Table 2.
Univariable and multivariable analyses of factors associated with booking late for antenatal care (≥ 13 gestational weeks), stratified by timing of HIV diagnosis
| Diagnosed prior to current pregnancy | Newly diagnosed during current pregnancy | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Booked at ≥ 13 weeks/total (%) | OR (95% CI) | P‐value | aOR (95% CI)a | P‐value | Booked at ≥ 13 weeks/total (%) | OR (95% CI) | P‐value | aOR (95% CI)b | P‐value | |
| Time period of delivery | ||||||||||
| 2009–2011 | 1027/2415 (42.5) | 1 | 390/748 (52.1) | 1 | 1 | |||||
| 2012–2014 | 600/1681 (35.7) | 0.75 (0.66–0.85) | < 0.001 | 0.74 (0.64–0.86) | < 0.001 | 163/318 (51.3) | 0.97 (0.74–1.26) | 0.792 | 1.00 (0.74–1.34) | 0.978 |
| Maternal age at delivery | ||||||||||
| < 25 years | 126/318 (39.6) | 1 | 84/162 (51.9) | 1 | ||||||
| 25–34 years | 855/2232 (38.3) | 0.95 (0.74–1.21) | 0.654 | – | 343/666 (51.5) | 0.99 (0.70–1.39) | 0.936 | – | ||
| ≥ 35 years | 646/1546 (41.8) | 1.09 (0.85–1.40) | 0.481 | – | – | 126/238 (52.9) | 1.04 (0.70–1.56) | 0.830 | – | – |
| Maternal region of origin | ||||||||||
| UK/Ireland | 177/551 (32.1) | 1 | 1 | 48/140 (34.3) | 1 | 1 | ||||
| Europe | 64/173 (37.0) | 1.24 (0.86–1.79) | 0.249 | 1.51 (1.01–2.26) | 0.044 | 31/70 (44.3) | 1.52 (0.85–2.74) | 0.160 | 1.54 (0.81–2.95) | 0.188 |
| Eastern Africa | 758/1823 (41.6) | 1.50 (1.22–1.85) | < 0.001 | 1.61 (1.28–2.02) | < 0.001 | 197/351 (56.1) | 2.45 (1.63–3.69) | < 0.001 | 2.73 (1.74–4.29) | < 0.001 |
| Middle Africa | 130/264 (49.2) | 2.05 (1.50–2.81) | < 0.001 | 2.24 (1.59–3.14) | < 0.001 | 33/48 (68.8) | 4.22 (2.09–8.52) | < 0.001 | 3.84 (1.82–8.13) | < 0.001 |
| Western Africa | 304/763 (39.8) | 1.40 (1.10–1.77) | 0.006 | 1.65 (1.27–2.14) | < 0.001 | 159/284 (56) | 2.44 (1.60–3.71) | < 0.001 | 2.14 (1.33–3.43) | 0.002 |
| Southern Africa | 81/190 (42.6) | 1.57 (1.11–2.23) | 0.012 | 1.65 (1.13–2.43) | 0.010 | 39/58 (67.2) | 3.93 (2.05–7.54) | < 0.001 | 3.92 (1.90–8.05) | < 0.001 |
| Africa (region unspecified) | 14/37 (37.8) | 1.29 (0.63–2.64) | 0.492 | 1.46 (0.68–3.16) | 0.335 | 7/18 (38.9) | 1.22 (0.44–3.35) | 0.700 | 1.52 (0.49–4.73) | 0.467 |
| Elsewhere | 84/248 (33.9) | 1.08 (0.78–1.51) | 0.639 | 1.26 (0.88–1.81) | 0.207 | 30/78 (38.5) | 1.20 (0.67–2.13) | 0.538 | 1.25 (0.67–2.33) | 0.490 |
| Reporting region | ||||||||||
| London | 656/1852 (35.4) | 1 | 1 | 265/459 (57.7) | 1 | 1 | ||||
| Midlands and the East | 353/836 (42.2) | 1.33 (1.13–1.58) | 0.001 | 1.42 (1.17–1.71) | < 0.001 | 118/240 (49.2) | 0.71 (0.52–0.97) | 0.031 | 0.65 (0.45–0.93) | 0.021 |
| North | 285/651 (43.8) | 1.42 (1.18–1.71) | < 0.001 | 1.36 (1.10–1.67) | 0.004 | 58/148 (39.2) | 0.47 (0.32–0.69) | < 0.001 | 0.39 (0.25–0.59) | < 0.001 |
