Factors associated with late prenatal care initiation in pregnant women who discontinued visits
Keywords:
healthcare disparities, pregnancy, prenatal care, prevalence ratio.Abstract
Introduction: Early prenatal care is crucial to prevent complications that imply a higher risk of maternal-fetal or neonatal morbidity and mortality.Objective: To determine the sociodemographic, personal, and institutional factors associated with late initiation of prenatal care in pregnant women with less than six visits.
Methods: Analytical, cross-sectional study. The population consisted of 252 records of women who had less than six prenatal visits during their pregnancy at a Peruvian public hospital, excluding those with zero visits. The Chi-square and Fisher's exact tests were applied to include those with p< 0.2 in the multivariate model. Poisson regression with robust variance with p< 0.05 was used to obtain the model.
Results: 78.9% of the pregnant women had late antenatal care. In the multivariate analysis, maternal age over 35 years (PRa: 1.260; CI: 1.099-1.444), inflexible employment (PRa: 1.169; CI: 1.024-1.334), lack of partner support (PRa: 2.068; CI: 1.556-2.749), and a negative relationship with the family (PRa: 1.384; CI: 1.165-1.644) were identified as factors associated with late initiation.
Conclusions: Being over 35 years old, having inflexible employment, lack of partner support, and having a negative relationship with the family significantly increase the prevalence of late prenatal care initiation in this population.
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References
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19. Mulungi A, Mukamurigo J, Rwunganira S, Njunwa K, Ntaganira J. Prevalence and risk factors for delayed antenatal care visits in Rwanda: an analysis of secondary data from Rwanda demographic health survey 2019-2020 [Internet]. Pan Afr Med J. 2023; 44: [aprox. 13 p.]. DOI: 10.11604/pamj.2023.44.74.37570
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21. Tesfaye G, Loxton D, Chojenta C, Semahegn A, Smith R. Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis [Internet]. Reprod Health. 2017; 14(1): [aprox. 17 p.]. DOI: 10.1186/s12978-017-0412-4
22. Reis Muleva B, Duarte LS, Silva CM, Gouveia LMR, Borges ALV. Antenatal care in Mozambique: Number of visits and gestational age at the beginning of antenatal care [Internet]. Rev Lat Am Enfermagem. 2021 [acceso:13/06/2024]; 29:e3481. Disponible en: http://www.scielo.br/j/rlae/a/smSKWkRzZykGkKPNf-YNNFTg/?lang=en
23. Quijaite T, Valverde N, Barja J. Factores asociados al inicio tardío de la atención prenatal en un Centro de Salud del Callao, Perú [Internet]. Rev Cuba Obstet Ginecol. 2019 [acceso: 26/10/2023]; 45(4):e613-e613. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pi-d=S0138-600X2019000400003
24. Rivera F, López N, Diaz JZ, Alcántara VH. Factores asociados al acceso a la atención prenatal en los hospitales de Huaral y Chancay, Perú [Internet]. An Fac Med. 2018; 79(2):131-7. DOI: 10.15381/anales.v79i2.14939
25. Vilca MZ. Predictores individuales, familiares e institucionales del inicio tardío del control prenatal, en gestantes adolescentes usuarias de los establecimientos de salud, Microred Ambo - 2015 [Internet]. [Tesis de maestría]. Huánuco: Universidad Nacional Hermilio Valdizán; 2015. [acceso: 26/10/2023]. Disponible en: http://repositorio.unheval.edu.pe/handle/20.500.-13080/3644
26. Acup W, Sam O, Akullo N, Muzinguzi M, Kigongo E, Opio B, et al. Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross-sectional study [Internet]. BMJ Open. Arch Public Health 2022; 79(70):e071165. DOI: 10.1136/bmjopen-2022-071165
