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Adequacy of prenatal care among women living with human immunodeficiency virus: a population-based study.
Ng, Ryan; Macdonald, Erin M; Loutfy, Mona R; Yudin, Mark H; Raboud, Janet; Masinde, Khatundi-Irene; Bayoumi, Ahmed M; Tharao, Wangari E; Brophy, Jason; Glazier, Richard H; Antoniou, Tony.
Afiliação
  • 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.
  • Yudin MH; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. mona.loutfy@wchospital.ca.
  • Raboud J; Department of Medicine, University of Toronto, Toronto, Ontario, Canada. mona.loutfy@wchospital.ca.
  • Masinde KI; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. mona.loutfy@wchospital.ca.
  • Bayoumi AM; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. yudinm@smh.ca.
  • Tharao WE; Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada. yudinm@smh.ca.
  • Brophy J; Department of Obstetrics and Gynecology, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada. yudinm@smh.ca.
  • Glazier RH; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. janet@raboud.net.
  • Antoniou T; Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada. janet@raboud.net.
BMC Public Health ; 15: 514, 2015 May 29.
Article em En | MEDLINE | ID: mdl-26058544
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.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cuidado Pré-Natal / Soropositividade para HIV / Emigrantes e Imigrantes / Disparidades em Assistência à Saúde Tipo de estudo: Etiology_studies / Prevalence_studies Limite: Adolescent / Adult / Female / Humans / Middle aged / Pregnancy País/Região como assunto: Africa / America do norte Idioma: En Revista: BMC Public Health Assunto da revista: SAUDE PUBLICA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cuidado Pré-Natal / Soropositividade para HIV / Emigrantes e Imigrantes / Disparidades em Assistência à Saúde Tipo de estudo: Etiology_studies / Prevalence_studies Limite: Adolescent / Adult / Female / Humans / Middle aged / Pregnancy País/Região como assunto: Africa / America do norte Idioma: En Revista: BMC Public Health Assunto da revista: SAUDE PUBLICA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Canadá