Factors Associated with Maternal Healthcare Utilization Before and After Delivery Among Migrant Pregnant Women in China: An Observational Study

Figures & data

Table 1 Descriptive Statistics of Variables

Variable (n=6337)	N/Mean±SD	%
Age
Average	29.05±4.71
<29	3088	48.73%
≥29	3259	51.27%
Education
Primary school and below	304	4.80%
Junior high school	2171	34.26%
Senior high school and above	3862	60.94%
Household Registration
Urban	1336	21.08%
Rural	5001	78.92%
Ethnic groups
Han	5659	89.30%
Minority	678	10.70%
Employment
Unemployed	3312	52.26%
Employed	3025	47.74%
Monthly Household Income
Average (CNY)	9152.12±13, 764.98
Q1	1851	29.21%
Q2	1387	21.89%
Q3	1933	30.50%
Q4	1166	18.40%
Family size	3.76±0.89
Number of Children	1.54±0.58
Health Insurance
None	413	6.52%
NCMS	2987	47.14%
URBMI	511	8.06%
CURBMI	690	10.89%
UEBMI	1736	27.39%
Migration range
Across provinces	2813	44.39%
Across cities within a province	2390	37.72%
Across counties within a city	1134	17.89%
Migration duration
Average	4.52±4.00
<4 years	3379	53.32%
≥4 years	2958	46.68%
Maternal health education
No	2350	37.08%
Yes	3987	62.92%

Figure 1 Maternal healthcare utilization among migrant pregnant women (2018). (A) Establishment of Maternal Record (B) ANC visits (C) Postpartum visit within 28 days after delivery (D) Health examination within 42 days after delivery.

Table 2 Factors Associated with Establishment of Maternal Record and ANC Visits

Variable (n=6337)	Establishment of Maternal Health Record Within the First 12 weEks of Pregnancy OR (95% CI)		Five ANC Times OR (95% CI)
	Model 1	Model 2	Model 3	Model 4
Age
<29	1	1	1	1
≥29	1.062 (0.944, 1.196)	1.077(0.954, 1.216)	1.294(1.085, 1.543) ***	1.245(1.038, 1.493) **
Education
Primary school and below	1	1	1	1
Junior high school	1.359 (1.060, 1.743) **	1.379(1.069, 1.780) **	1.937(1.461, 2.568) ***	1.870(1.390, 2.515) ***
Senior high school and above	1.447 (1.121, 1.868)***	1.516(1.165, 1.971) ***	2.973(2.197, 4.023) ***	2.880(2.090, 3.969) ***
Household Registration
Urban	1	1	1	1
Rural	1.090 (0.938, 1.267)	1.093(0.935, 1.277)	0.950(0.742, 1.218)	0.943(0.735, 1.212)
Ethic groups
Han	1	1	1	1
Minority	0.894(0.751, 1.063)	0.877(0.729, 1.056)	0.651(0.523, 0.811) ***	0.619(0.488, 0.784) ***
Employment
Unemployed	1	1	1	1
Employed	0.995(0.885, 1.117)	1.021(0.905, 1.152)	0.662(0.560, 0.783) ***	0.706(0.593, 0.841) ***
Monthly Household Income
Q1	1	1	1	1
Q2	1.148(0.990, 1.333)*	1.120(0.962, 1.304)	1.264(1.029, 1.552) **	1.191(0.964, 1.470)
Q3	1.200(1.039, 1.385)**	1.117(0.963, 1.296)	1.672(1.354, 2.065) ***	1.550(1.249, 1.924) ***
Q4	1.717(1.429, 2.063)***	1.352(1.116, 1.639) ***	2.516(1.854, 3.414) ***	2.057(1.508, 2.806) ***
Family size	0.993(0.920, 1.071)	0.982(0.907, 1.062)	1.017(0.905, 1.142)	1.032(0.919, 1.159)
Number of Child	0.840(0.739, 0.955)***	0.842(0.738, 0.960) **	0.754(0.624, 0.910) ***	0.742(0.613, 0.898) ***
Health Insurance
None	1	1	1	1
NCMS	1.154 (0.930, 1.431)	1.237(0.989, 1.547) *	0.966(0.708, 1.317)	1.032(0.750, 1.420)
URBMI	1.509(1.143, 1.993)***	1.615(1.211, 2.154) ***	0.937(0.628, 1.397)	1.093(0.729, 1.640)
CURBMI	1.440(1.114, 1.863)***	1.328(1.018, 1.734) **	1.236(0.840, 1.817)	1.334(0.891, 1.996)
UEBMI	1.799 (1.416, 2.286)***	1.599(1.247, 2.051) ***	2.120(1.440, 3.121) ***	1.861(1.258, 2.754) ***
Migration range
Across province	1.154(0.990, 1.346)*	0.858(0.721, 1.022) *	1.422(1.142, 1.769) ***	1.193(0.933, 1.525)
Across prefectural city	0.983(0.843, 1.145)	0.926(0.790, 1.086)	1.322(1.064, 1.642) **	1.281(1.149, 1.609) **
Across county	1	1	1	1
Migration year
<4 years	1	1	1	1
≥4 years	1.178(1.050, 1.322)***	1.150(1.021, 1.294) **	1.102(0.931, 1.305)	1.076(0.906, 1.277)
Maternal health education
No	1	1	1	1
Yes	1.220(1.092, 1.364)***	1.245 (1.109, 1.398) ***	1.217(1.033, 1.432) **	1.218(1.028, 1.443) **
Province	No	Yes	No	Yes
Chi-square	199.947	369.232	343.994	427.029
Prob>chi2	<0.001	<0.001	<0.001	<0.001

