caa a22 4500 397577540 CHVBK 20180308164900.0 cr unu---uuuuu 161202e199609 xx s 000 0 eng 10.1093/oxfordjournals.pubmed.a024513 doi (NATIONALLICENCE)oxford-10.1093/oxfordjournals.pubmed.a024513 Role of prenatal care in preterm birth and low birthweight in Portugal [Elektronische Daten] [Henrique Barros, Margarida Tavares, Teresa Rodrigues] Background It remains unclear if benefits of prenatal care can be attributed to the amount and content of care or to uncontrolled risk factors that might also affect its use. This study was designed to evaluate the independent association between prenatal care adequacy and adverse pregnancy outcomes, measured either as the occurrence of preterm birth or low birthweight. Method We studied 3734 single liveborn infants. Information on mothers' use of prenatal care, and demographic, anthropometric, behavioural, clinical and obstetric characteristics were obtained through questionnaire. Prenatal care was classified as inadequate, intermediate or adequate based on Kessner's Adequacy of Prenatal Care Index. To estimate the association of adequacy of prenatal care and the defined outcomes, both crude and adjusted odds ratios (OR) and 95 per cent confidence intervals (95 percent CI) were calculated by means of unconditional logistic regression. Results Adequate and intermediate (compared with inadequate) prenatal care was significantly associated with a lower risk of preterm (OR = 0⋅20, 95 per cent Cl 0⋅12-0⋅32, and OR = 0⋅35, 95 per cent Cl 0⋅23-0⋅54, respectively) or low birthweight (OR = 0⋅23, 95 per cent Cl 0⋅15-0⋅35, and OR = 0⋅31, 95 per cent Cl 0⋅20-0⋅46, respectively). After adjusting for maternal age, social class, marital status, complications of pregnancy and type of hospital, the risk of preterm delivery remained significantly lower for women receiving adequate (OR = 0⋅18, 95 per cent Cl 0⋅11-0⋅28) or intermediate care (OR = 0⋅35, 95 per cent Cl 0⋅23-0⋅54). Adjusted for maternal body mass index, marital status, cigarette smoking, pregnancy weight gain and complications, type of hospital, newborn sex and gestational age, a significant decreased risk of low birthweight remained for infants of women with adequate (OR = 0⋅39, 95 per cent Cl 0⋅23-0⋅65) or intermediate care (OR = 0⋅47, 95 per cent Cl 0⋅29-0⋅76). Conclusions Our findings show that in a population with free access to prenatal care, the quantitative adequacy of prenatal care has an independent effect on pregnancy outcome, whether assessed through the occurrence of preterm births or low birthweight infants © Oxford University Press Articles nationallicence low birthweight nationallicence prenatal care nationallicence preterm nationallicence risk nationallicence Barros Henrique Department of Hygiene and Epidemiology, University of Porto Medical School, 4200 Porto, Portugal aut Tavares Margarida Department of Hygiene and Epidemiology, University of Porto Medical School, 4200 Porto, Portugal aut Rodrigues Teresa Department of Hygiene and Epidemiology, University of Porto Medical School, 4200 Porto, Portugal aut Journal of Public Health Oxford University Press 18/3(1996-09), 321-328 1741-3842 18:3<321 1996 18 pubmed https://doi.org/10.1093/oxfordjournals.pubmed.a024513 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/oxfordjournals.pubmed.a024513 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Barros Henrique Department of Hygiene and Epidemiology, University of Porto Medical School, 4200 Porto, Portugal aut NATIONALLICENCE 700 1- Tavares Margarida Department of Hygiene and Epidemiology, University of Porto Medical School, 4200 Porto, Portugal aut NATIONALLICENCE 700 1- Rodrigues Teresa Department of Hygiene and Epidemiology, University of Porto Medical School, 4200 Porto, Portugal aut NATIONALLICENCE 773 0- Journal of Public Health Oxford University Press 18/3(1996-09), 321-328 1741-3842 18:3<321 1996 18 pubmed Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford