Womens Health Issues最新文献

{"title":"Vaginal Birth After Cesarean More Likely in Teaching Hospitals Versus Nonteaching Hospitals in Kentucky.","authors":"Melissa Eggen, Hamid Zarei, Mary Curnutte, Qi Zheng, Bridget Basile","doi":"10.1016/j.whi.2026.03.005","DOIUrl":"https://doi.org/10.1016/j.whi.2026.03.005","url":null,"abstract":"<p><strong>Introduction: </strong>While it is a safe and cost-effective mode of birth in most instances, there are patient and hospital characteristics that impede access to vaginal birth after cesarean (VBAC) in a hospital setting. This study examined the extent to which variations in hospital-level VBAC rates were associated with patient and hospital characteristics.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional retrospective study using 2017-2022 hospital discharge data and hospital characteristics for 45 Kentucky labor and delivery hospitals with VBAC as the outcome. We calculated risk-adjusted average hospital-level VBAC rates over the study period. Using a mixed-effects logistic regression model with hospital random effects, we calculated unadjusted and adjusted odds ratios, and adjusted predicted probabilities of VBAC, adjusting for hospital and patient characteristics. Unadjusted and adjusted intraclass correlation coefficients assessed hospital contribution to variation in VBAC rates.</p><p><strong>Results: </strong>Among 48,741 patients who gave birth after cesarean, 8.8% had a VBAC. Hospital-level VBAC rates ranged from .47% to 25.6%. Teaching hospital status was positively and significantly associated with VBAC (adjusted odds ratio: 2.73, 95% confidence interval [1.53, 4.86], p < .05). After adjusting for patient-level characteristics, no other hospital characteristics had a statistically significant association with VBAC. After adjusting for patient case mix, the delivery hospital accounted for 30% of the variation in VBAC rates. Less variation (11%) in VBAC rates was observed among teaching hospitals.</p><p><strong>Conclusions: </strong>Wide variation in hospital-level VBAC rates suggests that localized efforts focusing on intra-hospital factors such as hospital policies and provider behavior are an intervention point to increase VBAC access.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability of Protocols Supporting Transgender and Gender-Expansive Patients: Results From a National Survey of Clinics Providing Contraceptive Services.","authors":"Alicia VandeVusse, Priscille Osias, Madeleine Haas, Tamrin Ann Tchou, Jennifer Mueller","doi":"10.1016/j.whi.2026.02.006","DOIUrl":"https://doi.org/10.1016/j.whi.2026.02.006","url":null,"abstract":"<p><strong>Background: </strong>Publicly supported clinics providing contraceptive care serve millions of people each year, and their patient populations include large proportions of uninsured, low-income, and young people. They are uniquely situated to incorporate transgender-inclusive services, although data are lacking on the availability of this care.</p><p><strong>Aim: </strong>This study aimed to describe the extent to which publicly supported clinics offering contraceptive care follow protocols supportive of transgender patients overall, by clinic type, and by state policy regarding youth gender-affirming care.</p><p><strong>Methods: </strong>Using a national sample of publicly supported contraceptive-providing clinics in the United States, we conducted a cross-sectional survey from November 2022 through December 2023 that included measures of service provision for transgender patients. We used descriptive statistics to summarize sample characteristics and the provision of transgender-inclusive protocols. We used χ² tests and logistic regression to assess how these protocols differ by clinic type and state policy.</p><p><strong>Results: </strong>Among our analytic sample of 446 clinics, a quarter reported offering gender-affirming hormone therapy. A high proportion of Planned Parenthood clinics reported adhering to transgender-inclusive protocols compared with other clinic types, and higher proportions of clinics in states where youth gender-affirming care is allowed reported following such protocols than in clinics located in states with bans.</p><p><strong>Discussion: </strong>Many publicly supported clinics providing contraceptive services have adopted protocols supportive of transgender patients, although this masks significant variation by clinic type. Planned Parenthood clinics report widespread availability of transgender-inclusive services, whereas health department clinics report low availability. Furthermore, our findings suggest that bans on youth access to gender-affirming care may limit the availability of transgender-inclusive care for patients of all ages.