Sable M R, Stockbauer J W, Schramm W F, Land G H
Missouri Department of Health, Jefferson City 65102.
Public Health Rep. 1990 Nov-Dec;105(6):549-55.
Inadequate prenatal care has previously been identified as a significant risk factor for women who have low birth weight infants and infants who die during the neonatal period. Postpartum interviews with 1,484 primarily low-income women were conducted during 1987-88 in three areas of Missouri with the highest rates of inadequate prenatal care. The purpose of the study was to identify barriers to prenatal care and to determine which barriers differentiated between women receiving adequate and those receiving inadequate prenatal care. Women who received inadequate prenatal care were more likely to be black, unmarried, higher parity, and have less education than those who received adequate care. These women were also more likely to be poor, Medicaid-eligible, to have had an unwanted pregnancy, more stress and problems during pregnancy, and less social support. In the multivariate analysis, race and marital status lost their importance. The strongest predictor of inadequate prenatal care was women not knowing that they were pregnant in the first 4 months of pregnancy (adjusted odds ratio 9.28). To improve the rate of adequate prenatal care, society must address the issues of poverty and wantedness of pregnancy.
先前已确定，产前护理不足是导致低体重儿出生及新生儿期死亡的重要风险因素。1987 - 1988年期间，在密苏里州产前护理不足发生率最高的三个地区，对1484名主要为低收入的女性进行了产后访谈。该研究的目的是确定产前护理的障碍，并确定哪些障碍能区分接受充分产前护理和未接受充分产前护理的女性。与接受充分产前护理的女性相比，接受产前护理不足的女性更可能是黑人、未婚、多胎妊娠且受教育程度较低。这些女性也更可能贫困、符合医疗补助条件、意外怀孕、孕期压力和问题更多，且社会支持更少。在多变量分析中，种族和婚姻状况不再重要。产前护理不足的最强预测因素是女性在怀孕的前4个月不知道自己已怀孕（调整后的优势比为9.28）。为提高充分产前护理的比例，社会必须解决贫困和怀孕意愿的问题。
