Prevalence of late initiation of prenatal care. Association with the socioeconomic level of the pregnant woman. Cross-sectional study. Bucaramanga, Colombia, 2014-2015
DOI:
https://doi.org/10.18597/rcog.3034Keywords:
prenatal care, pregnant women, gestational age, healthcare, socioeconomic factors, social security, ColombiaAbstract
Objective: To describe the prevalence of late initiation of prenatal care and assess its association with the socioeconomic level of the pregnant woman.
Materials and methods: Cross-sectional study. Pregnant women from the urban area of Bucaramanga were included using sampling based on proportional affixation quotas according to the socioeconomic classification of the neighbourhood where they lived. Late initiation was considered to occur when prenatal care was started at 12 weeks or more of gestation. The association between late initiation and socioeconomic bracket was assessed, controlling by sociodemographic and clinical variables of the pregnant woman, and a multivariate log-binomial regression model was developed to estimate prevalence ratios and their 95% confidence intervals (95% CI).
Results: Overall, 391 pregnant women between 18 and 43 years of age (median 23) were included. Median for schooling was 11 years, with a range between 0 and 25 years. Late initiation was found in 29.7% (95% CI: 25.2-34.5) of the women. Association was found with low income brackets (prevalence ratio [PR] = 1.57; 95% CI: 1.08-2.56), no affiliation to social security at the start of pregnancy (PR = 2.73; 95% CI: 2.04-3.67), and low schooling (PR = 1.46; 95% CI: 1.02-2.16), and age between 18 and 24 years (PR = 1.53; 95% CI: 1.12-1.70). Remembering the date of the last menstruation (PR = 0.48; 95% CI: 0.32-0.71) and being in a stable relationship (PR = 0.82; 95% CI: 0.64-0.98) were protective factors.Author Biographies
Flor de María Cáceres Manrique, Universidad Industrial de Santander
Myriam Ruiz-Rodríguez, Universidad Industrial de Santander
Enfermera; Maestría en Ciencias; Doctorado en Ciencias de la Salud Pública con área de concentración en Sistemas de Salud. Profesora titular, Departamento de Salud Pública, Escuela de Medicina, Universidad Industrial de Santander, Bucaramanga (Colombia).
References
Colombia. Ministerio de Salud. Colciencias. Guía de práctica clínica para la prevención, detección temprana y tratamiento de las complicaciones del embarazo, parto o puerperio. 2013. Guías 11-15 [visitado 2017 jun 30]. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/INEC/IETS/Gu %C3 %ADa.completa.Embarazo.Parto.2013.pdf.
República de Colombia, Ministerio de Salud. Norma técnica para la detección temprana de las alteraciones del embarazo [visitado 2018 ene 27]. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/PP/norma-tecnica-parala-deteccion-temprana-embarazo.pdf.
Anwar I, Sami M, Akhtar N, Chowdhury ME, Salma U, Rahman M, et al. Inequity in maternal health-care services: Evidence from home-based skilled-birthattendant programs in Bangladesh. Bulletin of the World Health Organization. 2008 [visitado 2017 jun 30];86:252-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647426/. https://doi.org/10.2471/BLT.07.042754
Rodríguez-Villamizar L, Ruiz-Rodríguez M, Jaime García ML. Beneficios de combinar métodos para analizar causas de muertes maternas, Bucaramanga, Colombia. Rev Panam Salud Publica. 2011;29:213-9. https://doi.org/10.1590/S1020-49892011000400001
Rowe RE, Garcia J. Social class, ethnicity and attendance for antenatal care in the United Kingdom: A systematic review. J Public Health Med. 2003 [visitado 2017 jun 23];25:113-9. Disponible en:https://www.researchgate.net/publication/10673263_Social_class_ethnicity_and_attendance_for_antenatal_care_in_the_United_Kingdom_A_systematic_review. https://doi.org/10.1093/pubmed/fdg025
Corbett S, Chelimo C, Okesene-Gafa K. Barriers to early initiation of antenatal care in a multi-ethnic sample in South Auckland, New Zealand. N Z Med J. 2014;127:53-61.
