【摘 要】
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Background: Past research has largely focused on the association of inadequate prenatal care with preterm birth and low birth weight, but some investigators have argued that there is a need to go beyo
【机 构】
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University of Manitoba Canada
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Background: Past research has largely focused on the association of inadequate prenatal care with preterm birth and low birth weight, but some investigators have argued that there is a need to go beyond these outcome measures.The purpose of this population-based study was to examine the association between inadequate prenatal care and a variety of maternal-infant outcomes.Methods: We used administrative databases in the Repository housed at the Manitoba Centre for Health Policy: Registry, hospital discharge, physician claims, midwifery care, pharmaceutical, immunization, and census.We studied women giving birth in the Canadian province of Manitoba from2004/05 to 2008/09 (N=65,274).The proportion of women receiving inadequate, intermediate/adequate, and intensive prenatal care was calculated using the revised graduated index of prenatal care utilization index (R-GINDEX).Multivariable logistic regression was used to determine adjusted odds ratios (aOR) and 95% confidence intervals.Results: After adjusting for sociodemographic and obstetric factors, inadequate prenatal care was significantly associated with stillbirth (aOR 1.40), low birth weight (aOR 1.26), small for gestational age births (aOR 1.38), preterm birth (aOR 1.15), admission to NICU (aOR 1.18), maternal postpartum psychological distress (aOR 1.14), and short inter-pregnancy interval to next birth (aOR 1.33), but was not significantly associated with maternal or neonatal hospital readmission or infant mortality.Women with inadequate PNC were less likely to initiate breastfeeding (aOR 0.45) or have their infant immunized by 1 year (aOR 0.43).Conclusion: Inadequate prenatal care is associated with a variety of adverse maternal and feto-infant outcomes.Efforts to ensure women receive high quality prenatal care may help improve outcomes and promote a healthy start to life.
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