Reevaluating Associations between Prenatal Care Utilization and Current Trends in Preterm Birth.

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

American journal of perinatology Pub Date : 2024-10-01 Epub Date: 2024-03-27 DOI:10.1055/a-2295-6524

Macie L Champion, Elisa T Bushman, Kimberly D Martin, Ashley N Battarbee, Lindsay S Robbins, William W Andrews, Alan T Tita

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引用次数: 0

Abstract

Objective: Studies have suggested an association between prenatal care (PNC) and preterm birth (PTB). We evaluated trends in PTB and association of PNC and PTB.

Study design: This was a retrospective cohort study of singleton, viable nonanomalous deliveries from 1991 to 2018. PNC utilization was defined by World Health Organization using number of visits: adequate (≥8), suboptimal (5-7), and inadequate (<5). Primary outcome was PTB. Tests of trend were used to assess changes in PTB over time. Baseline characteristics and outcomes were compared. Logistic regression estimated the association of PNC and PTB. We evaluated for effect modification by year of birth.

Results: Of 92,294 patients, 14,057 (15%) had PTB. Inadequate and suboptimal PNC were associated with higher odds of PTB compared to adequate PNC (adjusted odds ratios = [aOR 6.21], 95% confidence interval [CI]: 5.84-6.60; aOR = 3.57, 95% CI: 3.36-3.79). Inadequate PNC was associated with higher odds of PTB over time (effect modification p < 0.0001). Inadequate PNC was associated with 5.4 times higher odds of PTB in 1998, 7.0 times in 2008, and 9.1 times in 2018.

Conclusion: Despite an increase in adequate PNC, there was a rise in PTB associated with inadequate and suboptimal PNC. PNC utilization was a stronger risk factor in recent years with higher PTB in patients who attended more than five PNC visits.

Key points: · PNC utilization is associated with the risk of PTB.. · Despite an increase in PNC utilization, PTB rates have increased.. · There is an even stronger association between PNC utilization and PTB over time..

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重新评估产前护理利用率与当前早产趋势之间的关联。

背景研究表明，产前保健（PNC）与早产（PTB）之间存在关联。我们评估了早产的趋势以及 PNC 与早产之间的关系。方法对 1991 年至 2018 年期间单胎、存活的非异常分娩进行回顾性队列研究。世卫组织使用就诊次数对 PNC 利用率进行了定义：充分（8）、次优（5-7）和不充分 (

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.