Using Trust databases to identify predictors of late booking for antenatal care within the UK

Baker, Eleanor; Rajasingam, Daghni

doi:10.1016/j.puhe.2011.10.007

Cited by 32 publications

(38 citation statements)

References 19 publications

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“…In accordance with previous studies [6-8], our analysis showed that timing of the antenatal booking appointment varied according to maternal ethnicity; however we found that the effect was modified by English language ability and place of birth. This suggests that a combination of language barriers and unfamiliarity with the maternity services, and cultural factors may play important contributing roles in women’s timing of access to antenatal care.…”

Section: Discussionsupporting

confidence: 92%

“…Late initiation of antenatal care has been found to be associated with non-White ethnicity in several previous studies conducted in Western European settings [6-9]. A cross-sectional survey of 200 hospitals across England, administered via a postal questionnaire, found that women who identified themselves as Black or Asian were less likely than women who identified themselves as White to attend their antenatal booking appointment before 12 weeks gestation in a univariate analysis, and that being born outside the UK was strongly associated with late booking in both the univariate and multivariable models [7].…”

Section: Introductionmentioning

confidence: 99%

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Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK

Cresswell

Hatherall

et al. 2013

BMC Pregnancy Childbirth

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BackgroundIn the UK, women are recommended to engage with maternity services and establish a plan of care prior to the 12th completed week of pregnancy. The aim of this study was to identify predictors for late initiation of antenatal care within an ethnically diverse cohort in East London.MethodsCross-sectional analysis of routinely collected electronic patient record data from Newham University Hospital NHS Trust (NUHT). All women who attended their antenatal booking appointment within NUHT between 1st January 2008 and 24th January 2011 were included in this study. The main outcome measure was late antenatal booking, defined as attendance at the antenatal booking appointment after 12 weeks (+6 days) gestation. Data were analysed using multivariable logistic regression with robust standard errors.ResultsLate initiation of antenatal care was independently associated with non-British (White) ethnicity, inability to speak English, and non-UK maternal birthplace in the multivariable model. However, among those women who both spoke English and were born in the UK, the only ethnic group at increased risk of late booking were women who identified as African/Caribbean (aOR: 1.40: 95% CI: 1.11, 1.76) relative to British (White). Other predictors identified include maternal age younger than 20 years (aOR: 1.32; 95% CI: 1.13-1.54), high parity (aOR: 2.09; 95% CI: 1.77-2.46) and living in temporary accommodation (aOR: 1.71; 95% CI: 1.35-2.16).ConclusionsSocio-cultural factors in addition to poor English ability or assimilation may play an important role in determining early initiation of antenatal care. Future research should focus on effective interventions to encourage and enable these minority groups to engage with the maternity services.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK

Cresswell

Hatherall

et al. 2013

BMC Pregnancy Childbirth

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“…Number of prenatal visits : low number of prenatal medical visits d [14] (LPV) (below 4) and standard number of prenatal visits (SPV) (at least 4).…”

Section: Methodsmentioning

confidence: 99%

“…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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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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“…1,2 Previous studies demonstrated that young women, 3e5 immigrants, 4,6,7 women with a low income, 7,8 low education, 3,5 living in a temporary accommodation 4 are more likely to initiate PNC late. Other factors described are (grande) multiparity, 3,4,9 poor language proficiency, 3,4 unplanned pregnancy, 3,8 not having a regular obstetrician, 7 not being married, 5 smoking 5,6 and living in a temporary accommodation. 4 Some of these variables related to late onset of PNC, such as income and education, are also associated as indicators for measuring deprivation.…”

Section: Introductionmentioning

confidence: 99%

Predictors of late initiation for prenatal care in a metropolitan region in Belgium. A cohort study

et al. 2015

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Using Trust databases to identify predictors of late booking for antenatal care within the UK

Cited by 32 publications

References 19 publications

Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK

Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK

Socio-demographic determinants and access to prenatal care in Italy

Predictors of late initiation for prenatal care in a metropolitan region in Belgium. A cohort study

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