title: Prenatal care and infant emergency department use.
abstract: OBJECTIVE
  To determine the relationship between mothers' use of prenatal care and pediatric emergency department (ED) use by their infants in the first 3 months of life.
  
  
  METHODS
  This is a retrospective, cohort-control study of well, full-term infants who use a children's hospital ED. Using logistic regression, the likelihood of an emergency visit in the first 3 months of life was compared between infants of women with fewer than two prenatal visits and infants of women with two or more prenatal visits. Covariates were maternal age, race, substance abuse history, parity, infant birth weight, insurance status, and distance from the ED.
  
  
  RESULTS
  The odds of an ED visit before age 3 months by infants of mothers with less than two prenatal visits was 29% lower than the comparison group. ED use was increased by proximity, Medicaid or no health insurance and younger maternal age. Seventy percent (70%) of visits by both cohorts were classified as unjustified. The odds of making an unjustified ED visit were increased by younger maternal age and proximity to the emergency department.
  
  
  CONCLUSIONS
  Women with poor prenatal care are less likely to seek ED care for their young infants. Although suboptimal prenatal care is associated with negative health outcomes, it is not known whether fewer infant ED visits are similarly deleterious.
authors.affiliation: Child Health Statistics Center, Children's Hospital Medical Center and University of Cincinnati Institute for Health Policy and Health Services Research, Ohio, USA. edward.donovan@uc.edu
authors.forename: E F
authors.initials: EF
authors.lastname: Donovan
authors.forename: P H
authors.initials: PH
authors.lastname: Perlstein
authors.forename: H D
authors.initials: HD
authors.lastname: Atherton
authors.forename: U R
authors.initials: UR
authors.lastname: Kotagal
mesh_terms: D000328:Adult; D001724:Birth Weight; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care; D007231:Infant, Newborn; D016015:Logistic Models; D008423:Maternal Age; D015999:Multivariate Analysis; D016017:Odds Ratio; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies