title: Inadequate prenatal care and risk of preterm delivery among adolescents: a retrospective study over 10 years.
abstract: OBJECTIVE
  The aim of this study was to determine whether inadequate prenatal care is associated with increased risk of preterm birth among adolescents.
  
  
  METHODS
  We selected a random sample of women under age 20 years with singleton pregnancies delivering in Washington State between 1995 and 2006. Multivariate logistic regression was used to assess the association between prenatal care adequacy (percent of expected visits attended, adjusted for gestational age) and preterm birth.
  
  
  RESULTS
  Of 30,000 subjects, 27,107 (90%) had complete data. Women without prenatal care had more than 7-fold higher risk of preterm birth (n = 84 [24.1%]; adjusted odds ratio [aOR], 7.4), compared with those attending 75-100% of recommended visits (n = 346 [3.9%]). Women with less than 25%, 25-49%, or 50-74% of expected prenatal visits were at significantly increased risk of preterm birth; risk decreased linearly as prenatal care increased (n = 60 [9.5%], 132 (5.9%], 288 [5%]; and aOR, 2.5, 1.5, and 1.3, respectively).
  
  
  CONCLUSIONS
  Inadequate prenatal care is strongly associated with preterm birth among adolescents.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Debiec
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Paul
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Mitchell
authors.forename: Jane E
authors.initials: JE
authors.lastname: Hitti
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D047928:Premature Birth / Q000453:epidemiology* / Q000209:etiology; D011295:Prenatal Care / Q000592:standards* / Q000639:trends; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors