PEDIATRICS Vol. 85 No. 2 February 1990, pp. 195-204
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tyson, J.
Right arrow Articles by Heartwell, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tyson, J.
Right arrow Articles by Heartwell, S.

Prenatal Care Evaluation and Cohort Analyses

Jon Tyson MD1, David Guzick MD, PhD1, Charles R. Rosenfeld MD1, Robert Lasky PhD1, Norman Gant MD1, Juan Jiminez MD1, and Stephen Heartwell DrPH1

1 From the Department of Pediatrics and Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas

The value of prenatal care has been obscured by multiple factors, including the limitations of birth certificate data, large socioeconomic disparities between women who seek prenatal care and those who do not, and the "preterm delivery bias", ie, the reduced pregnancy duration and opportunity for prenatal care among women who give birth prematurely. Perinatal mortality and morbidity (neonatal intensive care unit admission; ventilator therapy) were carefully assessed in an indigent population (28 838 deliveries at Parkland Memorial Hospital). To avoid the preterm delivery bias, a cohort of all women whose pregnancy reached a specific week of gestation was identified and their prenatal care status (zero vs one or more visits) by that week was related to pregnancy outcome. Separate cohorts were defined at 26, 30, 34, 38, and 42 weeks. Prenatal care was associated with improved pregnancy outcomes in only the 34-, 38-, and 42-week cohorts (P < .01) Findings suggest substantial benefit from prenatal care after 30 weeks' gestation but not from early prenatal care. Unfortunately, it may not be possible to assess prenatal care accurately in observational studies even if cohort analyses are used. Clinical trials are needed to assess the effects of strategies for increasing or improving prenatal care, especially in early pregnancy.

Key Words: prenatal care • perinatal mortality • neonatal intensive care • birth weight

Submitted on April 27, 1987
Accepted on March 31, 1989




This article has been cited by other articles:


Home page
 J Am Board Fam MedHome page
C. A. Partridge and J. R. Holman
Effects of a Reduced-Visit Prenatal Care Clinical Practice Guideline
J Am Board Fam Med, November 1, 2005; 18(6): 555 - 560.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Public HealthHome page
P. A. Braveman, S. A. Egerter, C. Cubbin, and K. S. Marchi
An Approach to Studying Social Disparities in Health and Health Care
Am J Public Health, December 1, 2004; 94(12): 2139 - 2148.
[Abstract] [Full Text] [PDF]