@article{10902/34397, year = {2015}, url = {https://hdl.handle.net/10902/34397}, abstract = {Objective: to examine the association and interaction between language proficiency, social risk factors and lack of adherence to antenatal care in African immigrant women (AIW). Methodology: retrospective cohort study. Two hundred and thirty-one AIW with delivery dates from 2007 to 2010 were identified, and data were collected on knowledge of Spanish, referral to a social worker because of social risk factors, and adequacy of antenatal care using the Kessner Index (KI) and the authors' own index (OI). The Spanish-born population sample was obtained by simple random sampling in a 1:3 ratio. Odds ratios (OR) were estimated by non-conditional logistic regression. The term 'language*referral to social worker' was included in the logistic models to study interaction. Findings: eighty-four per cent of AIW had insufficient knowledge of Spanish, and 47% had been referred to a social worker. Of the AIW who had not been referred to a social worker, the association between poor knowledge of Spanish and inadequate antenatal care was weak and not significant (OR for KI 1.31). On the contrary, of the AIW who had been referred to a social worker, the association was stronger and significant (OR for KI 8.98; p interaction=0.026). Social risk factors were the main independent factors associated with inadequate antenatal care in Spanish women (adjusted OR 3.17; 95% confidence interval 1.42-7.06). Conclusions: this study found that the main factor associated with inadequate antenatal care in AIW is insufficient language proficiency, but only in the presence of social risk factors, which have also been associated with worse antenatal care in Spanish women.}, organization = {Acknowledgements: The authors wish to thank all staff of the primary care management departments of the Cantabrian Health Service for support and use of facilities. The authors also wish to thank Rosa María Plata Quintanilla for her assistance in developing the database.}, publisher = {Churchill Livingstone}, publisher = {Midwifery, 2015, 31(1), 61-67}, title = {Factors associated with lack of adherence to antenatal care in African immigrant women and Spanish women in northern Spain: the role of social risk factors in combination with language proficiency}, author = {Santibáñez Margüello, Miguel and Paz Zulueta, María and Ruíz, María and Castro, Irene and Llorca Díaz, Francisco Javier}, }