Inadequate prenatal care and risk of preterm delivery among adolescents: a retrospective study over 10 years

Am J Obstet Gynecol. 2010 Aug;203(2):122.e1-6. doi: 10.1016/j.ajog.2010.03.001. Epub 2010 May 14.

Abstract

Objective: The aim of this study was to determine whether inadequate prenatal care is associated with increased risk of preterm birth among adolescents.

Study design: We selected a random sample of women under age 20 years with singleton pregnancies delivering in Washington State between 1995 and 2006. Multivariate logistic regression was used to assess the association between prenatal care adequacy (percent of expected visits attended, adjusted for gestational age) and preterm birth.

Results: Of 30,000 subjects, 27,107 (90%) had complete data. Women without prenatal care had more than 7-fold higher risk of preterm birth (n = 84 [24.1%]; adjusted odds ratio [aOR], 7.4), compared with those attending 75-100% of recommended visits (n = 346 [3.9%]). Women with less than 25%, 25-49%, or 50-74% of expected prenatal visits were at significantly increased risk of preterm birth; risk decreased linearly as prenatal care increased (n = 60 [9.5%], 132 (5.9%], 288 [5%]; and aOR, 2.5, 1.5, and 1.3, respectively).

Conclusion: Inadequate prenatal care is strongly associated with preterm birth among adolescents.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Cohort Studies
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Incidence
  • Logistic Models
  • Multivariate Analysis
  • Odds Ratio
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Compliance / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy in Adolescence / statistics & numerical data*
  • Premature Birth / epidemiology*
  • Premature Birth / etiology
  • Prenatal Care / standards*
  • Prenatal Care / trends
  • Probability
  • Retrospective Studies
  • Risk Assessment
  • Time Factors