Provider adherence to recommended prenatal care content: Does it differ for obese women

Michelle A. Kominiarek*, Kristin Rankin, Arden Handler

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The objective of this study was to examine provider adherence to prenatal care (PNC) content in obese and non-obese women and perinatal outcomes in obese women experiencing low and medium versus high adherence to PNC content. Provider adherence to PNC content (low<50 %, medium 50-79 %, and high ≥80 %) was compared between obese (n = 69) and non-obese (n = 128) women in a linked database of deliveries to low-income, minority women from 2003 to 2004. Sample content items included procedures delivered at every visit (blood pressure, urinalysis, maternal weight, fetal heart rate check), timed screenings for birth defects and gestational diabetes, prenatal vitamin prescriptions, and depression screening. Weight gain, preterm deliveries, cesareans, and birthweight were compared between obese women with low and medium versus high adherence to PNC content using multivariable logistic regression. High provider adherence to an eight-item PNC content score (56.3 vs. 66.5 %, p = 0.02) and depression screening (2.0 vs. 11.4 %, p = 0.001) were both lower for obese versus non-obese women. Among obese women, there were no differences by level of provider adherence to PNC content in preterm delivery, cesareans, and low birth weight, but obese women experiencing low and medium versus high adherence were more likely to gain ≥20 lbs (aOR 5.5, 95 % CI 1.3-23.3). Providers may be administering PNC differently to obese and non-obese women. PNC for obese women who are at high risk of adverse perinatal outcomes needs to be addressed especially as it relates to depression screening and gestational weight gain.

Original languageEnglish (US)
Pages (from-to)1114-1122
Number of pages9
JournalMaternal and Child Health Journal
Volume18
Issue number5
DOIs
StatePublished - Jan 1 2014

Fingerprint

Prenatal Care
Weight Gain
Fetal Heart Rate
Urinalysis
Gestational Diabetes
Low Birth Weight Infant
Vitamins
Prescriptions
Logistic Models
Mothers
Databases
Blood Pressure
Weights and Measures

Keywords

  • Obesity
  • Perinatal outcomes
  • Pregnancy
  • Prenatal care content

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Provider adherence to recommended prenatal care content: Does it differ for obese women",
abstract = "The objective of this study was to examine provider adherence to prenatal care (PNC) content in obese and non-obese women and perinatal outcomes in obese women experiencing low and medium versus high adherence to PNC content. Provider adherence to PNC content (low<50 {\%}, medium 50-79 {\%}, and high ≥80 {\%}) was compared between obese (n = 69) and non-obese (n = 128) women in a linked database of deliveries to low-income, minority women from 2003 to 2004. Sample content items included procedures delivered at every visit (blood pressure, urinalysis, maternal weight, fetal heart rate check), timed screenings for birth defects and gestational diabetes, prenatal vitamin prescriptions, and depression screening. Weight gain, preterm deliveries, cesareans, and birthweight were compared between obese women with low and medium versus high adherence to PNC content using multivariable logistic regression. High provider adherence to an eight-item PNC content score (56.3 vs. 66.5 {\%}, p = 0.02) and depression screening (2.0 vs. 11.4 {\%}, p = 0.001) were both lower for obese versus non-obese women. Among obese women, there were no differences by level of provider adherence to PNC content in preterm delivery, cesareans, and low birth weight, but obese women experiencing low and medium versus high adherence were more likely to gain ≥20 lbs (aOR 5.5, 95 {\%} CI 1.3-23.3). Providers may be administering PNC differently to obese and non-obese women. PNC for obese women who are at high risk of adverse perinatal outcomes needs to be addressed especially as it relates to depression screening and gestational weight gain.",
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Provider adherence to recommended prenatal care content : Does it differ for obese women. / Kominiarek, Michelle A.; Rankin, Kristin; Handler, Arden.

In: Maternal and Child Health Journal, Vol. 18, No. 5, 01.01.2014, p. 1114-1122.

Research output: Contribution to journalArticle

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AB - The objective of this study was to examine provider adherence to prenatal care (PNC) content in obese and non-obese women and perinatal outcomes in obese women experiencing low and medium versus high adherence to PNC content. Provider adherence to PNC content (low<50 %, medium 50-79 %, and high ≥80 %) was compared between obese (n = 69) and non-obese (n = 128) women in a linked database of deliveries to low-income, minority women from 2003 to 2004. Sample content items included procedures delivered at every visit (blood pressure, urinalysis, maternal weight, fetal heart rate check), timed screenings for birth defects and gestational diabetes, prenatal vitamin prescriptions, and depression screening. Weight gain, preterm deliveries, cesareans, and birthweight were compared between obese women with low and medium versus high adherence to PNC content using multivariable logistic regression. High provider adherence to an eight-item PNC content score (56.3 vs. 66.5 %, p = 0.02) and depression screening (2.0 vs. 11.4 %, p = 0.001) were both lower for obese versus non-obese women. Among obese women, there were no differences by level of provider adherence to PNC content in preterm delivery, cesareans, and low birth weight, but obese women experiencing low and medium versus high adherence were more likely to gain ≥20 lbs (aOR 5.5, 95 % CI 1.3-23.3). Providers may be administering PNC differently to obese and non-obese women. PNC for obese women who are at high risk of adverse perinatal outcomes needs to be addressed especially as it relates to depression screening and gestational weight gain.

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