title: Do demographic and socio-economic characteristics of women with epilepsy influence contact with joint obstetric/neurology services in Northern Ireland?: Women with epilepsy and joint obstetric/neurology services.
abstract: OBJECTIVE
  Care of pregnant women with epilepsy (WWE) should be shared between an epilepsy specialist and obstetrician. Joint care is provided by the regional, but not peripheral, maternity units in Northern Ireland (NI). We investigated whether demographic and socio-economic factors influenced access of joint obstetric/neurology services.
  
  
  METHODS
  Data on WWE delivering between 1st January 2012 and 31st December 2014 were collected. Demographic (age, parity, Trust residence) and socio-economic (employment status, deprivation level) factors were compared between three groups: (1) women delivering at the regional unit from its catchment, (2) women delivering at the regional unit from outside its catchment and (3) women delivering at peripheral units.
  
  
  RESULTS
  447 WWE delivered in the 3-year period. 48% (214/447) and 52% (233/447) delivered at regional and peripheral units respectively. 42% delivering at the regional unit were from its catchment and 58% outside. There was no difference in parity, employment status or deprivation of WWE from outside the regional unit catchment who accessed joint services and those who did not. Trust residence was the strongest predictor of delivery location with women from adjacent Trusts over 90% less likely to deliver at peripheral units. Maternal age was also a predictor of delivery location with a woman aged 30 being 50% less likely to deliver at a peripheral unit than one aged 20.
  
  
  CONCLUSIONS
  52% of all WWE and 63% outside the regional unit catchment do not access the joint service. Service models which deliver improved access should focus on those in geographically distant locations and of younger age.
authors.affiliation: Public Health Agency, 22 Linenhall Street, Belfast BT2 8BS, Northern Ireland.. Electronic address: damien.bennett@hscni.net.
authors.forename: Damien
authors.initials: D
authors.lastname: Bennett
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D009462:Neurology / Q000706:statistics & numerical data; D009660:Northern Ireland / Q000453:epidemiology; D009774:Obstetrics / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000628:therapy*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Demographic; Epilepsy; Neurology; Obstetric; Pregnancy; Socioeconomic