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

Esther I Feijen-de Jong, Danielle Emc Jansen, Frank Baarveld, Cees van der Schans, François G Schellevis, Sijmen A Reijneveld

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking.

OBJECTIVE: To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries.

METHOD: 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.

RESULTS: 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.

CONCLUSION: Evidence for determinants of prenatal care utilization is limited. More studies are needed to ensure adequate prenatal care for pregnant women at risk.

Original languageEnglish
Pages (from-to)904-913
JournalAdvances in public health
Volume22
Issue number6
DOIs
Publication statusPublished - Dec 2012

Keywords

  • developed countries
  • female
  • health behavior
  • humans
  • income
  • maternal age
  • parity
  • patient acceptance of health care
  • pregnancy
  • prenatal care
  • residence characteristics
  • socioeconomic factors
  • time factors
  • journal article
  • research support, non-U.S. Gov't
  • review

Cite this

Feijen-de Jong, Esther I ; Jansen, Danielle Emc ; Baarveld, Frank ; van der Schans, Cees ; Schellevis, François G ; Reijneveld, Sijmen A. / Determinants of late and/or inadequate use of prenatal healthcare in high-income countries : a systematic review. In: Advances in public health. 2012 ; Vol. 22, No. 6. pp. 904-913.
@article{a8abac149df64a3d9362ed06231ee342,
title = "Determinants of late and/or inadequate use of prenatal healthcare in high-income countries: a systematic review",
abstract = "BACKGROUND: Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking.OBJECTIVE: To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries.METHOD: 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.RESULTS: 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.CONCLUSION: Evidence for determinants of prenatal care utilization is limited. More studies are needed to ensure adequate prenatal care for pregnant women at risk.",
keywords = "developed countries, female, health behavior, humans, income, maternal age, parity, patient acceptance of health care, pregnancy, prenatal care, residence characteristics, socioeconomic factors, time factors, journal article, research support, non-U.S. Gov't, review, ontwikkelde landen, vrouwelijk, gezondheidsgedrag, mensen, inkomen, leeftijd van de moeder, pariteit, pati{\"e}nt acceptatie van gezondheidszorg, zwangerschap, prenatale zorg, verblijfskenmerken, sociaaleconomische factoren, tijdsfactoren, tijdschriftartikel, research support, non-U.S. Gov't, review",
author = "{Feijen-de Jong}, {Esther I} and Jansen, {Danielle Emc} and Frank Baarveld and {van der Schans}, Cees and Schellevis, {Fran{\cc}ois G} and Reijneveld, {Sijmen A}",
year = "2012",
month = "12",
doi = "10.1093/eurpub/ckr164",
language = "English",
volume = "22",
pages = "904--913",
journal = "Advances in public health",
issn = "2314-7784",
publisher = "Hindawi Publishing Corporation",
number = "6",

}

Determinants of late and/or inadequate use of prenatal healthcare in high-income countries : a systematic review. / Feijen-de Jong, Esther I; Jansen, Danielle Emc; Baarveld, Frank; van der Schans, Cees; Schellevis, François G; Reijneveld, Sijmen A.

In: Advances in public health, Vol. 22, No. 6, 12.2012, p. 904-913.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Determinants of late and/or inadequate use of prenatal healthcare in high-income countries

T2 - a systematic review

AU - Feijen-de Jong, Esther I

AU - Jansen, Danielle Emc

AU - Baarveld, Frank

AU - van der Schans, Cees

AU - Schellevis, François G

AU - Reijneveld, Sijmen A

PY - 2012/12

Y1 - 2012/12

N2 - BACKGROUND: Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking.OBJECTIVE: To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries.METHOD: 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.RESULTS: 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.CONCLUSION: Evidence for determinants of prenatal care utilization is limited. More studies are needed to ensure adequate prenatal care for pregnant women at risk.

AB - BACKGROUND: Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking.OBJECTIVE: To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries.METHOD: 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.RESULTS: 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.CONCLUSION: Evidence for determinants of prenatal care utilization is limited. More studies are needed to ensure adequate prenatal care for pregnant women at risk.

KW - developed countries

KW - female

KW - health behavior

KW - humans

KW - income

KW - maternal age

KW - parity

KW - patient acceptance of health care

KW - pregnancy

KW - prenatal care

KW - residence characteristics

KW - socioeconomic factors

KW - time factors

KW - journal article

KW - research support, non-U.S. Gov't

KW - review

KW - ontwikkelde landen

KW - vrouwelijk

KW - gezondheidsgedrag

KW - mensen

KW - inkomen

KW - leeftijd van de moeder

KW - pariteit

KW - patiënt acceptatie van gezondheidszorg

KW - zwangerschap

KW - prenatale zorg

KW - verblijfskenmerken

KW - sociaaleconomische factoren

KW - tijdsfactoren

KW - tijdschriftartikel

KW - research support, non-U.S. Gov't

KW - review

U2 - 10.1093/eurpub/ckr164

DO - 10.1093/eurpub/ckr164

M3 - Article

VL - 22

SP - 904

EP - 913

JO - Advances in public health

JF - Advances in public health

SN - 2314-7784

IS - 6

ER -