Sinyange N, Sitali L, Jacobs C, Musonda P, Michelo C. Factors associated with late antenatal care booking: population based observations from the 2007 Zambia demographic and health survey. Pan Afr Med J. 2016;25:109. https://doi.org/10.11604/pamj.2016.25.109.6873
Fobelets M, Beeckman K, Hoogewys A, Embo M, Buyl R, Putman K. Predictors of late initiation for prenatal care in a metropolitan region in Belgium. A cohort study. M. Public Health. 2015 [visitado 2017 may 30];648-654. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0033350615001237.pdf?locale=es_ES.
Beeckman K, Louckx F, Putman K. Predisposing, enabling and pregnancy-related determinants of late initiation of prenatal care. Matern Child Health J. 2011;15:1067-75. Doi: 10.1007/s10995-010-0652-1. https://doi.org/10.1007/s10995-010-0652-1
Zegeye AM, Bitew BD, Koy DN. Prevalence and determinants of early antenatal care visit among pregnant women attending antenatal care in debre berhan health institutions, central ethiopia. AJRH. 2013 [visitado 2017 feb 13];17:130. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24558789.
Cresswell JA, Yu G, Hatherall B, Morris J, Jamal F, Harden A. et al. Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK. BMC Pregnancy and Childbirth. 2013;13:103. https://doi.org/10.1186/1471-2393-13-103
Feijen-de Jon EI, Jansen D, Baarveld F, van der Schans CP, Ois G. Schellevis FG et al. Determinants of late and/or inadequate use of prenatal healthcare in high-income countries: a systematic review. Eur J Public Health. 2011;22:904-13. https://doi.org/10.1186/1471-2393-13-81.
Heredia-Pi I, Servan-Mori E, Darney BG, Reyes-Morales H, Lozano R. Measuring the adequacy of antenatal health care: A national cross-sectional study in Mexico. Bull World Health Organ. 2016;94:452-61. https://doi.org/10.2471/BLT.15.168302
Aung TZ, Oo WM, Khaing W, Dar TH. Late initiation of antenatal care and its determinants: A hospital based cross-sectional study. IJCMPH. 2016;3:900-905. https://doi.org/10.18203/2394-6040.ijcmph20160926
Say L, Raine R. A systematic review of inequalities in the use of maternal health care in developing countries: Examining the scale of the problema and the importance of context. Public Health Reviews. Bulletin WHO. 2007;85:812-9. https://doi.org/10.2471/BLT.06.035659
Miranda Mellado C. Factores de capacidad en el uso de control prenatal adecuado en gestantes de Sincelejo. Salud Uninorte. 2016;32:436-51. https://doi.org/10.14482/sun.32.2.9744
Moya-Plata D, Guiza-Salazar IJ, Mora-Merchán MA. Ingreso temprano al control prenatal en una unidad materno infantil. Rev Cuid. 2010;1:44-52. https://doi.org/10.15649/cuidarte.v1i1.73
Ortiz R, Anaya NI, Sepúlveda C, Torres SJ, Camacho P. Caracterización de las adolescentes gestantes de Bucaramanga, Colombia. Un estudio transversal. MedUnab, 2005 [visitado 2017 jul 2];8:71-7. Disponible en: http://revistas.unab.edu.co/index.php?journal=medunab&page=article&op=viewArticle&path%5B %5D=187.
Rodríguez-Páez FG, Jiménez-Barbosa WG, Jiménez-González CA, Coral-Córdoba AE, Ramírez-Solano PC, Ramos-Navas NR. Efecto de las barreras de acceso sobre la asistencia a citas de programa de control prenatal y desenlaces perinatales. Rev Gerenc Polít Salud. 2014;13:212-27. https://doi.org/10.11144/Javeriana.rgyps13-27.ebas
Aguado LF, Girón LE, Osorio AM, Tovar LM, Ahumada JR. Determinantes del uso de los servicios de salud materna en el Litoral Pacífico colombiano. Rev Latinoam Cienc Soc Niñez Juv. 2007;5:1-36.
