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

Article

Cresswell, Jenny A, Yu, Ge, Hatherall, B., Morris, Joanne, Jamal, Farah, Harden, A. and Renton, A. 2013. Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK. BMC Pregnancy and Childbirth. 13 (1), p. 103.
AuthorsCresswell, Jenny A, Yu, Ge, Hatherall, B., Morris, Joanne, Jamal, Farah, Harden, A. and Renton, A.
Abstract

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.

Keywordsantenatal care; ethnic minorities; London
JournalBMC Pregnancy and Childbirth
Journal citation13 (1), p. 103
ISSN1471-2393
Year2013
Publisher's version
License
CC BY
Web address (URL)http://dx.doi.org/10.1186/1471-2393-13-103
Publication dates
Print03 May 2013
Publication process dates
Deposited12 Aug 2013
FunderNational Institute for Health Research (NIHR)
Copyright information© 2013 Cresswell et al.; licensee BioMed Central Ltd.
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Harden, A. 2008. Critical appraisal and qualitative research: exploring sensitivity analysis. ESRC Research Methods Festival. St Catherine’s College, Oxford 30 Jun - 03 Jul 2008
Social and environmental interventions to reduce childhood obesity: a systematic map of reviews
Harden, A. 2008. Social and environmental interventions to reduce childhood obesity: a systematic map of reviews. London EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.
Including diverse groups of children and young people in health promotion and public health research: a review of methodology and practice
Harden, A. 2008. Including diverse groups of children and young people in health promotion and public health research: a review of methodology and practice. London EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.
Health promotion, inequalities and young people’s health: a systematic review of research
Harden, A. 2008. Health promotion, inequalities and young people’s health: a systematic review of research. London EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.
A review of effectiveness, including cost effectiveness wherever possible, of commissioned healthy weight-related projects in City and Hackney: final report
Harden, A., Estacio, Emee Vida, Tobi, Patrick, Adams-Eaton, Faye, Bertotti, Marcello and Lais, Shahana 2009. A review of effectiveness, including cost effectiveness wherever possible, of commissioned healthy weight-related projects in City and Hackney: final report. London Institute of Health and Human Development, University of East London.
A project to assist Family Actions's Building Bridges practitioners with the use of the Index of Family Relations as an outcome measurement: final report
Harden, A., Lloyd-Reichling, E., Mcdermott, M., Potter, Sylvia and Sayeed, Zahirun 2009. A project to assist Family Actions's Building Bridges practitioners with the use of the Index of Family Relations as an outcome measurement: final report. London University of East London.
The Well London program - a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results
Phillips, G., Renton, A., Moore, D., Bottomley, Christian, Schmidt, Elena, Lais, Shahana, Yu, Ge, Wall, Martin, Tobi, P., Frostick, C., Clow, Angela, Lock, Karen, Petticrew, Mark and Hayes, Richard 2012. The Well London program - a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results. Trials. 13 (105).
Methods for the thematic synthesis of qualitative research in systematic reviews
Thomas, James and Harden, A. 2008. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology. 8 (45), pp. 1471-2288.
The influence of environmental factors on the generalisability of public health research evidence: physical activity as a worked example
Watts, P., Phillips, Gemma, Harden, A. and Renton, A. 2011. The influence of environmental factors on the generalisability of public health research evidence: physical activity as a worked example. International Journal of Behavioural Nutrition and Physical Activity. 8 (1), pp. 1479-5868.
Creating and Maintaining a Healthy Stratford City: Principles and Practices for Success
Sampson, Alice, Harden, A., Brimicombe, A., Bertotti, Marcello, Lais, Shahana, Barrow-Guevera, Gail, Boniwell, Ilona, Joseph, Hipolina, Sheridan, Kevin, Adams-Eaton, Faye, Tobi, Patrick and Li, Yang 2010. Creating and Maintaining a Healthy Stratford City: Principles and Practices for Success. University of East London, Centre for Institutional Studies.
Protocol for a systematic review of the effects of schools and school-environment interventions on health: evidence mapping and syntheses
Harden, A. and Jamal, Farah 2011. Protocol for a systematic review of the effects of schools and school-environment interventions on health: evidence mapping and syntheses. BMC Public Health. 11 (453).
Antiretroviral treatment and the health workforce in South Africa: how have ART workers been affected by scaling up?
Tobi, Patrick, George, Gavin, Schmidt, Elena and Renton, A. 2008. Antiretroviral treatment and the health workforce in South Africa: how have ART workers been affected by scaling up? Tropical Medicine and International Health. 13 (12), pp. 1452-1458.
Integrating qualitative research with trials in systematic reviews
Thomas, James, Harden, A., Oakley, Ann, Oliver, Sandy, Sutcliffe, Katy, Rees, Rebecca, Brunton, Ginny and Kavanagh, Josephine 2004. Integrating qualitative research with trials in systematic reviews. British Medical Journal. 328 (7446), pp. 1010-1012.
Applying systematic review methods to studies of people’s views: an example from public health research
Harden, A., Garcia, Jo, Oliver, Sandy, Rees, Rebecca, Shepherd, Jonathan, Brunton, Ginny and Oakley, Ann 2004. Applying systematic review methods to studies of people’s views: an example from public health research. Journal of Epidemiology and Community Health. 58 (9), pp. 794-800.
A project to assist Family Action’s Building Bridges practitioners with the use of the Index of Family Relations as an outcome measurement (Final Report).
Harden, A., Lloyd-Reichling, E., Mcdermott, M., Potter, Sylvia and Sayeed, Zahirun 2009. A project to assist Family Action’s Building Bridges practitioners with the use of the Index of Family Relations as an outcome measurement (Final Report). Family Action, Institute of Health and Human Development and CASS School of Education, University of East London.
Teenage pregnancy and social disadvantage: systematic review integrating controlled trials and qualitative studies
Harden, A., Brunton, Ginny, Fletcher, Adam and Oakley, Ann 2009. Teenage pregnancy and social disadvantage: systematic review integrating controlled trials and qualitative studies. British Medical Journal. 339 (121).
Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial
Wall, Martin, Hayes, Richard, Moore, D., Petticrew, Mark, Clow, Angela, Schmidt, Elena, Draper, Alizon, Lock, Karen, Lynch, Rebecca and Renton, A. 2009. Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial. BMC Public Health. 9 (207).
Methods for the thematic synthesis of qualitative research in systematic reviews
Thomas, James and Harden, A. 2008. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology. 8 (45).