title: Application of the Kessner and Kotelchuck prenatal care adequacy indices in a preterm birth population.
abstract: OBJECTIVE
  Healthy People 2010 goals to eliminate racial and ethnic health disparities that persist in the utilization of prenatal care (PNC) highlight the importance of measuring PNC as a variable in maternal and infant health outcomes research. These disparities are significantly correlated to adverse infant outcomes in preterm birth (PTB), a leading cause of infant mortality and life-long morbidity. Currently the most extensively used PNC adequacy indices (Kessner and Kotelchuck) were developed to measure outcomes in populations consisting mostly of full-term births. It is unclear whether these PNC adequacy indices are reliable when pregnancy is truncated due to PTB (<37 weeks). This paper compares and demonstrates how they can be applied in a specific PTB cohort.
  
  
  METHODS
  This secondary analysis of a nested case-control study compares Kessner and Kotelchuck adequacy scores of 367 mothers of PTB infants.
  
  
  RESULTS
  There were significant differences in the rating of PNC inadequacy ( p<.001) depending on the PNC adequacy index used.
  
  
  CONCLUSIONS
  Critical evaluation is warranted before using these PNC adequacy indices in future public health nursing and PTB research.
authors.affiliation: College of Nursing & Health Professions, Drexel University, 245 N.15th Street, MS 1030, Philadelphia, PA 19102, USA. jrb68@drexel.edu
authors.forename: Joan Rosen
authors.initials: JR
authors.lastname: Bloch
authors.forename: Katy
authors.initials: K
authors.lastname: Dawley
authors.forename: Patricia Dunphy
authors.initials: PD
authors.lastname: Suplee
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005865:Gestational Age; D054625:Healthcare Disparities; D040361:Healthy People Programs; D006801:Humans; D009515:New Jersey; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D011295:Prenatal Care / Q000592:standards / Q000706:statistics & numerical data*; D055815:Young Adult