Determinants of late antenatal care presentation in rural and peri-urban communities in South Africa: A cross-sectional study.
Determinants of late antenatal care presentation in rural and peri-urban communities in South Africa: A cross-sectional study.
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DOI：
10.1371/journal.pone.0191903
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Medina-Marino A
中科院分区：
文献类型：
--
作者：
Ebonwu J;Mumbauer A;Uys M;Wainberg ML;Medina-Marino A
调查和比较延迟首次出现产前保健（ANC）服务的决定因素。一项横断面研究是在南非摩羯座农村地区和城郊的Tlokwe街道社区首次参加ANC访问的孕妇中进行的。数据收集包括问卷调查和病历提取。双变量和多变量分析评估了与晚期ANC表现相关的因素。我们招募了807名孕妇。其中，51%的农村妇女和28%的城郊妇女第一次ANC迟到。农村妇女更有可能出现第一次ANC的延迟（AOR = 2.65; 95% CI 1.98-3.55），并报告在获得ANC服务方面存在障碍（P<0.0001）。在农村社区，ANC的晚期发病与已婚（AOR = 2.36; 95% CI 1.33-4.19）、在职（AOR = 1.90; 95% CI 1.03-3.50）、<20岁（AOR = 2.19; 95% CI 1.10-4.37）和报告意外怀孕（AOR = 2.21; 95% CI 1.40-3.50）有关。在城郊社区，较晚出现与意外怀孕（AOR = 1.67; 95% CI 1.01-2.74）、较早出现后被告知稍后再开始ANC （AOR = 0.51; 95% CI 0.30-0.89）和首次怀孕（AOR = 0.56; 95% CI 0.34-0.94）相关。农村和城郊妇女首次ANC的较晚出现率都很高。然而，农村社区的妇女更有可能迟到。意外怀孕在农村和城郊社区都是一个独立的危险因素。需要围绕计划生育进行干预，特别是针对少女和年轻妇女的干预，以改善ANC的早期表现。
To investigate and compare determinates for delayed first presentation to antenatal care (ANC) services. A cross-sectional study was conducted amongst pregnant women attending their first ANC visit in rural Capricorn District and peri-urban Tlokwe sub-district communities in South Africa. Data collection included questionnaires and medical record abstraction. Bivariate and multivariate analyses assessed factors associated with late ANC presentation. We recruited 807 pregnant women. Of these, 51% of rural women and 28% of peri-urban women presented late for first ANC. Rural women were more likely to present late for first ANC (AOR = 2.65; 95% CI 1.98–3.55) and report barriers to accessing ANC services (P<0.0001). Late ANC presentation in rural communities was associated with being married (AOR = 2.36; 95% CI 1.33–4.19), employed (AOR = 1.90; 95% CI 1.03–3.50), <20 years of age (AOR = 2.19; 95% CI 1.10–4.37), and reporting an unplanned pregnancy (AOR = 2.21; 95% CI 1.40–3.50). Late presentation in peri-urban communities was associated with unplanned pregnancy (AOR = 1.67; 95% CI 1.01–2.74), being told to come back later to initiate ANC after presenting early (AOR 0.51; 95% CI 0.30–0.89) and being pregnant for the first time (AOR = 0.56; 95% CI 0.34–0.94) Both rural and peri-urban women had high rates of late presentation for first ANC. However, women in the rural communities were more likely to present late. Unplanned pregnancy was an independent risk factor in both rural and peri-urban communities. Interventions around family planning, especially for adolescent girls and young women, are needed to improve early presentation for ANC.