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PEDIATRICS Vol. 102 No. 1 July 1998, pp. 25-30

The Association Between Adequacy of Prenatal Care Utilization and Subsequent Pediatric Care Utilization in the United States

Received May 9, 1997; accepted Dec 3, 1997.

Michael D. Kogan*, Greg R. AlexanderDagger , Brian W. Jack§, and Marilee C. Allenparallel

From the * Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland; the Dagger  Department of Maternal and Child Health, the University of Alabama at Birmingham, Birmingham, Alabama; the § Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts; and the parallel  Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.

Objective.  To explore the association between adequacy of prenatal care utilization and subsequent pediatric care utilization.

Design.  A longitudinal follow-up of a nationally representative sample of infants born in 1988.

Participants.  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.

Main Outcome Measure.  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.

Results.  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.

Conclusions.  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.

Key words: prenatal care utilization, pediatric care utilization, well-child care, immunizations.




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