Abstract
To evaluate patterns of prenatal care utilization stratified by medical and psychosocial risk. A retrospective cohort of 786
pregnant women who subsequently delivered live births from 1999 to 2003 at the University of Michigan were classified into
high medical, high psychosocial, high medical and high psychosocial (dual high risk) and low-risk pregnancies. Chi-square
and logistic regression analyses assessed the association between risk and prenatal care utilization using the Kotelchuck
Index. Of 786 pregnancies, 202 (25.7 %) were high medical risk, 178 (22.7 %) were high psychosocial risk, 227 (28.9 %) were
dual high risk and 179 (22.8 %) were low-risk. Over 31 % of dual high risk and 25 % of high medical risk pregnancies received
“adequate plus” prenatal care versus 10 % of high psychosocial risk pregnancies. In multivariate analyses, adjusted for risk,
race and insurance, high psychosocial risk pregnancies (OR = 1.69; 95 % CI 1.06–2.72) were significantly more likely to receive
inadequate prenatal care than care of greater intensity. Many high psychosocial risk pregnancies do not receive adequate prenatal
care.
pregnant women who subsequently delivered live births from 1999 to 2003 at the University of Michigan were classified into
high medical, high psychosocial, high medical and high psychosocial (dual high risk) and low-risk pregnancies. Chi-square
and logistic regression analyses assessed the association between risk and prenatal care utilization using the Kotelchuck
Index. Of 786 pregnancies, 202 (25.7 %) were high medical risk, 178 (22.7 %) were high psychosocial risk, 227 (28.9 %) were
dual high risk and 179 (22.8 %) were low-risk. Over 31 % of dual high risk and 25 % of high medical risk pregnancies received
“adequate plus” prenatal care versus 10 % of high psychosocial risk pregnancies. In multivariate analyses, adjusted for risk,
race and insurance, high psychosocial risk pregnancies (OR = 1.69; 95 % CI 1.06–2.72) were significantly more likely to receive
inadequate prenatal care than care of greater intensity. Many high psychosocial risk pregnancies do not receive adequate prenatal
care.
- Content Type Journal Article
- Pages 1-7
- DOI 10.1007/s10995-012-1040-9
- Authors
- Elizabeth E. Krans, Magee-Womens Hospital, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, 300 Halket Street, Pittsburgh, PA, USA
- Matthew M. Davis, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
- Christie L. Palladino, Education Discovery Institute, Department of Obstetrics and Gynecology, Georgia Health Sciences University, Augusta, GA, USA
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875