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Prenatal care utilization in Mississippi: racial disparities and implications for unfavorable birth outcomes

Reagan G Cox1, Lei Zhang, Marianne E Zotti

  • 1Department of Microbiology and Immunology, Vanderbilt University School of Medicine, C2213 Medical Center North, 1161 21st Ave S, Nashville, TN, 37232-2581, USA. reagan.j.cox@vanderbilt.edu

Maternal and Child Health Journal
|November 28, 2009
PubMed

Insights

Racial disparities in prenatal care (PNC) exist in Mississippi, with Black women receiving inadequate or no care more often. Improving PNC access can reduce preterm birth, low birth weight, and infant mortality.

Area of Science:

  • Public Health
  • Maternal and Child Health
  • Health Disparities

Background:

  • Prenatal care (PNC) is crucial for positive birth outcomes.
  • Racial disparities in healthcare access and outcomes are a significant public health concern.
  • Mississippi has historically faced challenges in maternal and infant health.

Purpose of the Study:

  • To identify racial disparities in prenatal care (PNC) utilization among women in Mississippi.
  • To examine the association between PNC adequacy and adverse birth outcomes, including preterm birth (PTB), low birth weight (LBW), and infant mortality.
  • To provide empirical evidence on racial differences in PNC and birth outcomes.

Main Methods:

  • Retrospective cohort study using linked Mississippi birth and infant death files (1996-2003).
  • Analysis focused on live-born singleton infants of non-Hispanic white and Black women (n=292,776).
  • Prenatal care utilization was classified using Kotelchuck's Adequacy of Prenatal Care Utilization Index; logistic regression controlled for confounders.

Main Results:

  • Approximately 20% of Mississippi women received less than adequate PNC.
  • Significant racial disparities were observed: Black women were more likely to have inadequate or no PNC compared to white women.
  • Inadequate or no PNC were identified as strong risk factors for PTB, LBW, and infant death, irrespective of race.

Conclusions:

  • Empirical evidence confirms racial disparities in PNC utilization and birth outcomes in Mississippi.
  • Black women face greater barriers to adequate PNC, even when controlling for medical conditions.
  • Public health interventions aimed at improving PNC utilization may reduce adverse infant outcomes, particularly infant mortality.

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