title: [Antenatal course attendance among primiparous mothers, with physiological pregnancy and birth at term in Trentino (Northern Italy): characteristics of non-attender women and benefits among attender women in pregnancy behaviours, type of birth delivery and neonatal outcomes].
abstract: OBJECTIVE
  to outline the attendance rate of antenatal classes (ANCs) among women resident in Trentino Region (North-Eastern Italy) during the period 2000-2012; to identify the main sociodemographic characteristics of women who do not attend ANCs and to measure the effectiveness of ANCs attendance.
  
  
  METHODS
  cohort study with a retrospective data collection.
  
  
  METHODS
  by the computerised database of Trentino Certificates of delivery care, primiparous mothers living in Trentino presenting a physiological pregnancy and birth at term (≥37 weeks of gestation) were selected. Temporal trends of ANCs attendance were also studied for all mothers living in Trentino, all primiparous residents, all multiparous residents and all residents with foreign citizenship.
  
  
  METHODS
  possible associations between the probability of not attending ANCs and sociodemographic variables concerning mothers were analysed: age, professional status, educational level, marital status, citizenship and residence in an area served by a maternal and child health (MCH) clinic or not. Significant relationships between ANCs attendance and variables related to course of pregnancy, childbirth and neonatal outcomes were identified.
  
  
  RESULTS
  ANCs coverage has a statistically significant increasing trend over time for each group of women living in Trentino. Among the selected primiparous pregnant women, the principal barriers to ANCs access are being foreign, having an age ≤30 years, in particular ≤20 years, being housewives or unemployed, presenting a medium-low educational level, and residing in an area not served by a MCH clinic. ANCs-not-attending women show a lower awareness of the importance of performing serological tests for Syphilis and Cytomegalo-virus and they declare smoking in pregnancy. Benefits of ANCs attendance do not affect neonatal outcomes, but they concern a higher probability of vaginal birth and a higher breastfeeding predisposition.
  
  
  CONCLUSIONS
  data about ANCs attendance in Trentino Region appear higher than other national-regional studies. However, there are significant differences in access to ANCs regarding women's sociodemographic characteristics and resources distribution and MCH clinics measurement. In Italy, an evaluation about the accessibility of MCH clinics and their functioning criteria is desirable, focusing on marketing practices towards lower classes women. In Trentino, virtuosos MCH clinics have introduced elastic times in the ANCs planning and they have involved cultural mediators and private gynaecologists. Younger pregnant women are included in the ANCs after a preliminary meeting or by individual paths.
authors.affiliation: Servizio di epidemiologia clinica e valutativa, Azienda provinciale per i servizi sanitari di Trento. riccardo.pertile@apss.tn.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pertile
authors.affiliation: Servizio di epidemiologia clinica e valutativa, Azienda provinciale per i servizi sanitari di Trento.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Pedron
authors.affiliation: Consultorio per il singolo, la coppia e la famiglia di Trento e Mezzolombardo.
authors.forename: Michela
authors.initials: M
authors.lastname: Berlanda
authors.affiliation: Servizio di epidemiologia clinica e valutativa, Azienda provinciale per i servizi sanitari di Trento.
authors.forename: Silvano
authors.initials: S
authors.lastname: Piffer
mesh_terms: D000293:Adolescent; D000328:Adult; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D020073:Gravidity; D015438:Health Behavior; D006801:Humans; D007231:Infant, Newborn; D007558:Italy; D008458:Measles Vaccine; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D010358:Patient Participation; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D064186:Prenatal Education / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D047929:Term Birth; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D008458:Measles Vaccine