Purpose: To examine factors associated with the number of prenatal care visits during second pregnancy for adolescents having a short interval between pregnancies.
Methods: The sample includes all adolescents aged 13 to 17 years whose first pregnancy resulted in a birth at a regional medical center in southeastern North Carolina from January 1983 to December 1989 and who had a repeat pregnancy within 24 months which resulted in a birth. We abstracted data from medical records and birth certificates. We fit a negative binomial regression model to determine the effects of various factors on the number of prenatal care visits during second pregnancy.
Results: The number of prenatal care visits during the first pregnancy, poor first birth outcome, interval between first and second pregnancy, and care provided by health department staff during first pregnancy were all positively associated with number of prenatal care visits during second pregnancy when controlling for gestation age of second birth. Other independent variables in the model included maternal age, education, black race, and being unmarried at the time of second birth.
Conclusions: Because prenatal care is important for healthy mothers and babies, adolescents should be encouraged to seek prenatal care early in the first pregnancy. This could be an important time to implement interventions aimed at increasing prenatal care utilization in this and subsequent pregnancies.
PIP: Researchers analyzed data on 287 adolescents who delivered their first child between January 1983 and December 1989 at a regional medical center in southeastern North Carolina and had a repeat pregnancy within 24 months of the first birth to identify factors linked to the number of prenatal care visits during the second pregnancy for these adolescents. They were 13-17 years old during the first pregnancy and 15-19 years old during the second pregnancy. The interval between pregnancies was no more than 12 months for about 50% of the teens and no more than 18 months for more than 80%. The mean interval between pregnancies was 11.1 months. The teens were more likely to have received no prenatal care during their second pregnancy than their first pregnancy (7.9% vs. 2.9%; p 0.001). They also had fewer prenatal visits (7.5 vs. 9.2; p 0.0001). After controlling for gestation age of second birth, factors positively associated with the number of prenatal care visits during the second pregnancy were poor first birth outcome, number of prenatal care visits during first pregnancy, pregnancy interval, and care provided by the county health department. A poor first birth outcome had the greatest impact on the number of prenatal care visits during second pregnancy. These findings indicate the need to encourage teens to seek prenatal care early in their first pregnancy so clinicians can implement interventions which increase prenatal care use during this and subsequent pregnancies.