The Effect of Prenatal Care in a Population with Body Mass Index Greater than or equal to 30 on Apgar Score at 5 Minutes
AAPA ePoster library. Dunn B. 05/17/17; 180506; 121
Bethany Dunn
Bethany Dunn
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Abstract
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Abstract Purpose: Adverse birth outcomes continue to be prevalent nationally despite advances in medicine and they are not distributed evenly as a disparity continues between races, particularly Caucasian and African American populations. Several factors may contribute to this disparity including maternal pre-pregnancy obesity and prenatal care, both of which are modifiable factors. The objective of this study was to assess whether the relationship between the number of attended recommended prenatal care visits and 5-minute Apgar score differed between obese Caucasian and obese minority (African American or Hispanic) women. Racial group, maternal pre-pregnancy BMI, initiation of prenatal care, number of prenatal visits, and 5-minute Apgar score were analyzed. This study utilized the most recent infant natality data available for the U.S. It also built upon previous studies to explore the impact of prenatal care on infant outcomes as defined by the 5-minute Apgar score among women with pre-pregnancy BMI 30 or greater among Caucasian, African American and Hispanic populations. It was hypothesized that obese, minority women may have lower 5-minute Apgar scores as a function of number of attended recommended prenatal visits when compared with obese, Caucasian women. Methodology: A cross-sectional study was conducted utilizing a sample size of 39,779 women and their children from the 2014 Natality Public Use Dataset from the Center for Disease Control and Prevention (CDC). Hispanic, African American, and Caucasian women with a pre-pregnancy BMI of 30 or greater and age of 18-34 years who had a pregnancy in 2014 were selected. Women with pre-pregnancy hypertension, pre-pregnancy diabetes, multiple births or partial and missing data were excluded from the analyses. A randomized sample of 5% of the remaining pregnancies was taken in order to simplify the computations and analyses. The outcome of interest (child health at birth) was measured using the 5-minute Apgar score, and dichotomized into adequate (7-10) and low (0-6). Adequacy of prenatal care was assessed using the Adequacy for Prenatal Care Utilization index (APNCU), categorized as sufficient and insufficient prenatal care. Additional independent variables that may also be related to 5-minute Apgar score at birth were controlled for using multiple logistic regression analysis. These additional independent variables included: race, preeclampsia, gestational diabetes and smoking during pregnancy. ...
Abstract Purpose: Adverse birth outcomes continue to be prevalent nationally despite advances in medicine and they are not distributed evenly as a disparity continues between races, particularly Caucasian and African American populations. Several factors may contribute to this disparity including maternal pre-pregnancy obesity and prenatal care, both of which are modifiable factors. The objective of this study was to assess whether the relationship between the number of attended recommended prenatal care visits and 5-minute Apgar score differed between obese Caucasian and obese minority (African American or Hispanic) women. Racial group, maternal pre-pregnancy BMI, initiation of prenatal care, number of prenatal visits, and 5-minute Apgar score were analyzed. This study utilized the most recent infant natality data available for the U.S. It also built upon previous studies to explore the impact of prenatal care on infant outcomes as defined by the 5-minute Apgar score among women with pre-pregnancy BMI 30 or greater among Caucasian, African American and Hispanic populations. It was hypothesized that obese, minority women may have lower 5-minute Apgar scores as a function of number of attended recommended prenatal visits when compared with obese, Caucasian women. Methodology: A cross-sectional study was conducted utilizing a sample size of 39,779 women and their children from the 2014 Natality Public Use Dataset from the Center for Disease Control and Prevention (CDC). Hispanic, African American, and Caucasian women with a pre-pregnancy BMI of 30 or greater and age of 18-34 years who had a pregnancy in 2014 were selected. Women with pre-pregnancy hypertension, pre-pregnancy diabetes, multiple births or partial and missing data were excluded from the analyses. A randomized sample of 5% of the remaining pregnancies was taken in order to simplify the computations and analyses. The outcome of interest (child health at birth) was measured using the 5-minute Apgar score, and dichotomized into adequate (7-10) and low (0-6). Adequacy of prenatal care was assessed using the Adequacy for Prenatal Care Utilization index (APNCU), categorized as sufficient and insufficient prenatal care. Additional independent variables that may also be related to 5-minute Apgar score at birth were controlled for using multiple logistic regression analysis. These additional independent variables included: race, preeclampsia, gestational diabetes and smoking during pregnancy. ...
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