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Prenatal care, infant birthweight and infant mortality in Puerto Rico

J L Vázquez Calzada1, S Rivera Acevedo

  • 1Department of Social Sciences, Faculty of Biosocial Sciences, Graduate School of Public Health, University of Puerto Rico, San Juan 00936.

Insights

Prenatal care in Puerto Rico has improved, but disparities persist. Inadequate care is linked to higher rates of low birthweight and infant mortality among vulnerable populations.

Area of Science:

  • Public Health
  • Maternal and Child Health
  • Demography

Background:

  • Prenatal care is crucial for positive birth outcomes.
  • Understanding demographic and socioeconomic factors influencing prenatal care access and adequacy is essential for targeted interventions.
  • Previous trends in Puerto Rican prenatal care quality and its impact on infant health required updated analysis.

Purpose of the Study:

  • To analyze demographic and socioeconomic correlates of prenatal care adequacy in Puerto Rico.
  • To examine the relationship between prenatal care and infant birthweight and mortality.
  • To identify population subgroups with inadequate prenatal care and assess associated risks.

Main Methods:

  • Analysis of 1986 live birth and death certificates from Puerto Rico.
  • Utilization of three indicators for prenatal care adequacy: number of visits, trimester of initiation, and the Kessner Index.
  • Statistical examination of correlations between demographic/socioeconomic factors, prenatal care adequacy, birthweight, and infant mortality.

Main Results:

  • Prenatal care in Puerto Rico showed improvement in early initiation and continuity since 1980.
  • Significant geographical variations in prenatal care adequacy were observed across the island.
  • Inadequate prenatal care was more prevalent among adolescent, unwed, high-parity, and low-socioeconomic status mothers.
  • These vulnerable groups experienced higher rates of low birthweight infants and increased infant mortality.
  • A statistical association was found between inadequate prenatal care and adverse infant outcomes.

Conclusions:

  • Despite overall improvements, significant disparities in prenatal care adequacy exist in Puerto Rico.
  • Inadequate prenatal care is a contributing factor to higher rates of low birthweight and infant mortality among disadvantaged subgroups.
  • Targeted public health interventions are needed to address socioeconomic and demographic barriers to adequate prenatal care.

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