Health Care Utilization Patterns in Adolescent Pregnant Women: A Retrospective Analysis [A205]. (May 2022)

• Record Type: Journal Article
• Authors: Davitt, Katlin; Gurram, Padmalatha; White, Samantha; Staudenmaier, Emily; Denisova, Elizabeth; Abruzzese, Jessica
• Is Part Of: Obstetrics and gynecology. Volume 139(2022)Supplement 1
• Page Start: 59S
• Page End: 60S
• Publication Date: 2022-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000826096.99870.1f
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Adolescent mothers are at increased risk for adverse outcomes. Utilization of perinatal health care services across the continuum of care, antepartum, intrapartum, and postpartum is crucial to improve outcomes. We aimed to study utilization of perinatal health care services, including outpatient and inpatient resources by adolescent mothers. METHODS: Retrospective review of women who received prenatal care and delivered between February 2019 and February 2020. Subjects were divided into three cohorts based on age: adolescent (13–21), non-adolescent (22–34), and advanced maternal age (≥35, AMA). The adequacy of prenatal care was determined by Kessner index: Adequate (begins in first trimester or includes 9+ visits), Intermediate (begins in second trimester or includes 5–8 visits), and Inadequate (begins in third trimester or includes ≤4 visits). Utilization of inpatient services was determined by access ratio, calculated as inpatient services (emergency department + labor & delivery triages + antepartum admissions + postpartum ED visits) / ambulatory services (prenatal + postpartum + ultrasound visits). Institutional review board approval was obtained. RESULTS: A total of 79 adolescents, 203 non-adolescents, and 59 AMA were studied. Mean gestational age at initial care visit was 15 weeks in adolescents. Compared to other cohorts, adolescents had fewer prenatal, ultrasound, and postpartum visits ( P <.05). Adolescents were more likely to have intermediate (44.6%) and inadequate (18.9%) prenatal care ( P =.04). Adolescents also had higher antepartum admissions ( P =.006) and a higher access ratio ( P =.01). Outcomes were similar except for higher rates of preterm contractions ( P =.03). CONCLUSION: The pattern of resource utilization demonstrates an overall favoring of inpatient services among adolescent mothers with inadequate access to outpatient resources. Strategies to improve access to prenatal outpatient visits are essential.