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Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK

Cresswell, Jenny A and Yu, Ge and Hatherall, Bethan and Morris, Joanne and Jamal, Farah and Harden, Angela and Renton, Adrian (2013) Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK. BMC pregnancy and childbirth, 13. p. 103. ISSN 1471-2393. DOI UNSPECIFIED

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BACKGROUND: In the UK, women are recommended to engage with maternity services and establish a plan of care prior to the 12th completed week of pregnancy. The aim of this study was to identify predictors for late initiation of antenatal care within an ethnically diverse cohort in East London. METHODS: Cross-sectional analysis of routinely collected electronic patient record data from Newham University Hospital NHS Trust (NUHT). All women who attended their antenatal booking appointment within NUHT between 1st January 2008 and 24th January 2011 were included in this study. The main outcome measure was late antenatal booking, defined as attendance at the antenatal booking appointment after 12 weeks (+6 days) gestation. Data were analysed using multivariable logistic regression with robust standard errors. RESULTS: Late initiation of antenatal care was independently associated with non-British (White) ethnicity, inability to speak English, and non-UK maternal birthplace in the multivariable model. However, among those women who both spoke English and were born in the UK, the only ethnic group at increased risk of late booking were women who identified as African/Caribbean (aOR: 1.40: 95% CI: 1.11, 1.76) relative to British (White). Other predictors identified include maternal age younger than 20 years (aOR: 1.32; 95% CI: 1.13-1.54), high parity (aOR: 2.09; 95% CI: 1.77-2.46) and living in temporary accommodation (aOR: 1.71; 95% CI: 1.35-2.16). CONCLUSIONS: Socio-cultural factors in addition to poor English ability or assimilation may play an important role in determining early initiation of antenatal care. Future research should focus on effective interventions to encourage and enable these minority groups to engage with the maternity services.

Item Type: Article
Controlled Keywords: Adult, Africa, Caribbean Region, Cross-Sectional Studies, Europe, Eastern, Female, Housing, Humans, Language, London, Maternal Age, Parity, Pregnancy, Pregnancy Trimester, First, Pregnancy Trimester, Second, Prenatal Care, Time Factors, Urban Population, Young Adult
Depositing User: Atira Pure
Date Deposited: 04 Aug 2014 10:01
Last Modified: 29 Jan 2015 09:12
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