University of Nevada, Reno, School of Public Health, Reno, USA.
Oregon State University, College of Public Health and Human Sciences, Corvallis, USA.
BMC Pregnancy Childbirth. 2022 May 5;22(1):391. doi: 10.1186/s12884-022-04709-9.
Early antenatal care (ANC) is essential for improving maternal and child health outcomes. The primary aims of this study were to 1) estimate the association between partners' education attainment and early ANC, and 2) determine whether partners' level of education modified the relationship between mothers' education, mothers' age, planned pregnancy, employment status and early ANC.
Data were obtained from a cross-sectional study conducted from April to May 2021 among 519 mothers with a live birth in the past year in the Nabdam district in the Upper East Region in northern Ghana. Generalized estimating equations were used to assess whether partners' level of education modified the relationship between mothers' education, mothers' age, planned pregnancy, employment status and early ANC. Effect modification was assessed on the additive and multiplicative scales using adjusted prevalence ratios (aPR) and corresponding 95% confidence intervals.
Mothers whose partners had secondary or higher education had a 26% higher prevalence of early ANC compared to mothers whose partners had less than a secondary level of education (aPR: 1.26, 95% CI: 1.05,1.51). There was evidence of effect modification by partners' education on the relationship between planned pregnancy and early ANC on both the additive (Relative excess risk due to interaction [RERI]: 0.61, 95% CI: 0.07,0.99), and multiplicative (ratio of PRs: 1.64, 95% CI: 1.01,2.70) scales. Among mothers whose partners had less than secondary education, mothers who had teenage pregnancy (i.e., aged 18-19 years old during pregnancy) were less likely to have early ANC compared to those who did not have teenage pregnancy (aPR: 0.71, 95% CI: 0.53,0.97). Among mothers whose partners had a secondary or higher education, early ANC was more prevalent among employed mothers compared to those who were unemployed (aPR: 1.27, 95% CI: 1.02,1.57).
Our findings suggest that whilst mothers whose partners had a secondary or higher education were more likely to initiate early ANC, supporting such women to plan their pregnancies can further increase the coverage of early ANC.
早期产前保健（ANC）对于改善母婴健康结果至关重要。本研究的主要目的是：1）评估伴侣教育程度与早期 ANC 的关联；2）确定伴侣的教育水平是否改变了母亲的教育程度、母亲年龄、计划妊娠、就业状况与早期 ANC 的关系。
本研究于 2021 年 4 月至 5 月期间在加纳北部上东部纳布丹区对过去一年生育活产儿的 519 名母亲进行了横断面研究。采用广义估计方程评估了伴侣的教育程度是否改变了母亲的教育程度、母亲年龄、计划妊娠、就业状况与早期 ANC 的关系。采用调整后的流行率比值（aPR）及其相应的 95%置信区间，从加性和乘法尺度评估了效应修饰作用。
与伴侣受教育程度低于中学相比，伴侣接受过中学或更高等教育的母亲，其早期 ANC 的流行率高 26%（aPR：1.26，95%CI：1.05，1.51）。在计划妊娠与早期 ANC 的关系上，伴侣的教育程度对其存在相加（交互归因超额危险度[RERI]：0.61，95%CI：0.07，0.99）和相乘（比值比：1.64，95%CI：1.01，2.70）尺度上的修饰作用。在伴侣受教育程度低于中学的母亲中，与没有青少年妊娠（妊娠时年龄为 18-19 岁）的母亲相比，青少年妊娠的母亲更不可能进行早期 ANC（aPR：0.71，95%CI：0.53，0.97）。在伴侣接受过中学或更高等教育的母亲中，与失业母亲相比，就业母亲的早期 ANC 更常见（aPR：1.27，95%CI：1.02，1.57）。
我们的研究结果表明，虽然伴侣接受过中学或更高等教育的母亲更有可能开始早期 ANC，但支持这些女性计划妊娠可以进一步提高早期 ANC 的普及率。
