Butz A M, Funkhouser A, Caleb L, Rosenstein B J
Johns Hopkins University, School of Nursing, Baltimore, MD 21287.
Pediatrics. 1993 Jul;92(1):50-4.
The objective of this study was to examine the relationship between patterns of prenatal care and subsequent infant health care use in a sample of inner-city women and their infants. In testing this relationship we controlled for several sociodemographic, economic, and psychological factors.
This case-control study examined medical records of 148 infants born to mothers previously enrolled in a 9-month study of prenatal care and use or nonuse of illicit drugs. Cases (N = 62) were defined as infants born to women who first registered for prenatal care after 28 weeks' gestation or completed fewer than four prenatal visits. Controls (N = 86) were all other infants matched by date of birth. Data on maternal health and sociodemographic factors were obtained from a maternal interview and medical record review. Maternal drug use was defined as the use of illicit drugs at any time during the pregnancy based on maternal interview and/or a positive maternal or neonatal urine toxicology screen obtained within 48 hours of delivery.
Infants of case mothers had significantly lower birth weight and gestational age, increased number of protective service referrals, and lower completion rate of three or more health supervision visits by 9 months of age. Multiple logistic regression analysis revealed that adequate prenatal care was significantly associated with adequate use of infant health care independent of maternal drug use, educational level, marital status, and number of previous living children.
Patterns of infant health care use can be predicted before birth based on the mother's pattern of prenatal care use.
本研究的目的是在一组市中心区妇女及其婴儿样本中，检验产前护理模式与随后婴儿医疗保健利用之间的关系。在检验这种关系时，我们控制了几个社会人口学、经济和心理因素。
这项病例对照研究检查了148名婴儿的医疗记录，这些婴儿的母亲先前参加了一项为期9个月的产前护理及是否使用非法药物的研究。病例组（N = 62）定义为其母亲在妊娠28周后首次登记产前护理或产前检查次数少于4次的婴儿。对照组（N = 86）为所有其他按出生日期匹配的婴儿。通过产妇访谈和病历审查获取产妇健康和社会人口学因素的数据。产妇药物使用定义为根据产妇访谈和/或分娩后48小时内获得的阳性产妇或新生儿尿液毒理学筛查结果，在孕期任何时间使用非法药物。
病例组母亲的婴儿出生体重和孕周显著较低，儿童保护服务转介次数增加，到9个月大时三次或更多次健康监督访视的完成率较低。多元逻辑回归分析显示，充分的产前护理与婴儿医疗保健的充分利用显著相关，且不受产妇药物使用、教育水平、婚姻状况和既往存活子女数量的影响。
根据母亲的产前护理模式，可以在出生前预测婴儿医疗保健的利用模式。
