What the study found
The study found that individual-level socioeconomic status and demographic variables had limited ability to explain antenatal care completion among disadvantaged pregnant women. In the empirical data, socioeconomic status was not significantly associated with completion after adjustment, while the broader review found an association between socioeconomic disadvantage and inadequate or delayed prenatal care.
Why the authors say this matters
The authors conclude that the findings highlight the possible importance of broader structural and health system-level factors in antenatal care access. The study suggests that social vulnerability may be reflected by factors such as migrant status and neighborhood risk, which were used as proxies for broader disadvantage.
What the researchers tested
The researchers combined secondary analysis of data from 2,019 women from the Institute for Health Metrics and Evaluation dataset with a systematic review and meta-analysis following PRISMA 2020 guidelines. They used multivariable logistic regression and exploratory machine learning methods, specifically K-Nearest Neighbors and XGBoost, to assess prediction of antenatal care completion, and a random-effects meta-analysis to pool adjusted odds ratios from observational studies.
What worked and what didn't
In the IHME dataset, socioeconomic status was not significantly associated with antenatal care completion after adjustment, with an adjusted odds ratio of 0.97 and a 95% confidence interval of 0.78 to 1.21. The individual-level models had limited discriminatory performance, with area under the curve values from 0.49 to 0.50. By contrast, the meta-analysis of six studies found a significant association between socioeconomic disadvantage and inadequate or delayed prenatal care, with a pooled adjusted odds ratio of 1.96 and a 95% confidence interval of 1.26 to 3.07, and the studies showed substantial heterogeneity.
What to keep in mind
The abstract reports substantial heterogeneity across the studies included in the meta-analysis. It also notes that indicators such as migrant status and neighborhood risk were synthesized as proxies for broader social vulnerability, and it does not provide further limitations beyond what is stated here.
Key points
- Adjusted socioeconomic status was not significantly linked to antenatal care completion in the IHME dataset.
- Individual-level models performed poorly, with AUC values between 0.49 and 0.50.
- A meta-analysis of six studies found socioeconomic disadvantage was associated with inadequate or delayed prenatal care.
- The pooled adjusted odds ratio in the meta-analysis was 1.96, with substantial heterogeneity across studies.
- The authors suggest broader structural and health system-level factors may be important for antenatal care access.
Disclosure
- Research title:
- Individual-level SES poorly explained antenatal care completion
- Authors:
- Rani Wulandari
- Institutions:
- University of Raparin
- Publication date:
- 2026-02-26
- OpenAlex record:
- View
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