Factors Related to Early Initiation and Adequate Prenatal Care in Virginia: A 5-Year Study

Late and inadequate prenatal care (PNC) increases risk of poor birth outcomes, such as low birth weight and risk of prematurity. There remain persistent maternal and infant racial and socioeconomic disparities and inequities in PNC initiation and adequacy of PNC in Virginia. The objective of this study is to describe sociodemographic factors associated with initiation of PNC and adequacy of PNC and birth outcomes.

Cross-sectional study using secondary analysis of 2016-2020 Virginia Pregnancy Risk Assessment Monitoring System was performed (N = 4,516). The outcomes of interest included initiation of PNC in the first trimester, adequacy of PNC, and birth outcomes. Sociodemographic variables included age, race/ethnicity, education, insurance, and maternal education. Bivariate analysis and multivariate logistic regressions were performed.

Race/ethnicity, income, education, and insurance had significant association with initiation of PNC in the first trimester. Non-Hispanic Black women (adjusted odds ratio [aOR] = 0.634; 95% CI: 0.45-0.90) and Hispanic women (aOR = 0.602; 95% confidence interval [CI]: 0.42-0.87) were less likely to have adequate PNC compared with non-Hispanic White women. Those who were over age 35 had higher odds of preterm birth compared with those aged 25-34 (odds ratio [OR] = 1.57; 95% CI: 1.07-2.32). Non-Hispanic Black mothers had higher odds of low birth weight compared with non-Hispanic White mothers (OR = 2.09; 95% CI: 1.27-3.45).

The findings highlight the opportunity to provide PNC for Hispanic and non-Hispanic Black women, women with low income and low education. Results will lead to the identification of strategic partnerships across disciplines and agencies to address gaps in services for these subpopulations.