Prenatal Care Adequacy Among Nulliparous and Primiparous or Multiparous Pregnant Individuals [ID 1304]

INTRODUCTION: Pregnant individuals who receive inadequate prenatal care have higher rates of maternal and infant morbidity and mortality. Thus, increasing rates of adequate prenatal care access is an opportunity to improve pregnancy and neonatal outcomes. METHODS: This retrospective study uses publicly available Centers for Disease Control and Prevention (CDC) data to compare the percentage of pregnant individuals who received adequate prenatal care for individuals with zero prior live births to individuals with one or more prior live birth. The study variables are rates of adequate prenatal care as defined by the Kessner index. The total study population is 478,881. Statistical analysis was performed using a chi-squared test. RESULTS: The CDC Pregnancy Risk Assessment Monitoring System (PRAMS) Data Set is composed of a stratified sample set randomly drawn from the current birth certificate file for each jurisdiction; selected subjects are surveyed using standardized data collection procedures. All subjects in the 2000–2011 PRAMS data set were included; subjects with missing data were excluded. For individuals with one or more prior live birth, 66.8% (183,130/274,028) received adequate prenatal care compared with 70.1% (143,678/204,853) of individuals with zero prior live births. A chi-squared test of independence showed statistical significance, chi-squared (1, N =478,881)=593.56, P <.00001. CONCLUSIONS/IMPLICATIONS: Pregnant individuals with one or more prior live birth are less likely to receive adequate prenatal care than nulliparous individuals. Strategies that encourage prenatal care for primiparous and multiparous patients could improve perinatal outcomes for this group.