Determinants of the number of antenatal visits in a metropolitan region

Abstract

BackgroundAntenatal care has a positive effect on pregnancy, both clinically and psychologically, but consensus about the optimal number of antenatal visits is lacking. This study aims to provide insight into the dynamics of the number of antenatal visits a woman receives. Independent effects of predisposing, enabling and pregnancy-related determinants are examined.MethodsWomen were recruited in nine clinical centres in the Brussels Metropolitan region. Antenatal care use was measured prospectively. A Poisson regression model was applied to measure the independent effect of individual determinants on the number of antenatal visits.ResultsData on antenatal care trajectories in 333 women were collected. The multivariate analyses showed that women with a Maghreb or Turkish origin had 14% fewer visits compared with European (EU15) women. More highly educated women had 22% more visits compared with those with a low education. Women with a high income had 14% more antenatal visits compared with those with a low income. Fewer antenatal visits were observed in multiparae (15%), women initiating care after 14 weeks of gestation (31%), women without medical risks during the pregnancy (12%) and in women with a continuity of care index of 50% or more (12%). More visits were observed in delivering after week 37 (22% increase).ConclusionsPredisposing and enabling factors have to be considered when antenatal care programmes are evaluated in a metropolitan area. Variations in the number of antenatal visits show that socially vulnerable women are more at risk of having fewer visits.

Determinants of Time of Start of Prenatal Care and Number of Prenatal Care Visits During Pregnancy Among Nepalese Women

“…Petrou et al [20] also observed that number of prenatal care visits were associated with increasing age. On contrary, some studies have found no association of number of visits with age [21,22].…”

Pré-natal na atenção primária do município de João Pessoa-PB: caracterização de serviços e usuárias

“…20 A alta cobertura de realização dos procedimentos clínicos obstétricos de importância no pré-natal, e a deficiência da maioria dos serviços em planejar atividades de educação em saúde e utilizar indicadores para monitoramento interno é corroborado com os achados de Silveira et al 16 Merece destaque esta última informação uma vez que autores afirmam que o conhecimento e o acompanhamento do impacto das ações em saúde devem ser viabilizados por meio de indicadores adequados, o que implica na existência de registros locais fáceis, confiáveis e contínuos. 3 Os resultados quanto à semana de início do pré-natal apresentaram-se inferiores com achados de outro estudo em âmbito internacional 21 apontando diferenças no início da atenção entre países desenvolvidos e em desenvolvimento. Entretanto os achados encontrados podem indicar uma boa captação precoce das gestantes pelos serviços, observado pela média e mediana de início do pré-natal ainda no primeiro trimestre gestacional.…”

Individual and local level factors and antenatal care use in Colombia: a multilevel analysis

“…Other studies show inequalities in access to or use of antenatal care in metropolitan areas of European countries 48 and developing countries 18,46 .…”