title: Immigrant mothers and access to prenatal care: evidence from a regional population study in Italy.
abstract: OBJECTIVE
  We addressed the question of whether use of adequate prenatal care differs between foreign-born and Italian mothers and estimated the extent to which unobservable characteristics bias results.
  
  
  METHODS
  This study is on primary care and especially on adequate access to prenatal healthcare services by immigrant mothers.
  
  
  METHODS
  Approximately 37,000 mothers of both Italian and foreign nationality were studied. Data were obtained from the Standard Certificate of Live Birth between 2005 and 2010 in Umbria.
  
  
  RESULTS
  Estimates from the bivariate probit model indicate that immigrant mothers are three times more likely to make fewer than four prenatal visits (OR=3.35) and 1.66 times more likely to make a late first visit (OR=1.66). The effect is found to be strongest for Asian women.
  
  
  CONCLUSIONS
  Standard probit models lead to underestimation of the probability of inadequate use of prenatal care services by immigrant women, whereas bivariate probit models, which allow us to consider immigrant status as an endogenous variable, estimated ORs to be three times larger than those obtained with univariate models.
authors: Unit of Public Health, Department of Experimental Medicine, University of Perugia, Perugia, Italy.
authors: Manuela
authors: M
authors: Chiavarini
authors: Department of Medicine, University of Perugia, Piazzale Lucio Severi, Perugia, Italy.
authors: Donatella
authors: D
authors: Lanari
authors: Unit of Public Health, Department of Experimental Medicine, University of Perugia, Perugia, Italy.
authors: Liliana
authors: L
authors: Minelli
authors: Department of Political Science, University of Perugia, Perugia, Italy.
authors: Luca
authors: L
authors: Pieroni
authors: Department of Political Science, University of Perugia, Perugia, Italy.
authors: Luca
authors: http://orcid.org/0000-0001-6674-9215
authors: L
authors: Salmasi
mesh_terms: D000328:Adult; D054242:Emigrants and Immigrants; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007558:Italy; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
keywords: EPIDEMIOLOGY; HEALTH ECONOMICS; HEALTH SERVICES ADMINISTRATION & MANAGEMENT