Inadequate Prenatal Care Utilization and Risks of Infant Mortality and Poor Birth Outcome: A Retrospective Analysis of 28,729,765 U.S. Deliveries over 8 Years

Abstract Background Some groups of migrant women have a higher risk of inadequate prenatal care utilization (PCU), severe maternal morbidity (SMM) and severe perinatal morbidity (SPM). To better understand this association, our aim was to assess the association between the legal status and PCU, SMM and SPM during pregnancy. Methods The analysis was performed in the database of the multicenter prospective PreCARE cohort. All pregnant women registered for delivery in 4 university hospital maternity units in Paris north area from October 2010 to May 2012 were included (N = 10 419). Women whose pregnancies ended before 22 weeks of gestation or who delivered in another maternity unit were excluded (N = 820). Women were distributed according to legal status in 4 groups: non-migrants, migrants with French or European nationality, legal migrants and undocumented migrants. The associations between the legal status and the composite variables of prenatal care utilization, SMM and SPM were tested through multivariate logistic regressions also adjusted for maternal characteristics. Results The illegal status was associated with increased risk of inadequate prenatal care utilization [adjusted odds ratio (aOR) 2,52 (2,10 - 3,01)]. Overall, the prevalence of SMM was 3,2 % and SPM 7,0 %. The illegal status was associated with higher risk of SMM [aOR 1,84 (1,21 - 2,79)], especially severe hypertensive disorder of pregnancy [aOR 2,29 (1,19 - 4,40)]. However, no significant association with SPM was found [aOR 1,29 (0,95 - 1,74)]. The sensitivity analysis demonstrates that results do not change after exclusion of women who arrived less than 12 months before delivery and those who started their follow-up after 14 weeks of gestation. Conclusions The illegal status was associated with an inadequate prenatal care utilization and a higher risk of SMM, especially severe hypertensive disorder of pregnancy. Key messages The illegal status was associated with increased risk of inadequate prenatal care utilization. The illegal status was associated with higher risk of severe maternal morbidity during pregnancy.

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The relationship between social capital, social support and the adequate use of prenatal care

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2011001400011 ◽

2011 ◽

Vol 27 (suppl 2) ◽

pp. s237-s253 ◽

Cited By ~ 9

Author(s):

Maria do Carmo Leal ◽

Ana Paula Esteves Pereira ◽

Gabriela de Almeida Lamarca ◽

Mario Vianna Vettore

Keyword(s):

Social Support ◽

Social Capital ◽

Prenatal Care ◽

Multinomial Logistic Regression ◽

Post Partum ◽

First Trimester ◽

Care Utilization ◽

Prenatal Care Utilization ◽

Inadequate Prenatal Care ◽

The Relationship

This study investigated the relationship between social capital and social support and the adequate use of prenatal care. A follow-up study involving 1,485 pregnant women was conducted in two cities in the Rio de Janeiro State, Brazil. Demographic and socioeconomic characteristics, social support and social capital data were collected during the first trimester of pregnancy. The post-partum period included information on levels of prenatal care utilization, social networks, parity, obstetric and gestational risk and prenatal care attendance. Hierarchized multinomial logistic regression was used in the statistical analysis. Prenatal care use above adequate levels was associated with high social capital at the city level (aggregated social capital), socioeconomic status and working during pregnancy. Lower non-aggregated contextual and compositional social capital, gestational risk and pattern of prenatal care were associated with inadequate prenatal care utilization. Contextual social capital and social support were found to be social determinants for the appropriate use of prenatal care.

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Exposure to Interpersonal Violence During Pregnancy and Its Association With Women’s Prenatal Care Utilization: A Meta-Analytic Review

Trauma Violence & Abuse ◽

10.1177/1524838018806511 ◽

2018 ◽

Vol 21 (5) ◽

pp. 904-921 ◽

Cited By ~ 3

Author(s):

Brittany Jamieson

Keyword(s):

Prenatal Care ◽

Pregnant Women ◽

Interpersonal Violence ◽

Care Utilization ◽

Obstetric Outcomes ◽

Prenatal Care Utilization ◽

Analytic Review ◽

Study Results ◽

Violence During Pregnancy ◽

Inadequate Prenatal Care

Inadequate prenatal care utilization has been proposed as a mechanism between exposure to violence during pregnancy and adverse maternal and fetal obstetric outcomes. Adequate prenatal care is important for identifying and treating obstetric complications as they arise and connecting pregnant women to supports and interventions as needed. There is some evidence that pregnant women experiencing relational violence may delay or never enter prenatal care, though this association has not been systematically or quantitatively synthesized. The present meta-analysis investigates the relationship between interpersonal violence during pregnancy and inadequate prenatal care utilization across two dimensions: (1) no prenatal care during gestation ( k = 9) and (2) delayed entry into prenatal care ( k = 25). Studies were identified via comprehensive search of 9 social science and health-related databases and relevant reference lists. Studies were included if (1) participants were human, (2) violence occurred in the context of an interpersonal relationship, (3) abuse occurred during pregnancy (including abuse within 12 months before the time of assessment during pregnancy), (4) the study was empirical, peer-reviewed, and included quantitative data, (5) prenatal care utilization data were available, (6) they were in English, and (7) they were not part of an intervention study. Results from random-effects models found that women abused during pregnancy were more likely to never enter care (odds ratio [ OR] = 2.62, 95% confidence interval [CI] = [1.55, 4.42]) or to delay care ( OR = 1.81, 95% CI [1.48, 2.23]). Sociodemographic, abuse-related, and methodological factors emerged as moderators. Practice, policy, and research implications are discussed.

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Factors explaining inadequate prenatal care utilization by first and second generation non-western women in The Netherlands

European Journal of Public Health ◽

10.1093/eurpub/ckt126.139 ◽

2013 ◽

Vol 23 (suppl_1) ◽

Author(s):

AW Boerleider ◽

J Manniën ◽

TA Wiegers ◽

AL Francke ◽

WLJM Devillé

Keyword(s):

Prenatal Care ◽

The Netherlands ◽

Second Generation ◽

Care Utilization ◽

Prenatal Care Utilization ◽

Inadequate Prenatal Care ◽

First And Second Generation

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Predictors of Timely Prenatal Care Initiation and Adequate Utilization in a Sample of Late Adolescent Texas Latinas

Hispanic Health Care International ◽

10.1177/1540415318764096 ◽

2018 ◽

Vol 16 (1) ◽

pp. 29-35

Author(s):

Rosamar Torres ◽

Priscilla Kehoe ◽

MarySue V. Heilemann

Keyword(s):

Social Media ◽

Prenatal Care ◽

Care Utilization ◽

Late Adolescent ◽

Prenatal Care Utilization ◽

Eligibility Criteria ◽

Uncomplicated Pregnancy ◽

Inadequate Prenatal Care ◽

Adequate Prenatal Care ◽

Care Index

Introduction: Little is known of late adolescent Texas Latinas’ prenatal care perceptions or how these perceptions predict timely prenatal care initiation or adequate utilization. Hence, the purpose of this study is to describe and compare these perceptions between participants with timely versus late prenatal care initiation and adequate, intermediate, and inadequate prenatal care utilization; and to determine predictors of timely prenatal care initiation and adequate utilization. Methods: Fifty-four postpartum Latinas were recruited through social media. Eligibility criteria were 18 to 21 years old, Texas-born, primiparous, uncomplicated pregnancy/delivery, and English literate. Prenatal care perceptions were measured with the Revised Better Babies Survey and Access Barriers to Care Index. Results: Participants had favorable views of prenatal care benefits; however, not living with the baby’s father predicted inadequate prenatal care, Wald χ2(1) = 4.93, p = .026. Perceived benefits of timely and adequate prenatal care predicted timely prenatal care initiation, χ2(1) = 7.47, p = .006. Self-reported depression during pregnancy predicted timely entry into prenatal care, χ2(1) = 4.73, p = .03. Conclusion: Participants’ positive prenatal care perceptions did not predict adequate prenatal care utilization, indicating that barriers serve as powerful obstacles in late adolescent Texas Latinas.

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