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Inadequate Prenatal Care and Risk of Preterm Delivery Among Adolescents: a Retrospective Study over 10 Years


The aim of this study was to determine whether inadequate prenatal care is associated with increased risk of preterm birth among adolescents.
Study Design

We selected a random sample of women under age 20 years with singleton pregnancies delivering in Washington State between 1995 and 2006. Multivariate logistic regression was used to assess the association between prenatal care adequacy (percent of expected visits attended, adjusted for gestational age) and preterm birth.

Of 30,000 subjects, 27,107 (90%) had complete data. Women without prenatal care had more than 7-fold higher risk of preterm birth (n = 84 [24.1%]; adjusted odds ratio [aOR], 7.4), compared with those attending 75-100% of recommended visits (n = 346 [3.9%]). Women with less than 25%, 25-49%, or 50-74% of expected prenatal visits were at significantly increased risk of preterm birth; risk decreased linearly as prenatal care increased (n = 60 [9.5%], 132 (5.9%], 288 [5%]; and aOR, 2.5, 1.5, and 1.3, respectively).
Inadequate prenatal care is strongly associated with preterm birth among adolescents.

Debiec. Inadequate prenatal care and risk of preterm delivery in adolescents. Am J Obstet Gynecol 2010.
a Adjusted odds ratio: adjusted for maternal age, ethnicity, marital status, smoking, and prior preterm birth.
C.M.M. is supported by the National Institute of Child Health and Human Development Women's Reproductive Health Research Award.
Cite this article as: Debiec KE, Paul KJ, Mitchell CM, et al. Inadequate prenatal care and risk of preterm delivery among adolescents: a retrospective study over 10 years. Am J Obstet Gynecol 2010;203:122.e1-6.
American Journal of Obstetrics and Gynecology
Volume 203, Issue 2, August 2010, Pages 122.e1-122.e6
Katherine E. Debiec MDa, Kathleen J. Paul MPHa, Caroline M. Mitchell MD, MPHa and Jane E. Hitti MD, MPHa
Available online 14 May 2010.