TITLE:
Relationship of Prenatal Care to Poor Postnatal Outcomes in Infants Requiring Neurodevelopmental Assessment
AUTHORS:
Juniper J. Lee-Park, Trevor L. Valentine
KEYWORDS:
Prenatal Care, Neurodevelopmental Outcomes, Mother-Baby Dyad
JOURNAL NAME:
Open Access Library Journal,
Vol.6 No.12,
December
24,
2019
ABSTRACT: Objectives: We aimed to determine whether complete lack of prenatal care (NPC: No Prenatal Care) is associated with social, as well as medical vul-nerability of the mother-infant dyad and how it affects neurodevelopmental outcomes in infants. Methods: Selected social determinants indicative of the family’s social vulnerability, including intrauterine drug exposure (IUDE) of the infant and child protective service (CPS) involvement before discharge, were compared between a cohort of infants whose mothers sought prenatal care and their counterparts with complete lack of PC. Also, selected medical conditions indicative of an infants’ medical vulnerability, including cardiovascular, pulmonary, and neurological diagnoses, were compared between two groups. Fifty seven infants in a neonatal intensive care unit (NICU) and 10,483 infants in the newborn nursery at an urban level III hospital who were admitted between 2016 and 2018 were retrospectively evaluated. Results: Higher social vulnerability was observed in NPC group as indicated by a more prevalent history of IUDE and higher rates of CPS involvement. NPC mothers were also more likely to be Medicaid recipients and younger. Infants in both the NICU and the newborn nursery also had a lower mean birth weights for gestational age, lower APGAR scores as well as poorer respiratory and neurological outcomes. Conclusion for Practice: Prenatal care can have long lasting benefits to the mother-infant dyad by lowering the risks associated with pregnancy, increasing birth weights and lowering the risk for developing pulmonary and neurological complications. Promoting the family’s active engagement in prenatal care can also serve as an easily achievable first step in minimizing health disparities.