Relationship Between First-Trimester Pregnancy Bleeding and Prenatal Care in Cochabamba Municipalities: A Comparative Analysis

Un Análisis Comparativo.

Abstract

Introduction: First-trimester pregnancy bleeding is a significant cause of maternal morbidity and mortality, often associated with severe complications such as spontaneous abortion and ectopic pregnancy. In Bolivia, disparities in access to prenatal care between urban and rural areas exacerbate this issue. This study analyzes the relationship between pregnancy bleeding and prenatal care coverage in Cochabamba to design effective policies. Methodology: This quantitative, descriptive, and retrospective study analyzed 2023 data from Bolivia's National Health Information System (SNIS) to evaluate the relationship between first-trimester pregnancy bleeding and prenatal care in 30 municipalities in Cochabamba. Regional patterns and urban-rural disparities were identified by calculating the proportion of pregnancy bleeding cases relative to prenatal care visits. The analysis highlights the need to improve prenatal coverage to reduce obstetric complications. Results: The results indicate that Cochabamba accounts for 32.83% of pregnancy bleeding cases (<22 weeks), followed by Quillacollo (12.50%) and Sacaba (10.83%). The highest rates of pregnancy bleeding relative to prenatal care were observed in Puerto Villarroel (28.2%) and Punata (27.5%). Women aged 20–39 years represented 83.83% of the cases, highlighting urban-rural disparities in prenatal care. Discussion: The analysis reveals that pregnancy bleeding is influenced by the coverage and quality of health services. Higher rates in rural and peri-urban areas reflect inequities, emphasizing the need to improve prenatal care, strengthen maternal health programs, train medical personnel, and establish monitoring systems to reduce maternal morbidity and mortality in Cochabamba.