Delivery and newborn assistance program in Botucatu city, São Paulo State, Brazil – results of 1999

Abstract

Objective – To evaluate the effectiveness of the hierarchyzation process in the Delivery and Newborn Assistance Program in Botucatu City. Patients and methods – A prospective and comparative study carried out from January 1 to December 31, 1999. It was compared the results of two delivery assistance services in convenant with SUS and differenciated at the level of secondary (HR-ABHS) and tertiary (HC-FMB/Unesp) attention. Maternal age, parity, consultations number, place of prenatal, type of delivery, indications for Caesarean, gestational age, weight at birth, Apgar indexes, cause of hospitalar maternal mortality and precocious neonatal mortality were related. For statistical analysis, it was used the ?2 and Goodman tests, with significance level at 5% (p<0.05). Results – The frequency of old and multiparous pregnant women with delivery attendance at SUS was higher in high risk service, respectively, 10.4% and 33.5%, than in low risk (4.0% and 21.9%). Concerning delivery attention level, it was confirmed adequacy in the indexes (26.0% at HR-ABHS and 36.0% at HC-FMB/Unesp) and in indications for Caesarean. In the low risk service, higher proportion of newborns was at time (88.5% and 74.0%), with appropriate weight (89.7% and 74.4%) with no sign of hypoxia, receiving hospital release within 72 hours (95.3% and 63.0%). The occurrence and causes of maternal death were compatible with the levels of service complexity, and precocious neonatal obituary was exclusive in the tertiary attendance. Conclusion – The results of the Delivery and Newborn Assistance Program in Botucatu city show efficacy of the hierarchyzation system, with adequate definition of secondary (HR-ABHS) and tertiary (HC-FMB/Unesp) attention levels.