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CME Credit Offered
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Abstract Award
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Poster Session 2

(438) The importance of the number of prenatal visits on pregnancy outcomes

Thursday, January 30, 2025
4:00 PM – 6:00 PM  

    Presenting Author(s)

  • Anna Gehret, BS

    Medical Student
    Ohio University College of Medicine
    Athens, OH, United States

    • Submitting Author(s)

  • Braxton Forde, MD

    Assistant Professor
    University of Cincinnati College of Medicine
    Cincinnati, OH, United States

Objective: Most guidelines recommend roughly 11-15 prenatal visits in each pregnancy, with possibly more for high-risk pregnancies. While no prenatal care is associated with adverse outcomes, the true risk of limited prenatal care is unknown. Thus, we sought to evaluate the association of the number of prenatal visits with pregnancy outcomes.

Study Design:

Retrospective cohort of all United States births in 2022 using National Vital Statistics US birth certificate data. Pregnancy demographics, as well as maternal and neonatal outcomes were compared between a referent group of patients that attended 11-15 prenatal visits with 3 investigational cohorts: patients with < 5 prenatal visits, 5-10 prenatal visits, and > 15 prenatal visits. Linear regression models were used to calculate the attributable effect of prenatal visit number upon delivery gestational age, and multivariate logistic regression was used to calculate the odds of adverse maternal and neonatal outcomes.

Results: During study period, 232,616 patients had < 5 prenatal visits, while 1,341,990 had 5-10, 1,702,481 had 11-15, and 320,008 had > 15 visits. Demographics were significantly different amongst groups (Table 1).  While all study groups had increased rates of adverse outcomes, the findings were strongest with < 5 visits, which was attributable to a 1.5 week (95% CI 1.44-1.54) decrease in gestational age at delivery, even after adjustment for known risk factors of preterm birth. Conversely, attending 5-10 visits attributed to only 0.66 week (95% CI 0.64-0.68) decrease, and attending > 15 visits attributed to a clinically irrelevant 0.19 week decrease in delivery gestational age. Similar trends were identified when evaluating maternal and neonatal outcomes, in which < 5 prenatal visits significantly increased the odds of adverse maternal and neonatal outcomes (Figure 1).

Conclusion: Attending < 5 prenatal visits is strongly associated with adverse pregnancy outcomes. As patients attend more visits, the odds of adverse outcomes decrease. This highlights the extremely important role of routine prenatal care upon maternal and child health.