259271 Prenatal Care Utilization, Content, and Satisfaction: Associations with Infant/Fetal Mortality among 2007 LAMB & HOPE Mothers

Tuesday, October 30, 2012

Heejoo Jo, MPH , Rollins School of Public Health, Emory University, Atlanta, GA
Sai Liu, MPH , Master of Public Health Candidate 2012, Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA
Shin Margaret Chao, PhD, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Chandra Higgins, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Marian Eldahaby , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
C. Bemis, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Cynthia Harding, MPH , Maternal, Child and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Background: Past research has shown associations between adequate prenatal care (PNC) and reduced infant/fetal mortality risk, but there is limited data on the effect of PNC content and satisfaction. Our goal was to determine the relationship between three PNC indicators and infant/fetal mortality.

Methods: LAMB and LA HOPE are population-based surveillance projects measuring mothers' PNC experiences. A case-control study involving 624 cases of infant/fetal loss and 1,872 live birth controls in LAC in 2007 examined the relationship between three PNC indicators (adequate use, satisfaction, content) and infant/fetal mortality. Multivariate logistic regression models stratified by race were used to find associations between PNC indicators and infant/fetal mortality.

Results: 73.2% of mothers satisfied with PNC and 73.4% of mothers who reported PNC met guidelines had live births. After adjusting for maternal age, MediCal use, previous obstetric history, and previous medical conditions, African American (AA) and Latina mothers with infant/fetal loss were 5.0 (95% CI=2.03, 12.30) and 5.44 times more likely (95% CI=3.69, 8.02), respectively, to receive inadequate PNC than those with live births. Having ≤12 years of education, previous low birth weight or preterm birth also predicted infant/fetal mortality (AA: aOR=6.55, 95% CI=2.24, 19.14; Latinas: aOR=3.66, 95% CI=2.12, 6.32). None of the tested interaction terms were significant with infant/fetal loss.

Conclusions: LAC public health officials and policymakers should continue to emphasize PNC utilization, address racial disparities, and focus on treating high-risk women to prevent low birth weight/preterm births that increase mortality. Further research is needed to better assess PNC content and quality.

Learning Areas:
Epidemiology
Planning of health education strategies, interventions, and programs
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Evaluate the relationship between various prenatal care indicators and infant/fetal mortality; 3. Describe health disparities in birth outcome among sub-populations; 2. Identify prenatal intervention strategies for improving birth outcome;

Keywords: Infant Mortality, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently an MPH candidate in Department of Epidemiology . I completed a summer graduate student internship at the Los Angeles County Department of Public Health, Maternal Child and Adolescent Health Programs in 2011. My research interests include maternal and child health, specifically birth outcomes in relation to prenatal care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4364.0: SIDS, Infant Mortality, Data, & Epidemiology Poster session