NA	NA	60,20%	NA	NA	NA	NA
Number of neonatal deaths (first week)	NA	NA	94,80%	NA	NA	NA	NA
New-born weight < 2,500g	67,2%	NA	78,60%	NA	NA	NA	NA
Date of last period	10%	0-10%	24%	NA	NA	10,64%	2,6%
Expected Due Date	14,25%	0-10%	28,6%	NA	NA	7,75%	7,7%
Smoking	67,2%	40-50%	24%	NA	NA	NA	NA
Weight	NA	1,20%	NA	69%	25,9%	3,61%	NA
Gestational age/weight curve	NA	80,20%	NA	NA	NA	97,75%	NA
Pre-pregnancy weight	NA	10-20%	49,90%	NA	NA	NA	33,3%
Height	NA	20-30%	54,10%	NA	NA	NA	41,9%
LABORATORY EXAMINATION PERFORMED DURING THE CURRENT PREGNANCY
First Routine: Glycaemia	10,80%	NA	27,40%	16%	24,3%	46,7%	29,1%
First Routine: HIV serology	12%	NA	34%	5%	32,4%	28,4%	39,3%
First Routine: Serology for syphilis	14,50%	70-80%	28,20%	NA	23,2%	27,7%	28,1%
First Routine: Urine (ASE)	16,60%	NA	32,90%	NA	22,2%	44,3%	30,8%
Second routine: serology for syphilis	NA	NA	65,50	NA	NA	NA	49,6%
Second routine: Urine (ASE)	NA	NA	65,10%	NA	NA	NA	41,9%
Second routine: glycaemia	NA	NA	63,90%	NA	NA	NA	55,6%
Second Routine: HIV serology	NA	NA	74,8%	NA	NA	NA	76,1%
Readability	NA	NA	NA	37%	4,9%	NA	NA

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E-mail: publicacoes@ims.uerj.br

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[1] Editor: Jane Russo