Associations Between Virtual Prenatal Care Utilization, Social Determinants of Health, and Stressful Life Events: A Multistate Analysis of U.S. Women, 2020–2021

OBJECTIVES: To examine associations between virtual prenatal care utilization, social determinants of health, and stressful life events. METHODS: We analyzed cross-sectional pooled survey data (N = 11,966) from phase 8 of the Pregnancy Risk Assessment Monitoring System for women who gave birth in 2020 or 2021 and received prenatal care. RESULTS: A third (35%) of women utilized virtual rather than in-person-only prenatal care. Adjusted odds of receiving any virtual prenatal care were greater for women who identified as Asian (aOR = 1.23; 95% CI[1.01, 1.51]) or Hispanic (aOR = 1.61; 95% CI[1.37, 1.88]), and for those who experienced homelessness (aOR = 1.90; 95% CI[1.27, 2.84]) or job loss (aOR = 1.25; 95% CI[1.04, 1.51]). Adjusted odds were lower for women who did not have a bachelor's degree, had previously given birth, had no insurance pre-pregnancy (aOR = 0.69; 95% CI[0.56, 0.85]), were rural residents (aOR = 0.51; 95% CI[0.41, 0.63]), had been exposed to incarceration (aOR = 0.49; 95% CI[0.30, 0.79]), and had given birth in 2021 (aOR = 0.77; 95% CI[0.69, 0.86]). CONCLUSIONS: Social determinants of health and stressful life events are not uniformly associated with greater or lesser odds of utilizing virtual prenatal care.