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Association between prenatal care utilization and Risk of preterm birth among Chinese Women

Journal of Huazhong University of Science and Technology(Medical Sciences) 2017年第4期37卷 605-611页

作者：张斌杨蓉梁胜文王静 Jen Jen ChANG 胡柯董光辉胡荣华 Louise H.Flick 章一鸣张丹李庆杰郑同章徐顺青杨少萍钱正敏 Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital) Tongji Medical CollegeHuazhong University of Science and Technology Wuhan Environmental Monitoring Center Saint Louis University College for Public Health and Social Justice Sun Yat-sen University School of Public Health Brown University School of Public HealthProvidence School of Public Health Tongji Medical CollegeHuazhong University of Science and Technology

It is recognized that prenatal care plays an important role in reducing adverse birth. Chinese pregnant women with medical condition were required to seek additional health care based on the recommended at least 5 times health care visits. This study was to estimate the association between prenatal care utilization（PCU） and preterm birth（PTB）, and to investigate if medical conditions during pregnancy modified the association. This population-based case control study sampled women with PTB as cases; one control for each case was randomly selected from women with term births. The Electronic Perinatal Health care Information System（EPHCIS） and a questionnaire were used for data collection. The PCU was measured by a renewed prenatal care utilization（APNCU） index. Logistic regression models were used to estimate odds ratios（OR） and the 95% confidence interval（95% CI）. Totally, 2393 women with PTBs and 4263 women with term births were collected. In this study, 695（10.5%） women experienced inadequate prenatal care, and 5131（77.1%） received adequate plus prenatal care. Inadequate PCU was associated with PTB（adjusted OR： 1.41, 95% CI： 1.32–1.84）; the similar positive association was found between adequate plus PCU and PTB. Among women with medical conditions, these associations still existed; but among women without medical conditions, the association between inadequate PCU and PTB disappeared. Our data suggests that women receiving inappropriate PCU are at an increased risk of having PTB, but it does depend on whether the woman has a medical condition during pregnancy.

关键词： preterm birth very preterm birth moderate preterm birth prenatal care prenatal care utilization

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