Adequate Prenatal Care and Maternal Morbidity Among Birthing People with Preexisting Comorbidities

Abstract

Introduction: Preexisting comorbidities can make the pregnancy experience difficult. Prenatal care has been suggested as a mechanism to identify and control preexisting conditions and prevent adverse maternal outcomes. Maternal morbidity encompasses health conditions attributed to and/or aggravated by pregnancy and childbirth that negatively impact the birthing person's well-being.

Methods: Using North Carolina's birth records for 2011-2019, this analysis employs multivariate logistic regression to examine whether adequate prenatal care reduces the likelihood of maternal morbidity outcomes. The analysis examines both the overall birthing population (n = 1,020,639) and the birthing population with preexisting diabetes and/or hypertension (n = 29,230).

Results: Having inadequate prenatal care increases the probability of experiencing maternal morbidity outcomes by 7.2% (OR = 1.072, 95%CI:1.01-1.13) compared to having adequate prenatal care. The effect is more pronounced among individuals with preexisting diabetes and/or hypertension, where having inadequate prenatal care increases the probability of maternal morbidity outcomes by 45.6% (OR = 1.456, 95% CI: 1.03-2.07) compared to those with adequate prenatal care.

Discussion: These results suggest that adequate prenatal care may help prevent maternal morbidity outcomes across the birthing population, with particularly strong protective effects for those with preexisting conditions.

Keywords: Comorbidities; Healthcare utilization; Maternal morbidity; Prenatal care.