INFANT HEALTH-CARE UTILIZATION PREDICTED BY PATTERN OF PRENATAL-CARE

Study objective. The objective of this study was to examine the relati onship between patterns of prenatal care and subsequent infant health care use in a sample of inner-city women and their infants. In testing this relationship we controlled for several sociodemographic, economi c, and psychological factors. Design. This case-control study examined medical records of 148 infants born to mothers previously enrolled in a 9-month study of prenatal care and use or nonuse of illicit drugs. Cases (N = 62) were defined as infants born to women who first registe red for prenatal care after 28 weeks' gestation or completed fewer tha n four prenatal visits. Controls (N = 86) were all other infants match ed by date of birth. Data on maternal health and sociodemographic fact ors were obtained from a maternal interview and medical record review. Maternal drug use was defined as the use of illicit drugs at any time during the pregnancy based on maternal interview and/or a positive ma ternal or neonatal urine toxicology screen obtained within 48 hours of delivery. Results. Infants of case mothers had significantly lower bi rth weight and gestational age, increased number of protective service referrals, and lower completion rate of three or more health supervis ion visits by 9 months of age. Multiple logistic regression analysis r evealed that adequate prenatal care was significantly associated with adequate use of infant health care independent of maternal drug use, e ducational level, marital status, and number of previous living childr en. Conclusions. Patterns of infant health care use can be predicted b efore birth based on the mother's pattern of prenatal care use.