Addressing Disparities in Maternal Health: An Analysis of Prenatal Service Receipt and its Impact on Fetal Deaths and Low Birth Weight in Georgia's Perinatal Regions Restricted; Files Only
Mohammad Samim Soroush (Fall 2024)
Abstract
Objective. This study aims to examine the impact of prenatal care visits on birth outcomes, specifically fetal death rates and the incidence of low birth weight, among women in Georgia's six perinatal regions. The goal is to evaluate how receipt of prenatal care services influences these outcomes, with the intention of informing interventions that improve maternal health equity.
Methods. A retrospective cohort design was used, analyzing Georgia's fetal death and birth records from 2019 to 2022. Adverse pregnancy outcomes, including fetal death (after 20 weeks of gestation) and low birth weight, were assessed. Prenatal care receipt was the primary independent variable and racial and ethnic grouping was the additional key exposure. Covariates included maternal risk factors (e.g., age, tobacco use, diabetes) and demographic variables (e.g., education level, region). Logistic regression models were used to assess associations, reporting adjusted odds ratios and 95% confidence intervals.
Results. Significant racial/ethnic disparities in fetal death rates were identified, with Black non-Hispanic mothers experiencing higher odds of fetal death compared to White non-Hispanic mothers (aOR = 1.1, 95% CI: 1.0–1.2). Fewer than five prenatal visits were associated with increased odds of fetal death (aOR = 3.8, 95% CI: 3.5–4.2), with the highest risks observed in White non-Hispanic (aOR = 4.2, 95% CI: 3.5–5.0) and Black non-Hispanic (aOR = 3.7, 95% CI: 3.3–4.2) populations. Low birth weight (<2500g) was more prominent among Hispanic mothers (aOR = 11.7, 95% CI: 7.7–17.7) and White non-Hispanic mothers (aOR = 10.8, 95% CI: 8.4–13.9). Diabetes was consistently associated with fetal death across all groups, with strongest association in Hispanic mothers (aOR = 3.8, 95% CI: 2.3–6.3). Regional disparities were also notable, with higher odds of fetal death for White non-Hispanic mothers in Macon (aOR = 1.6, 95% CI: 1.2–2.1).
Conclusion. Racial disparities in birth outcomes persist in Georgia, particularly for Black non-Hispanic mothers. Prenatal care visits, especially early and frequent visits, is crucial for improving outcomes. Regional differences highlight the need for targeted interventions. These findings emphasize the importance of equitable healthcare access and tailored policies to address disparities in maternal and neonatal health.
Table of Contents
Table of Contents
Introduction 1
Literature Review 2
Methods 8
Study Population 8
Study Design 8
Analyses 10
Results 12
Sample Characteristics 12
Bivariate Analysis 14
Association of Prenatal Care Visits and Other Covariates with Fetal Death 16
Association between Maternal, Infant, and Geographical Factors with Prenatal Care Visits 19
Association between Covariates and Low Birth Weight 21
Race/Ethnicity Stratified Analysis of Risk Factors for Fetal Death 23
Discussion 26
Key Results 26
Limitations 27
Implications 27
Recommendations 28
Conclusion 29
Bibliography 30
About this Master's Thesis
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File download under embargo until 10 January 2027 | 2024-12-05 14:09:25 -0500 | File download under embargo until 10 January 2027 |
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