Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018–2021
Abstract Background During the COVID-19 pandemic, hospitals’ decision of not admitting pregnant women’s partner or support person, and pregnant women’s fear of contracting COVID-19 in hospitals may disrupt prenatal care. We aimed to examine whether prenatal care utilization in South Carolina varied...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-05983-x |
| _version_ | 1797555808723009536 |
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| author | Emmanuel Fabrice Julceus Bankole Olatosi Peiyin Hung Jiajia Zhang Xiaoming Li Jihong Liu |
| author_facet | Emmanuel Fabrice Julceus Bankole Olatosi Peiyin Hung Jiajia Zhang Xiaoming Li Jihong Liu |
| author_sort | Emmanuel Fabrice Julceus |
| collection | DOAJ |
| description | Abstract Background During the COVID-19 pandemic, hospitals’ decision of not admitting pregnant women’s partner or support person, and pregnant women’s fear of contracting COVID-19 in hospitals may disrupt prenatal care. We aimed to examine whether prenatal care utilization in South Carolina varied before and during the COVID-19 pandemic, and whether the variation was different by race. Methods We utilized 2018–2021 statewide birth certificate data using a pre-post design, including all women who delivered a live birth in South Carolina. The Kotelchuck Index - incorporating the timing of prenatal care initiation and the frequency of gestational age-adjusted visits - was employed to categorize prenatal care into inadequate versus adequate care. Self-reported race includes White, Black, and other race groups. Multiple logistic regression models were used to calculate adjusted odds ratio of inadequate prenatal care and prenatal care initiation after first trimester by maternal race before and during the pandemic. Results A total of 118,925 women became pregnant before the pandemic (before March 2020) and 29,237 women during the COVID-19 pandemic (March 2020 – June 2021). Regarding race, 65.2% were White women, 32.0% were Black women and 2.8% were of other races. Lack of adequate prenatal care was more prevalent during the pandemic compared to pre-pandemic (24.1% vs. 21.6%, p < 0.001), so was the percentage of initiating prenatal care after the first trimester (27.2% vs. 25.0%, p < 0.001). The interaction of race and pandemic period on prenatal care adequacy and initiation was significant. The odds of not receiving adequate prenatal care were higher during the pandemic compared to before for Black women (OR 1.26, 95% CI 1.20–1.33) and White women (OR 1.10, 95% CI 1.06–1.15). The odds of initiating prenatal care after the first trimester were higher during the pandemic for Black women (OR 1.18, 95% CI 1.13–1.24) and White women (OR 1.09, 95% CI 1.04–1.13). Conclusions Compared to pre-pandemic, the odds of not receiving adequate prenatal care in South Carolina was increased by 10% for White women and 26% for Black women during the pandemic, highlighting the needs to develop individual tailored interventions to reverse this trend. |
| first_indexed | 2024-03-10T16:52:54Z |
| format | Article |
| id | doaj.art-6174d313aae3471aaca6eb91fdef089b |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-10T16:52:54Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-6174d313aae3471aaca6eb91fdef089b2023-11-20T11:14:06ZengBMCBMC Pregnancy and Childbirth1471-23932023-09-0123111010.1186/s12884-023-05983-xRacial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018–2021Emmanuel Fabrice Julceus0Bankole Olatosi1Peiyin Hung2Jiajia Zhang3Xiaoming Li4Jihong Liu5Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South CarolinaDepartment of Health Services Policy and Management, Arnold School of Public Health, University of South CarolinaDepartment of Health Services Policy and Management, Arnold School of Public Health, University of South CarolinaDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South CarolinaDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South CarolinaDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South CarolinaAbstract Background During the COVID-19 pandemic, hospitals’ decision of not admitting pregnant women’s partner or support person, and pregnant women’s fear of contracting COVID-19 in hospitals may disrupt prenatal care. We aimed to examine whether prenatal care utilization in South Carolina varied before and during the COVID-19 pandemic, and whether the variation was different by race. Methods We utilized 2018–2021 statewide birth certificate data using a pre-post design, including all women who delivered a live birth in South Carolina. The Kotelchuck Index - incorporating the timing of prenatal care initiation and the frequency of gestational age-adjusted visits - was employed to categorize prenatal care into inadequate versus adequate care. Self-reported race includes White, Black, and other race groups. Multiple logistic regression models were used to calculate adjusted odds ratio of inadequate prenatal care and prenatal care initiation after first trimester by maternal race before and during the pandemic. Results A total of 118,925 women became pregnant before the pandemic (before March 2020) and 29,237 women during the COVID-19 pandemic (March 2020 – June 2021). Regarding race, 65.2% were White women, 32.0% were Black women and 2.8% were of other races. Lack of adequate prenatal care was more prevalent during the pandemic compared to pre-pandemic (24.1% vs. 21.6%, p < 0.001), so was the percentage of initiating prenatal care after the first trimester (27.2% vs. 25.0%, p < 0.001). The interaction of race and pandemic period on prenatal care adequacy and initiation was significant. The odds of not receiving adequate prenatal care were higher during the pandemic compared to before for Black women (OR 1.26, 95% CI 1.20–1.33) and White women (OR 1.10, 95% CI 1.06–1.15). The odds of initiating prenatal care after the first trimester were higher during the pandemic for Black women (OR 1.18, 95% CI 1.13–1.24) and White women (OR 1.09, 95% CI 1.04–1.13). Conclusions Compared to pre-pandemic, the odds of not receiving adequate prenatal care in South Carolina was increased by 10% for White women and 26% for Black women during the pandemic, highlighting the needs to develop individual tailored interventions to reverse this trend.https://doi.org/10.1186/s12884-023-05983-xPrenatal careCOVID-19RaceDisparitiesSouth CarolinaAdequacy of prenatal care utilization |
| spellingShingle | Emmanuel Fabrice Julceus Bankole Olatosi Peiyin Hung Jiajia Zhang Xiaoming Li Jihong Liu Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018–2021 BMC Pregnancy and Childbirth Prenatal care COVID-19 Race Disparities South Carolina Adequacy of prenatal care utilization |
| title | Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018–2021 |
| title_full | Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018–2021 |
| title_fullStr | Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018–2021 |
| title_full_unstemmed | Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018–2021 |
| title_short | Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018–2021 |
| title_sort | racial disparities in adequacy of prenatal care during the covid 19 pandemic in south carolina 2018 2021 |
| topic | Prenatal care COVID-19 Race Disparities South Carolina Adequacy of prenatal care utilization |
| url | https://doi.org/10.1186/s12884-023-05983-x |
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