An Early Pregnancy Access Center in a Complex Family Planning Clinic Enhances First-Trimester Prenatal Care [ID 1475]

INTRODUCTION: Timely initiation of prenatal care (PNC) is critical for positive maternal and fetal outcomes. To streamline comprehensive early pregnancy care, we established an Early Pregnancy Access Center (EPAC), integrating nurse practitioner-led prenatal intake with pregnancy confirmation ultrasound by complex family planning (CFP) physicians. METHODS: Patients initiating PNC at EPAC and non-EPAC sites within a Bronx, New York, health care system from February to June 2023 were included. Primary outcomes included diagnosis and management of early pregnancy loss (EPL), first-trimester emergency department (ED) utilization, and nuchal translucency (NT) screening. Demographic and clinical data were analyzed using descriptive statistics, chi-squared, and Mann–Whitney U tests. Logistic regression evaluated the association between EPAC access and ED utilization. RESULTS: Of 891 patients, 59% were seen at EPAC and 41% at non-EPAC sites. The cohort included 34% Black, 43% Hispanic, and 70% publicly insured patients. The mean age was 29.7 years. The EPAC patients initiated PNC earlier (10 versus 14 weeks, P <.0001). Early pregnancy loss diagnosis during intake occurred more frequently at EPAC (7.9% versus 1.4%, P <.001); 70% of patients experiencing EPL at EPAC accepted same-day management with CFP. Emergency department utilization did not differ after adjusting for gestational age (adjusted odds ratio 1.24; 95% CI [0.69, 2.22]). Nuchal translucency rates were similar (43% EPAC versus 48% non-EPAC, P =.14). CONCLUSIONS/IMPLICATIONS: The EPAC participants initiated PNC earlier and had prompt diagnosis and management of EPL, but no differences in ED utilization or NT. Continued system-wide assessment of barriers to early pregnancy care remains essential, and further changes should address care gaps.