Are neonatal morbidities associated with no prenatal care different from those associated with inadequate prenatal care?

作     者：Ekwutosi M. Okoroh Dean V. Coonrod Kristina Chapple David Drachman 

作者机构：Consultant 9239 E. Desert View Scottsdale USA Department of Obstetrics Gynecology & Women’s Health Maricopa Integrated Health System and University of Arizona College of Medicine Phoenix USA Department of Research Maricopa Integrated Health System Phoenix USA Division of Blood Disorders National Center for Birth Defects and Developmental Disorders Atlanta USA 

出 版 物：《Open Journal of Obstetrics and Gynecology》 (妇产科期刊（英文）)

年 卷 期：2012年第2卷第2期

页      面：89-97页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Prenatal Care Neonatal Outcomes Retrospective Cohort Study 

摘      要：Objective: Compare neonatal morbidities in women with no prenatal care, and women with inadequate prenatal care, to those with adequate prenatal care. Methods: Retrospective cohort study of neonatal morbidities of 3 exposure groups. Group 1: No prenatal care;Group 2: Inadequate prenatal care;Group 3: Intermediate/adequate prenatal care. Results: 2.5%, 23.3% and 74.1% of subjects (N = 264,138) were in Groups 1, 2 and 3 respectively. Severe neonatal morbidity was more common in Group 1, followed by Group 2, and least common in Group 3. After controlling for gestational age and birth weight, most of these differences were attenuated and not significant except for the following Group 1 vs Group 3 comparisons: meconium aspiration, odds ratio (OR) 2.15 and 95% confidence interval (CI) 1.39 - 3.33;suspected sepsis, OR 1.30 and CI 1.13 - 1.49;proven viral sepsis, OR 2.23 and CI 1.24 - 4.00. Conclusions: Severe neonatal morbidity was most common in those with no prenatal care followed by those with inadequate prenatal care. For most neonatal morbidities, this could largely be explained by gestational age and birth weight differences, but for some neonatal morbidities (meconium aspirations, viral sepsis and dysmorphic features) the impact of no prenatal care persisted after adjustment for these factors.