Mp21-01 Prenatal Care Utilization for Fetuses With Spina Bifida in California

You have accessJournal of UrologyPediatrics II (MP21)1 May 2024MP21-01 PRENATAL CARE UTILIZATION FOR FETUSES WITH SPINA BIFIDA IN CALIFORNIA Than S. Kyaw, Natalia Leva, Debbie Goldberg, Isabel E. Allen, Rory Grant, Lindsay A. Hampson, and Hillary L. Copp Than S. KyawThan S. Kyaw , Natalia LevaNatalia Leva , Debbie GoldbergDebbie Goldberg , Isabel E. AllenIsabel E. Allen , Rory GrantRory Grant , Lindsay A. HampsonLindsay A. Hampson , and Hillary L. CoppHillary L. Copp View All Author Informationhttps://doi.org/10.1097/01.JU.0001008844.84871.17.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Spina bifida (SB) remains prevalent despite an initial decline in incidence following folic acid fortification of enriched grain products in the United States. In utero diagnosis of SB is considered a high-risk pregnancy and frequent prenatal care (PNC) is recommended. We conducted a retrospective observational case-control study to examine the prevalence of and risk factors associated with SB births, compare PNC utilization of women carrying fetuses with and without SB, explore factors associated with insufficient PNC in SB group, and correlate neonatal morbidities with PNC in SB group. METHODS: We queried the California Department of Health Care Access and Information Database for all liveborn infants born in 2005 – 2012. To assess PNC utilization, we used the Adequacy of Prenatal Care Utilization Index to stratify the number of PNC visits into two groups: sufficient care (adequate/adequate plus care) and insufficient care (inadequate/intermediate care). We performed univariate and multivariable analyses to identify factors associated with insufficient PNC among women with SB fetus. Associations between neonatal morbidity and PNC utilization were examined. RESULTS: Of 4,046,311 babies born between 2005 – 2012 in California, 1,049 babies (1 in 3,857 births; annual incidence of 131) were born with SB. Compared to non-SB controls, SB births were associated with maternal race (p=0.01), pre-pregnancy obesity (p<0.01), diabetes (p<0.01), insurance status (p<0.01), and neighborhood socioeconomic status (p<0.01). Consistent with our hypothesis, the percentage of women in the adequate plus care group was significantly higher in the SB group compared to the non-SB group (47% vs. 37%; p<0.001). 21% received insufficient care in both SB cases and non-SB controls. Insufficient PNC in the SB group was associated with non-private insurance status (2.26 odd-ratio; p<0.01) based on both the univariate and multivariate analyses after adjusting for maternal demographics. Neonatal morbidities were higher in the adequate plus PNC group compared to other PNC groups in SB births (p<0.001). CONCLUSIONS: SB cases remain prevalent in California. Although about half of the women with a SB fetus had more PNC visits than what is recommended for healthy fetuses, 1 in 5 of these women did not receive sufficient prenatal care. A major risk factor for insufficient PNC in SB cases was having non-private insurance, which is a potential target to improve care for women with a SB fetus and will prompt future studies to further examine such association. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e329 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Than S. Kyaw More articles by this author Natalia Leva More articles by this author Debbie Goldberg More articles by this author Isabel E. Allen More articles by this author Rory Grant More articles by this author Lindsay A. Hampson More articles by this author Hillary L. Copp More articles by this author Expand All Advertisement PDF downloadLoading ...