ArticleBMC pregnancy and childbirth2008
Inadequate prenatal care and its association with adverse pregnancy outcomes: a comparison of indices.
Article in BMC pregnancy and childbirth, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03489174 (Routine Pregnancy Screening for Women on Opioid Substitution Therapy), which is not on this map. Cited by 68 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Routine Pregnancy Screening for Women on Opioid Substitution Therapy: A Randomized Controlled Trial
Who cites it
68 citing papers in PubMed, 4 syntheses or guidelines pooled it, 171 citations in OpenAlex.
- Systematic review of the measurement properties of indices of prenatal care utilization.BMC pregnancy and childbirth · 2020Pooled it
- A systematic review of the effect of reproductive intention screening in primary care settings on reproductive health outcomes.Family practice · 2018Pooled it
- Incentives for increasing prenatal care use by women in order to improve maternal and neonatal outcomes.The Cochrane database of systematic reviews · 2015Pooled it
- Migrant women's utilization of prenatal care: a systematic review.Maternal and child health journal · 2013Pooled it
- Identifying psychosocial predictors and developing a risk score for preterm birth among Kenyan pregnant women.BMC pregnancy and childbirth · 2025Trial
- A cluster randomized trial of delivery of intermittent preventive treatment of malaria in pregnancy at the community level in Burkina Faso.Malaria journal · 2020Trial
- Prevalence and determinants of low-birth-weight deliveries at four district hospitals in Kigali, Rwanda: a cross-sectional study.BMC pregnancy and childbirth · 2026Article
- Defining Prenatal Care Surveillance Metrics Using Electronic Health Record Data.JAMA health forum · 2026Article
- Assessment of the Adequacy of Prenatal Care With Different Evaluation Indices Using Maternal and Fetal Outcomes: A Cross-Sectional Study.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2026Article
- Prospective Comparative Study on the Relationship Between Adverse Maternal and Fetal Outcomes and the Total Number of Antenatal Visits: Evaluating the Focused Antenatal Care Model and Assessment of Prenatal Care Utilization Index.Oman medical journal · 2026Article
- SARS-CoV-2 infection in pregnancy and infant outcomes in the first year of life: a retrospective cohort study.BMC pediatrics · 2025Article
- Trends and factors associated with delays in the first prenatal consultation in Guinea.Journal of public health in Africa · 2025Article
- Insurance coverage and discontinuity during pregnancy: Frequency and associations documented in the PROMISE cohort.Health services research · 2024Article
- Evaluating the relationship between conditional cash transfer programme on preterm births: a retrospective longitudinal study using the 100 million Brazilian cohort.BMC public health · 2024Article
- Survival analysis of early intention of antenatal care among women in Bangladesh.Scientific reports · 2024Article
- The association of Chinese and American antenatal care utilization indices with birth outcomes.Frontiers in public health · 2024Article
- Association of Antenatal Housing Instability with Perinatal Care Utilization and Outcomes.Journal of women's health (2002) · 2024Article
- Independent and joint contributions of inadequate antenatal care timing, contacts and content to adverse pregnancy outcomes.Annals of medicine · 2023Article
- Neighborhood Deprivation and Association With Neonatal Intensive Care Unit Mortality and Morbidity for Extremely Premature Infants.JAMA network open · 2023Article
- Receipt of adequate prenatal care for privately sponsored versus government-assisted refugees in Ontario, Canada: a population-based cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe objectives of this study were to determine rates of prenatal care utilization in Winnipeg, Manitoba, Canada from 1991 to 2000; to compare two indices of prenatal care utilization in identifying the proportion of the population receiving inadequate prenatal care; to determine the association between inadequate prenatal care and adverse pregnancy outcomes (preterm birth, low birth weight [LBW], and small-for-gestational age [SGA]), using each of the indices; and, to assess whether or not, and to what extent, gestational age modifies this association.
methodsWe conducted a population-based study of women having a hospital-based singleton live birth from 1991 to 2000 (N = 80,989). Data sources consisted of a linked mother-baby database and a physician claims file maintained by Manitoba Health. Rates of inadequate prenatal care were calculated using two indices, the R-GINDEX and the APNCU. Logistic regression analysis was used to determine the association between inadequate prenatal care and adverse pregnancy outcomes. Stratified analysis was then used to determine whether the association between inadequate prenatal care and LBW or SGA differed by gestational age.
resultsRates of inadequate/no prenatal care ranged from 8.3% using APNCU to 8.9% using R-GINDEX. The association between inadequate prenatal care and preterm birth and LBW varied depending on the index used, with adjusted odds ratios (AOR) ranging from 1.0 to 1.3. In contrast, both indices revealed the same strength of association of inadequate prenatal care with SGA (AOR 1.4). Both indices demonstrated heterogeneity (non-uniformity) across gestational age strata, indicating the presence of effect modification by gestational age.
conclusionSelection of a prenatal care utilization index requires careful consideration of its methodological underpinnings and limitations. The two indices compared in this study revealed different patterns of utilization of prenatal care, and should not be used interchangeably. Use of these indices to study the association between utilization of prenatal care and pregnancy outcomes affected by the duration of pregnancy should be approached cautiously.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.