Ruiz M, Cristancho LP, Ramírez C. Características del programa de control prenatal en instituciones de salud públicas de Bucaramanga. Médicas UIS. 2001;15: 159-68.
Brice-o-Ayala L, Pinzón-Rondón ÁM, Zárate-Ardila CJ. Acceso, seguridad e integralidad en registros de gestantes colombianas entre los años 2007 al 2009. Rev Cienc Salud. 2015;13:355-67. https://doi.org/10.12804/revsalud13.03.2015.03
Miranda C, Castillo IY. Factores de necesidad asociados al uso adecuado del control prenatal. Rev Cuid. 2016;7:1345-51. https://doi.org/10.15649/cuidarte.v7i2.340
Castillo IY, Fortich LM, Padilla J, Monroy MA, Morales Y, Ahumada AM. Factores asociados al uso adecuado del control prenatal en 13 municipios de Bolívar, Colombia. Rev Cubana Enfermer. 2017 [visitado 2018 mar 9];33. Disponible en: http://www.revenfermeria.sld.cu/index.php/enf/article/view/840/230.
Vecino-Ortiz AI. Determinants of demand for antenatal care in Colombia. Health Policy. 2008;86:363-372. https://doi.org/10.1016/j.healthpol.2007.12.002
Liu G. Sample surveys. En: Gail MH, Benichou J. Editors. Encyclopedia of Epidemiologic Methods. Armitage P, Colton T. Sussex: Wiley and Sons; 2000. p. 794-812.
CDC. Epi-InfoTM. 2017 [visitado 2017 jun 10]. Disponible en: https://www.cdc.gov/epiinfo/index.html.
Bucaramanga. Plan de Ordenamiento Territorial [visitado 2017 jun 30]. Disponible en: http://www.concejodebucaramanga.gov.co/planordenamientoterritorial/tomo2.pdf.
Colombia, Departamento Administrativo Nacional de Estadística (DANE). Estratificación socioeconómica para servicios públicos domiciliarios [visitado 2018 ene 29]. Disponible en: http://www.dane.gov.co/index.php/servicios-al-ciudadano/servicios-de-informacion/estratificacion-socioeconomica.
Colombia. Departamento Nacional de Planeación. Ministerio de Hacienda y Crédito Público. Evaluación de la estratificación socioeconómica como instrumento de clasificación de los usuarios y herramienta de asignación de subsidios y contribuciones a los servicios públicos domiciliarios. Informe institucional, enero 10 de 2008 [visitado 2018 ene 29]. Disponible en: http://www.dane.gov.co/files/geoestadistica/Evaluacion_Estratificaicon.pdf
Barros AJD, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio [visitado 2018 mar 9]. Disponible en: httt/publication/26382727_Alternatives_for_logistic_regression_in_cross-sectional_studies_an_empirical_comparison_of_models_that_directly_estimate_the_prevalence_ratio.
Espelt A, Marí-Dell’Olmo M, Penelo E, Bosque-Prous M. Estimación de las razones de prevalencia con distintos modelos de regresión: ejemplo de un estudio internacional en investigación de las adicciones. Adicciones. 2017 [visitado 2018 mar 9];29:105-12. Disponible en: http://www.adicciones.es/index.php/adicciones/article/view/823.
Andersen R. Revisiting the behavioral model and Access to medical care: Does it matter? J Health Soc Behav. 1995 [visitado 2017 jun 29];36:1-10. Disponible en: http://www.jstor.org/stable/2137284?seq=1#page_scan_tab_contents.
Travassos C, Martins M. A review of concepts in health services access and utilization. Cad Saúde Pública. 2004;20 (Supl 2):S190-S198.
Poeran J, Maas AFG, Birnie E, Denktas S, Steegers EAP, Bonsel GJ. Social deprivation and adverse perinatal outcomes among Western and Non-Western pregnant women in a Dutch urban population. Soc Sci Med. 2013 [visitado 2018 mar 9];83:42-9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23465203.
How to Cite
Downloads
Downloads
Published
Issue
Section
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
