Pertile Riccardo, Pedron Mariangela, Berlanda Michela, Piffer Silvano
Servizio di epidemiologia clinica e valutativa, Azienda provinciale per i servizi sanitari di Trento.
Consultorio per il singolo, la coppia e la famiglia di Trento e Mezzolombardo.
Epidemiol Prev. 2015 Mar-Apr;39(2):88-97.
to outline the attendance rate of antenatal classes (ANCs) among women resident in Trentino Region (North-Eastern Italy) during the period 2000-2012; to identify the main sociodemographic characteristics of women who do not attend ANCs and to measure the effectiveness of ANCs attendance.
cohort study with a retrospective data collection.
by the computerised database of Trentino Certificates of delivery care, primiparous mothers living in Trentino presenting a physiological pregnancy and birth at term (≥37 weeks of gestation) were selected. Temporal trends of ANCs attendance were also studied for all mothers living in Trentino, all primiparous residents, all multiparous residents and all residents with foreign citizenship.
possible associations between the probability of not attending ANCs and sociodemographic variables concerning mothers were analysed: age, professional status, educational level, marital status, citizenship and residence in an area served by a maternal and child health (MCH) clinic or not. Significant relationships between ANCs attendance and variables related to course of pregnancy, childbirth and neonatal outcomes were identified.
ANCs coverage has a statistically significant increasing trend over time for each group of women living in Trentino. Among the selected primiparous pregnant women, the principal barriers to ANCs access are being foreign, having an age ≤30 years, in particular ≤20 years, being housewives or unemployed, presenting a medium-low educational level, and residing in an area not served by a MCH clinic. ANCs-not-attending women show a lower awareness of the importance of performing serological tests for Syphilis and Cytomegalo-virus and they declare smoking in pregnancy. Benefits of ANCs attendance do not affect neonatal outcomes, but they concern a higher probability of vaginal birth and a higher breastfeeding predisposition.
data about ANCs attendance in Trentino Region appear higher than other national-regional studies. However, there are significant differences in access to ANCs regarding women's sociodemographic characteristics and resources distribution and MCH clinics measurement. In Italy, an evaluation about the accessibility of MCH clinics and their functioning criteria is desirable, focusing on marketing practices towards lower classes women. In Trentino, virtuosos MCH clinics have introduced elastic times in the ANCs planning and they have involved cultural mediators and private gynaecologists. Younger pregnant women are included in the ANCs after a preliminary meeting or by individual paths.
概述2000 - 2012年期间居住在意大利东北部特伦蒂诺地区的妇女参加产前课程（ANC）的出勤率；确定未参加产前课程的妇女的主要社会人口学特征，并衡量参加产前课程的效果。
采用回顾性数据收集的队列研究。
通过特伦蒂诺分娩护理证书的计算机数据库，选择居住在特伦蒂诺、妊娠生理且足月分娩（妊娠≥37周）的初产妇。还研究了特伦蒂诺所有母亲、所有初产居民、所有经产居民以及所有具有外国国籍居民参加产前课程的时间趋势。
分析未参加产前课程的可能性与母亲的社会人口学变量之间可能存在的关联：年龄、职业状况、教育水平、婚姻状况、国籍以及是否居住在母婴健康（MCH）诊所服务的地区。确定了参加产前课程与妊娠过程、分娩及新生儿结局相关变量之间的显著关系。
特伦蒂诺地区每组妇女参加产前课程的覆盖率随时间有统计学显著的上升趋势。在选定的初产孕妇中，参加产前课程的主要障碍包括为外国人、年龄≤30岁，尤其是≤20岁，为家庭主妇或失业者，教育水平为中低等，以及居住在没有母婴健康诊所服务的地区。未参加产前课程的妇女对梅毒和巨细胞病毒血清学检测重要性的认识较低，且她们宣称在孕期吸烟。参加产前课程的益处虽不影响新生儿结局，但与阴道分娩概率较高和母乳喂养倾向较高有关。
特伦蒂诺地区参加产前课程的数据似乎高于其他国家 - 地区的研究。然而，在获取产前课程方面，妇女的社会人口学特征、资源分配和母婴健康诊所的衡量标准存在显著差异。在意大利，需要对母婴健康诊所的可及性及其运作标准进行评估，重点关注针对较低阶层妇女的营销手段。在特伦蒂诺，优秀的母婴健康诊所已在产前课程规划中引入灵活时间，并让文化调解人和私人妇科医生参与其中。较年轻的孕妇在经过初步会面或通过个性化途径后被纳入产前课程。
