Sociodemographic Characteristics and Clinical Outcomes of People Receiving Inadequate Prenatal Care: A Retrospective Cohort Study |
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| Affiliation: | 1. McMaster Midwifery Research Centre, Hamilton, ON;2. Department of Pediatrics, McMaster University, Hamilton, ON;3. Department of Pediatrics, St. Joseph''s Healthcare Hamilton, Hamilton, ON;4. Neonatal Intensive Care Unit, St. Joseph''s Healthcare Hamilton, Hamilton, ON;5. Women''s and Infant''s Program, St. Joseph''s Healthcare Hamilton, Hamilton, ON;6. Department of Family Medicine, McMaster University, Hamilton, ON;7. Maternity Centre of Hamilton, Hamilton, ON;8. Department of Family Medicine, St. Joseph''s Healthcare Hamilton, Hamilton, ON;9. Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON;10. Midwifery Education Program, McMaster University, Hamilton, ON;1. Rédacteur en chef, JOGC;2. BC Women''s Centre for Pelvic Pain and Endometriosis, Vancouver, C.-B.;3. University of British Columbia, Vancouver, C.-B.;1. Editor-in-Chief, JOGC;2. BC Women''s Centre for Pelvic Pain and Endometriosis, Vancouver, BC;3. University of British Columbia, Vancouver, BC;1. Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver BC;2. Department of Radiology, Abdominal Imaging, University of British Columbia, Vancouver BC |
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| Abstract: | ObjectiveThis study sought to describe the incidence inadequate prenatal care (IPNC) at an urban level II hospital in Hamilton, Ontario, and to compare the characteristics and outcomes of mothers who received IPNC and their newborns with those who received adequate prenatal care (APNC). This study is the first part of a mixed-methods research program aimed at informing the development of an interdisciplinary, patient-centred, prenatal care program for people who struggle to access conventional modes of care.MethodsThis retrospective cohort study compared mothers and neonates born at St. Joseph's Health Care Hamilton in 2016 with IPNC (fewer than or equal to four antenatal visits, or first visit in third trimester) with those born with APNC (five or more prenatal visits and initial visit before the third trimester). Cases and controls matched 3:1 for age and parity were identified through a retrospective chart review.ResultsIn total 3235 charts were reviewed, and 69 cases of IPNC were identified (2.1%). The IPNC group had lower education and higher unemployment levels, as well as higher rates of smoking and drug use. Our primary and secondary outcomes of newborn custody loss, neonatal intensive care unit admission, and neonatal length of stay were significantly higher in the IPNC group.ConclusionPatients delivering with IPNC represent a high-risk group with increased rates of adverse neonatal outcomes and newborn custody loss. This quantitative study will inform future research and innovative interdisciplinary program development aimed at increasing access to prenatal care in an effort to improve maternal and neonatal outcomes. |
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