Risk Factors Affecting Rising Rate of No Prenatal Care in US Births Between 2012–2016 [27C]

Abstract

INTRODUCTION: To describe changes in rate of no prenatal care (PNC) in US between the years 2012–2016, and identify patient demographic and maternal medical risk factors for receiving no PNC. METHODS: Case-control study of US live births between 20–42 weeks gestation using vital statistics birth records. We analyzed maternal sociodemographic factors and medical characteristics as risk factors. Logistic regression estimated the influence of factors on outcome of no PNC, as indicated on the US birth certificate. No prenatal care was defined by having 0 visits prior to delivery. RESULTS: The frequency of births to mothers with no PNC increased each year during the study period, from 1.36% to 1.58%, P<.001. The rate of no PNC was highest among mothers with low maternal education level, Medicaid insurance and maternal hepatitis C (rates 2–5% and adjusted odds >2.2). Maternal black race, unmarried, and tobacco use were also significant risk factors (adjusted odds ratio >1.4). CONCLUSION: The rate of no PNC in the US has risen in recent years, 2012–2016. Women with factors that are associated with increased risk for adverse pregnancy outcome are those most likely to have no PNC. Public health initiatives should focus educational efforts on the importance of prenatal care to minimize risk of adverse pregnancy outcomes. Programs aimed to increase access to prenatal care in at-risk pregnancies should be developed to address the increase in no PNC in the US.

Maternal education level and maternal healthcare utilization in the Democratic Republic of the Congo: an analysis of the multiple indicator cluster survey 2017/18

“…A positive association between maternal education level and prenatal care services utilization was observed in the current study, with the association stronger among the low-income population. The overall positive association between maternal education and maternal health services utilization was consistent with previous studies conducted in both developing countries such as India [ 26 ] and Ethiopia [ 27 ] and developed countries such as Canada [ 28 ] and the United States [ 29 ]. A recent study conducted in the DRC also indicated that educational level was positively associated with having their first visit to antenatal care facilities within endemic malaria settings [ 14 ].…”

Determinants of Antenatal Education and Breastfeeding Uptake in Refugee-Background and Australian-Born Women

“…Antenatal services are predominantly attended by women with higher levels of education and from the middle-to-upper socioeconomic strata across various developed nations, namely Canada and the United States [62,63], South Korea [64], and Belgium [65]. Regardless of immigration background, women attaining higher levels of education typically exhibit greater health literacy and autonomy in navigating their pregnancy [66,67].…”