Prenatal Care Utilization in Mississippi: Racial Disparities and Implications for Unfavorable Birth Outcomes

Abstract

The objective of the study is to identify racial disparities in prenatal care (PNC) utilization and to examine the relationship between PNC and preterm birth (PTB), low birth weight (LBW) and infant mortality in Mississippi. Retrospective cohort from 1996 to 2003 linked Mississippi birth and infant death files was used. Analysis was limited to live-born singleton infants born to non-Hispanic white and black women (n = 292,776). PNC was classified by Kotelchuck's Adequacy of Prenatal Care Utilization Index. Factors associated with PTB, LBW and infant death were identified using multiple logistic regression after controlling for maternal age, education, marital status, place of residence, tobacco use and medical risk. About one in five Mississippi women had less than adequate PNC, and racial disparities in PNC utilization were observed. Black women delayed PNC, received too few visits, and were more likely to have either "inadequate PNC" (P< 0.0001) or "no care" (P < 0.0001) compared to white women. Furthermore, among women with medical conditions, black women were twice as likely to receive inadequate PNC compared to white women. Regardless of race, "no care" and "inadequate PNC" were strong risk factors for PTB, LBW and infant death. We provide empirical evidence to support the existence of racial disparities in PNC utilization and infant birth outcomes in Mississippi. Further study is needed to explain racial differences in PNC utilization. However, this study suggests that public health interventions designed to improve PNC utilization among women might reduce unfavorable birth outcomes especially infant mortality.

Factors associated with the quality of prenatal care: an approach to premature birth

“…These results corroborate other studies that have also found a higher proportion of inadequate prenatal care for women with unfavorable characteristics, such as ethnicity/black and brown skin color (24) , who did not plan their pregnancy and unmarried, which tend to start Prenatal care late and perform fewer visits (1,(25)(26)(27) . Also, there was association of inadequate prenatal care to mothers who have made combined prenatal care (OR=3.9 in the univariate analysis and AOR=5.7 in the multivariate analysis).…”

Pediction by Maternal Risk Factors and Prenatal Care of Neonatal Intensive Care of Neonatal Intensive Care Admission in A University Hospital, Turkey, A Case Control Study

“…PNC is generally known to be related to preterm labor, low birth weight, fetal death and neonatal death [5,6,14,15]. However, number of PNC evaluated in several studies is different from each other and numbers greater than 4 can be suggested according to results [15].…”

“…Studies done presents that inadequate PNC is related to preterm labor, low birth weight an newborn deaths [5,6].…”

“…A qualified prenatal care (PNC) service primarily provides to determine and harness the risks endangering pre-pregnancy and during pregnancy in the future mother and therefore provides the prevention of negative results which can occur both in the mother and the newborn [3,4].Studies done presents that inadequate PNC is related to preterm labor, low birth weight an newborn deaths [5,6].Besides PNC, interventions during birth and right after that are important and deliveries should be made by health personnel and NICU's should be at least found in certain centers.It is important to determine the factors affecting the intense care requirement of the newborn in terms of creating effective interventions to be made in this respect in the whole process starting from prenatal period.This study aims to compare the mothers delivering between January -June 2010 in Hacettepe University Obstetrics and Gynaecology Clinic whose babies were admitted and whose babies were not admitted to NICU and determine the effects of socio-economic factors, prenatal care received risk factors during pregnancy and delivery on the new-born's being in intensive care. …”

The Iranian Integrated Maternal Health Care Guideline Based on Evidence-Based Medicine and American Guidelines: A Comparative Study

“…Lynch et al (3) showed that severe maternal morbidity occurs 26.5 times more than mortality in a developed country. Many maternal deaths, stillbirths, preterm births, and low birth weight cases are associated with inadequate prenatal care; therefore, by using adequate prenatal care, future complications can be reduced (4). The benefits of prenatal care may spread throughout the maternal life from one pregnancy to the next or even to the next generations (5).…”