Relationship of prenatal care and perinatal morbidity in low-birth-weight infants

Melissa A. Herbst, Brian M. Mercer, Dorothy Beazley, Norman Meyer, Teresa Carr

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

OBJECTIVE: Lack of or no prenatal care (NPC) is associated with preterm birth (PTB) and low birth weight (LBW). Our purpose was to determine whether LBW infants delivered after NPC have worse outcomes than LBW infants with prenatal care (PC). STUDY DESIGN: Eight thousand sixty-five consecutive women delivered at six hospitals in Shelby County, Tenn, were evaluated regarding clinical characteristics and perinatal outcomes depending on the occurrence of PC. Infant and LBW infant outcomes were evaluated on the basis of the occurrence of PC. Multivariate analysis was performed for neonatal outcomes adjusting for race, plurality, antenatal steroids, amnionitis, and ponderal index. A P value less than .05 was considered significant. RESULTS: NPC women were more likely multiparous (80% vs 65%), African American (70% vs 61%), and uninsured (25% vs 4%), P < .0001 for each. PTB (36% vs 15%) and LBW (22% vs 12%) were more common with NPC, P < .0001 for each. Women with NPC had more advanced cervical dilation (ACD) greater than 4 cm (ACD: 63% vs 39%) and more amnionitis on admission (2% vs 1%), P ≤ .001 for each, and had more fetal distress in labor, P = .02. NPC infants had increased mortality, respiratory distress syndrome, intraventricular hemorrhage, retinopathy, and bronchopulmonary dysplasia. Among LBW infants, NPC was associated with premature rupture of membranes, antepartum hemorrhage, amnionitis, and ACD. Controlling for other factors, NPC LBW infants had increased mortality (17% vs 9%), respiratory distress syndrome (31% vs 24%), intraventricular hemorrhage (10% vs 5%), retinopathy (13% vs 9%), and bronchopulmonary dysplasia (11% vs 7%), P ≤ .04 for each. CONCLUSION: In addition to increasing PTB and LBW, NPC is associated with increased perinatal morbidity and mortality among LBW infants after controlling for confounding factors.

Original languageEnglish (US)
Pages (from-to)930-933
Number of pages4
JournalAmerican Journal of Obstetrics and Gynecology
Volume189
Issue number4
DOIs
StatePublished - Jan 1 2003

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Prenatal Care
Low Birth Weight Infant
Morbidity
Chorioamnionitis
Premature Birth
Dilatation
Bronchopulmonary Dysplasia
Hemorrhage
Fetal Distress
Mortality
Perinatal Mortality
African Americans
Rupture
Multivariate Analysis
Steroids

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Relationship of prenatal care and perinatal morbidity in low-birth-weight infants. / Herbst, Melissa A.; Mercer, Brian M.; Beazley, Dorothy; Meyer, Norman; Carr, Teresa.

In: American Journal of Obstetrics and Gynecology, Vol. 189, No. 4, 01.01.2003, p. 930-933.

Research output: Contribution to journalArticle

Herbst, Melissa A. ; Mercer, Brian M. ; Beazley, Dorothy ; Meyer, Norman ; Carr, Teresa. / Relationship of prenatal care and perinatal morbidity in low-birth-weight infants. In: American Journal of Obstetrics and Gynecology. 2003 ; Vol. 189, No. 4. pp. 930-933.
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