269863 Infant birthweight data show importance of minimally adequate prenatal care

Monday, October 29, 2012

Grace C. Poertner, RN, MSW, PhD , Administration, Wellness Research, a not-for-profit corporation, Saint Charles, MO
Links between health policy and maternal/fetal healthcare are important because maternal healthcare affects the future of child health and the future of child healthcare. This research srudied a one-year birth cohort and asked: What factors most likely affect birth at very-low-birthweight (VLBW: less than 1500 grams)? Data were from the NCHS file of linked birth/infant-death records for this one-year cohort. From the population of nearly four million, an 8 percent random sample was drawn. Logistic regression analyzed factors associated with the dichotomous dependent variable, birth at VLBW or Above-VLBW. Independent variables were: infant race (African-American, Caucasian, All Others); parental factors (marital status, maternal age/schooling, maternal residence at birth - urban, suburban, rural); and prenatal care (a dichotomous variable - inadequate or not). VLBW accounted for 1.2% of births; however, of those infants who died by the age of one-year, 43.6% of deaths were among infants born at VLBW. Logistic regression results showed that risk of VLBW birth increased most significantly with inadequate prenatal care; secondarily, significant risk was found for the parental factors of single-parenthood; less schooling; and, among Afican-Americans, older maternal age. Since inadequate prnatal care most strongly predicts birth at VLBW, health policy and health insurance need to provide universal access to minimally adequate prenatal care across the United States; in addition, health education and community outreach need to assure that mothers know about and feel comfortable with using the prenatal care that is available.

Learning Areas:
Other professions or practice related to public health
Provision of health care to the public
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
1. Describe levels of prenatal care adequacy. 2. Differentiate between moms' and babies' benefits of adequate prenatal care. 3. Analyze harm of inadequate prenatal care on birthweight.

Keywords: Prenatal Care, Infant Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Social Worker and an RN; I was the author of a dissertation, Medicaid Policy and Infant Survivability; this presentation is developed from one of the seven equations analyzed in that dissertation. Two grants were awarded to me, one from the Agency for Healthcare Policy & Research and another from the National Association of Social Workers.
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.