Clinical, provider and sociodemographic predictors of late initiation of antenatal care in England and Wales

Kupek, Emil

doi:10.1016/s1470-0328(02)00524-4

Cited by 16 publications

(26 citation statements)

References 17 publications

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“…These findings concur with those of other Australian research showing differences in mortality rates between Indigenous and non‐Indigenous Australians at every socioeconomic level 1 , 6 , 15 . International research has also indicated that some minority populations, such as African Americans, Inuit, Māori and Scandinavian Sami, are disadvantaged in terms of health at every level of socioeconomic status, regardless of how this is measured 2 , 11 . ‐ 13 , 16 …”

Section: Discussionsupporting

confidence: 89%

“…There are also issues specific to Indigenous communities that may explain the differences in birth outcomes between Indigenous and non‐Indigenous infants 9 . Dispossession has been the subject of an emerging debate, with sociopolitical explanations such as discrimination, sense of control and power, identity, and stress possibly being critical 10 , 11 . Informal discussions with local Indigenous health workers after we analysed the data elicited perceptions of high chronic stress levels among mothers of Indigenous infants, resulting from feelings of disempowerment, complex identity issues and social isolation.…”

Section: Discussionmentioning

confidence: 99%

“…Several potential maternal risk factors for birth outcomes including age, single‐parent status, and smoking were examined. Maternal age was classified to indicate mothers who were aged less than 20 years at delivery (higher risk group 11 , 12 ). Mothers were classified as single (also a higher risk group 13 ) if they reported that they were not married or in a de‐facto relationship.…”

Section: Methodsmentioning

confidence: 99%

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The roles of socioeconomic status and Aboriginality in birth outcomes at an urban hospital

Titmuss

Harris

Comino

2008

Medical Journal of Australia

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Objectives: To explore the role of socioeconomic status and Aboriginality on birthweight at an urban hospital. Design, participants and setting: Extraction of data on the demographic characteristics (socioeconomic status, mothers’ single‐parent status, age and smoking status) and infants’ birthweight from a clinical record system. Infants delivered at an outer urban hospital to mothers residing in the local government area during 2002 were included. Infants were identified and results interpreted in consultation with Indigenous health workers. Main outcome measure: Infant birthweight. Results: Indigenous infants had a lower mean birthweight than non‐Indigenous infants (difference, 127 g), and were more likely to weigh < 2500 g. Mothers of Indigenous infants were more likely to be single, aged < 20 years and to smoke during pregnancy. Lower birthweight was associated with lower socioeconomic status for Indigenous and non‐Indigenous infants. Indigenous infants in the most socioeconomically disadvantaged quintile in this study were at higher risk and had a mean birthweight 204 g less than non‐Indigenous infants in the same quintile. In multivariate analysis, differences in birthweight were associated with socioeconomic status and smoking during pregnancy. Conclusions: For both Indigenous and non‐Indigenous infants, birthweights were associated with socioeconomic status. Differences between Indigenous and non‐Indigenous infants were largely explained by low socioeconomic status and smoking during pregnancy.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The roles of socioeconomic status and Aboriginality in birth outcomes at an urban hospital

Titmuss

Harris

Comino

2008

Medical Journal of Australia

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“…Late booking to specialist care in the TG is due to the fact that pregnancy in teenagers with diabetes is likely to be unplanned. Late booking among young women has been demonstrated previously (12). This may be due to young women failing to take pregnancy tests at an early gestational age compared to older women (13).…”

