Infant health care utilization predicted by pattern of prenatal care.
OBJECTIVE
The objective of this study was to examine the relationship between patterns of prenatal care and subsequent infant health care use in a sample of inner-city women and their infants. In testing this relationship we controlled for several sociodemographic, economic, and psychological factors.


METHODS
This case-control study examined medical records of 148 infants born to mothers previously enrolled in a 9-month study of prenatal care and use or nonuse of illicit drugs. Cases (N = 62) were defined as infants born to women who first registered for prenatal care after 28 weeks' gestation or completed fewer than four prenatal visits. Controls (N = 86) were all other infants matched by date of birth. Data on maternal health and sociodemographic factors were obtained from a maternal interview and medical record review. Maternal drug use was defined as the use of illicit drugs at any time during the pregnancy based on maternal interview and/or a positive maternal or neonatal urine toxicology screen obtained within 48 hours of delivery.


RESULTS
Infants of case mothers had significantly lower birth weight and gestational age, increased number of protective service referrals, and lower completion rate of three or more health supervision visits by 9 months of age. Multiple logistic regression analysis revealed that adequate prenatal care was significantly associated with adequate use of infant health care independent of maternal drug use, educational level, marital status, and number of previous living children.


CONCLUSIONS
Patterns of infant health care use can be predicted before birth based on the mother's pattern of prenatal care use.
Johns Hopkins University, School of Nursing, Baltimore, MD 21287.
A M
AM
Butz
A
A
Funkhouser
L
L
Caleb
B J
BJ
Rosenstein
D000328:Adult; D015142:Baltimore; D016022:Case-Control Studies; D002662:Child Health Services / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology