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

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.

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).

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.

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.