Although prenatal care is an established mechanism for identifying and managing medical, sociodemographic and behavioral risk factors impacting pregnancy outcomes, some U.S. women still receive no care prior to delivery. While they may be different from women who delay or receive inadequate care, women who receive no care may not be a homogenous group. It was hypothesized that women who receive no care comprise several groups with distinctive sociodemographic characteristics and that differences in birth outcome measures exist among the no care sub-groups. Singleton births to U.S. resident, multiparous women reporting no care were identified from 1992-1996 birth certificate data. Using clustering methodology, five clusters emerged from preliminary analysis: Cluster 1 - unmarried, adult, white women living in rural areas; Cluster 2 - foreign-born, adult, Hispanic women with low education; Cluster 3 - married, adult, Black women with low education; Cluster 4 - married, adult white women with mid-level education; and Cluster 5 - older, non-Hispanic women with high parity, birth interval greater than 4 years, living in rural areas and reporting substance abuse. Birth outcome measures varied significantly among clusters. Cluster 2 had the lowest rates of low birth weight and preterm birth, and Cluster 5 had the highest rates for these measures. These findings indicate that intervention efforts aimed at reducing the proportion of women receiving no care should be individually tailored and targeted to specific no care sub-groups with priority given to those sub-groups with the highest risk of a poor pregnancy outcome.
Learning Objectives: At the conclusion of the session, participants should be able to: 1. Describe sociodemographic characteristics of defined sub-groups of multiparous women in the United States who receive no prenatal care prior to delivery. 2. Compare birth outcomes among defined sub-groups of multiparous women in the United States who receive no prenatal care prior to delivery
Keywords: Prenatal Care, Pregnancy Outcomes
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA