Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
Health, Nursing and Environmental Studies, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
BMC Pregnancy Childbirth. 2019 May 10;19(1):164. doi: 10.1186/s12884-019-2309-4.
The aim of this study was to investigate the factors associated with the timing of the first prenatal ultrasound in Canada.
This was a secondary data analysis of the Maternity Experiences Survey, a cross-sectional survey covering different aspects of pregnancy, labour, birth and the post-partum period. Bivariate and multivariate multinomial logistic regressions were performed to assess the relationship between timing of first prenatal ultrasound and different independent variables.
68.4% of Canadian women received an optimally timed first prenatal ultrasound, 27.4% received early ultrasounds and 4.3% received late ultrasound. The highest prevalence of early ultrasound was in Ontario (33.3%) and the lowest was in Manitoba (13.3%). The highest prevalence of late ultrasound was found in Manitoba (12.1%) and the lowest was in British Columbia and Ontario (3.5% each). The highest prevalence of optimal timing of first prenatal ultrasound was in Quebec (77%) and the lowest was in Ontario (63.2%). Factors influencing the timing of ultrasound included: Early - maternal age < 20 (adjusted OR = 0.54, 95%CI:0.34-0.84), alcohol use during pregnancy (adjusted OR = 0.69, 95%CI:0.53-0.90), history of premature birth (adjusted OR = 1.41, 95%CI:1.06-1.89), multiparity (adjusted OR = 0.67, 95%CI:0.57-0.78), born outside of Canada (adjusted OR = 0.82, 95%CI:0.67-0.99), prenatal care in Newfoundland and Labrador (adjusted OR = 1.66, 95%CI:1.20-1.30), Nova Scotia (adjusted OR = 1.68, 95%CI:1.25-2.28), Ontario (adjusted OR = 2.16, 95%CI:1.76-2.65), Saskatchewan (adjusted OR = 1.50, 95%CI:1.05-2.14), Alberta (adjusted OR = 1.37, 95%CI:1.05-1.77) British Columbia (adjusted OR = 1.90, 95%CI:1.45-2.50) and Manitoba (adjusted OR = 0.66, 95%CI:0.45-0.98) Late - unintended pregnancy (adjusted OR = 1.89, 95%CI:1.38-2.59), born outside of Canada (adjusted OR = 1.75, 95%CI:1.14-2.68), prenatal care in Manitoba (adjusted OR = 2.88, 95%CI:1.64-5.05) and the Territories (adjusted OR = 4.50, 95%CI:2.27-8.93). An interaction between history of miscarriage and having 'other' prenatal care provider significantly affected timing of ultrasound (adjusted OR = 0.31, 95%CI:0.14-0.66).
Only 68% of Canadian women received an optimally timed prenatal ultrasound which was influenced by several factors including province of prenatal care, maternal age and country of birth, and an interaction effect between prenatal care provider and history of miscarriage. These findings establish a baseline of factors influencing the timing of prenatal ultrasound in Canada, which can be built upon by future studies.
本研究旨在调查加拿大首次产前超声检查时间的相关因素。
这是对母婴经历调查的二次数据分析，该调查涵盖了怀孕、分娩和产后期间的不同方面。采用二分类和多分类逻辑回归分析来评估首次产前超声检查时间与不同独立变量之间的关系。
68.4%的加拿大女性接受了最佳时间的首次产前超声检查，27.4%接受了早期超声检查，4.3%接受了晚期超声检查。早期超声检查的最高患病率是安大略省（33.3%），最低的是马尼托巴省（13.3%）。晚期超声检查的最高患病率是马尼托巴省（12.1%），最低的是不列颠哥伦比亚省和安大略省（各为 3.5%）。首次产前超声检查最佳时间的最高患病率是魁北克省（77%），最低的是安大略省（63.2%）。影响超声检查时间的因素包括：早期 - 母亲年龄 < 20 岁（调整后的比值比[OR] = 0.54，95%置信区间[CI]：0.34-0.84）、怀孕期间饮酒（调整后的 OR = 0.69，95%CI：0.53-0.90）、早产史（调整后的 OR = 1.41，95%CI：1.06-1.89）、多胎（调整后的 OR = 0.67，95%CI：0.57-0.78）、出生于加拿大境外（调整后的 OR = 0.82，95%CI：0.67-0.99）、纽芬兰和拉布拉多省（调整后的 OR = 1.66，95%CI：1.20-1.30）、新斯科舍省（调整后的 OR = 1.68，95%CI：1.25-2.28）、安大略省（调整后的 OR = 2.16，95%CI：1.76-2.65）、萨斯喀彻温省（调整后的 OR = 1.50，95%CI：1.05-2.14）、艾伯塔省（调整后的 OR = 1.37，95%CI：1.05-1.77）、不列颠哥伦比亚省（调整后的 OR = 1.90，95%CI：1.45-2.50）和马尼托巴省（调整后的 OR = 0.66，95%CI：0.45-0.98）。晚期 - 意外怀孕（调整后的 OR = 1.89，95%CI：1.38-2.59）、出生于加拿大境外（调整后的 OR = 1.75，95%CI：1.14-2.68）、在马尼托巴省接受产前护理（调整后的 OR = 2.88，95%CI：1.64-5.05）和在地区接受产前护理（调整后的 OR = 4.50，95%CI：2.27-8.93）。流产史和“其他”产前护理提供者之间的相互作用显著影响了超声检查的时间（调整后的 OR = 0.31，95%CI：0.14-0.66）。
只有 68%的加拿大女性接受了最佳时间的产前超声检查，这受到包括产前护理省、母亲年龄和出生国家在内的多个因素的影响，以及产前护理提供者和流产史之间的相互作用。这些发现为加拿大产前超声检查时间的影响因素奠定了基础，可以为未来的研究提供参考。