Section: Discussionmentioning

confidence: 90%

Teenage pregnancy in type 1 diabetes mellitus

et al. 2010

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Younger maternal age at delivery has been linked to adverse reproductive outcomes. Pregnancy complicated by type 1 diabetes mellitus (T1DM) is also associated with adverse pregnancy outcomes. Optimising diabetic glycaemic control prior to pregnancy is known to reduce the rate of congenital abnormalities and improve pregnancy outcomes. Teenage pregnancies are not usually planned and little data exist on teenage pregnancy complicated by T1DM. We sought to identify the glycemic control achieved in teenage pregnancy with T1DM and to clarify if there is an associated increase in adverse pregnancy outcomes compared to those seen in older women with T1DM. We compared outcomes in 18 teenagers (TG) with 582 older women with T1DM (CON) from 1995-2007. TG booked to the combined diabetes-obstetrical service at a median gestational age of 11 weeks (range 6-22) compared to 7 weeks in CON (range 4-40, p < 0.02). Glycaemic was worse in TG compared to CON at 13, 26 and 35 weeks gestation, despite higher insulin doses. First trimester miscarriage rate did not differ between groups. Major congenital anomaly rate was 6.2% (1/16) compared to 3.2% in CON. This preliminary study has demonstrated that pregnant teenage women with T1DM book later to specialised care and have worse glycaemic control in pregnancy compared to older women with T1DM. This group also appear to be more insulin resistant than older women in early pregnancy. Our data would suggest that teenagers with type 1 diabetes mellitus may constitute a high-risk group for adverse pregnancy outcomes.

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“…The fact that after including more proximate factors in the model the effect of education on the odds of low scores remained quite the same suggests that other proximate factors not available here may be the true source of disparity between educational groups. Examples would be time of initiation of prenatal care [46-48], quality of prenatal care, or certain maternal morbidities more common in later stages of the reproductive career, such as diabetes or maternal hypertension.…”

Section: Discussionmentioning

confidence: 99%

Early Infant Morbidity in the City of São Paulo, Brazil

Machado

Hill

2003

Popul Health Metrics

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BackgroundEarly infant morbidities may produce adverse outcomes in subsequent life. A low Apgar score is a convenient measure of early infant morbidity. We study determinants of early infant morbidity (sex, plurality, mode of delivery, prior losses, gestational age, prenatal care and birth weight, parity and maternal age, race, maternal education and community development) for the 1998-birth cohort, City of São Paulo, Brazil.MethodsThis study identified all deliveries that took place in the City of São Paulo during 1998. Information was extracted from 209,628 birth records. We used multivariate logistic regression to assess the effect of each independent variable on Apgar score less than seven at one minute and Apgar score less than seven at five minutes.ResultsLow birth weight, prematurity and community development were found to be strong predictors of morbidity. Maternal education showed strong negative correlation with both Apgar scores. The negative correlations between maternal schooling and Apgar scores were observed after prenatal care, parity and maternal age were included in the model. Unmeasured proximate factors may thus be the true source of disparity between educational groups. Children of very young adolescent mothers had lower Apgar scores at one minute (but not at five minutes) than those born to mothers 15 to 19. Parity one or higher was associated with decreased odds of low Apgar scores. Cesarean section and operative delivery were associated with higher odds of early infant morbidity.ConclusionEducation may allow mothers to have better care in the peripartum period. More educated mothers may be more likely to recognize certain morbidities through the pregnancy period and the monitoring of such morbidities yields better infant outcomes. Also, having less than seven prenatal care visits was found to predict early infant morbidity and one way to increase the use of such services is to focus on aspects of care that may lead to easier accessibility and continuity of prenatal care. Physicians should inform mothers about the risks associated with high number of children for a next infant and also about the risks for the infant associated with unnecessary cesarean sections. Special attention should be paid to adolescent mothers, since much of their increased risk is likely to be minimized by counseling.

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Clinical, provider and sociodemographic predictors of late initiation of antenatal care in England and Wales

Cited by 16 publications

References 17 publications

The roles of socioeconomic status and Aboriginality in birth outcomes at an urban hospital

The roles of socioeconomic status and Aboriginality in birth outcomes at an urban hospital

Teenage pregnancy in type 1 diabetes mellitus

Early Infant Morbidity in the City of São Paulo, Brazil

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