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Among Physical Activity, Leukocyte Telomere Length, and Depression in Pregnancy: A Cohort Study.","authors":"Danielle M Panelli, Jessica L Buthmann, Kok Hian Tan, Helen Chen, Ai Peng Tan, Yap-Seng Chong, Katherine Bianco, Ian H Gotlib","doi":"10.1016/j.whi.2026.02.005","DOIUrl":"https://doi.org/10.1016/j.whi.2026.02.005","url":null,"abstract":"<p><strong>Objective: </strong>We investigated whether physical activity is associated with psychobiological improvements in pregnant individuals with symptoms of depression.</p><p><strong>Methods: </strong>This secondary analysis used data from a prospective cohort in Singapore (2009-2010). We included pregnant participants at 26-28 weeks' gestation with depressive symptoms (Edinburgh Postnatal Depression Scale [EPDS] score ≥9). The primary outcome was maternal leukocyte telomere length (a marker of cumulative stress and biological aging), measured from buffy coat at 26-28 weeks using quantitative polymerase chain reaction and expressed as telomere/single gene (T/S) ratios. We examined 1) cross-sectional association of EPDS scores with telomere length, 2) moderation by physical activity, and 3) whether telomere length and physical activity level in pregnancy predicted postpartum EPDS scores. Self-reported physical activity was categorized into none, moderate, or high amounts of moderate to vigorous physical activity (estimated from time spent and metabolic equivalent tasks). We used linear regression models, adjusting for confounders.</p><p><strong>Results: </strong>Among 169 participants, 36 (21%) were inactive, 95 (56%) had moderate physical activity levels, and 28 (17%) had high physical activity levels. Higher EPDS scores were associated with shorter telomeres among inactive participants (T/S effect -.03, 95% confidence interval [CI] [-.05, -.00]), but not in those with moderate (p-interaction .01) or high activity (p-interaction .06). Longer telomeres and higher physical activity during pregnancy were related to greater within-person decreases in EPDS scores by 3 months postpartum (ß estimate -17.6, 95% CI [-32.6, -2.6], p-interaction .02 for high physical activity).</p><p><strong>Conclusion: </strong>Physical activity during pregnancy may buffer against stress-related maternal leukocyte telomere shortening, and this biological buffering effect may support better mental health outcomes by 3 months postpartum.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Military Women's Health Strategic Research Blueprint.","authors":"Richard Shoge, Angela M Simmons, Diana M Luan, Christy Kenady, Melinda L Patrick, Lynette Hamlin","doi":"10.1016/j.whi.2026.02.002","DOIUrl":"https://doi.org/10.1016/j.whi.2026.02.002","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 Pandemic on Contraceptive Utilization and Costs in the United States: An Interrupted Time Series Analysis Using ARIMA.","authors":"Chia-Yun Hsu, Diana N Carvajal, Eberechukwu Onukwugha","doi":"10.1016/j.whi.2026.01.006","DOIUrl":"https://doi.org/10.1016/j.whi.2026.01.006","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to characterize the trends in contraceptive utilization rates and unit costs of contraceptive prescriptions, and to evaluate the impact of the COVID-19 pandemic on contraceptive utilization and costs.</p><p><strong>Study design: </strong>We conducted an interrupted time series analysis using the IQVIA PharMetrics® Plus for Academics database from 2018 to 2022. We identified female enrollees aged 15-44 years with pharmacy coverage to estimate their monthly contraceptive utilization rate (number of contraception pharmacy claims per 100,000 female enrollees) and unit cost of contraceptive prescription (cost per prescription). Autoregressive integrated moving average models were used to analyze the time series data. The model estimated forecasted outcomes and impact parameters, including level changes and slope changes, to assess the impact of the COVID-19 pandemic.</p><p><strong>Results: </strong>We identified 896,761 and 696,409 individuals during the prepandemic and pandemic periods. Implants and intrauterine devices had a significant drop in monthly utilization rates immediately after the onset of the pandemic, with decreases of 17 and 38 pharmacy claims per 100,000 female enrollees, respectively. Injections had a delayed decreasing trend after the onset of the pandemic. The observed monthly unit cost of oral emergency contraception (EC) was at least twice the forecasted unit cost during the pandemic period ($86 vs. $33).</p><p><strong>Conclusion: </strong>The immediate decrease in utilization of long-acting reversible contraception following the onset of the pandemic suggests barriers to access. The increase in the unit price of oral EC suggests that individuals with limited financial resources might face greater barriers to access.