PATTERNS OF PRENATAL-CARE INITIATION IN GEORGIA, 1980-1992

Objective: To determine whether characteristics in a woman's first pre gnancy were associated with the trimester in which she initiated prena tal care in her second pregnancy. Methods: Data for white and black wo men whose first and second pregnancies resulted in singleton live birt hs between 1980 and 1992 were obtained from Georgia birth certificates (n = 177,041). Adjusted relative risks (RRs) for early prenatal care in the second pregnancy were computed by logistic regression models th at included trimester of prenatal care initiation, infant outcomes, or maternal conditions in the woman's first pregnancy as the exposure an d controlled for maternal age, education, child's year of birth, inter val between first and second pregnancy, presence of father's name on t he birth certificate, and the interaction between prenatal care and ed ucation. Models were stratified by race. Results: Women of both races who initiated prenatal care in the first trimester of their first preg nancies were more likely than those with delayed care to initiate pren atal care in the first trimester of their second pregnancies (RR = 1.2 5 and 1.63 for white and black women educated beyond high school, resp ectively). Both white and black women who delivered a baby with very l ow birth weight (RR = 1.06 and 1.15, respectively) or who suffered an infant death (RR 1.09 and 1.31, respectively) in their first pregnanci es were more likely than those who did not experience these events to begin prenatal care in the first trimester of their second pregnancies . Conclusion: Women with some potentially preventable adverse infant o utcomes tend to obtain earlier care in their next pregnancy. Unfortuna tely, women who delayed prenatal care in their first pregnancy frequen tly delay prenatal care in their next.