Adequacy of prenatal care among women living with human immunodeficiency virus: a population-based study.

Autor: Ng R; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. ryan.ng@ices.on.ca., Macdonald EM; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. erin.macdonald@ices.on.ca., Loutfy MR; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. mona.loutfy@wchospital.ca.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. mona.loutfy@wchospital.ca.; Department of Medicine, University of Toronto, Toronto, Ontario, Canada. mona.loutfy@wchospital.ca.; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. mona.loutfy@wchospital.ca., Yudin MH; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. yudinm@smh.ca.; Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada. yudinm@smh.ca.; Department of Obstetrics and Gynecology, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada. yudinm@smh.ca., Raboud J; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. janet@raboud.net.; Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada. janet@raboud.net.; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. janet@raboud.net., Masinde KI; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. miss_irene509@hotmail.com., Bayoumi AM; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. ahmed.bayoumi@utoronto.ca.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. ahmed.bayoumi@utoronto.ca.; Department of Medicine, University of Toronto, Toronto, Ontario, Canada. ahmed.bayoumi@utoronto.ca.; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. ahmed.bayoumi@utoronto.ca.; Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada. ahmed.bayoumi@utoronto.ca., Tharao WE; Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada. wangari@whiwh.com., Brophy J; Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario, Canada. JBrophy@cheo.on.ca., Glazier RH; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. rick.glazier@ices.on.ca.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. rick.glazier@ices.on.ca.; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. rick.glazier@ices.on.ca.; Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada. rick.glazier@ices.on.ca.; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. rick.glazier@ices.on.ca.; Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada. rick.glazier@ices.on.ca., Antoniou T; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. tantoniou@smh.ca.; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. tantoniou@smh.ca.; Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada. tantoniou@smh.ca.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2015 May 29; Vol. 15, pp. 514. Date of Electronic Publication: 2015 May 29.
DOI: 10.1186/s12889-015-1842-y
Abstrakt: Background: Prenatal care reduces perinatal morbidity. However, there are no population-based studies examining the adequacy of prenatal care among women living with HIV. Accordingly, we compared the prevalence of adequate prenatal care among women living with and without HIV infection in Ontario, Canada.
Methods: Using administrative data in a universal single-payer setting, we determined the proportions of women initiating care in the first trimester and receiving adequate prenatal care according to the Revised-Graduated Prenatal Care Utilization Index . We also determined the proportion of women with HIV receiving adequate prenatal care by immigration status. We used generalized estimating equations with a logit link function to derive adjusted odds ratios (aORs) and 95% confidence intervals (CI) for all analyses.
Results: Between April 1, 2002 and March 31, 2011, a total of 1,132,135 pregnancies were available for analysis, of which 634 (0.06%) were among women living with HIV. Following multivariable adjustment, women living with HIV were less likely to receive adequate prenatal care (36.1% versus 43.3%; aOR 0.74, 95% CI 0.62 to 0.88) or initiate prenatal care in the first trimester (50.8% versus 70.0%; aOR 0.51, 95% CI 0.43 to 0.60) than women without HIV. Among women with HIV, recent (i.e. ≤ 5 years) immigrants from Africa and the Caribbean were less likely to receive adequate prenatal care (25.5% versus 38.5%; adjusted odds ratio 0.51; 95% CI, 0.32 to 0.81) than Canadian-born women.
Conclusion: Despite universal health care, disparities exist in the receipt of adequate prenatal care between women living with and without HIV. Interventions are required to ensure that women with HIV receive timely and adequate prenatal care.
Databáze: MEDLINE
Externí odkaz: