Clinical, provider and sociodemographic determinants of the number of antenatal visits in England and Wales
Clinical, provider and sociodemographic determinants of the number of antenatal visits in England and Wales
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DOI：
10.1016/s0277-9536(00)00212-4
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发表时间：
2001-04-01
影响因子：
5.4
通讯作者：
Maresh, M
中科院分区：
文献类型：
--
作者：
Petrou, S;Kupek, E;Maresh, M
本研究的目的是衡量临床因素和非临床因素（例如提供者和社会人口特征）对英格兰和威尔士妇女产前检查次数的独立影响。这项研究基于对 1994 年 8 月 1 日至 1995 年 7 月 31 日期间分娩的 20,771 名单胎妊娠妇女的次要病例记录的调查。调查中的妇女就读于英格兰北部和北威尔士地区的九个产科中心之一，这些产科中心是在这些地区选择的，以反映地理差异以及机构规模和教学状况的差异。开发了多变量泊松回归模型来检查具有不同临床和非临床特征的女性进行产前检查次数的差异。非临床因素，在预约时被确定为高风险的初产妇的就诊次数比在预约时被确定为低风险的初产妇多 1.0% (p = 0.196)。在预约时被确定为高风险的经产妇的就诊次数比低风险女性多 3.5% (p < 0.001)。产前护理期间的高风险定义标准导致初产妇女的产前检查次数每周增加 0.3% (p < 0.001)，而经产妇女的产前检查次数每周增加 0.4% (p < 0.001)。回归分析揭示了其他文献中未报道的几个值得注意的结果。控制所有自变量后，入住城市教学医院的女性产前检查次数比入住城市非教学医院的女性少 10%。巴基斯坦裔女性的产前检查次数比英国白人女性少 9.1%。印度裔女性和其他族裔女性也得出了类似的结果。不吸烟者的产前检查次数比吸烟者多 6.0%。计划的产前护理模式、看诊的护理人员数量、首次就诊时的妊娠情况和产妇年龄也对产前检查的次数有显着的独立影响。该研究强调了非临床因素对产前保健提供过程的巨大影响，并指出了减少产前保健差异的方法。 (C) 2001 Elsevier Science Ltd. 保留所有权利。
The objective of this study was to measure the independent effects of clinical factors and non-clinical factors, such as provider and sociodemographic characteristics, on the number of antenatal visits made by women in England and Wales. The study was based on a survey of the secondary case records of 20,771 women with singleton pregnancies who were delivered between 1 August 1994 and 31 July 1995. The women in the survey attended one of nine maternity units in Northern England and North Wales selected within those areas to reflect geographical variations, as well as variations in the size and teaching status of the institution. A multivariate Poisson regression model was developed to examine differences in the number of antenatal visits made by women with different clinical and non-clinical characteristics.After controlling for. non-clinical factors, primiparous women identified as high risk at booking made 1.0% more visits than primiparous women identified as low risk at booking (p = 0.196). Multiparous women identified as high risk at booking made 3.5% more visits than their low risk counterparts (p < 0.001). High risk-defining criteria during antenatal care led to a 0.3% weekly increase in the number of antenatal visits amongst primiparous women (p < 0.001) and a 0.4% weekly increase in the number of antenatal visits amongst multiparous women (p < 0.001). Several notable results, not reported elsewhere in the literature, were revealed by the regression analyses. After all independent variables were controlled for, women who were booked into urban teaching hospitals made 10% fewer antenatal visits than the women who were booked into the urban non-teaching hospitals. Women of Pakistani origin made 9.1% fewer antenatal visits than women of white British origin. Similar results were revealed for women of Indian origin and women from other ethnic groups. Non-smokers made 6.0% more antenatal visits than smokers. The planned pattern of antenatal care, number of carers seen, gestation at first presentation and maternal age also had significant independent impacts on the number of antenatal visits. The study highlights the sizeable impact of non-clinical factors on the antenatal care delivery process and indicates ways in which variations in antenatal care might be reduced. (C) 2001 Elsevier Science Ltd. All rights reserved.