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Clinical, provider and sociodemographic predictors of late initiation of antenatal care in England and Wales
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Kupek, Emil, Petrou, Stavros, Vause, Sarah and Maresh, Michael (2002) Clinical, provider and sociodemographic predictors of late initiation of antenatal care in England and Wales. BJOG: An International Journal of Obstetrics and Gynaecology, 109 (3). pp. 265-273. doi:10.1111/j.1471-0528.2002.00524.x ISSN 1470-0328.
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Official URL: http://dx.doi.org/10.1111/j.1471-0528.2002.00524.x
Abstract
Objective To identify factors that are predictive of late initiation of antenatal care in England and Wales.
Design A multivariate binomial regression model was constructed to examine the association between clinical, provider and sociodemographic characteristics and late initiation of antenatal care.
Setting Nine maternity units in Northern England and North Wales.
Population A total of 20,771 women with a singleton pregnancy who delivered a liveborn or stillborn baby between 1 August 1994 and 31 July 1995. All analyses were based on the 17,765 (85.5%) women for whom information on gestational age at initial presentation for antenatal care and other variables incorporated into the regression model was retrievable from the case records
Results Primiparous women of high obstetric risk were 13.4% more likely to initiate antenatal care after 10 weeks of gestation than a low risk reference group (adjusted OR 1.134, 95% CI 1.011, 1.272; P= 0.0312), and 34.3% more likely to initiate antenatal care after 18 weeks of gestation (adjusted OR 1.343, 95% CI 1.046, 1.724; P= 0.0208). This association between high obstetric risk status and late initiation of antenatal care was not replicated among multiparous women. When the effects of other independent variables on gestational age at booking were examined, the following characteristics were associated with failure to initiate antenatal care by 10 weeks of gestation (Pā¤ 0.05): maternal age at booking, smoking status, ethnicity, type of hospital at booking, the planned pattern of antenatal care and the planned place of delivery. Adopting a criterion of 18 weeks of gestation exacerbated the association between clinical and sociodemographic characteristics and late initiation of antenatal care, but appeared to dilute the association between provider characteristics and late initiation of antenatal care.
Conclusions There is a pressing need for further research to identify the specific concerns of late bookers, to identify areas where new interventions might encourage the uptake of services and to gauge the likely impact of increased dissemination of information about the availability of antenatal care services.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | BJOG: An International Journal of Obstetrics and Gynaecology | ||||
Publisher: | Blackwell Publishing | ||||
ISSN: | 1470-0328 | ||||
Official Date: | 2002 | ||||
Dates: |
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Volume: | 109 | ||||
Number: | 3 | ||||
Page Range: | pp. 265-273 | ||||
DOI: | 10.1111/j.1471-0528.2002.00524.x | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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