2. Ministerio de Salud. Norma técnica de salud para la atención integral de la salud materna [Internet]. Perú, Lima; 2022. [acceso: 16/10/2023]. Disponible en: http://bvs.minsa.gob.pe/local/MINSA/5013.pdf
3. Organización Mundial de la Salud. La OMS señala que las embarazadas deben poder tener acceso a una atención adecuada en el momento adecuado [Internet]. Ginebra: OMS; 2016. [acceso: 16/10/2023]. Disponible en: https://www.who.int/es/news/item/07-11-2016-pregnant-women-must-be-able-to-access-the-right-care-at-the-right-time-says-who
4. Instituto Nacional de Estadística e Informática. Encuesta Demográfica y de Salud Familiar ENDES 2021 [Internet]. Perú, Lima; 2021. [acceso: 16/10/2023]. Disponible en: https://www.gob.pe/institucion/inei/informes-publicaciones/2982736-peru-encuesta-demografica-y-de-salud-familiar-endes-2021
5. Instituto Nacional de Estadística e Informática: Encuesta Demográfica y de Salud Familiar - ENDES 2022 [Internet]. Perú, Lima; 2022. [acceso: 15/10/2023]. Disponible en: https://www.gob.pe/institucion/inei/informes-publicaciones/4233597-peru-encuesta-demografica-y-de-salud-familiar-endes-2022
6. Kolola T, Morka W, Abdissa B. Antenatal care booking within the first trimester of pregnancy and its associated factors among pregnant women residing in an urban area: a cross-sectional study in Debre Berhan town, Ethiopia [Internet]. BMJ Open. 2020; 10(6):e032960. DOI: 10.1136/bmjopen-2019-032960
7. Organización Mundial de la Salud. Recomendaciones de la OMS sobre atención prenatal para una experiencia positiva del embarazo: resumen de orientación [Internet]. Suiza, Ginebra; 2018. [acceso: 16/10/2023]. Disponible en: https://www.who.int/es/publications/i/item/WHO-RHR-16.12
8. Andrade-Romo Z, Heredia-Pi IB, Fuentes-Rivera E, Alcalde-Rabanal J, Cacho LBB, Jurkiewicz L, et al. Group prenatal care: effectiveness and challenges to implementation [Internet]. Rev Saúde Pública. 2019; 53:85. DOI: 10.11606/s1518-8787.2019053001303
9. Satcher MF, Bruce ML, Goodman DJ, Lord SE. Biopsychosocial contexts of timely and adequate prenatal care utilization among women with criminal legal involvement and opioid use disorder [Internet]. BMC Public Health. 2023; 23(1): [aprox. 14 p.]. DOI: 10.1186/s12889-023-15627-6
10. Guillen-Calle BE. Motivos de abandono de la atención prenatal de gestantes en el contexto de COVID-19. Hospital San Juan de Lurigancho, 2022 [Internet]. [Tesis de licenciatura]. Lima, Perú: Universidad Nacional Mayor de San Marcos; 2023. [acceso: 16/04/2024]. Disponible en: https://cybertesis.unmsm.edu.pe/backend/api/co-re/bitstreams/22898686-e4db-4587-8e32-b98f7af72b4d/content
11. Tola W, Negash E, Sileshi T, Wakgari N. Late initiation of antenatal care and associated factors among pregnant women attending antenatal clinic of Ilu Ababor Zone, southwest Ethiopia: A cross-sectional study [Internet]. PLOS ONE. 2021; 16(1):e0246230. DOI: 10.1371/journal.pone.0246230
12. Puthussery S, Tseng PC, Sharma E, Harden A, Griffiths M, Bamfo J, et al. Disparities in the timing of antenatal care initiation and associated factors in an ethnically dense maternal cohort with high levels of area deprivation [Internet]. BMC Pregnancy Childbirth. 2022; 22(1): [aprox. 11 p.]. DOI: 10.1186/s12884-022-04984-6
13. Dansereau E, McNellan CR, Gagnier MC, Desai SS, Haakenstad A, Johanns CK, et al. Coverage and Timing of Antenatal Care among Poor Women in 6 Mesoamerican Countries [Internet]. BMC Pregnancy Childbirth. 2017; 16(1): [aprox. 11 p.]. DOI: 10.1186/s12884-016-1018-5
14. Della F, Singh VC, Goyechea JS, Zimmer M, Contreras NB. Peso de recién nacidos y su relación con factores maternos sociodemográficos, obstétricos y del proceso de atención durante el control prenatal. Salta Capital, Argentina [Internet]. Antropo. 2022 [acceso: 23/10/2023]; 47:17-27. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=8-874432
