Determinants of first trimester attendance at antenatal care clinics in the Amazon region of Peru: A case-control study
Determinants of first trimester attendance at antenatal care clinics in the Amazon region of Peru: A case-control study
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DOI：
10.1371/journal.pone.0171136
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发表时间：
2017-02-16
期刊：
影响因子：
3.7
通讯作者：
Gyorkos, Theresa W.
中科院分区：
文献类型：
--
作者：
Moore, Nora;Blouin, Brittany;Gyorkos, Theresa W.
目的确定影响孕妇首次产前检查(ANC)时间的影响因素。设计采用嵌套病例对照研究，在秘鲁亚马逊地区设立Belen和6 de Octubre两个保健中心。人口所有在2010、2011和2012年间参加过ANC的孕妇。方法从2010年至2012年ANC登记中选择所有病例(819例初诊ANC)。随机抽取819名怀孕中期或晚期的妇女作为对照，将其与健康中心的病例和第一次非国大就诊日期1：1匹配。数据来自非国大登记处。结果1)已婚或同居(AOR=1.69；95%CI：1.19，2.41)；2)完成中学学业或上大专(AOR=1.45；95%CI：1.02，2.06)；3)居住在城市环境(AOR=1.79；95%CI：1.04，3.10)；4)有流产史(AOR=1.56；95%可信区间：1.13，2.15)。胎次的优势比无统计学差异(AOR=1.08；95%CI：0.85，1.36)。结论本研究为首次ANC就诊的决定因素提供了经验证据。这些发现对于针对孕妇的当地干预措施的规划和时机选择至关重要，这些干预措施旨在使孕妇能够获得并充分受益于政府提供的所有非国大服务。
ObjectiveTo identify determinants which influence the timing of the first antenatal care (ANC) visit in pregnant women.DesignRetrospective matched nested case-control study.SettingTwo health centres, Belen and 6 de Octubre, in the Peruvian Amazon.PopulationAll pregnant women who had attended ANC during the years 2010, 2011, and 2012.MethodsAll cases (819 women initiating ANC in their first trimester) were selected from ANC registries from 2010 to 2012. A random sample of controls (819 women initiating ANC in their second or third trimester) was matched 1: 1 to cases on health centre and date of first ANC visit. Data were obtained from ANC registries. Conditional logistic regression analyses were performed.Main outcome measureCase-control status of each woman determined by the gestational age at first ANC visit.ResultsCases had higher odds of: 1) being married or cohabiting (aOR = 1.69; 95% CI: 1.19, 2.41); 2) completing secondary school or attending post-secondary school (aOR = 1.45; 95% CI: 1.02, 2.06); 3) living in an urban environment (aOR = 1.79; 95% CI: 1.04, 3.10) and 4) having had a previous miscarriage (aOR = 1.56; 95% CI: 1.13, 2.15), compared to controls. No statistically significant difference in odds was found for parity (aOR = 1.08; 95% CI: 0.85, 1.36).ConclusionsThis study provides empirical evidence of determinants of first ANC attendance. These findings are crucial to the planning and timing of local interventions, like deworming, aimed at pregnant women so that they can access and benefit fully from all government-provided ANC services.