This study examined the effects of traditional risk factors on receipt of inadequate prenatal care when controlling for interactions of multiple factors. Birth certificate data on 11,936 births were obtained from a state birth cohort file. A logistic regression model indicated significant interactions between maternal ethnicity (black vs white), marital status, and education in the prediction of inadequate prenatal care. Examining only main effects and ignoring interactions can produce oversimplified conclusions about individual risk factors.
References
1.
AlexanderG. R.CornelyD. A. (1987a) Prenatal care utilization: its measurement and relationship to pregnancy outcome. American Journal of Preventive Medicine, 3, 243–253.
2.
AlexanderG. R.CornelyD. A. (1987b) Racial disparities in pregnancy outcomes: the role of prenatal care utilization and maternal risk status. American Journal of Preventive Medicine, 3, 254–261.
3.
BuescherP. A.MeisP. J.ErnestJ. M.MooreM. L.MichieulutteR.SharpP. (1988) A comparison of women in and out of a prematurity prevention project in a North Carolina perinatal care region. American Journal of Public Health, 78, 2264–2267.
4.
CaldwellJ. (1981) Maternal education as a factor in child mortality. World Health Forum, 2, 75–79.
5.
CollinsJ. W.DavidR. J. (1990) The differential effect of traditional risk factors on infant birthweight among blacks and whites in Chicago. American Journal of Public Health, 80, 679–681.
6.
EdelmanM. W. (1987) Families in peril: an agenda for social change. Cambridge, MA: Harvard Univer. Press.
7.
GreenbergR. S. (1983) The impact of prenatal care in different social groups. American Journal of Obstetrics and Gynecology. 145, 797–801.
8.
HosmerD. W.Jr.LemeshowS. (1989) Applied logistic regression. New York: Wiley.
9.
HughesJ.JohnsonK.RosenbaumS.ButlerE.SimonsJ. (1988) The health of America's children: maternal and child health data book. Washington, DC: Children's Defense Fund.
10.
IngramD. D.MakucD.KleinmanJ. C. (1986) National and state trends in the use of prenatal care, 1970–83. American Journal of Public Health, 76, 415–423.
11.
JoyceT.CormanH.GrossmanM. (1988) A cost-effectiveness analysts of strategies to reduce infant mortality. Medical Care, 26, 348–359.
12.
KaliszerM.KiddM. (1981) Some factors affecting attendance at antenatal clinics. Social Science and Medicine, 15, 421–424.
13.
KessnerD. M.SingerJ.KalkC. E.SchlesingerE. R. (1973) Infant death: an analysis by maternal risk and health care. Washington, DC: Institute of Medicine, National Academy of Sciences.
14.
KleinbaumD. G. (1994) Logistic regression. New York: Springer-Verlag.
15.
KoppC. B.KalerS. R. (1989) Risk in infancy. American Psychologist, 44, 224–230.
16.
Lia-HoagbergB.RodeP.SkovholtC. J.ObergC. N.BergC.MullettS.ChoiT. (1990) Barriers and motivators to prenatal care among low-income women. Social Science and Medicine, 30, 487–495
17.
MurrayI. L.BernfieldM. (1988) The differential effect of prenatal care on the incidence of low birthweight among blacks and whites in a prepaid health care plan. New England Journal of Medicine, 319, 1385–1391.
18.
PeoplesM. D.GrimsonR. C.DaughtryG. L. (1984) Evaluation of the effects of the North Carolina improved pregnancy outcome project: implications for state decision-making. American Journal of Public Health, 74, 549–554.
19.
PeoplesM. D.SiegelE. (1983) Measuring the impact of programs for mothers and infants on prenatal care and low birth weight: the values of refined analysis. Medical Care, 21, 586–608.
20.
PollandM. L.AgerJ. W.OlsonJ. M. (1987) Barriers to receiving adequate prenatal care. American Journal of Obstetrics and Gynecology157, 297–393.
21.
RyanG.SweeneyP.SololaA. (1980) Prenatal cue and pregnancy outcome. American Journal of Obstetrics and Gynecology, 137, 876–881.
22.
SchrammW. F. (1992) Weighing costs and benefits of adequate prenatal care for 12,023 births in Missouri's Medicaid program, 1988Public Health Reports, 107, 647–652.
23.
ShowstackJ. A.BudettiP. P.MinklerD. (1984) Factors associated with birthweight: an exploration of the roles of prenatal care and length of gestation. American Journal of Public Health, 74, 1003–1008.
24.
SokolR. J.WoolfR. B.RosenM. G.WeingardenK. (1980) Risk, antepartum care, and outcome: impact of a maternity and infant care project. Obstetrics and Gynecology, 56, 150–156.
25.
StickleG.MaP. (1977) Some social and medical correlates of pregnancy outcome. American Journal of Obstetrics and Gynecology, 127, 162–166.
26.
St. JohnC.WinstonT. J. (1989) The effect of social support on prenatal care. The Journal of Applied Behavioral Science. 25, 79–98.
27.
WegmanM. E. (1987) Annual summary of vital statistics 1986Pediatrics, 80, 817–827.