Utilisation of antenatal care by country of birth in a multi-ethnic population: a four-year community-based study in Malmö, Sweden.
BACKGROUND
The aim of this study was to investigate differences in use of antenatal care in a multi-ethnic population in Malmö, Sweden, over a 4-year period. Age, parity, cohabiting status, use of an interpreter, and tobacco-use were examined to assess the potential effects of confounding factors.


METHODS
A 4-year (2000-2003) retrospective community-based register study was performed. Low-risk singleton pregnancies (n=5,373) registered for antenatal care at 5 municipal clinics and at the delivery ward at Malmö University Hospital were included, and divided into 6 subgroups by country of origin. The odds for utilisation of antenatal care were analysed by means of logistic regression.


RESULTS
Significantly increased odds of lower utilisation of planned antenatal care were found among some groups of foreign-born women. Women born in Eastern and Southern Europe, Iraq and Lebanon, and Asia had fewer antenatal visits than recommended, and all foreign-born women (except for women born in Iraq and Lebanon, and South and Central America) had a late first visit compared to Swedish-born women. Foreign-born women had, in general, fewer unplanned visits to a physician at the delivery ward, but women originating from Asia, Iraq and Lebanon, and Africa had higher utilisation visits to midwives at the delivery ward compared to Swedish-born women.


CONCLUSIONS
Foreign-born women had lower utilisation of planned antenatal care. Approximately 50% of women had higher utilisation of care, by making unplanned visits to the delivery ward. This puts strain on both economical as well as staff resources. The delivery clinic at the hospital level is not intended to handle routine visits, and, moreover, some of these women do not receive the full benefits of planned routine antenatal care.
Ny
Pernilla
P
Faculty of Health and Society, Malmö University, Malmö, Sweden. pernilla.ny@hs.mah.se
Dykes
Anna-Karin
AK
Molin
Johan
J
Dejin-Karlsson
Elisabeth
E
D000328:Adult; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D011247:Pregnancy / Q000208:ethnology*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies; D013548:Sweden