INTRODUCTION: While cervical cancer screening is guideline-recommended during prenatal care, patients with positive cervical cancer screenings are often lost to follow-up. Previous research suggests that childcare barriers limit follow-up for women with positive cervical cancer screenings. This study examined the association between childcare barriers and cervical cancer screening follow-up among pregnant patients screened during prenatal care. METHODS: This prospective cohort study included pregnant and postpartum patients who delivered within the last 6 months in a safety-net health system from 2023 to 2025. Patients with positive cervical cancer screenings were referred to gynecology and surveyed on childcare barriers. Patient characteristics, colposcopy completion, and appointment completion up to 1-year postpartum were collected with chart review. Comparison groups included patients reporting childcare responsibilities with childcare barriers, patients with childcare responsibilities without childcare barriers, and patients without childcare responsibilities. RESULTS: Among 316 patients, the mean age was 30.2±4.5 years; 265 (83.9%) self-identified as Hispanic, and 188 (59.5%) received state-funded coverage. Forty-five (14.2%) patients reported childcare responsibilities and childcare barriers; 202 (63.9%) reported childcare responsibilities without childcare barriers; 69 (21.8%) without childcare responsibilities. Patients with childcare barriers were less likely to complete colposcopy (adjusted odds ratio 0.5 95% CI, 0.2–0.9, P =.046). Patients with childcare barriers had an adjusted 17.9% (95% CI, 6.5–29.4) higher gynecology appointment non-completion rate ( P =.002). CONCLUSIONS/IMPLICATIONS: Childcare barriers were associated with lower colposcopy completion and higher appointment non-completion rate among pregnant and postpartum patients with positive cervical cancer screenings. Childcare interventions may support follow-up of positive cervical cancer screenings detected during prenatal care.
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