Sociodemographic Characteristics and Clinical Outcomes of People Receiving Inadequate Prenatal Care: A Retrospective Cohort Study

Nussey, Lisa; Hunter, Andrea; Krueger, Samantha; Malhi, Ranu; Giglia, Lucy; Seigel, S; Simpson, Sarah; R, Wässer; Patel, Tejal; Small, David; Darling, Elizabeth

doi:10.1016/j.jogc.2019.08.005

Cited by 14 publications

(6 citation statements)

References 21 publications

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“…11 Inadequate prenatal care, defined in one study as fewer than or equal to four antenatal visits, or first visit in the third trimester, has been linked to adverse neonatal outcomes. 12 Unfortunately, only 77.1% of women initiate pregnancy care in the first trimester. 13 This number is lower among certain minority groups; only 66.5% of African American and 63.0% of American Indian/Alaska native women receive prenatal care in the first trimester.…”

Section: Introductionmentioning

confidence: 99%

Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

et al. 2021

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Introduction: Health is impacted by a wide range of nonmedical factors, collectively termed the social determinants of health (SDoH). As the mechanisms by which these factors influence wellness and disease continue to be uncovered, health systems are beginning to assess their roles in addressing patient's social needs. This study seeks to identify and analyze clinic-based interventions aimed at addressing patients' social needs in perinatal care, including prenatal, antepartum, and postpartum care. Methods: We conducted a search of six databases through May 2020 for articles describing screening or intervention activities addressing social needs in at least one SDoH domain as defined by Healthy People 2020. We required that studies include pregnant or postpartum women and be based in a clinical setting. Results: Thirty-one publications describing 26 unique studies were identified. Most studies were either randomized-controlled trials (n = 10) or observational studies (n = 7) and study settings were both public and private. The mean age of women ranged from 17.4 to 34.1 years. Most studies addressed intimate partner violence (n = 19). The next most common need addressed was social support (n = 5), followed by food insecurity (n = 3), and housing (n = 2). Types of interventions varied from simple screening to ongoing counseling and case management. There was wide heterogeneity in outcomes investigated. Most IPV interventions that included counseling or ongoing support resulted in reduced IPV recurrence and severity. No intervention with only screening showed a reduction in rate of IPV. Conclusion: This systematic review shines light on several avenues to support pregnant and postpartum women through interventions that embed acknowledgment of social needs and actions addressing these needs into the clinical environment. The results of this review suggest that interventions with counseling or ongoing support may show promise in alleviating social risk factors and improving some clinical outcomes. However, the strength of this evidence is limited by the paucity of studies. More rigorous research is imperative to augment the knowledge of social needs interventions, especially in domains outside of IPV.

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Section: Introductionmentioning

confidence: 99%

Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

et al. 2021

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“…These services are to ensure early intervention through adequate prenatal care and to address the complications that may occur in the mother and baby during pregnancy. In addition, these services aim to decrease maternal and neonatal mortality and morbidity (3).…”

Section: Introductionmentioning

confidence: 99%

Factors affecting women's access to antenatal care services

ARAS¹,

KIRAT²,

Korkmazer³

2022

J. Exp. Clin. Med.

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The aim of this study was to quantitatively investigate the antenatal care provided by healthcare physicians in a rural area of North East Anatolia, Turkey, and the effective factors. Patients who applied to a Second-tier health institution for delivery were asked how many times they went for a check-up during their pregnancy. In addition, the sociodemographic characteristics of the responding patients were recorded. In this study, the rate of pregnant women who received inadequate antenatal care was 41.0%. Examining the risk factors for inadequate antenatal care in pregnant women who attended fewer than four antenatal care visits revealed that the risk was 2,115 (confidence interval [CI] = 1.328–3.368) times higher for those receiving spousal education for <5. Longer years than those with ≥6 years of partner training. Pregnant women who received inadequate antenatal care in the North East Anatolia region preferred to visit Secondary and Tertiary healthcare institutions instead of visiting primary care physicians. In conclusion, it is necessary to establish a referral chain through health plans and expand Primary antenatal care services to reduce both maternal and neonatal mortality and morbidity.

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“…5 A number of sociodemographic factors, such as age, race, income, and education level, have been found to be predictors of healthcare utilization in general. [6][7][8][9][10][11][12][13] Less research has focused on sociodemographic and geographic predictors of imaging utilization, including utilization of ultrasound. Our previous research found that status First Nations individuals, individuals residing in rural and remote areas, and individuals in low-income neighborhoods were less likely to have a second trimester obstetrical ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Sociodemographic and Geographic Factors Associated With Non-Obstetrical Ultrasound Imaging Utilization: A Population-Based Study

et al. 2021

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Objective: Ultrasound is one of the most commonly used imaging modalities, though some populations face barriers in accessing ultrasound services, potentially resulting in disparities in utilization. The objective of this study was to assess the association between sociodemographic and geographic factors and non-obstetrical ultrasound utilization in the province of Saskatchewan, Canada. Methods: All non-obstetrical ultrasound exams performed from 2014 to 2018 in Saskatchewan, Canada were retrospectively identified from province-wide databases. Univariate and multivariate Poisson regression analyses were performed to assess the association between ultrasound utilization and sex, age, First Nations status, Charlson Comorbidity Index, urban vs. rural residence, geographic remoteness, and neighborhood income. Results: A total of 1,324,846 individuals (5,857,044 person-years) were included in the analysis. Female sex (adjusted incidence rate ratio [aIRR], 2.20; 95% confidence interval [CI], 2.19-2.22), age (aIRR, 4.97; 95% CI, 4.90-5.05 for ≥57 years vs. <11 years), comorbidities (aIRR, 4.36 for Charlson Comorbidity Index >10 vs. 0; 95% CI, 3.78-5.03), and higher neighborhood income (aIRR, 1.04; 95% CI, 1.02-1.05 for highest vs. lowest quintile) were associated with higher rates of ultrasound utilization. Individuals who were status First Nations (aIRR, 0.91; 95% CI, 0.90-0.92) or resided in geographically remote areas (aIRR, 0.87 for most vs. least remote; 95% CI, 0.83-0.91) had lower rates of ultrasound utilization. Individuals who lived in a rural area also had lower rates of ultrasound utilization (aIRR, 0.93; 95% CI, 0.92-0.94). Conclusion: Substantial disparities exist in non-obstetrical ultrasound utilization among individuals in low-income neighborhoods, status First Nations individuals, and individuals in rural and remote communities.

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Sociodemographic Characteristics and Clinical Outcomes of People Receiving Inadequate Prenatal Care: A Retrospective Cohort Study

Cited by 14 publications

References 21 publications

Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

Factors affecting women's access to antenatal care services

Sociodemographic and Geographic Factors Associated With Non-Obstetrical Ultrasound Imaging Utilization: A Population-Based Study

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