Petitti D, Coleman C, Binsacca D, Allen B
Birth. 1990 Mar;17(1):1-5. doi: 10.1111/j.1523-536x.1990.tb00001.x.
If the ultimate success of efforts to improve pregnancy outcome depends on assurance that prenatal care begins in the first trimester, it is important to identify potentially modifiable factors associated with the start of care as well as the groups in which it is most likely to be late. This topic was explored in a population-based study of low birthweight in 766 black women and 462 white women who gave birth in Alameda County, California, in 1987. Variables related to insurance coverage and financial status showed the greatest difference between early and late attenders at prenatal care in both groups. At virtually every level of almost every variable studied, black women were less likely than white women to begin prenatal care in the first trimester. The data suggested that some of the difference in the timing of prenatal care may be due to lack of awareness of, or failure to pay attention to, the signs of early pregnancy. We conclude that, although addressing problems of insurance coverage and financial status is critical to the solution of the problem of late initiation of prenatal care, as financing difficulties are solved, attention should be paid to women's internal factors such as depression and denial as modifiers of the earliness of seeking prenatal care.
如果改善妊娠结局的努力最终能否成功取决于确保孕期保健在孕早期开始，那么识别与开始保健相关的潜在可改变因素以及最有可能延迟开始保健的人群就很重要。1987年在加利福尼亚州阿拉米达县分娩的766名黑人妇女和462名白人妇女的低体重儿人群研究探讨了这个话题。与保险覆盖范围和财务状况相关的变量在两组中早期和晚期接受产前保健者之间显示出最大差异。几乎在所研究的每个变量的几乎每个水平上，黑人妇女在孕早期开始产前保健的可能性都低于白人妇女。数据表明，产前保健时间上的一些差异可能是由于对早孕迹象缺乏认识或未予以关注。我们得出结论，虽然解决保险覆盖范围和财务状况问题对于解决产前保健开始延迟的问题至关重要，但随着融资困难的解决，应关注女性的内在因素，如抑郁和否认，这些因素会影响寻求产前保健的及时性。
