Iniquidade racial no acesso ao pré-natal no primeiro trimestre de gestação: uma revisão sistemática e metanálise

• Ano de defesa: 2020
• Autor(a) principal: Silva, Pedro Henrique Alcântara da
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Rio Grande do Norte; Brasil; UFRN; PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA
• Palavras-chave em Português: Cuidado pré-natal; Acesso aos serviços de saúde; Fatores raciais; Prenatal Care; Access to health services; Racial factors
• Link de acesso: https://repositorio.ufrn.br/handle/123456789/30619

Access to prenatal care is the main promoter of healthy birth and the main preventive measure of maternal mortality from preventable causes in primary care. Early entry to this service makes it possible to reach the appropriate number of consultations, as well as the performance of the recommended procedures and suitability definers. Race / skin color is an important predictor of the population's health status, as well as a marker of social inequalities. The objective was, then, to carry out a systematic review of the literature and meta-analysis of cross-sectional studies, to identify the prevalence of access to prenatal care in the first trimester of pregnancy according to race or ethnicity and its magnitude of association. The protocol for this review is registered on the PROSPERO platform under number CRD42020159968. Searches were conducted at PUBMED, LILACS, Web of Science, Scopus, CINAHL and in the gray literature (Google Scholar and Opengray), using the descriptors "pregnancy", "prenatal" and "Accessibility to health services". The quality of studies and the risk of biaswere analyzed using the Joanna Briggs Critical Assessment Checklist for Cross-Sectional Analytical Studies. After the analysis steps, 17 studies were included in this review. The extracted data were tabulated and distributed qualitatively and quantitatively through meta-analysis. It was observed that, in most of the included studies, black women were those who had less access to prenatal services in the first trimester, with a prevalenceof access ranging from 53% to 56.4%; white women between 74% and 76.5%; and those of other ethnicities from 64.2% to 68.8%. In the quantitative analysis of the data, it was found that black women, when compared to white women, had a 43% less chance (OR = 0.57 95% CI 0.51-0.64) of obtaining obstetric care in the first trimester, and of 22% less chances when compared with women of other ethnicities (OR = 0.78 CI 95% 0.65-0.95). Thus, it is concluded that black women, even when contrasted with white and otherminorities of similar sociodemographic characteristics, still received a difficulty in accessing maternal health services, and it can be inferred that the issue of race / skin color is itself an important determinant in obtaining obstetric care, requiringthe development of public policies aimed at this population and expanding their access to health services