Determinants of late and/or inadequate use of prenatal healthcare in high-income countries: a systematic review

Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking. To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries. Search of publications in EMBASE, CINAHL and PubMe...

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Veröffentlicht in:European journal of public health 2012-12, Vol.22 (6), p.904-913
Hauptverfasser: Feijen-de Jong, Esther I, Jansen, Danielle Emc, Baarveld, Frank, van der Schans, Cees P, Schellevis, François G, Reijneveld, Sijmen A
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container_end_page 913
container_issue 6
container_start_page 904
container_title European journal of public health
container_volume 22
creator Feijen-de Jong, Esther I
Jansen, Danielle Emc
Baarveld, Frank
van der Schans, Cees P
Schellevis, François G
Reijneveld, Sijmen A
description Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking. To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries. Search of publications in EMBASE, CINAHL and PubMed (1992-2010). Studies that attempted to study determinants of prenatal healthcare utilization in high-income countries were included. Two reviewers independently assessed the eligibility and methodological quality of the studies. Only high-quality studies were included. Data on inadequate use (i.e. late initiation, low-use, inadequate use or non-use) were categorized as individual, contextual and health behaviour-related determinants. Due to the heterogeneity of the studies, a quantitative meta-analysis was not possible. Ultimately eight high-quality studies were included. Low maternal age, low educational level, non-marital status, ethnic minority, planned pattern of prenatal care, hospital type, unplanned place of delivery, uninsured status, high parity, no previous premature birth and late recognition of pregnancy were identified as individual determinants of inadequate use. Contextual determinants included living in distressed neighbourhoods. Living in neighbourhoods with higher rates of unemployment, single parent families, medium-average family incomes, low-educated residents, and women reporting Canadian Aboriginal status were associated with inadequate use or entering care after 6 months. Regarding health behaviour, inadequate use was more likely among women who smoked during pregnancy. Evidence for determinants of prenatal care utilization is limited. More studies are needed to ensure adequate prenatal care for pregnant women at risk.
doi_str_mv 10.1093/eurpub/ckr164
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source Oxford Journals Open Access Collection; MEDLINE; PAIS Index; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection
subjects Births
Canadians
Developed Countries
Family
Female
Health Behavior
Health policy
Health services utilization
High income
Hospitals
Humans
Income
Industrialized nations
Maternal Age
Meta-analysis
Minorities
Parity
Patient Acceptance of Health Care
Pregnancy
Prenatal care
Prenatal Care - utilization
Reproductive health
Residence Characteristics
Risk
Single parent family
Socioeconomic Factors
Status
Systematic review
Time Factors
Unemployment
Uninsured persons
Women
Womens health
title Determinants of late and/or inadequate use of prenatal healthcare in high-income countries: a systematic review
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