Social Inequalities in Use of Prenatal Care in Manitoba

Heaman, Maureen; Green, Chris G.; Newburn‐Cook, Christine; Elliott, Lawrence; Helewa, Michael

doi:10.1016/s1701-2163(16)32637-8

Cited by 65 publications

(73 citation statements)

References 50 publications

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“…Heaman et al 29 , in a research developed in Manitoba, Canada, found prenatal inadequacy rates ranging between 1.1 and 21.5%, and the highest concentrations of inadequate rates of prenatal care were observed in less favored areas. At the same time, a global study found that the number of prenatal visits decreased according to the reduction Rev BRas epidemiol oUT-deZ 2016; 19(4): 835-850 of income quintile in all analyzed regions (East Asia and Pacific, Europe and Central Asia, Latin America and Caribbean, Middle East and North Africa, South Asia and Sub-Saharan Africa).…”

Section: Discussionmentioning

confidence: 99%

“…Studies carried out in different countries show the occurrence of inadequate prenatal care in less favored regions 29,30 . Heaman et al 29 , in a research developed in Manitoba, Canada, found prenatal inadequacy rates ranging between 1.1 and 21.5%, and the highest concentrations of inadequate rates of prenatal care were observed in less favored areas.…”

Section: Discussionmentioning

confidence: 99%

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Diferenças regionais e fatores associados ao número de consultas de pré-natal no Brasil: análise do Sistema de Informações sobre Nascidos Vivos em 2013

Anjos

Boing

2016

Rev. bras. epidemiol.

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diferenças regionais e fatores associados ao número de consultas de pré-natal no Brasil: análise do Sistema de Informações sobre Nascidos Vivos em 2013

Anjos

Boing

2016

Rev. bras. epidemiol.

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“…They were also more frequently accompanied exclusively at public prenatal care providers. These results may be explained by limited social support and lack of financial resources 4 , adverse social conditions that constrain the capacity of mothers to find and use prenatal care services 20 , social stigma 9 and stress exposure 10 .…”

Section: Discussionmentioning

confidence: 99%

Family structure and use of prenatal care

Alves

Silva

Martins³

et al. 2015

Cad. Saúde Pública

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This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.

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“…저소득층은 열악한 주거 환경, 영양 상태, 건강에 역행하는 생활습관 등으로 의료서비스에 대한 요구도가 높지만, 의료비에 대한 부담감으로 의료서비스 접근성이 비 교적 낮은 의료 취약 집단이다 [5]. 특히 저소득층 여성은 빈곤, 장시간 노동, 임신과 출산으로 인한 스트레스 등으로 인해 산전진찰을 덜 받고 있으며, 임신중독증, 전치태반, 태반조기박리증, 조기 양수파수, 조산, 사산, 임신성 당뇨병, 산욕기 정신질환 등 임신 관련 합병증의 발생 빈 도가 높다 [6,7]. 저소득층의 경우 고소득층보다 총 가구 수입 중 임신, 출산 관련 의료비가 차지하는 비중이 더 높기 때문에 의료서비스 이용 에 대한 제약이 더욱 많은 것으로 보고되고 있다 [8][9][10].…”

Section: Kyung Ha Kim Et Al Obstetric Services By Income Classesunclassified

A comparative study on the obstetric services utilization by income classes among the National Health Insurance Beneficiaries

Kim

Hwang

Yoon

et al. 2012

Korean J Obstet Gynecol

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ObjectiveThis study was conducted to compare the trend of obstetrical care service and its performance, different kinds of common obstetrical disease, and different pattern of health care utilization by the classification of income among the National Health Insurance Beneficiaries. MethodsThis study was investigated on the base of data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium from 2004 to 2008. Subjects were divided into five income classes by the amount of medical insurance premium. Statistical analysis was performed using SAS program. ResultsIn terms of the lowest income class, there was the lowest rate of admission but the highest rate of outpatient visits, which were remarkably increased during the last 2 years. The lowest income group showed higher rate of abortion (O00−O08), ectopic pregnancy and preeclampsia (O10−O16) but there was small number of delivery (O80−O84). The highest income group showed higher rate of multifetal gestation and elderly gravida. As they have higher income, they showed tendency to visit general hospital for admission care or outpatient care. ConclusionThere were significant differences in obstetric services utilization and prevalence of common obstetrical disease according to income class. New strategy of public medical insurance is needed to support different disease category according to the socioeconomic status. Especially, institutional support should be considered for lower income women who are exposed to higher pregnancy complications.

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Social Inequalities in Use of Prenatal Care in Manitoba

Cited by 65 publications

References 50 publications

Diferenças regionais e fatores associados ao número de consultas de pré-natal no Brasil: análise do Sistema de Informações sobre Nascidos Vivos em 2013

Diferenças regionais e fatores associados ao número de consultas de pré-natal no Brasil: análise do Sistema de Informações sobre Nascidos Vivos em 2013

Family structure and use of prenatal care

A comparative study on the obstetric services utilization by income classes among the National Health Insurance Beneficiaries

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