Trends and Racial/Ethnic Disparities in Prenatal Care (PNC) Use from 2016 to 2021 in the United States.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Racial and Ethnic Health Disparities Pub Date : 2024-08-05 DOI:10.1007/s40615-024-02115-9

Jusung Lee, Krista J Howard, Austin Greif, Jeffrey T Howard

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引用次数: 0

Abstract

Objectives: To investigate the trends and racial/ethnic disparities in adequate prenatal care (PNC) use in the USA.

Methods: A repeated cross-sectional study was conducted using May 2016-May 2021 data from the Pregnancy Risk Assessment Monitoring System (PRAMS). A primary outcome was the Kotelchuck index, a measure of the adequacy of PNC use, and the year was a key independent variable. Multinomial and binary logistic regression analyses were performed to examine PNC utilization using multiple imputations with chained equations.

Results: Among the 190,262 pregnant individuals, adequate PNC use was largely consistent from 2016 to 2019. However, there was an immediate drop from 77.4-78.3% between 2016 and 2019 to 75.2% in 2020 and 75.8% in 2021. Conversely, both intermediate and inadequate PNC use tended to increase in 2020 and 2021. Adequate PNC use, when compared to inadequate use, showed significantly lower odds in 2020 (adjusted Odds Ratio [aOR] 0.87, 95% CI 0.78-0.96; p = 0.009) and 2021 (aOR 0.87, 95% CI 0.77-0.99; p = 0.033) than in 2016. Notably, Hispanic participants experienced substantial impacts (aOR 0.75, 95% CI 0.64-0.88; p = 0.001 in 2020 and aOR 0.72, 95% CI 0.59-0.89; p = 0.002 in 2021).

Conclusions: While adequate PNC use was a steady, slightly upward trend before 2020, it had a steep decline afterward. It is worth noting that Hispanic individuals were severely affected. Targeted interventions or policies to address barriers to PNC and foster equitable and sustainable care models are required.

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美国 2016 年至 2021 年产前护理 (PNC) 使用趋势和种族/族裔差异。

目的调查美国充分使用产前保健（PNC）的趋势和种族/民族差异：利用妊娠风险评估监测系统（PRAMS）中 2016 年 5 月至 2021 年 5 月的数据进行了一项重复横断面研究。主要结果是科特查克指数，这是衡量 PNC 使用是否充分的一个指标，年份是一个关键的自变量。利用链式方程的多重归因对 PNC 使用情况进行了多项式和二元逻辑回归分析：在 190262 名孕妇中，从 2016 年到 2019 年，充分使用 PNC 的情况基本一致。然而，在 2016 年至 2019 年期间，PNC 使用率从 77.4%-78.3% 立即降至 2020 年的 75.2% 和 2021 年的 75.8%。相反，在 2020 年和 2021 年，PNC 的中等使用率和不足使用率都呈上升趋势。与不充分使用相比，充分使用 PNC 的几率在 2020 年（调整后比值比 [aOR] 0.87，95% CI 0.78-0.96；p = 0.009）和 2021 年（aOR 0.87，95% CI 0.77-0.99；p = 0.033）显著低于 2016 年。值得注意的是，西班牙裔参与者受到了很大影响（2020 年的 aOR 为 0.75，95% CI 为 0.64-0.88；p = 0.001；2021 年的 aOR 为 0.72，95% CI 为 0.59-0.89；p = 0.002）：虽然在 2020 年之前，PNC 的充分使用呈稳定、略微上升趋势，但之后却急剧下降。值得注意的是，西班牙裔受影响严重。有必要采取有针对性的干预措施或政策，以解决 PNC 的障碍，并促进公平和可持续的护理模式。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.