Kogan M D, Alexander G R, Jack B W, Allen M C
Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland 20782, USA.
Pediatrics. 1998 Jul;102(1 Pt 1):25-30. doi: 10.1542/peds.102.1.25.
To explore the association between adequacy of prenatal care utilization and subsequent pediatric care utilization.
A longitudinal follow-up of a nationally representative sample of infants born in 1988.
Nine thousand four hundred forty women who had a live birth in 1988, and whose child was alive at the time of interview, and 8285 women from the original sample who were reinterviewed in 1991.
There were four outcome measures: number of well-child visits; adequate immunization for diphtheria, tetanus, and pertussis; adequate immunization for polio; and continuity of a regular source of care, as measured by the number of sites for pediatric care.
Children whose mothers had less than adequate prenatal care utilization had significantly fewer well-child visits, and were significantly less likely to have adequate immunizations, even after income, health insurance coverage, content of prenatal care, wantedness of child, sites of prenatal and pediatric care, and maternal and pregnancy risk characteristics were taken into account. Less than adequate prenatal care utilization was not associated with having more than one pediatric care site.
Prenatal care utilization can be used to identify and target interventions to women who are at risk for not obtaining well-child care or complete immunizations for their children.
探讨产前保健利用的充分程度与后续儿童保健利用之间的关联。
对1988年出生的具有全国代表性的婴儿样本进行纵向随访。
1988年有活产且在访谈时其孩子仍存活的9440名妇女，以及1991年接受重新访谈的来自原始样本的8285名妇女。
有四项结局指标：儿童健康检查次数；白喉、破伤风和百日咳的充分免疫接种；脊髓灰质炎的充分免疫接种；以及以儿童保健机构数量衡量的常规保健来源的连续性。
即使在考虑了收入、医疗保险覆盖范围、产前保健内容、孩子的意愿、产前和儿童保健机构、母亲及妊娠风险特征之后，母亲产前保健利用不足的儿童进行儿童健康检查的次数显著较少，且进行充分免疫接种的可能性也显著较低。产前保健利用不足与有不止一个儿童保健机构无关。
产前保健利用情况可用于识别有孩子得不到儿童健康保健或完整免疫接种风险的妇女，并针对她们进行干预。
