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Open Access Research article

Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK

Jenny A Cresswell1*, Ge Yu2, Bethan Hatherall3, Joanne Morris4, Farah Jamal3, Angela Harden3 and Adrian Renton3

Author Affiliations

1 London School of Hygiene and Tropical Medicine, London, United Kingdom

2 University of Leeds, Leeds, United Kingdom

3 Institute for Health and Human Development (IHHD), University of East London, London, United Kingdom

4 Barts Health NHS Trust, London, United Kingdom

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BMC Pregnancy and Childbirth 2013, 13:103  doi:10.1186/1471-2393-13-103

Published: 3 May 2013

Abstract

Background

In the UK, women are recommended to engage with maternity services and establish a plan of care prior to the 12th completed week of pregnancy. The aim of this study was to identify predictors for late initiation of antenatal care within an ethnically diverse cohort in East London.

Methods

Cross-sectional analysis of routinely collected electronic patient record data from Newham University Hospital NHS Trust (NUHT). All women who attended their antenatal booking appointment within NUHT between 1st January 2008 and 24th January 2011 were included in this study. The main outcome measure was late antenatal booking, defined as attendance at the antenatal booking appointment after 12 weeks (+6 days) gestation. Data were analysed using multivariable logistic regression with robust standard errors.

Results

Late initiation of antenatal care was independently associated with non-British (White) ethnicity, inability to speak English, and non-UK maternal birthplace in the multivariable model. However, among those women who both spoke English and were born in the UK, the only ethnic group at increased risk of late booking were women who identified as African/Caribbean (aOR: 1.40: 95% CI: 1.11, 1.76) relative to British (White). Other predictors identified include maternal age younger than 20 years (aOR: 1.32; 95% CI: 1.13-1.54), high parity (aOR: 2.09; 95% CI: 1.77-2.46) and living in temporary accommodation (aOR: 1.71; 95% CI: 1.35-2.16).

Conclusions

Socio-cultural factors in addition to poor English ability or assimilation may play an important role in determining early initiation of antenatal care. Future research should focus on effective interventions to encourage and enable these minority groups to engage with the maternity services.