{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:49:28Z","timestamp":1791431368572,"version":"4.3.3"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study analyzed the ratio between antenatal care visits and live births (LB) in Brazil as an indicator of service utilization intensity. This nationwide ecological longitudinal study combined descriptive temporal and spatial analyses of outpatient antenatal consultations recorded in SIA\/SUS and LB reported in SINASC across Brazilian federative units and macroregions from 2008 to 2023. The ANC\/LB ratio was interpreted as an indirect measure of the intensity of consultation utilization and recording relative to LB, rather than as an individual\u2010level measure of antenatal care coverage or adequacy. An increase in the ANC\/LB ratio was observed until 2014, followed by fluctuations and lower values from 2020 onward, with partial increases in some regions in subsequent years. Spatial analysis showed marked geographic variation, with higher ratios more frequently observed in the South and Southeast and lower values in several states in the North and Northeast. In 2023, nurses accounted for the largest proportion of antenatal consultations nationwide, particularly in the North and Northeast, whereas obstetrician\u2013gynecologists had greater relative participation in the Southeast. Limitations include potential variation in the quality and completeness of SIA\/SUS records, which may affect temporal and geographic comparability. These findings provide a nationwide perspective on the recorded intensity and professional composition of antenatal care and may support monitoring and health\u2010service planning.<\/jats:p>","DOI":"10.1002\/puh2.70387","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:51:00Z","timestamp":1791427860000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Analyzing the Ratio Between Prenatal Consultations and Live Births in Brazil: Spatial and Professional Patterns, 2008\u20132023"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9840-0309","authenticated-orcid":false,"given":"M\u00e1rcio Cristiano","family":"de Melo","sequence":"first","affiliation":[{"name":"S\u00e3o Leopoldo Mandic School of Medicine  Araras S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jucilene Casati","family":"Lodi","sequence":"additional","affiliation":[{"name":"S\u00e3o Leopoldo Mandic School of Medicine  Araras S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8817-3343","authenticated-orcid":false,"given":"Luiz Eduardo","family":"Coelho Emerenciano","sequence":"additional","affiliation":[{"name":"S\u00e3o Leopoldo Mandic School of Medicine  Limeira S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1856-8847","authenticated-orcid":false,"given":"Nayara Amelia","family":"Guirau Veronez","sequence":"additional","affiliation":[{"name":"S\u00e3o Leopoldo Mandic School of Medicine  Araras S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0043-9649","authenticated-orcid":false,"given":"Tassia Fraga","family":"Bastos","sequence":"additional","affiliation":[{"name":"S\u00e3o Leopoldo Mandic School of Medicine  Araras S\u00e3o Paulo Brazil"},{"name":"S\u00e3o Leopoldo Mandic School of Medicine  Limeira S\u00e3o Paulo Brazil"},{"name":"S\u00e3o Leopoldo Mandic School of Medicine  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8340-5334","authenticated-orcid":false,"given":"Naila Albertina","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"S\u00e3o Leopoldo Mandic School of Medicine  Araras S\u00e3o Paulo Brazil"},{"name":"S\u00e3o Leopoldo Mandic School of Medicine  Limeira S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","unstructured":"Programa de Humaniza\u00e7\u00e3o no Pr\u00e9\u2010natal e Nascimento. \u201cRev Bras Saude Mater Infant [Internet].\u201d2 no.1(2002):6971 https:\/\/doi.org\/10.1590\/S1519-38292002000100011.","DOI":"10.1590\/S1519-38292002000100011"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/2358\u2010289820241408152P"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ijcoms\/lyad014"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13192414"},{"key":"e_1_2_10_6_1","volume-title":"Maternal Mortality","author":"World Health Organization","year":"2025"},{"key":"e_1_2_10_7_1","volume-title":"Maternal and Child Health in Brazil: Challenges and Public Policies","author":"Laneuville H.","year":"2024"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010024\u201011409\u2010x"},{"key":"e_1_2_10_9_1","volume-title":"Portaria n\u00b0 2.979, de 12 de novembro de 2019","author":"Brasil. 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