AUTHOR=Zhou Haibo , Yang Yi , Chi Peihan , Cheng Haoyue , Alifu Xialidan , Qiu Yiwen , Huang Ye , Zhang Libi , Ainiwan Diliyaer , Zhuang Yan , Liu Hui , Chen Zhi , Yu Yunxian 

TITLE=The association of Chinese and American antenatal care utilization indices with birth outcomes

JOURNAL=Frontiers in Public Health

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1420943

DOI=10.3389/fpubh.2024.1420943

ISSN=2296-2565

ABSTRACT=Objective: Few comparisons have been implemented between different prenatal care utilization indexes and their effects on adverse outcomes. This study investigated the appropriateness of Chinese antenatal care (ANC) regulations and compared Chinese and American adequacy of prenatal care utilization (APNCU) scores.From 2010 to 2022, 60114 pregnant women's medical records were collected from the Electronic Medical Record System (EMRS) in Zhoushan, China.Antenatal care use was measured using the adequacy of prenatal care utilization (APNCU) score and five times antenatal care (ANC5). Birth weight outcomes, including small for gestational age (SGA) and large for gestational age (LGA), low birth weight (LBW), macrosomia, birth weight, as well as preterm birth (PTB), were utilized as outcomes. Multinomial, linear, and logistic regression were employed to analyze the association of ANC5 and APNCU with outcomes, respectively. Crossover analysis was implemented to compare the interaction between ANC5 and APNCU on the outcomes.Women who received inadequate prenatal care had increased odds for PTB (ANC5: odds ratio (OR) = 1.12, 95% confidence interval (95%CI) = 1.03-1.21; APNCU: OR = 1.18, 95%CI: 1.07-1.29), delivering SGA infants (ANC5: OR = 1.13, 95%CI = 1.07-1.21; APNCU: OR = 1.11, 95%CI = 1.03-1.20). Crossover analysis revealed that inadequate prenatal care in APNCU only was significantly associated with an increased risk of PTB (OR = 1.48, 95%CI: 1.26-1.73).Women with inadequate prenatal care in ANC5 or APNCU were more likely to suffer from adverse birth outcomes, including PTB, birth weight loss, SGA and LBW. It indicated that adequate prenatal care use is necessary for pregnant women. However, ANC5 and APNCU had interaction on PTB and only inadequate prenatal care use by APNCU had the highest risk of PTB, which indicated that APNCU would be better tool for evaluating prenatal care use.