The association of Chinese and American antenatal care utilization indices with birth outcomes

Haibo Zhou; Haibo Zhou; Haibo Zhou; Yi Yang; Peihan Chi; Peihan Chi; Haoyue Cheng; Haoyue Cheng; Xialidan Alifu; Xialidan Alifu; Yiwen Qiu; Yiwen Qiu; Ye Huang; Ye Huang; Libi Zhang; Libi Zhang; Diliyaer Ainiwan; Diliyaer Ainiwan; Yan Zhuang; Yan Zhuang; Hui Liu; Zhi Chen; Yunxian Yu; Yunxian Yu

doi:10.3389/fpubh.2024.1420943

Frontiers in Public Health (Aug 2024)

The association of Chinese and American antenatal care utilization indices with birth outcomes

Haibo Zhou,
Haibo Zhou,
Haibo Zhou,
Yi Yang,
Peihan Chi,
Peihan Chi,
Haoyue Cheng,
Haoyue Cheng,
Xialidan Alifu,
Xialidan Alifu,
Yiwen Qiu,
Yiwen Qiu,
Ye Huang,
Ye Huang,
Libi Zhang,
Libi Zhang,
Diliyaer Ainiwan,
Diliyaer Ainiwan,
Yan Zhuang,
Yan Zhuang,
Hui Liu,
Zhi Chen,
Yunxian Yu,
Yunxian Yu

Affiliations

Haibo Zhou: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Haibo Zhou: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
Haibo Zhou: Department of Science and Education of the Fourth Affiliated Hospital, and Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
Yi Yang: Department of Science and Education of the Fourth Affiliated Hospital, and Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
Peihan Chi: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Peihan Chi: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
Haoyue Cheng: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Haoyue Cheng: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
Xialidan Alifu: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Xialidan Alifu: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
Yiwen Qiu: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Yiwen Qiu: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
Ye Huang: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Ye Huang: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
Libi Zhang: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Libi Zhang: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
Diliyaer Ainiwan: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Diliyaer Ainiwan: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
Yan Zhuang: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Yan Zhuang: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
Hui Liu: Clinical Research Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
Zhi Chen: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
Yunxian Yu: Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Yunxian Yu: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China

DOI: https://doi.org/10.3389/fpubh.2024.1420943
Journal volume & issue: Vol. 12

Abstract

Read online

ObjectiveFew comparisons have been implemented between different prenatal care utilization indices and their effects on adverse outcomes. This study investigated the appropriateness of Chinese antenatal care (ANC) regulations and compared Chinese and American adequacy of prenatal care utilization (APNCU) scores.MethodsFrom 2010 to 2022, the medical records of 60,114 pregnant women were collected from the electronic medical record system (EMRS) in Zhoushan, China. ANC utilization was measured using the APNCU score and five times antenatal care (ANC5). Birth weight outcomes, including small for gestational age (SGA) and large for gestational age (LGA), low birth weight (LBW), macrosomia, birth weight, and preterm birth (PTB), were utilized as outcomes. Multinomial, linear, and logistic regression were used to analyze the association of ANC5 and APNCU with outcomes, respectively. Crossover analysis was implemented to compare the interaction between ANC5 and APNCU on the outcomes.ResultsWomen who received inadequate prenatal care had increased odds for PTB (ANC5: odds ratio (OR) = 1.12, 95% confidence interval (95%CI) = 1.03–1.21; APNCU: OR = 1.18, 95%CI: 1.07–1.29), delivering SGA infants (ANC5: OR = 1.13, 95%CI = 1.07–1.21; APNCU: OR = 1.11, 95%CI = 1.03–1.20). Crossover analysis revealed that inadequate prenatal care in APNCU only was significantly associated with an increased risk of PTB (OR = 1.48, 95%CI: 1.26–1.73).ConclusionWomen with inadequate prenatal care in ANC5 or APNCU were more likely to suffer from adverse birth outcomes, including PTB, birth weight loss, SGA, and LBW. It indicated that adequate prenatal care is necessary for pregnant women. However, there were interactions between ANC5 and APNCU on PTB, with inadequate prenatal care use by APNCU showing the highest risk of PTB. This indicates that APNCU would be a better tool for evaluating prenatal care use.

Published in Frontiers in Public Health

ISSN: 2296-2565 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.frontiersin.org/journals/public-health

About the journal

Abstract

Keywords