Background: The aim of this study was to investigate the factors associated with the timing of the first prenatal\nultrasound in Canada.\nMethods: This was a secondary data analysis of the Maternity Experiences Survey, a cross-sectional survey covering\ndifferent aspects of pregnancy, labour, birth and the post-partum period. Bivariate and multivariate multinomial\nlogistic regressions were performed to assess the relationship between timing of first prenatal ultrasound and\ndifferent independent variables.\nResults: 68.4% of Canadian women received an optimally timed first prenatal ultrasound, 27.4% received early\nultrasounds and 4.3% received late ultrasound. The highest prevalence of early ultrasound was in Ontario (33.3%)\nand the lowest was in Manitoba (13.3%). The highest prevalence of late ultrasound was found in Manitoba (12.1%)\nand the lowest was in British Columbia and Ontario (3.5% each). The highest prevalence of optimal timing of first\nprenatal ultrasound was in Quebec (77%) and the lowest was in Ontario (63.2%). Factors influencing the timing of\nultrasound included: Early - maternal age < 20 (adjusted OR = 0.54, 95%CI:0.34-0.84), alcohol use during pregnancy\n(adjusted OR = 0.69, 95%CI:0.53-0.90), history of premature birth (adjusted OR = 1.41, 95%CI:1.06-1.89), multiparity\n(adjusted OR = 0.67, 95%CI:0.57-0.78), born outside of Canada (adjusted OR = 0.82, 95%CI:0.67-0.99), prenatal care in\nNewfoundland and Labrador (adjusted OR = 1.66, 95%CI:1.20-1.30), Nova Scotia (adjusted OR = 1.68, 95%CI:1.25-2.\n28), Ontario (adjusted OR = 2.16, 95%CI:1.76-2.65), Saskatchewan (adjusted OR = 1.50, 95%CI:1.05-2.14), Alberta\n(adjusted OR = 1.37, 95%CI:1.05-1.77) British Columbia (adjusted OR = 1.90, 95%CI:1.45-2.50) and Manitoba (adjusted\nOR = 0.66, 95%CI:0.45-0.98) Late - unintended pregnancy (adjusted OR = 1.89, 95%CI:1.38-2.59), born outside of\nCanada (adjusted OR = 1.75, 95%CI:1.14-2.68), prenatal care in Manitoba (adjusted OR = 2.88, 95%CI:1.64-5.05) and\nthe Territories (adjusted OR = 4.50, 95%CI:2.27-8.93). An interaction between history of miscarriage and having\nâ??otherâ?? prenatal care provider significantly affected timing of ultrasound (adjusted OR = 0.31, 95%CI:0.14-0.66).\nConclusion: Only 68% of Canadian women received an optimally timed prenatal ultrasound which was influenced\nby several factors including province of prenatal care, maternal age and country of birth, and an interaction effect\nbetween prenatal care provider and history of miscarriage. These findings establish a baseline of factors influencing\nthe timing of prenatal ultrasound in Canada, which can be built upon by future studies.
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