| South | 212/512 (41.4) | 1.29 (1.05–1.58) | 0.015 | 1.53 (1.22–1.93) | < 0.001 | 64/133 (48.1) | 0.68 (0.46–1.00) | 0.050 | 0.66 (0.42–1.03) | 0.069 |
| Wales, Scotland and Northern Ireland | 119/237 (50.2) | 1.84 (1.40–2.42) | < 0.001 | 2.06 (1.50–2.84) | < 0.001 | 46/83 (55.4) | 0.91 (0.57–1.46) | 0.695 | 1.18 (0.69–2.01) | 0.545 |
| Parity | ||||||||||
| Nulliparous | 254/799 (31.8) | 1 | 1 | 265/525 (50.5) | 1 | 1 | ||||
| One previous birth | 541/1459 (37.1) | 1.26 (1.05–1.52) | 0.012 | 1.19 (0.97–1.45) | 0.091 | 150/293 (51.2) | 1.03 (0.77–1.37) | 0.844 | 1.05 (0.77–1.44) | 0.742 |
| Two previous births | 460/1033 (44.5) | 1.72 (1.42–2.09) | < 0.001 | 1.60 (1.30–1.98) | < 0.001 | 78/126 (61.9) | 1.59 (1.07–2.37) | 0.022 | 1.87 (1.21–2.87) | 0.004 |
| At least three previous births | 297/605 (49.1) | 2.07 (1.66–2.58) | < 0.001 | 1.92 (1.52–2.44) | < 0.001 | 36/64 (56.3) | 1.26 (0.75–2.13) | 0.384 | 1.29 (0.73–2.29) | 0.377 |
| On ART at conception | ||||||||||
| No | 650/1458 (44.6) | 1 | 1 | n/a | – | n/a | ||||
| Yes | 964/2602 (37.0) | 0.73 (0.64–0.84) | < 0.001 | 0.70 (0.61–0.82) | < 0.001 | n/a | – | – | n/a | – |
| Earliest CD4 countc | ||||||||||
| ≥ 500 cells/μL | 557/1492 (37.3) | 1 | 1 | 138/278 (49.6) | 1 | 1 | ||||
| 350–499 cells/μL | 460/1125 (40.9) | 1.16 (0.99–1.36) | 0.067 | 1.12 (0.95–1.33) | 0.183 | 120/235 (51.1) | 1.06 (0.75–1.50) | 0.748 | (dropped) | – |
| 200–349 cells/μL | 330/796 (41.5) | 1.19 (1.00–1.42) | 0.057 | 1.10 (0.91–1.33) | 0.331 | 153/292 (52.4) | 1.12 (0.80–1.55) | 0.510 | 0.93 (0.64–1.36) | 0.706 |
| < 200 cells/μL | 152/300 (50.7) | 1.72 (1.34–2.22) | < 0.001 | 1.67 (1.27–2.18) | < 0.001 | 105/196 (53.6) | 1.17 (0.81–1.69) | 0.399 | 0.95 (0.66–1.36) | 0.781 |
| Earliest viral loadc | ||||||||||
| < 30 000 copies/mL | 1416/3552 (39.9) | 1 | 402/775 (51.9) | 1 | ||||||
| 30 000–99 999 cells/μL | 101/213 (47.4) | 1.36 (1.02–1.81) | 0.034 | – | 81/156 (51.9) | 1.00 (0.71–1.41) | 0.991 | – | ||
| ≥ 100 000 cells/μL | 45/106 (42.5) | 1.11 (0.74–1.67) | 0.606 | – | – | 57/111 (51.4) | 0.98 (0.66–1.46) | 0.918 | – | – |
aOR, adjusted odds ratio; ART, antiretroviral therapy; CI, confidence interval; OR, odds ratio.
a
The multivariable model for pregnancies in previously diagnosed women included 3493 observations (and analyses were adjusted for 3149 clusters; i.e. the 3493 pregnancies occurred in 3149 women).
b
The multivariable model for pregnancies in women diagnosed during their current pregnancy included 938 observations.
c
Earliest antenatal measurement in that pregnancy, not restricted to measurements prior to ART initiation.