MATERIALS AND METHODS
We used Washington State birth record
data to conduct a population-based cohort
study of women who had delivered
in 1995-2006. Eligible subjects were
women under 20 years of age who had
singleton births during the study period.
From this population, 30,000 women
were selected at random for inclusion.
The primary outcome was delivery at
less than 37 weeks. The primary exposure
of interest was adequacy of prenatal
visits.
To classify adequacy of prenatal care,
we calculated a ratio of the actual number
of prenatal visits compared with the
expected number of visits for a delivery
at a given gestational age. We created a
ratio of observed to expected visits similar
to Kotelchuck’s Adequacy of Prenatal
Care Utilization Index. For the purposes
of analysis, we divided adequacy of prenatal
care into 6 categories: no prenatal
care and less than 25%, 25-49%, 50-74%,
75-100%, and greater than 100% of expected
care. We used an observed to expected
visit ratio of 75-100% of prenatal
visits as our referent or ideal category.
MATERIALS AND METHODSWe used Washington State birth recorddata to conduct a population-based cohortstudy of women who had deliveredin 1995-2006. Eligible subjects werewomen under 20 years of age who hadsingleton births during the study period.From this population, 30,000 womenwere selected at random for inclusion.The primary outcome was delivery atless than 37 weeks. The primary exposureof interest was adequacy of prenatalvisits.To classify adequacy of prenatal care,we calculated a ratio of the actual numberof prenatal visits compared with theexpected number of visits for a deliveryat a given gestational age. We created aratio of observed to expected visits similarto Kotelchuck’s Adequacy of PrenatalCare Utilization Index. For the purposesof analysis, we divided adequacy of prenatalcare into 6 categories: no prenatalcare and less than 25%, 25-49%, 50-74%,75-100%, and greater than 100% of expectedcare. We used an observed to expectedvisit ratio of 75-100% of prenatalvisits as our referent or ideal category.
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