Abstract
Objective: Healthy People 2010 goals to eliminate racial and ethnic health disparities that persist in the utilization of prenatal care (PNC) highlight the importance of measuring PNC as a variable in maternal and infant health outcomes research. These disparities are significantly correlated to adverse infant outcomes in preterm birth (PTB), a leading cause of infant mortality and life-long morbidity. Currently the most extensively used PNC adequacy indices (Kessner and Kotelchuck) were developed to measure outcomes in populations consisting mostly of full-term births. It is unclear whether these PNC adequacy indices are reliable when pregnancy is truncated due to PTB (<37 weeks). This paper compares and demonstrates how they can be applied in a specific PTB cohort. Design and Sample: This secondary analysis of a nested case-control study compares Kessner and Kotelchuck adequacy scores of 367 mothers of PTB infants. Results: There were significant differences in the rating of PNC inadequacy ( p<.001) depending on the PNC adequacy index used. Conclusion: Critical evaluation is warranted before using these PNC adequacy indices in future public health nursing and PTB research.
Original language | English (US) |
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Pages (from-to) | 449-459 |
Number of pages | 11 |
Journal | Public Health Nursing |
Volume | 26 |
Issue number | 5 |
DOIs | |
State | Published - Sep 2009 |
Externally published | Yes |
All Science Journal Classification (ASJC) codes
- Nursing(all)
- Public Health, Environmental and Occupational Health
Keywords
- Kessner Index
- Kotelchuck Index
- Methodological challenges measuring PNC
- Prenatal care adequacy indices
- Prenatal care utilization
- Preterm birth