Notes: Robust Standard errors clustered in province level are reported in the Parentheses; ***P<0.01, **P<0.05, *P<0.1; Models 1 and 3 did not control the provincial dummy variables, while models 2 and 4 controlled the provincial dummy variables.

Table 3 Factors Associated with Postpartum Visit Within 28 Days and Health Examination Within 42 Days After Delivery

Variable (n=6337)	Received a Postpartum Visit Within 28 Days After Delivery OR (95% CI)		Received a Health Examination Within 42 Days After Delivery OR (95% CI)
	Model 1	Model 2	Model 3	Model 4
Age
<29	1	1	1	1
≥29	1.289(1.128, 1.473) ***	1.272(1.107, 1.460) ***	1.227(1.052, 1.431) ***	1.174(1.002, 1.376) **
Education
Primary school and below	1	1	1	1
Junior high school	1.257(0.968, 1.632) *	1.239(0.944, 1.625)	1.575(1.198, 2.070) ***	1.515(1.140, 2.012) ***
Senior high school and above	1.506(1.150, 1.974) ***	1.502(1.133, 1.992) ***	2.449(1.832, 3.274) ***	2.336(1.725, 3.164) ***
Household Registration
Urban	1	1	1	1
Rural	1.162(0.980, 1.379) *	1.123(0.941, 1.340)	0.886(0.714, 1.100)	0.868(0.697, 1.082)
Ethic groups
Han	1	1	1	1
Minority	1.007(0.832, 1.219)	1.001(0.813, 1.233)	0.942(0.758, 1.170)	0.897(0.709, 1.135)
Employment
Unemployed	1	1	1	1
Employed	0.970(0.852, 1.105)	1.013(0.886, 1.159)	1.168(1.002, 1.361) **	1.187(1.013, 1.390) **
Monthly Household Income
Q1	1	1	1	1
Q2	1.222(1.035, 1.443) **	1.221(1.029, 1.448) **	1.270(1.052, 1.532) **	1.274(1.052, 1.542) **
Q3	1.328(1.128, 1.564) ***	1.260(1.065, 1.492) ***	1.385(1.151, 1.666) ***	1.354(1.122, 1.634) ***
Q4	1.184(0.971, 1.442) *	1.110(0.902, 1.367)	1.417(1.116, 1.798) ***	1.311(1.026, 1.676) **
Family size	1.014(0.930, 1.107)	1.005(0.919, 1.100)	0.963(0.870, 1.065)	0.957(0.864, 1.060)
Number of Child	0.852(0.738, 0.984) **	0.868(0.750, 1.005) *	0.711(0.605, 0.837) ***	0.720(0.610, 0.849) ***
Health Insurance
None	1	1	1	1
NCMS	0.987(0.779, 1.249)	1.071(0.843, 1.360)	1.361(1.049, 1.766) **	1.442(1.105, 1.883) ***
URBMI	1.478(1.076, 2.029) **	1.668(1.204, 2.311) ***	1.921(1.321, 2.794) ***	1.963(1.336, 2.883) ***
CURBMI	1.204(0.908, 1.597)	1.204(0.899, 1.613)	1.635 (1.186, 2.254) ***	1.587(1.137, 2.216) ***
UEBMI	1.721(1.315, 2.251) ***	1.612(1.226, 2.120) ***	1.976(1.449, 2.695) ***	1.802(1.312, 2.475) ***
Migration range
Across province	1.166(0.985, 1.380) *	1.011(0.831, 1.230)	1.437(1.181, 1.749)***	1.229(0.981, 1.540) *
Across prefectural city	1.237(1.042, 1.468) **	1.154(0.961, 1.385)	1.089(0.897, 1.322)	1.013(0.827, 1.242)
Across county	1	1	1	1
Migration year
<4 years	1	1	1	1
≥4 years	1.126(0.991, 1.281) *	1.096(0.960, 1.252)	1.071(0.923, 1.243)	1.033(0.888, 1.202)
Maternal health education
No	1	1	1	1
Yes	2.033(1.800, 2.296) ***	2.015(1.774, 2.289) ***	1.684(1.463, 1.939) ***	1.681(1.452, 1.945) ***
Province	No	Yes	No	Yes
Chi-square	288.943	441.773	327.892	383.686
Prob>chi2	<0.001	<0.001	<0.001	<0.001

Notes: Robust Standard errors clustered in province level are reported in the Parentheses; ***P<0.01, **P<0.05, *P<0.1; Models 1 and 3 did not control the provincial dummy variables, while models 2 and 4 controlled the provincial dummy variables.