title: Prenatal care initiation among pregnant teens in the United States: an analysis over 25 years.
abstract: OBJECTIVE
  To examine changes in the initiation of prenatal care by teenage girls in the United States between 1978 and 2003.
  
  
  METHODS
  Using birth certificate data collected by the National Center for Health Statistics from 1978, 1983, 1988, 1993, 1998, and 2003 we described initiation of prenatal care in preteens (aged 10-14 years), young adolescents (aged 15-16), and older adolescents (aged 17-19) by the trimester in which care began.
  
  
  RESULTS
  Although all three age groups showed trends toward earlier prenatal care, shifts to earlier prenatal care were mainly the result of more girls starting care in the first trimester and fewer in the second trimester. Younger teens were more likely to delay prenatal care or to receive no prenatal care for every year studied. Less education and prior births were also associated with increased likelihood of receiving delayed care.
  
  
  CONCLUSIONS
  Shifts in timing of prenatal care initiation occurred in the U.S from 1978 to 2003. Much of the change corresponded to expanded eligibility in Medicaid coverage, suggesting that lack of health care coverage was a significant impediment to early prenatal care.
authors.affiliation: Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA. huestowj@musc.edu
authors.forename: William J
authors.initials: WJ
authors.lastname: Hueston
authors.forename: Mark E
authors.initials: ME
authors.lastname: Geesey
authors.forename: Vanessa
authors.initials: V
authors.lastname: Diaz
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D017677:Age Distribution; D002648:Child; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016013:Likelihood Functions; D016015:Logistic Models; D008137:Longitudinal Studies; D008423:Maternal Age; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology