Prenatal care of women who give birth to children with fetal alcohol spectrum disorder in a universal health care system: a case-control study using linked administrative data.

Journal

CMAJ open
ISSN: 2291-0026
Titre abrégé: CMAJ Open
Pays: Canada
ID NLM: 101620603

Informations de publication

Date de publication:
Historique:
entrez: 14 2 2019
pubmed: 14 2 2019
medline: 14 2 2019
Statut: epublish

Résumé

Few studies have investigated prenatal care use among women who use alcohol during pregnancy. The objective of this study was to investigate rates of prenatal care usage of women who have given birth to children with fetal alcohol spectrum disorder (FASD). We conducted a case-control study of women with children born in Manitoba between Apr. 1, 1984, and Mar. 31, 2012, with follow-up until 2013, using linkable administrative data. The study group included women whose child(ren) was (were) diagnosed with FASD ( Women in the study group had lower socioeconomic status than women in the comparison group and were more likely to have mental disorders and involvement with the child welfare system. Rates of inadequate prenatal care were higher among women in the study group (adjusted relative risk 2.47, 95% confidence interval [CI] 2.08-2.94), as were rates of no prenatal care (adjusted relative risk 3.55, 95% CI 2.42-5.22). In the study group, 41% of women accessed inadequate or no prenatal care, and 59% received intermediate, adequate or intensive prenatal care. Women who give birth to children with FASD have higher rates of inadequate prenatal care and significant social complexities. Socioeconomic disparities in the use of prenatal care should be addressed; multisector interventions are needed that facilitate the uptake of prenatal care by high-risk women who use alcohol.

Sections du résumé

BACKGROUND BACKGROUND
Few studies have investigated prenatal care use among women who use alcohol during pregnancy. The objective of this study was to investigate rates of prenatal care usage of women who have given birth to children with fetal alcohol spectrum disorder (FASD).
METHODS METHODS
We conducted a case-control study of women with children born in Manitoba between Apr. 1, 1984, and Mar. 31, 2012, with follow-up until 2013, using linkable administrative data. The study group included women whose child(ren) was (were) diagnosed with FASD (
RESULTS RESULTS
Women in the study group had lower socioeconomic status than women in the comparison group and were more likely to have mental disorders and involvement with the child welfare system. Rates of inadequate prenatal care were higher among women in the study group (adjusted relative risk 2.47, 95% confidence interval [CI] 2.08-2.94), as were rates of no prenatal care (adjusted relative risk 3.55, 95% CI 2.42-5.22). In the study group, 41% of women accessed inadequate or no prenatal care, and 59% received intermediate, adequate or intensive prenatal care.
INTERPRETATION CONCLUSIONS
Women who give birth to children with FASD have higher rates of inadequate prenatal care and significant social complexities. Socioeconomic disparities in the use of prenatal care should be addressed; multisector interventions are needed that facilitate the uptake of prenatal care by high-risk women who use alcohol.

Identifiants

DOI: 10.9778/cmajo.20180027 PMID: 30755413 PMC: PMC6404961
pubmed: 30755413
pii: 7/1/E63
doi: 10.9778/cmajo.20180027
pmc: PMC6404961
doi:

Types de publication

Journal Article

Langues

eng

Pagination

E63-E72

Informations de copyright

Copyright 2019, Joule Inc. or its licensors.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Deepa Singal (D)

Department of Community Health Sciences (Singal, Brownell, Chateau, Roos), Department of Paediatrics and Child Health (Hanlon-Dearman, Longstaffe) and Manitoba Centre for Health Policy (Brownell, Chateau), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Wall-Wieler), Stanford University, Stanford, Calif. deepakapoorsingal@gmail.com.

Marni Brownell (M)

Department of Community Health Sciences (Singal, Brownell, Chateau, Roos), Department of Paediatrics and Child Health (Hanlon-Dearman, Longstaffe) and Manitoba Centre for Health Policy (Brownell, Chateau), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Wall-Wieler), Stanford University, Stanford, Calif.

Elizabeth Wall-Wieler (E)

Department of Community Health Sciences (Singal, Brownell, Chateau, Roos), Department of Paediatrics and Child Health (Hanlon-Dearman, Longstaffe) and Manitoba Centre for Health Policy (Brownell, Chateau), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Wall-Wieler), Stanford University, Stanford, Calif.

Dan Chateau (D)

Department of Community Health Sciences (Singal, Brownell, Chateau, Roos), Department of Paediatrics and Child Health (Hanlon-Dearman, Longstaffe) and Manitoba Centre for Health Policy (Brownell, Chateau), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Wall-Wieler), Stanford University, Stanford, Calif.

Ana Hanlon-Dearman (A)

Department of Community Health Sciences (Singal, Brownell, Chateau, Roos), Department of Paediatrics and Child Health (Hanlon-Dearman, Longstaffe) and Manitoba Centre for Health Policy (Brownell, Chateau), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Wall-Wieler), Stanford University, Stanford, Calif.

Sally Longstaffe (S)

Department of Community Health Sciences (Singal, Brownell, Chateau, Roos), Department of Paediatrics and Child Health (Hanlon-Dearman, Longstaffe) and Manitoba Centre for Health Policy (Brownell, Chateau), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Wall-Wieler), Stanford University, Stanford, Calif.

Leslie L Roos (LL)

Department of Community Health Sciences (Singal, Brownell, Chateau, Roos), Department of Paediatrics and Child Health (Hanlon-Dearman, Longstaffe) and Manitoba Centre for Health Policy (Brownell, Chateau), University of Manitoba, Winnipeg, Man.; Department of Pediatrics (Wall-Wieler), Stanford University, Stanford, Calif.

Classifications MeSH