Objective: to analyze evolution as to conducting seven or more prenatal consultations with pregnant women in Brazil, in the period 2000-2015 according to maternal education level and race/skin color of the newborn baby. Methods: this was a time series study based on Live Births Information System (SINASC) data; relative and absolute inequalities were investigated, adjusted for maternal age and gestational week in which childbirth occurred. Results: we analyzed approximately 48 million births; the proportion of seven or more prenatal consultations increased nationally (from 46.0% to 66.9%) in all groups analyzed; the relative difference between the extremes of education level ranged from 3.0 to 2.0, while the absolute difference ranged from 53.1 to 47.7 percentage points; the adjusted ratio between White/Black race/skin color was 1.4 in 2000 and 1.2 in 2015. Conclusion: the proportion of pregnant women having seven or more prenatal consultations has increased in Brazil, although inequalities are still found.

ABSTRACT:Objective: To investigate factors associated with seven or more prenatal visits, in Brazil, in 2013. Methods: Cross-sectional study from the database of Information System on Live Births. The association of explanatory variables was tested with prenatal visits by means of the analysis of single and multiple multinomial regressions. The spatial distribution of prenatal visits according to the Brazilian municipalities was also analyzed. Results: It was found that 2.7% of pregnant women attended no prenatal visit and 63.1% attended 7 or more. The chance to attend 7 or more prenatal visits was higher among pregnant women aged 40 years or more, with 12 years or more of schooling, living with a roommate, living in the South and Southeast regions, who had a triplet or more pregnancy, with gestational age of 42 weeks or more, and who had children with normal birth weight. Significant regional disparities were identified in the prevalence of women with seven or more prenatal visits. Conclusion: Although Brazil has a Unified Health System that provides universal prenatal care, the use of this service is uneven according to geographic, demographic, and socioeconomic characteristics. Keywords 836Rev BRas epidemiol oUT-deZ 2016; 19(4): 835-850 INTRODUCTIONAccess to prenatal care is associated with better health outcomes for pregnant women and newborns. This care is essential to prevent and/or early detect maternal and fetal pathologies, promoting the healthy development of the baby and reducing the risk to the pregnant women 1 . By monitoring the pregnancy since the first quarter there is greater possibility of the mother undergo laboratory tests, reducing maternal and child morbidity and mortality. Consequently, the results are better intrauterine growth, higher birth weight, fewer occurrences of prematurity and neonatal mortality, and, for the mother, lower rate of complications during pregnancy and at delivery 1 . Studies show that the higher the number of prenatal visits, the lower the neonatal 2 and maternal 3,4 mortality rates, the prevalence of prematurity 3 , the low birth weight 5,6 , and the hypertension during pregnancy 3,4 . In this scenario, the anti-tetanus vaccination coverage 7 and supplementation with ferrous sulfate 7 are also greater. Owing to these benefits indicated by the literature and in order to improve access, coverage, and quality of prenatal care in Brazil, the Ministry of Health launched, in 2000, the Program of Humanization in Prenatal and Birth (PHPN). Among other guidelines, the document recommends that pregnant women attend at least six prenatal visits during pregnancy: one in the first quarter, two in the second, and three in the third 1 . Studies that analyzed the factors associated with low number of prenatal care visits found that this negative outcome is more common among women with low education 8 , pregnant adolescents 2,8 , with high parity 6,8 , and living without a partner 6 . However, in Brazil, RESUMO: Objetivo: Investigar os fatores associados à realização de sete ou ma...

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Resumo O câncer de mama é um problema de saúde pública por sua elevada incidência, morbidade e mortalidade. A análise de sobrevida dessa doença contribui para a descrição do comportamento e dos fatores prognósticos. O objetivo deste artigo é investigar a sobrevida em 10 anos após o diagnóstico, e os fatores prognósticos de mulheres com câncer de mama admitidas no Serviço de Mastologia do Sistema Único de Saúde em Joinville, Santa Catarina, entre 2000-2014. Estudo de coorte histórica com dados dos prontuários e das declarações de óbito de 1.321 mulheres, sendo que 471 foram consideradas elegíveis nos critérios tempo de acompanhamento mínimo de 10 anos (n = 288), e/ou óbito antes deste período (n = 183). Análise de sobrevida realizada pelo modelo de Kaplan-Meier, Teste de Log-Rank e Regressão de Cox. A sobrevida global em 10 anos foi 41,0% (IC95% 36,1% 45,0%). O risco de mortalidade em 10 anos estratificado pelo estadiamento tumoral foi maior entre as mulheres com invasão linfática e estadiamento II, e com 60 anos ou mais e estadiamento III. Os achados sugerem que a presença de invasão linfática,idade avançada e estadiamento intermediário/avançado da doença podem ser considerados indicadores de pior prognóstico para o câncer de mama.