The Demographic Characteristics of Early and Late Attenders for Antenatal Care

Essex, Charles; Counsell, Anthea M.; Geddis, David C.

doi:10.1111/j.1479-828x.1992.tb02839.x

Cited by 29 publications

(20 citation statements)

References 10 publications

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“…Poorly educated women had a higher propensity to make LPV and LFV; however, the magnitude of our estimated odds ratio is slightly larger than that obtained from other countries: see [27]. Our estimates also indicate a positive relation between marital status and adequate use of PNC, a result confirmed also by [4,28]. Disrupted family situations, such as single parenting or a poor relationship with the baby’s father, significantly affect the use of PNC services [29,30].…”

Section: Discussionsupporting

confidence: 83%

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Socio-demographic determinants and access to prenatal care in Italy

Chiavarini

Lanari

Minelli

et al. 2014

BMC Health Serv Res

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BackgroundMany governments have made commitments to examine inequalities in healthcare access based on studies assessing the association between several socio-demographic factors and late initiation or fewer prenatal examinations. This study addressed the question of whether socio-demographic determinants were significant in explaining differences in prenatal care in one administrative region of Italy, Umbria.MethodsData were obtained from the administrative source of the regional Standard Certificate of Live Births between 2005 and 2010, and were merged with Census data to include a socio-economic deprivation index. Standard and multilevel logistic regression models were used to analyze the magnitude of various individual-level maternal characteristics and socio-demographic indicators, such as nationality, employment status, education with respect to late access to the first examination, and low number of medical visits.ResultsThe study involved approximately 37,000 women. The heterogeneous effects of socio-demographic variables were documented on the prenatal care indicators analyzed. A multivariate model showed that women born outside Italy had a higher probability of making their first visit later than the 12th week of pregnancy and low numbers of prenatal medical visits; the estimated odds ratio for the analyzed indicators range from 2.25 to 3.05. Inadequate prenatal healthcare use was also observed in younger and pluriparous women and those with low education; in addition, having a job improved the use of services, possibly through transmission of information of negative consequences due to delayed or few prenatal visits. Interestingly, this study found a substantial reduction in the number of pregnant women who do not use prenatal healthcare services properly.ConclusionsThe aim of this research is to provide more accurate knowledge about the inadequate use of prenatal healthcare in Italy. Results highlight the existence of differences in healthcare use during pregnancy, especially for women from less advantaged social classes (i.e., unemployed or poorly educated). Such inequalities should be examined in all areas of public policy and public services, to ensure equal opportunity for their use.

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Section: Discussionsupporting

confidence: 83%

“…Previous studies have shown that young maternal age [4-6], low education [2,6-9], unemployed status [10,11], immigrant status [8,12,13], pluriparous status [5,8,14] and single marital status [6,15-17] are all barriers to early initiation of prenatal care and to an appropriate number of prenatal examinations.…”

Section: Introductionmentioning

confidence: 99%

Socio-demographic determinants and access to prenatal care in Italy

Chiavarini

Lanari

Minelli

et al. 2014

BMC Health Serv Res

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“…Despite obvious advantages of antenatal care, many women in both developing and developed countries do not get adequate care or do not seek care at all. Different factors have proved to influence the healthcare seeking pattern of pregnant women (Abbas & Walker 1986, Essex et al . 1992, Swenson et al .…”

Section: Introductionmentioning

confidence: 99%

Characteristics of antenatal care attenders in a rural population in Tamil Nadu, South India: a community-based cross-sectional study

Nielsen

Liljestrand

Thilsted³

et al. 2001

Health &Amp; Social Care in the Community

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The objectives of the study were to identify factors associated with utilisation of antenatal care facilities in a rural population in South India. A community-based, cross-sectional questionnaire study of 30 randomly selected areas was used. A total of 1254 women (95%) had at least one antenatal care visit. The median number of visits was four. High utilisation of antenatal care facilities was associated with low parity and adverse obstetrical history, short distance to healthcare facilities and literacy. It was concluded that antenatal care coverage was high. Information about the above few aspects can be used to target women who are at risk of getting inadequate antenatal care.

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“…Documented external or organisational barriers to early initiation of antenatal care include financial barriers, such as the lack of health insurance 14 -26 , difficulties in obtaining an appointment 17,20,25,27,28 , long distances from care settings 17,19 , problems with child care 17,25 and lack of transportation 25,29 . Documented sociodemographic barriers to early initiation of antenatal care include non-caucasian ethnic origin 15,18 -20,22 -24,26,27,30 -33 , young maternal age 20,22 -26,30,31,34 , few educational achievements on the part of the mother 20,23,24,26,30,31 , low social class 17,31,34,35 , low parental income 19,24,25 , unmarried status of the mother 20,23,31,36 and high parity 20,23,25,27 -31,34,37 . Furthermore, a number of intrinsic psychosocial or cultural barriers to early initiation of antenatal care have been reported.…”

Section: Bjog: An International Journal Of Obstetrics and Gynaecologymentioning

confidence: 99%

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

Kupek

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To identify factors that are predictive of late initiation of antenatal care in England and Wales.Design A multivariate binomial regression model was constructed to examine the association between clinical, provider and sociodemographic characteristics and late initiation of antenatal care. Setting Nine maternity units in Northern England and North Wales.Population A total of 20,771 women with a singleton pregnancy who delivered a liveborn or stillborn baby between 1 August 1994 and 31 July 1995. All analyses were based on the 17,765 (85.5%) women for whom information on gestational age at initial presentation for antenatal care and other variables incorporated into the regression model was retrievable from the case records. Results Primiparous women of high obstetric risk were 13.4% more likely to initiate antenatal care after 10 weeks of gestation than a low risk reference group (adjusted OR 1.134, 95% CI 1.011, 1.272; P ¼ 0.0312), and 34.3% more likely to initiate antenatal care after 18 weeks of gestation (adjusted OR 1.343, 95% CI 1.046, 1.724; P ¼ 0.0208). This association between high obstetric risk status and late initiation of antenatal care was not replicated among multiparous women. When the effects of other independent variables on gestational age at booking were examined, the following characteristics were associated with failure to initiate antenatal care by 10 weeks of gestation ( P 0.05): maternal age at booking, smoking status, ethnicity, type of hospital at booking, the planned pattern of antenatal care and the planned place of delivery. Adopting a criterion of 18 weeks of gestation exacerbated the association between clinical and sociodemographic characteristics and late initiation of antenatal care, but appeared to dilute the association between provider characteristics and late initiation of antenatal care. Conclusions There is a pressing need for further research to identify the specific concerns of late bookers, to identify areas where new interventions might encourage the uptake of services and to gauge the likely impact of increased dissemination of information about the availability of antenatal care services.

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The Demographic Characteristics of Early and Late Attenders for Antenatal Care

Cited by 29 publications

References 10 publications

Socio-demographic determinants and access to prenatal care in Italy

Socio-demographic determinants and access to prenatal care in Italy

Characteristics of antenatal care attenders in a rural population in Tamil Nadu, South India: a community-based cross-sectional study

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

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