Routine Health Care Utilization and Prenatal Care Adequacy in Mississippi Mothers.

Abstract

Purpose: Engagement with routine health care services before pregnancy provides an opportunity for providers to identify and address preexisting conditions or behaviors that may be associated with adverse maternal and infant outcomes. Research demonstrates the importance of timely and adequate prenatal care (PNC) to mitigate adverse pregnancy outcomes. This study examines the relationships between routine health care utilization in the year before pregnancy, PNC adequacy, and gestational age at birth in Mississippi residents who recently gave birth.

Methods: A cross-sectional, secondary analysis of Mississippi Pregnancy Risk Assessment Monitoring System data from 2016 to 2021 was completed. Descriptive statistics, correlational analysis, and generalized linear models for complex survey design were conducted. Variables of interest included health care utilization in the year before pregnancy, PNC adequacy, and gestational age at birth. The adequacy of PNC was reported as a categorical variable using the Kessner Index.

Results: Among a sample of 6,552, 52% engaged in routine health care in the year before pregnancy; participants who engaged in routine health care in the year before pregnancy had a higher probability of receiving adequate PNC compared with those who did not (p = .009). Compared with those without, participants with health insurance had a higher probability of receiving routine health care in the year before pregnancy and adequate PNC (p < .001). Compared with those with lower incomes, participants with higher incomes had a higher probability of receiving routine health care in the year before pregnancy and adequate PNC (p < .001). The probability of adequate PNC was 77%, with white participants having a higher probability of receiving adequate PNC than Black participants (p < .001).

Conclusion: Routine health care utilization in the year before pregnancy increases the likelihood of receiving adequate PNC. Providers should maximize opportunities in the prepregnancy period to address health concerns and lifestyle choices that will impact future pregnancies. Additional research focused on the barriers to routine health care is warranted as researchers seek to understand high maternal and infant mortality rates.