Selchau Katherine, Babuca Maricela, Bower Kara, Castro Yara, Coakley Eugenie, Flores Araceli, Garcia Jonah O, Reyes Maria Lourdes F, Rojas Yvonne, Rubin Jason, Samuels Deanne, Shattuck Laura
California Border Healthy Start+ Project, Project Concern International (PCI) U.S. & Border Programs, 4305 University Ave, Suite 345, San Diego, CA, 92105, USA.
Santa Cruz County Healthy Start, Mariposa Community Health Center, 1852 N. Mastick Way, Nogales, AZ, 85621, USA.
Matern Child Health J. 2017 Dec;21(Suppl 1):11-18. doi: 10.1007/s10995-017-2374-0.
Background First trimester prenatal care (FTPNC) is associated with improved birth outcomes. U.S.-Mexico border Hispanic women have lower FTPNC than non-border or non-Hispanic women. This study aimed to identify (1) what demographic, knowledge and care-seeking factors influence FTPNC among Hispanic women in border counties served by five Healthy Start sites, and (2) what FTPNC barriers may be unique to this target population. Healthy Starts work to eliminate disparities in perinatal health in areas with high poverty and poor birth outcomes. Methods 403 Hispanic women of reproductive age in border communities of California, Arizona, New Mexico and Texas were surveyed on knowledge and behaviors related to prenatal care (PNC) and basic demographic information. Chi square analyses and logistic regressions were used to identify important relationships. Results Chi square analyses revealed that primiparous women were significantly less likely to start FTPNC than multiparous women (χ = 6.8372, p = 0.0089). Women with accurate knowledge about FTPNC were more likely to obtain FTPNC (χ = 29.280, p < .001) and more likely to have seen a doctor within the past year (χ = 5.550, p = .018). Logistic regression confirmed that multiparity was associated with FTPNC and also that living in Texas was negatively associated with FTPNC (R = 0.066, F(9,340) = 2.662, p = .005). Among 27 women with non-FTPNC, barriers included late pregnancy recognition (n = 19) and no medical insurance (n = 5). Conclusions This study supports research that first time pregnancies have lower FTPNC, and demonstrated a strong association between delayed PNC and late pregnancy recognition. Strengthened investments in preconception planning could improve FTPNC in this population.
背景 孕早期产前护理（FTPNC）与改善分娩结局相关。美墨边境的西班牙裔女性接受FTPNC的比例低于非边境或非西班牙裔女性。本研究旨在确定：（1）在由五个健康开端项目点服务的边境县的西班牙裔女性中，哪些人口统计学、知识和就医因素会影响FTPNC；（2）该目标人群可能特有的FTPNC障碍。健康开端项目致力于消除贫困率高和分娩结局差地区围产期健康方面的差异。方法 对加利福尼亚州、亚利桑那州、新墨西哥州和得克萨斯州边境社区的403名育龄西班牙裔女性进行了关于产前护理（PNC）相关知识和行为以及基本人口统计学信息的调查。采用卡方分析和逻辑回归来确定重要关系。结果 卡方分析显示，初产妇开始接受FTPNC的可能性显著低于经产妇（χ = 6.8372，p = 0.0089）。对FTPNC有准确了解的女性更有可能接受FTPNC（χ = 29.280，p <.001），并且在过去一年中更有可能看过医生（χ = 5.550，p =.018）。逻辑回归证实经产与FTPNC相关，并且居住在得克萨斯州与FTPNC呈负相关（R = 0.066，F(9,340) = 2.662，p =.005）。在27名未接受FTPNC的女性中，障碍包括怀孕认识较晚（n = 19）和没有医疗保险（n = 5）。结论 本研究支持首次怀孕的女性接受FTPNC的比例较低的研究，并表明延迟进行PNC与怀孕认识较晚之间存在密切关联。加强孕前规划方面的投入可以改善该人群的FTPNC。
