McElfish Pearl A, Caldwell Aaron, Watson Donya, Langner Jonathan, Callaghan-Koru Jennifer, Porter Austin, Willis Don E, Andersen Jennifer A, Hawley Nicola L, Selig James P, Forati Amir, Alcala Maria R, White Lanita, Gomez-Pomar Enrique, Brown Clare C
College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA.
Fay W. Boozman, College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA.
Prev Med Rep. 2025 Jan 17;51:102983. doi: 10.1016/j.pmedr.2025.102983. eCollection 2025 Mar.
This study examines prenatal care utilization differences in Arkansas.
Birth records data from the National Center for Health Statistics were used. The study population consisted of singleton live births in Arkansas from 2014 to 2022. Primary outcomes included number of prenatal visits, fewer than the recommended number of prenatal visits, late prenatal care, and no prenatal care. Summary statistics were computed, and adjusted rates ratios were calculated adjusting for maternal age, maternal education, and parity for payer, race/ethnicity, and rural/urban residence.
Mothers with a Medicaid-covered birth had 0.90 times fewer prenatal care visits and were 1.26 times more likely to have fewer than the recommended number of visits, 1.60 times more likely to initiate prenatal care late, and 1.46 times more likely to have reported no prenatal visits at all. Number of prenatal care visits was lower for all racial/ethnic groups relative to white mothers and for mothers living in rural areas. The largest differences were for Native Hawaiian and Pacific Islander (NHPI) mothers, who reported almost half the number of visits (ARR = 0.67, 95 % CI [0.64, 0.70]). Having no prenatal care was more prevalent among NHPI (ARR = 3.68, 95 % CI [2.66, 5.10]) and Black (ARR = 1.47, 95 % CI [1.34, 1.61]) mothers. Racially/ethnically minoritized groups were more likely to have late prenatal care and fewer than the recommended number of prenatal visits, with the greatest difference for NHPI.
Findings document disparities in prenatal care utilization related to payer, race/ethnicity, and rural/urban residence.
本研究考察阿肯色州产前护理利用情况的差异。
使用了美国国家卫生统计中心的出生记录数据。研究人群包括2014年至2022年在阿肯色州的单胎活产。主要结局包括产前检查次数、产前检查次数少于推荐次数、产前护理开始时间晚以及未接受产前护理。计算了汇总统计量，并计算了调整后的率比，对产妇年龄、产妇教育程度、产次进行了调整，同时考虑了支付方、种族/族裔和农村/城市居住情况。
享受医疗补助分娩的母亲产前检查次数少0.90倍，产前检查次数少于推荐次数的可能性高1.26倍，产前护理开始时间晚的可能性高1.60倍，完全没有产前检查的可能性高1.46倍。相对于白人母亲以及居住在农村地区的母亲，所有种族/族裔群体的产前检查次数都较低。差异最大的是夏威夷原住民和太平洋岛民（NHPI）母亲，她们报告的检查次数几乎只有一半（调整后率比=0.67，95%置信区间[0.64,0.70]）。未接受产前护理在NHPI（调整后率比=3.68，95%置信区间[2.66,5.10]）和黑人（调整后率比=1.47，95%置信区间[1.34,1.61]）母亲中更为普遍。种族/族裔少数群体更有可能产前护理开始时间晚且产前检查次数少于推荐次数，NHPI的差异最大。
研究结果证明了产前护理利用情况在支付方、种族/族裔和农村/城市居住方面存在差异。
