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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