15. Nigatu SG, Birhan TY. The magnitude and determinants of delayed initiation of antenatal care among pregnant women in Gambia; evidence from Gambia demographic and health survey data [Internet]. BMC Public Health. 2023;23(1): [aprox. 10 p.]. DOI: 10.1186/s12889-023-15506-0
16. Mendoza LA, Arias MD, Peñaranda CB, Mendoza LI, Manzano S, Varela AM. Influencia de la adolescencia y su entorno en la adherencia al control prenatal e impacto sobre la prematuridad, bajo peso al nacer y mortalidad neonatal [Internet]. Rev Chil Obstet Ginecol. 2015; 80(4):306-15. DOI: 10.4067/S0717-7526201500040000
17. Yaya S, Oladimeji O, Oladimeji KE, Bishwajit G. Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique [Internet]. BMC Pregnancy Childbirth. 2019; 19(1): [aprox. 1 p.]. DOI: 10.1186/s12884-019-2540-z
18. Krukowski RA, Jacobson LT, John J, Kinser P, Campbell K, Ledoux T, et al. Correlates of Early Prenatal Care Access among U.S. Women: Data from the Pregnancy Risk Assessment Monitoring System (PRAMS) [Internet]. Matern Child Health J. 2022; 26(2):328-41. DOI: 10.1007/s10995-021-03232-1
19. Mulungi A, Mukamurigo J, Rwunganira S, Njunwa K, Ntaganira J. Prevalence and risk factors for delayed antenatal care visits in Rwanda: an analysis of secondary data from Rwanda demographic health survey 2019-2020 [Internet]. Pan Afr Med J. 2023; 44: [aprox. 13 p.]. DOI: 10.11604/pamj.2023.44.74.37570
20. Wolde HF, Tsegaye AT, Sisay MM. Late initiation of antenatal care and associated factors among pregnant women in Addis Zemen primary hospital, South Gondar, Ethiopia [Internet]. Reprod Health. 2019; 16(1): [aprox. 8 p.]. DOI: 10.1186/s12978-019-0745-2
21. Tesfaye G, Loxton D, Chojenta C, Semahegn A, Smith R. Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis [Internet]. Reprod Health. 2017; 14(1): [aprox. 17 p.]. DOI: 10.1186/s12978-017-0412-4
22. Reis Muleva B, Duarte LS, Silva CM, Gouveia LMR, Borges ALV. Antenatal care in Mozambique: Number of visits and gestational age at the beginning of antenatal care [Internet]. Rev Lat Am Enfermagem. 2021 [acceso:13/06/2024]; 29:e3481. Disponible en: http://www.scielo.br/j/rlae/a/smSKWkRzZykGkKPNf-YNNFTg/?lang=en
23. Quijaite T, Valverde N, Barja J. Factores asociados al inicio tardío de la atención prenatal en un Centro de Salud del Callao, Perú [Internet]. Rev Cuba Obstet Ginecol. 2019 [acceso: 26/10/2023]; 45(4):e613-e613. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pi-d=S0138-600X2019000400003
24. Rivera F, López N, Diaz JZ, Alcántara VH. Factores asociados al acceso a la atención prenatal en los hospitales de Huaral y Chancay, Perú [Internet]. An Fac Med. 2018; 79(2):131-7. DOI: 10.15381/anales.v79i2.14939
25. Vilca MZ. Predictores individuales, familiares e institucionales del inicio tardío del control prenatal, en gestantes adolescentes usuarias de los establecimientos de salud, Microred Ambo - 2015 [Internet]. [Tesis de maestría]. Huánuco: Universidad Nacional Hermilio Valdizán; 2015. [acceso: 26/10/2023]. Disponible en: http://repositorio.unheval.edu.pe/handle/20.500.-13080/3644
26. Acup W, Sam O, Akullo N, Muzinguzi M, Kigongo E, Opio B, et al. Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross-sectional study [Internet]. BMJ Open. Arch Public Health 2022; 79(70):e071165. DOI: 10.1136/bmjopen-2022-071165
Published
2024-12-05
How to Cite
1.
Guillen Calle BE, Santos Rosales YR, Campos Correa KE. Factors associated with late prenatal care initiation in pregnant women who discontinued visits. Rev Cubana Med Milit [Internet]. 2024 Dec. 5 [cited 2025 Apr. 3];53(4):e024056101. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/56101
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