Extent and relative changes of equities in using the prenatal care services among premature delivery women with different educational levels / 中华流行病学杂志

ABSTRACT

Objective To understand the extent and relative changes of equities in using the prenatal care services among premature delivery women from 4 counties/cities in Jiangsu and Zhejiang provinces, from 1995 to 2000. Methods The study population consisted of 97 537women who delivered singleton live birth of 28 to 41 gestational weeks in 4 counties/cities of Jiangsu and Zhejiang provinces, from 1995 to 2000. The proportions of women with early prenatal visit, of those with at least five prenatal visits and the hospital delivery rates between premature and term delivery groups were calculated. Inequalities in the above indictors by comparing rate difference ( RD), rate ratio ( RR ) and concentration index ( CI ) among women with different educational levels,were examined. Chi-square and One-way ANOVA were used to compare the differences. Results The proportions of having received early prenatal among those women with premature delivery in different education levels were 82.89%, 91.06%, 93.96%, 93.11% respectively, which were less than that of those with full term delivery (86.36%, 93.95%, 95.65%, 96.41%, P=0.008). The proportions of having received early prenatal among the women with high educational levels were higher (RD=-10.05, RR=0.90, CI=0.0104) than those with low educational attainment (RD=-10.22, RR=0.89, CI=0.0131); The proportions of having received at least five prenatal visits among those women with premature delivery in different education levels were 86.54%, 93.17%, 92.99%, 96.49%,respectively, which were less than those with full term delivery (94.60%, 96.65%, 96.15%, 96.66%,P=0.005). The proportions of having had at least five prenatal visits among the women with high educational attainment were higher (RD=-2.06, RR=0.98, CI=0.0006) than those with lower educational attainment (RD=-9.95, RR=0.90, CI=0.0077); The proportions of hospital delivery among the women with full term delivery in different education levels were significantly higher (99.45%, 99.75%, 99.83%, 99.77% ) than those with premature deliveries (98.42%, 99.54%, 99.61%,100.00%, P=0.005). The proportions of hospital delivery among women with high educational attainment was higher (RD =-0.32, CI= 0.0003 ) than those with lower educational attainment ( RD =-1.58, CI=0.0013). Conclusion Education related inequities in prenatal care utilization had not been improved among the Chinese women under our study. Inequities were seen in those women with full-term delivery the preterm delivery ones.