Characteristics of inner-city women giving birth with little or no prenatal care: a case-control study.
Lack of prenatal care has been identified as an important risk factor for poor perinatal outcomes. A case-control study was conducted to identify risk factors for inadequate prenatal care. Records of women giving birth at an inner-city hospital who had fewer than three prenatal visits (cases) were compared with those of women giving birth at the same hospital who had more adequate prenatal care (controls). The final sample contained 120 women in each group. Women in the case group were more likely to be multiparous, to be less educated, and to have no telephone in the home. Tobacco and drug abuse were recorded significantly more often among these women. There was no difference in racial distribution between the case and control groups. Infants of women with minimal or no prenatal care had a lower mean birthweight and a higher frequency of prematurity. In logistic regression analysis, higher parity, age less than 30 years, single status, smoking, drug abuse, and residence in one of two statistical planning areas in the city were independently associated with increased odds of not receiving prenatal care. To be effective, prenatal outreach programs for inner-city women must be based on knowledge of the characteristics and needs of this population.
Melnikow
J
J
Department of Family Practice, MetroHealth Medical Center, Cleveland, OH 44109.
Alemagno
S A
SA
Rottman
C
C
Zyzanski
S J
SJ
D000328:Adult; D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009820:Ohio; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012111:Residence Characteristics; D012307:Risk Factors; D012907:Smoking; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications; D014504:Urban Health