I-CHER (Interuniversity Centre for Health Economics Research), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium.
Department of Medical Sociology and Health Sciences, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussel, Belgium; Department of Nursing and Midwifery, Nursing and Midwifery Research Group, Universitair Ziekenhuis Brussel, Brussel, Belgium.
Public Health. 2015 Jun;129(6):648-54. doi: 10.1016/j.puhe.2015.03.008. Epub 2015 Apr 21.
Timely initiation of prenatal care (PNC) in the first pregnancy trimester allows prevention, identification and treatment of risk factors. However, not all women initiate PNC timely, especially women in a deprived situation. The aim of this study was to measure the prevalence of late initiation, defined as initiation after 14 weeks of gestational age. Secondly the authors wanted to identify predictors for late PNC onset.
Observational cohort study.
Pregnant women (n = 1750) were recruited in all four hospitals in Ghent (Belgium), a metropolitan region. A socio-economic deprivation ranking was measured by using a General Deprivation Index (GDI), which consists of six criteria to assess a socio-economic situation as deprived. A univariate analysis and a forward conditional multivariate logistic regression model were used analysing the association between deprivation and the likelihood to initiate PNC late.
1115 women were included of whom 6.1% (n = 68) initiated PNC late. A foreign maternal country of birth (OR 2.10; 95% CI 1.15-3.83) and a total GDI ≥3 (OR 4.40; 95% CI 2.36-8.21) were good predictors for late initiation. More specifically, the GDI criteria education (OR 4.02; 95% CI 2.00-8.08) and unemployment (OR 2.40; 95% CI 1.17-4.90) were significantly associated with higher likelihood for late initiation.
A small group of women initiates PNC late. Vulnerable groups, at risk for late initiation can be identified through assessing their deprivation status. Priority for additional support should be given to women with low educational attainment or women in uncertain employment situations.
初次妊娠的产前保健（PNC）应尽早开始，以预防、识别和治疗风险因素。然而，并非所有女性都能及时开始 PNC，尤其是处境不利的女性。本研究旨在衡量晚期 PNC 开始的流行率，定义为妊娠 14 周后开始。其次，作者希望确定晚期 PNC 开始的预测因素。
观察性队列研究。
在比利时根特的所有四家医院（大都市地区）招募了 1750 名孕妇。使用一般剥夺指数（GDI）来衡量社会经济剥夺程度，该指数由六个标准组成，用于评估社会经济状况的剥夺程度。使用单变量分析和向前条件多元逻辑回归模型来分析剥夺与晚期开始 PNC 的可能性之间的关联。
纳入 1115 名妇女，其中 6.1%（n=68）晚期开始 PNC。外国出生的母亲（OR 2.10；95%CI 1.15-3.83）和总 GDI≥3（OR 4.40；95%CI 2.36-8.21）是晚期开始的良好预测因素。更具体地说，GDI 标准教育（OR 4.02；95%CI 2.00-8.08）和失业（OR 2.40；95%CI 1.17-4.90）与晚期开始的可能性显著相关。
一小部分女性晚期开始 PNC。通过评估其贫困状况，可以确定处于晚期开始风险中的弱势群体。应优先为教育程度低或就业情况不确定的妇女提供额外支持。
