Are neonatal morbidities associated with no prenatal care different from those associated with inadequate prenatal care英文文献资料.docVIP

Open Journal of Obstetrics and Gynecology, 2012, 2, 89-97 OJOG /10.4236/ojog.2012.22018 Published Online June 2012 (http://www.SciRP.org/journal/ojog/) Are neonatal morbidities associated with no prenatal care different from those associated with inadequate prenatal care? Ekwutosi M. Okoroh , Dean V. Coonrod , Kristina Chapple , David Drachman 1 2 3 4 1 2 Division of Blood Disorders, National Center for Birth Defects and Developmental Disorders, Atlanta, USA Department of Obstetrics, Gynecology, Women’s Health, Maricopa Integrated Health System, University of Arizona College of Medicine, Phoenix, USA 3 Consultant, 9239 E. Desert View, Scottsdale, USA Department of Research, Maricopa Integrated Health System, Phoenix, USA 4 Email: eokoroh@ Received 21 April 2012; revised 20 May 2012; accepted 28 May 2012 ABSTRACT and childbirth [1]. Worldwide, 3.7 million children under 5 die each year, with 40% of these occurring in the neo- natal period [2]. Many more children and mothers suffer ill health and permanent disabilities as a result of com- plications of pregnancy and childbirth. Credited by some as an American innovation [3], prenatal care is an estab- lished mechanism for identifying and managing medical, socio-demographic, and behavioral risk factors that may contribute to poor pregnancy outcomes. There are 3 main indices (Kessner [4], Kotelchuck [5] and GINDEX [6]) currently used in the literature to meas- ure the adequacy of prenatal care. They vary in definition and limitations. Regardless of how prenatal care is meas- ured, the optimal amount and content of care in low- or high-risk pregnancies is not yet resolved [7]. Further- more, even when prenatal care is easily accessible and of high quality, some pregnant women choose not to use it. In this study, we used the Kotelch