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Content and timing of antenatal care: predisposing enabling and pregnancy related determinants of care trajectories
Tijdschriftbijdrage - Tijdschriftartikel
BACKGROUND When examining risk factors for inadequate antenatal care, assessment of antenatal care hardly considers content and timing of interventions during pregnancy. This study aims to provide information about the importance of predisposing, enabling and pregnancy-related determinants on received content and timing of antenatal care.
METHODS In the Brussels Metropolitan Region, 333 women were consecutively recruited at the beginning of their pregnancies. Antenatal care use was recorded prospectively. A classification system measuring Content and Timing of Care during Pregnancy (CTP) divided the women into four categories. Ordinal regression analyses were applied to define unadjusted and adjusted odds ratios, measuring the effect of different determinants on being assigned to a higher CTP category.
RESULTS 10.2% of the women had an inadequate, 8.4% an intermediate, 36% a sufficient and 45.3% an appropriate antenatal care trajectory. Adjusted odds ratios showed a lower likelihood of being assigned to a higher CTP category for lower educated women (OR 0.58; 95%CI 0.37-0.92), women of Maghreb origin (OR 0.38; 95%CI 0.22-0.66) and women with higher discontinuity of care (OR: 0.56; 95%CI: 0.34-0.90).
CONCLUSIONS When controlling for confounders, no enabling determinants were found affect content and timing of care in pregnancy. Although antenatal care is equally available to all women, predisposing and pregnancy-related factors were related to the likelihood of completing an appropriate antenatal care trajectory. Besides stimulating knowledge about the import antenatal care in less-educated and Maghreb women, supporting continuity of care during pregnancy might result in higher levels of received antenatal care.
METHODS In the Brussels Metropolitan Region, 333 women were consecutively recruited at the beginning of their pregnancies. Antenatal care use was recorded prospectively. A classification system measuring Content and Timing of Care during Pregnancy (CTP) divided the women into four categories. Ordinal regression analyses were applied to define unadjusted and adjusted odds ratios, measuring the effect of different determinants on being assigned to a higher CTP category.
RESULTS 10.2% of the women had an inadequate, 8.4% an intermediate, 36% a sufficient and 45.3% an appropriate antenatal care trajectory. Adjusted odds ratios showed a lower likelihood of being assigned to a higher CTP category for lower educated women (OR 0.58; 95%CI 0.37-0.92), women of Maghreb origin (OR 0.38; 95%CI 0.22-0.66) and women with higher discontinuity of care (OR: 0.56; 95%CI: 0.34-0.90).
CONCLUSIONS When controlling for confounders, no enabling determinants were found affect content and timing of care in pregnancy. Although antenatal care is equally available to all women, predisposing and pregnancy-related factors were related to the likelihood of completing an appropriate antenatal care trajectory. Besides stimulating knowledge about the import antenatal care in less-educated and Maghreb women, supporting continuity of care during pregnancy might result in higher levels of received antenatal care.
Tijdschrift: Eur J Public Health
ISSN: 1101-1262
Volume: 23
Pagina's: 67-73
Jaar van publicatie:2013
Trefwoorden:prenatal care, health behaviour model, socioeconomic factors, pregnancy, content of care, content and timing of care in Pregnancy
CSS-citation score:1