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Association between prenatal care utilization and risk of preterm birth among Chinese women

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Summary

It is recognized that prenatal care plays an important role in reducing adverse birth. Chinese pregnant women with medical condition were required to seek additional health care based on the recommended at least 5 times health care visits. This study was to estimate the association between prenatal care utilization (PCU) and preterm birth (PTB), and to investigate if medical conditions during pregnancy modified the association. This population-based case control study sampled women with PTB as cases; one control for each case was randomly selected from women with term births. The Electronic Perinatal Health Care Information System (EPHCIS) and a questionnaire were used for data collection. The PCU was measured by a renewed Prenatal Care Utilization (APNCU) index. Logistic regression models were used to estimate odds ratios (OR) and the 95% confidence interval (95% CI). Totally, 2393 women with PTBs and 4263 women with term births were collected. In this study, 695 (10.5%) women experienced inadequate prenatal care, and 5131 (77.1%) received adequate plus prenatal care. Inadequate PCU was associated with PTB (adjusted OR: 1.41, 95% CI: 1.32–1.84); the similar positive association was found between adequate plus PCU and PTB. Among women with medical conditions, these associations still existed; but among women without medical conditions, the association between inadequate PCU and PTB disappeared. Our data suggests that women receiving inappropriate PCU are at an increased risk of having PTB, but it does depend on whether the woman has a medical condition during pregnancy.

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Acknowledgements

We appreciated the hard work of all the staffs of maternal and child health care in the District Maternal and Child Health Care Hospitals and Community Health Service Centers in inner-city, Wuhan, China.

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Author notes

  1. These authors contributed equally to this study.

Authors and Affiliations

  1. Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430015, China

    Bin Zhang  (张 斌), Rong Yang  (杨 蓉), Rong-hua Hu  (胡荣华), Yi-ming Zhang  (章一鸣), Dan Zhang  (张 丹) & Shao-ping Yang  (杨少萍)

  2. Wuhan Environmental Monitoring Center, Wuhan, 430015, China

    Sheng-wen Liang  (梁胜文), Ke Hu  (胡 柯) & Qing-jie Li  (李庆杰)

  3. College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA

    Jing Wang  (王 静), Jen Jen Chang, Louise H. Flick & Zheng-min Qian  (钱正敏)

  4. School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China

    Guang-hui Dong  (董光辉)

  5. School of Public Health, Brown University, Providence, Rhode Island, 02912, USA

    Tong-zhang Zheng  (郑同章)

  6. School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Shun-qing Xu  (徐顺清)

Authors
  1. Bin Zhang  (张 斌)
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  2. Rong Yang  (杨 蓉)
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  3. Sheng-wen Liang  (梁胜文)
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  4. Jing Wang  (王 静)
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  5. Jen Jen Chang
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  6. Ke Hu  (胡 柯)
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  7. Guang-hui Dong  (董光辉)
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  8. Rong-hua Hu  (胡荣华)
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  9. Louise H. Flick
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  10. Yi-ming Zhang  (章一鸣)
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  11. Dan Zhang  (张 丹)
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  12. Qing-jie Li  (李庆杰)
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  13. Tong-zhang Zheng  (郑同章)
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  14. Shun-qing Xu  (徐顺清)
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  15. Shao-ping Yang  (杨少萍)
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  16. Zheng-min Qian  (钱正敏)
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Corresponding authors

Correspondence to Shao-ping Yang  (杨少萍) or Zheng-min Qian  (钱正敏).

Additional information

This study was sponsored by the Health Effects Institute, US (No. #4791-RFA09-2/10-5) and Hubei Provincial Natural Science Foundation of China (No. 2010CDB08803).

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Zhang, B., Yang, R., Liang, Sw. et al. Association between prenatal care utilization and risk of preterm birth among Chinese women. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 37, 605–611 (2017). https://doi.org/10.1007/s11596-017-1779-8

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  • DOI: https://doi.org/10.1007/s11596-017-1779-8

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