The impact of timing and frequency of prenatal visits on the outcome of pregnancy in the perinatal registry of Bavaria 1987-1988.
A retrospective analysis was made on the singleton births included in the Bavarian statewide perinatal registry (Bayerische Perinatalerhebung, BPE; 99,252 births from BPE 1987 and 79,661 births from BPE 1988) with respect to the timing of the first prenatal consultation and the frequency of visits during pregnancy. If the first prenatal visit was scheduled after 21 weeks, the rates of infants transferred to pediatric units relative risk (RR = 1.34, P < 0.0001, chi 2-test), of low birth weight (RR = 1.41, P < 0.0001) and of stillbirths (RR = 1.70, P < 0.025) were higher than if the first visit was at 9-12 weeks. Similarly, after < 4 prenatal visits, the rates of infants transferred (RR = 3.91), of low birth weight (RR = 9.18), of stillbirths (RR = 7.65) and of neonatal deaths (RR = 29.5) were significantly (P < 0.0001) higher than after > 10 visits. Prenatal care was defined as 'standard' if the initial consultation was scheduled at or before 12 weeks and whether 10-12 visits were completed during a normal duration of pregnancy. 'Below standard' prenatal care was associated with a higher rate of infants transferred (P < 0.01) and of stillbirths (P < 0.0005). Prenatal care was more frequently (P < 0.0001) classified as 'below standard' in mothers older than 39 years (40.45%, RR = 2.45) and in adolescent mothers (58.67%, RR = 5.12) than in those 25-29 years of age (21.71%), in fourth and subsequent (48.22%, RR = 3.44) than in first pregnancies (21.32%) and in foreign (39.65%, RR = 2.18) than in German mothers (23.19%).(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Obstetrics and Gynecology, University of Würzburg, Germany.
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D005260:Female; D005858:Germany; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000592:standards; D012042:Registries; D013997:Time Factors