The Association Between Adequate Prenatal Care and Severe Maternal Morbidity Among Teenage Pregnancies: A Population-Based Cohort Study

Frontiers in Public Health

article

Jin Young Nam¹  Sarah Soyeon Oh²  Eun-Cheol Park³ 

[1] Department of Healthcare Management, Eulji University;Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health;Department of Preventive Medicine, Yonsei University College of Medicine;Institute of Health Services Research, Yonsei University College of Medicine

关键词: severe maternal morbidity;    prenatal care;    Kessner Adequacy of Prenatal Care Index;    teenage pregnancy;    adolescent pregnancy;    teenage mother;    cohort study;   

DOI  :  10.3389/fpubh.2022.782143

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background The aim of this study was to examine whether inadequate prenatal care affect the risk of severe maternal morbidity in teenage pregnancies. Methods We included 23,202 delivery cases among adolescent mothers aged between 13 and 19 years old with ≥ 37 weeks' gestational age. Data were derived from the National Health Insurance Service National Delivery Cohort in Korea between 2003 and 2018. We used a generalized estimating equation model while adjusting for numerous covariates to determine the adjusted relative risk (RR) associated with severe maternal morbidity. The main outcome measures were severe maternal morbidity and the Kessner Adequacy of Prenatal Care Index. Results Severe maternal morbidity occurred in 723 (3.1%) of the 23,202 investigated delivery cases. The risk of severe maternal morbidity was 1.8-fold higher among adolescent mothers who had received inadequate prenatal care (RR, 1.81, 95% confidence interval [CI], 1.39–2.37) and 1.6-fold higher among those who had received intermediate prenatal care (RR, 1.59, 95% CI, 1.33–1.87) compared to those with adequate prenatal care. Synergistic effects of inadequate prenatal care and maternal comorbidities affected severe maternal morbidity. Conclusion This study confirmed that inadequate prenatal care is associated with increased risk of severe maternal morbidity among pregnant teenagers. Notably, maternal comorbidity and inadequate prenatal care produced synergistic effects on severe maternal morbidity. Public health policy makers should focus on the development and implementation of programs to ensure that adequate prenatal care and financial/healthcare support is provided to teenage mothers during their pregnancies.

【 授权许可】

CC BY