Leveno K J, Cunningham F G, Roark M L, Nelson S D, Williams M L
Obstet Gynecol. 1985 Nov;66(5):599-605.
In this study the authors assessed human and economic consequences of low birth weight linked to the lack of prenatal care for indigent women. Low birth weight infants were defined as those who weighed between 860 and 2220 g, corresponding to the 50th percentiles at 26 and 34 weeks' gestation. Women seeking prenatal care had a significantly decreased incidence of low birth weight infants compared with those without such care. Concomitantly, low birth weight infants born to women with prenatal care had significantly better perinatal survival as well as less frequent respiratory distress and intraventricular hemorrhage. Because of these factors, infants born to clinic mothers used fewer neonatal intensive care days and had shorter hospitalizations. Hospital costs were reviewed for 175 surviving infants and failure to obtain prenatal care was associated with a 50% increase in costs for each infant. The frequencies of the most common pregnancy complications in women with and without prenatal care, coupled with corresponding obstetric interventions, suggest that such care facilitates identification and management of women at risk for delivery of low birth weight infants. The authors conclude that there are important human and economic advantages of antenatal care for indigent women.
在本研究中,作者评估了与贫困妇女缺乏产前护理相关的低出生体重的人力和经济后果。低出生体重婴儿定义为体重在860至2220克之间的婴儿,这对应于妊娠26周和34周时的第50百分位数。寻求产前护理的妇女与未接受此类护理的妇女相比,低出生体重婴儿的发生率显著降低。与此同时,接受产前护理的妇女所生的低出生体重婴儿围产期存活率显著更高,呼吸窘迫和脑室内出血的发生率也更低。由于这些因素,诊所母亲所生的婴儿使用新生儿重症监护的天数更少,住院时间更短。对175名存活婴儿的医院费用进行了审查,未获得产前护理与每名婴儿费用增加50%相关。有无产前护理的妇女中最常见妊娠并发症的发生率,以及相应的产科干预措施表明,此类护理有助于识别和管理有分娩低出生体重婴儿风险的妇女。作者得出结论,贫困妇女接受产前护理具有重要的人力和经济优势。