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Wehby, George L., Jeffrey C. Murray, Eduardo E. Castilla, Jorge S. Lopez-Camelo and Robert L. Ohsfeldt. Prenatal care effectiveness and utilization in Brazil. Health Policy and Planning, 2009; 24, 175–188

Low birth weights (LBW) and pre-term births have frequent adverse outcomes that contribute significantly to infant mortality and delayed child development. The increase in incidence rates and improved survival of affected births could raise the prevalence of developmental disabilities, particularly among very LBW and pre-term babies in less developed settings. Indirectly, LBW and pre-term birth also increase health care utilisation and costs to the family. Timely prenatal care visits can diagnose or identify all the complications and risks that might lead to low birth weights and preterm infant babies. The study measured the impact of different pre-natal care use on birth outcomes through a cohort study in Brazil. More specifically, attempts were made to measure the effects of pre-natal care visits on birth weight and gestational age outcomes among sample of 1716 infants born without and 1695 born with common birth defects. Pre-natal visits found to be significant in the group without birth defects for birth weight through increasing both fetal growth rate and gestational age whereas for the reverse result was insignificant when the gestational age was adjusted. It was seen that delay in pre-natal care had no effects on the BW on both the groups, but increase pre-term and low birth weight risk among the second group. It was also revealed that use of multivitamin and number of previous live births have an effect on infants born without defects whereas; more number of prenatal care visits was found to be significant for the several maternal and fertility indicators. Further, quintiles’ regression concludes that prenatal care visits had larger effect on the high BW quantile as compared to the LW quantiles. Based on the study findings, the authors recommended that more frequent visits of prenatal care can increase the BW significantly in Brazil especially among pregnancies that are not complicated. They also recommended understanding the issues on effect of prenatal care use for pregnancies that are complicated with birth defects.