Atenção pré-natal ofertada às gestantes infectadas pelo HIV nos municípios fronteiriços de Mato Grosso do Sul

Abstract

Objective: To analyze the quality of care offered to HIV-infected pregnant women, their sociodemographic, clinical, and laboratory characteristics of prenatal care and delivery, and the detection rate of pregnant women living in border municipalities with conurbation, and non-conurbation, areas of Mato Grosso do Sul. South. Methods: Ecological, retrospective, and descriptive study on prenatal care and clinical and laboratory conditions of pregnant women notified with HIV infection, residing in the 12 (twelve) municipalities of the international border line of Mato Grosso do Sul, in 2012 and 2020, from four secondary databases: Notifiable Diseases Information System (Sinan), Live Birth Information System (Sinasc), Mortality Information System (SIM) and Laboratory Test Control System (Siscel ) to investigate sociodemographic variables, prenatal care, and delivery, clinical and laboratory conditions. The municipalities were divided into two groups: those bordering a conurbation urban area (dry border or river border) were grouped into Group 1 (G1), cities bordering a non-conurbation urban area (with proximity to an urban area).) were grouped into Group 2 (G2). The detection rate trend coefficient was calculated using the R ® 4.1.2 software for Windows 2016. Results: The study population included 117 pregnant women with live newborns (NB). In G1, the cumulative detection rate of HIV in pregnant women was 2.7/1,000 Live Births (LB); in G2, the rate was 1.7/1,000 LB. It was observed that 74.7% were 20 years old or older; 41.7% had four to seven years of study; both had 50.0% with and without a partner; 61.3% were mulatto, and the housewife’s profession had 89.3%. 91.4% of pregnant women had access to prenatal care, and 57.1% started in the 1st trimester of pregnancy, and 53.9% had fewer consultations than recommended, 57.0% received inadequate prenatal care. Cesarean delivery occurred in 86.3%; 82.1% of the newborns were not premature, and 92.3% were not low birth weight. About the serological condition, 51.3% of the pregnant women already knew before the current pregnancy. 40.2% of the notifications were made in the 3rd trimester or at delivery. Prophylaxis during prenatal care occurred in 90.1% of pregnant women. The viral load was undetectable in 56.0% of the pregnant women, and a TCD4+ lymphocyte count equal to or above 500 cells/mm3 was present in 44.2%. Conclusion: It was found that the municipalities of G1 had a higher detection rate than pregnant women who started prenatal care in the first trimester. In G2, there was a higher proportion of prenatal care and prenatal prophylaxis, however, there was a more significant number of cesarean deliveries, detectable viral load, and T-CD4+ count below 350 cells/mm3, which refers to a possible failure in the follow-up of these pregnant women.