title: Association of preconceptional health care utilization and early initiation of prenatal care.
abstract: OBJECTIVE
  To assess whether women having preconceptional health care utilization were more likely to have early initiation of prenatal care than were women not having preconceptional health care utilization.
  
  
  METHODS
  In this cohort study, data were collected prospectively from a population-based Perinatal Health Care Surveillance System in China. The analysis included 195 796 women who delivered single live births in 13 cities/counties during 1997 to 2000. Mantel-Haenszel test was employed to calculate risk ratios and 95% confidence intervals (CI). Multivariate logistic regression was conducted to assess the association between preconceptional health care utilization and early initiation of prenatal care after controlling for maternal residence, age at delivery, educational attainment, occupation, parity, preconceptional medical disorders, and high-risk medical experiences during the first trimester. SPSS 11.5 (SPSS Inc.) was employed for data analysis.
  
  
  RESULTS
  Women having preconceptional health care utilization were 2.6 times (95%CI: 2.5 to 2.6) more likely to have early initiation of prenatal care compared with women not having preconceptional health care utilization. When stratified by maternal residence, age at delivery, educational attainment, occupation, parity, preconceptional medical disorder, high-risk medical experiences during the first trimester, and preconceptional medical disorders, this association still existed. After controlling for stratification factors mentioned above and the interaction of maternal age, educational attainment, and parity, women having preconceptional health care utilization were 2.7 times (95%CI: 2.6 to 2.8) more likely to have early initiation of prenatal care than were women not having preconceptional health care utilization.
  
  
  CONCLUSIONS
  Women who had preconceptional health care utilization were more likely to have early prenatal care than were women not having preconceptional health care utilization.
authors.affiliation: Institute of Reproductive and Child Health, Peking University, Hai Dian District, Beijing, People's Republic of China. liuyh@ncmih.bjmu.edu.cn
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.forename: R
authors.initials: R
authors.lastname: Ye
authors.forename: Z
authors.initials: Z
authors.lastname: Li
mesh_terms: D000328:Adult; D002681:China; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D016742:Preconception Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012424:Rural Population