Predictors of Prenatal Care Among Case & Control Mothers in the National Birth Defects Prevention Study, 1997-2009 Open Access
Godoshian, Valerie Joy (2015)
Abstract
Background: Prenatal care, one of the most highly utilized health care services in the United Sates, is associated with positive pregnancy outcomes among women and their babies. The majority of pregnant women obtain prenatal care at some point during their pregnancy. However, annually 1.5-2.0% of pregnant women are not receiving prenatal care. Women who give birth without having had prenatal care at any point during their pregnancy, put their baby's health at risk.
Methods: This study analyzed data from the National Birth Defects Prevention Study (NBDPS); a population based multi-center case control study, to assess predictors of prenatal care among 37,816 women (27,673 cases and 10,143 controls). Crude and adjusted odds ratios (ORs), as well as corresponding 95% confidence intervals (CIs), were calculated for newly proposed predictor variables (i.e. previous pregnancy outcomes, maternal health and stress/social support). Known predictor variables from the literature were used as covariates.
Results: A total of 98.8% (n=37,346) of women reported obtaining prenatal care during pregnancy and 1.2% (n=470) of women reported no prenatal care during pregnancy. Compared with women reporting no prenatal care, women reporting prenatal care were more likely to: be non-Hispanic white; have an educational attainment beyond high school; have a household income of >$40,000; want to be pregnant at the time of conception; and report alcohol use from B3 to P9. These women were less likely to: be multiparous; report tobacco use from B3 to P9; and less likely to report illicit drug use from B3 to P9.Significant associations were found for history of miscarriage(s), morning sickness, emotional support, financial help and low stress/low support.
Conclusions: The data suggest that history of miscarriage(s), morning sickness, emotional support, financial help and low stress/low support may be associated with prenatal care utilization among women. Future research should continue to examine potential predictors of prenatal care, to help inform interventions targeted at increasing use among pregnant women in the United States.
Table of Contents
Chapter I: Introduction……………………………………………………………………..1
Chapter II: Literature Review………………………………………………..........…..…9
Chapter III: Methods……………………………………………………….....................21
Chapter IV: Results…………………………….………………………………….........…28
Chapter V: Discussion……………………………………………………......................37
References……………..…………………………………….....................…………...….46
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