Document Detail


Clinical, provider and sociodemographic determinants of the number of antenatal visits in England and Wales.
MedLine Citation:
PMID:  11266054     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to measure the independent effects of clinical factors and non-clinical factors, such as provider and sociodemographic characteristics, on the number of antenatal visits made by women in England and Wales. The study was based on a survey of the secondary case records of 20,771 women with singleton pregnancies who were delivered between 1 August 1994 and 31 July 1995. The women in the survey attended one of nine maternity units in Northern England and North Wales selected within those areas to reflect geographical variations, as well as variations in the size and teaching status of the institution. A multivariate Poisson regression model was developed to examine differences in the number of antenatal visits made by women with different clinical and non-clinical characteristics. After controlling for non-clinical factors, primiparous women identified as high risk at booking made 1.0% more visits than primiparous women identified as low risk at booking (p = 0.196). Multiparous women identified as high risk at booking made 3.5% more visits than their low risk counterparts (p<0.001). High risk-defining criteria during antenatal care led to a 0.3% weekly increase in the number of antenatal visits amongst primiparous women (p <0.001) and a 0.4% weekly increase in the number of antenatal visits amongst multiparous women (p < 0.001). Several notable results, not reported elsewhere in the literature, were revealed by the regression analyses. After all independent variables were controlled for, women who were booked into urban teaching hospitals made 10% fewer antenatal visits than the women who were booked into the urban non-teaching hospitals. Women of Pakistani origin made 9.1% fewer antenatal visits than women of white British origin. Similar results were revealed for women of Indian origin and women from other ethnic groups. Non-smokers made 6.0% more antenatal visits than smokers. The planned pattern of antenatal care, number of carers seen, gestation at first presentation and maternal age also had significant independent impacts on the number of antenatal visits. The study highlights the sizeable impact of non-clinical factors on the antenatal care delivery process and indicates ways in which variations in antenatal care might be reduced.
Authors:
S Petrou; E Kupek; S Vause; M Maresh
Related Documents :
23364014 - Physical activity and sedentary leisure time and their associations with bmi, waist cir...
23196054 - Histories of childhood victimization and subsequent mental health problems, substance u...
18780174 - Body size at birth and same-sex marriage in young adulthood.
24639714 - Fetal radiation doses and subsequent risks from x-ray examinations: should we be concer...
3491724 - Endometrial cancer. epidemiology.
8826994 - Apolipoprotein e in alzheimer's disease risk and case detection: a case-control study.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Social science & medicine (1982)     Volume:  52     ISSN:  0277-9536     ISO Abbreviation:  Soc Sci Med     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-03-26     Completed Date:  2001-05-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8303205     Medline TA:  Soc Sci Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1123-34     Citation Subset:  IM    
Affiliation:
National Perinatal Epidemiology Unit, Institute of Health Sciences, University of Oxford, UK. stavros.petrou@perinatal-epidemiology.oxford.ac.uk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Demography
England / epidemiology
Ethnic Groups
Female
Gestational Age
Health Care Surveys
Hospitals / utilization
Humans
Maternal Age
Multivariate Analysis
Parity
Patient Acceptance of Health Care / ethnology,  statistics & numerical data*
Poisson Distribution
Pregnancy
Pregnancy Complications / epidemiology
Pregnancy, High-Risk
Prenatal Care / utilization*
Regression (Psychology)
Wales / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Negotiating control and meaning: home birth as a self-constructed choice in Finland.
Next Document:  Social patterns of birth weight in Hong Kong, 1984-1997.