Length of gestation and postpartum visit attendance

Area of Science:

• Obstetrics and Gynecology
• Neonatal Care
• Public Health

Background:

• Approximately 40% of obstetric patients miss postpartum visits.
• Parents of preterm infants often prioritize infant care in the neonatal intensive care unit (NICU) over their own postpartum appointments.
• This can lead to missed opportunities for essential maternal health assessments.

Purpose of the Study:

• To investigate the association between gestational age at birth and postpartum visit attendance.
• To determine if parents of preterm infants are less likely to attend postpartum visits compared to parents of full-term infants.

Main Methods:

• Retrospective cohort study using a national electronic health record database (2018-2024).
• Included births with documented prenatal visits to ensure postpartum visit capture.
• Multivariable modified Poisson regression models analyzed adjusted risk ratios for non-attendance based on gestational age, controlling for demographic and clinical factors.

Main Results:

• Over 2.4 million births were analyzed; 27% of parents did not attend postpartum visits.
• Higher non-attendance rates were observed for Black non-Hispanic individuals (32%), smokers (56%), those with BMI >30 kg/m² (30%), and multiparous individuals (29%).
• All gestational age categories, including preterm, early-term, and late/post-term births, showed increased risk of non-attendance compared to full-term births. Periviable births (22-23 weeks) had the highest adjusted risk ratio (aRR 1.21).

Conclusions:

• Gestational age at birth is significantly associated with postpartum visit attendance, with periviable births posing the highest risk.
• Current postpartum care models may not adequately address the needs of parents with preterm infants.
• Interdisciplinary and innovative approaches are crucial to improve postpartum care access for this vulnerable population.