Many pregnant women not receiving recommended care

Many pregnant patients do not receive guideline-based services and the number of prenatal visits does not explain this gap in provision of services, according to a study published online Oct. 3 in the American Journal of Obstetrics and Gynecology.

Rebecca A. Gourevitch, from Harvard Medical School in Boston and colleagues measured the receipt of guideline-based prenatal care (eight components) among pregnant patients and described the association of guideline-based prenatal care with the number of prenatal visits and other patient characteristics. The analysis included 176,092 pregnancies between 2016 and 2019 identified using the OptumLabs Data Warehouse.

The researchers found that guideline-based care varied by service, from 51 percent receiving a timely urinalysis to 90 percent receiving an anatomy scan and 91 percent completing testing for sexually transmitted infections. On average, six of the eight guideline-based services were received by patients with at least four prenatal visits. Additional prenatal visits did not increase guideline-based care. Counties with high proportions of minority populations, lower education, and lower income had lower rates of tetanus, diphtheria, and pertussis vaccination.

“Guideline-based prenatal care is not universal for pregnant patients, does not increase with the number of prenatal visits, and varies by patient- and area-level characteristics,” the authors write.