Oral

Much of the literature to date on the benefits of prenatal care has focused on certain immediate infant outcomes at delivery, such as low birthweight and pre-term birth. Evidence from this literature has been mixed, and has often been hampered by limited sample size and other facets of study design. Very limited research has focused on maternal outcomes related to adequate prenatal care, and on maternal or infant outcomes beyond delivery. This session provides evidence from a broad population-based study, sponsored by the March of Dimes, on infant and maternal inpatient hospitalization and cost related to adequacy of prenatal care for a cohort of infants born in 1997 followed from delivery through the next decade. The analysis was afforded by a unique linkage of birth certificates to all hospital discharge data at the individual level for the cohort of over 30,000 infants born in Utah in 1997 and their mothers. A rich set of characteristics from these data permitted multivariate analyses that adjusted for several dimensions of prenatal care, demographic and behavioral characteristics of the mother, delivery characteristics, birth outcomes, and expected source of payment, among others. The outcomes that were estimated were inpatient hospitalization days and cost for both mother and infant at delivery; through the neonatal period; through infancy; and beyond infancy, with dedicated focus on subsequent births. Evidence from this research indicates that reductions in inpatient days and costs associated with prenatal care often extend beyond delivery, and in several cases, redound to the most vulnerable populations. This session is divided into four presentations drawing upon different dimensions of the study: Presentation 1: Overview of the study with detail on methods, including data, study design, modeling, and issues related to measurement. Presentation 2: The effects of adequate prenatal care on hospitalization stay and cost at delivery, and through the neonatal period. Presentation 3: The effects of adequate prenatal care at one year and at subsequent delivery (mothers only). Presentation 4: Implications for payment policy, and for further study.

Session Objectives: Evaluate how prenatal care is associated with infant and maternal inpatient hospitalization and cost from delivery through the next decade.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH) , Masters Certified Health Education Specialist (MCHES)