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in Perinatal Toxicology Testing and Consent Practices Among United States Birthing Hospitals: Results From a National Survey.","authors":"Leah N Schwartz, Adrian J Caiazzo, Eleanor Watson, Julia Reddy, Aria Armstrong, Christina N Schmidt, Leela Sarathy, Barbara H Chaiyachati, Sarah N Bernstein, Mishka Terplan, Davida M Schiff","doi":"10.1016/j.whi.2026.02.001","DOIUrl":"https://doi.org/10.1016/j.whi.2026.02.001","url":null,"abstract":"<p><strong>Background: </strong>Professional society guidelines recommend risk-based, consent-informed perinatal toxicology testing, emphasizing its use only when results inform clinical care. How these guidelines are implemented in U.S. hospitals remains unclear.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey (July 2023-June 2024) via perinatal quality collaboratives and national professional networks, including one response per hospital. The survey assessed hospital-level practices related to substance use screening, perinatal toxicology testing, and consent procedures. We captured hospital and state characteristics, including cannabis legalization and mandatory reporting laws. Descriptive statistics and multivariable modified Poisson regression models assessed associations between hospital/state characteristics and testing and consent practices.</p><p><strong>Results: </strong>We received 217 eligible responses from birthing hospitals across 43 states. Most hospitals screened for substance use at delivery (84.4%), although fewer than half used validated screening tools. Written protocols were common (69.3% for birthing person, 73.9% for newborn testing), but informed consent was inconsistently obtained (69.8% for birthing person, 27.8% for newborn testing). Testing was predominantly risk based, although rationales included a range of substance-related, medical, and social factors. Hospitals in states without cannabis legalization were significantly more likely to test for cannabis-related reasons (p < .001). Adjusted models showed regional variation in consent practices and lower odds of written protocols in hospitals serving larger Medicaid populations. Mandatory reporting laws were not significantly associated with testing practices.</p><p><strong>Conclusions: </strong>Perinatal toxicology testing practices vary widely and often diverge from professional society recommendations, especially regarding consent and testing rationales. Testing frequently occurs for nonclinical reasons, underscoring the need for standardized, evidence-informed policies that prioritize informed consent.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a Social Needs Screening and Referral Program for Obstetrics and Gynecology Patients.","authors":"Kavita Vani, Samantha R Levano, Jessica R Haughton, Miya S Lemberg, Renee Whiskey-LaLanne, Kevin P Fiori","doi":"10.1016/j.whi.2026.01.004","DOIUrl":"10.1016/j.whi.2026.01.004","url":null,"abstract":"<p><strong>Background: </strong>Health-related social needs (HRSNs) contribute to poor obstetrics and gynecology (OB/GYN) outcomes. Community health worker (CHW) interventions are a promising model for connecting patients with social resources, improving patient outcomes, and advancing health equity; however, limited research exists evaluating such interventions in OB/GYN practices.</p><p><strong>Objective: </strong>We aimed to describe the implementation of a novel program for OB/GYN patients that included standardized HRSN screening and referral to CHWs.</p><p><strong>Study design: </strong>This was a retrospective cohort study of patients seen by CHW-supported OB/GYN clinical practices who completed a standardized HRSN screener between June 2022 and May 2024. Patients who were screened and/or self-reported unmet HRSNs were eligible for referral to CHWs by their clinician. We used descriptive statistics to assess RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) outcomes and sociodemographic characteristics of patients.</p><p><strong>Results: </strong>Of 11,191 OB/GYN patients screened, 1,871 (16.7%) reported unmet HRSNs. There were 944 patients with outreach attempted by CHWs, of whom 696 (73.7%) consented to work with CHWs. Overall, 93.5% of patients were connected or equipped to connect to social services and 92.7% reported improvement or resolution of HRSNs. Referral rates varied by clinical team (median 22.3%, IQR 15.5-30.9%), with a median of 8 days (IQR 3-19 days) between referral and first CHW contact. The median annual program cost per patient was $289.07 (IQR $230.17-$431.91).</p><p><strong>Conclusion: </strong>This HRSN screening and referral program was highly effective in connecting referred OB/GYN patients with unmet HRSNs to relevant social services. Addressing patients' unmet HRSNs may allow patients to better engage in OB/GYN care and improve clinical outcomes.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black Women's Accounts of Clinician Interactions in the Context of High-Risk Pregnancies.","authors":"Shewit Jaynes, Maggie Mangas, Rosa M Gonzalez-Guarda, Kristin P Tully","doi":"10.1016/j.whi.2026.02.003","DOIUrl":"10.1016/j.whi.2026.02.003","url":null,"abstract":"<p><strong>Purpose: </strong>Respectful maternity care practices are important to understand and support. Enhancing practice to promote positive experiences and optimal health among Black women experiencing a high-risk pregnancy is particularly urgent. Using principles of relationship-centered care through a critical race lens, our aims were to describe individuals' accounts of clinician interactions, including the role of racial concordance, and participant accounts of the short-term and potential long-term outcomes of these interactions.</p><p><strong>Methods: </strong>We conducted a qualitative descriptive study (N = 14) between September 2022 and December 2024. For inclusion, participants had to self-identify as Black, have given birth at ≤6 months, and have had a diagnosis of gestational diabetes or a hypertensive disorder of pregnancy. We used directed content analysis with deductive codes and in vivo, inductive codes.</p><p><strong>Results: </strong>Positive interactions were characterized by clinicians being emotionally present, acknowledging patients' expertise, using shared decision making, establishing genuine relationships, and, in some cases, exceeding standard care. These interactions were described to lead to increased trust, satisfaction, and better health outcomes. Harmful interactions were often influenced by bias and stereotypes and included lack of empathy, disregarding patient's expertise of their body, and making unilateral decisions. Harmful interactions contributed to worse health outcomes, birth trauma, posttraumatic stress disorder-like symptoms, and frustration, while patients also displayed resilience. Racial concordance sometimes enhanced experiences but did not guarantee positive interactions.</p><p><strong>Conclusion: </strong>The findings illuminate the impact clinician interactions have on Black women's mental and physical health outcomes and satisfaction with care. Relationship-centered care principles can be used to develop clinician-facing interventions that foster respectful care and reduce severe maternal morbidity and mortality.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Perspectives on Obstetric Anesthesia Informed Consent for Patients With Limited English Proficiency: A Qualitative Study.","authors":"Won Lee, Sherry Liou, Ronald B George, Alicia Fernandez","doi":"10.1016/j.whi.2026.02.004","DOIUrl":"https://doi.org/10.1016/j.whi.2026.02.004","url":null,"abstract":"<p><strong>Introduction: </strong>Informed consent in obstetric anesthesia often takes place under urgent and emotionally intense conditions. For patients with limited English proficiency (LEP), language barriers further compromise the ability to engage in informed, value-aligned decisions. Obstetric anesthesiologists must navigate these challenges while delivering safe and patient-centered care. This study explored clinician perspectives on how language barriers affect the informed consent process in obstetric anesthesia.</p><p><strong>Materials and methods: </strong>We conducted semi-structured interviews with obstetric anesthesia fellowship directors and Center of Excellence leaders across the United States. Participants described their experiences obtaining informed consent from LEP patients, including interpreter use and nonuse, workflow challenges, and communication barriers. Data were analyzed thematically using the Capability, Opportunity, Motivation, Behavior (COM-B) framework.</p><p><strong>Results: </strong>Thirteen participants from eight states reported substantial barriers to informed consent for LEP patients. Key themes included 1) Capability: lack of training on interpreter use, concerns about interpretation accuracy; 2) Opportunity: workflow constraints, limited antepartum preparation, and challenges accessing interpreters during emergencies; and 3) Motivation: frustration with care inequities and difficulty navigating cultural nuances while aligning care with patient preferences. Clinicians described how language barriers often led to less effective communication, limited analgesia options, and greater reliance on general anesthesia.</p><p><strong>Discussion: </strong>From the clinician perspective, language barriers pose serious challenges to informed consent in obstetric anesthesia. Addressing these barriers requires system-level interventions, including formal interpreter training, language-concordant education materials, and earlier engagement during prenatal care.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine Health Care Utilization and Prenatal Care Adequacy in Mississippi Mothers.","authors":"Mary M McBride, Katie C Hall, Seth T Lirette, Danielle Frieson","doi":"10.1016/j.whi.2026.01.007","DOIUrl":"https://doi.org/10.1016/j.whi.2026.01.007","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}