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Provider Adherence to Recommended Prenatal Care Content: Does It Differ for Obese Women?

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Abstract

The objective of this study was to examine provider adherence to prenatal care (PNC) content in obese and non-obese women and perinatal outcomes in obese women experiencing low and medium versus high adherence to PNC content. Provider adherence to PNC content (low <50 %, medium 50–79 %, and high ≥80 %) was compared between obese (n = 69) and non-obese (n = 128) women in a linked database of deliveries to low-income, minority women from 2003 to 2004. Sample content items included procedures delivered at every visit (blood pressure, urinalysis, maternal weight, fetal heart rate check), timed screenings for birth defects and gestational diabetes, prenatal vitamin prescriptions, and depression screening. Weight gain, preterm deliveries, cesareans, and birthweight were compared between obese women with low and medium versus high adherence to PNC content using multivariable logistic regression. High provider adherence to an eight-item PNC content score (56.3 vs. 66.5 %, p = 0.02) and depression screening (2.0 vs. 11.4 %, p = 0.001) were both lower for obese versus non-obese women. Among obese women, there were no differences by level of provider adherence to PNC content in preterm delivery, cesareans, and low birth weight, but obese women experiencing low and medium versus high adherence were more likely to gain ≥20 lbs (aOR 5.5, 95 % CI 1.3–23.3). Providers may be administering PNC differently to obese and non-obese women. PNC for obese women who are at high risk of adverse perinatal outcomes needs to be addressed especially as it relates to depression screening and gestational weight gain.

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Acknowledgments

This study was supported by Grant Number K12HD055892 from the NICHD and the NIH Office of Research on Women’s Health (ORWH) (MAK).

Conflict of interest

The authors have no conflicts of interest.

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Authors and Affiliations

  1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street M/C 808, Chicago, IL, 60612, USA

    Michelle A. Kominiarek

  2. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA

    Kristin Rankin

  3. Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA

    Arden Handler

Authors
  1. Michelle A. Kominiarek
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  2. Kristin Rankin
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  3. Arden Handler
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Correspondence to Michelle A. Kominiarek.

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Kominiarek, M.A., Rankin, K. & Handler, A. Provider Adherence to Recommended Prenatal Care Content: Does It Differ for Obese Women?. Matern Child Health J 18, 1114–1122 (2014). https://doi.org/10.1007/s10995-013-1341-7

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