Aggregate level association between prenatal care and infant mortality rate

Objectives: The objectives of this study include understanding the association between adequate prenatal care and the infant mortality rate (IMR) at the aggregate level and studying the effects of other factors, such as race and income, on the association. Methodology: IMR and the rate of pregnant women who receive prenatal care during the first trimester (PNC) were examined. Annual state-level aggregate data from 1997 to 2005 were extracted. Covariance of IMR and PNC was calculated. Scatterplots of IMR versus PNC were drawn. Two-variable and multivariable regressions were used to study the effects of several factors, including PNC on IMR. Results: Substantial differences were observed in IMR and PNC across states within the US. An insignificant inverse association between PNC and IMR was observed at the aggregate level for data from 1997 to 2005. Significant inverse associations were observed between IMR and the percentage of Non-Hispanic White population, the percentage of Hispanic population, and income level. Conclusions: Differences in IMR and PNC across states were observed. PNC has a modest effect on reducing IMR. Race and income level may have more significant impacts on IMR. Public health relevance: High infant mortality leads to high social and economic costs. Previous studies suggested that inadequate prenatal care is associated with adverse birth outcomes, such as preterm birth and infant mortality. It is possible that ensuring the availability of early prenatal care during the first trimesters could help reduce IMR. In addition, reducing health disparities between different racial and income groups could help reduce the IMR in the US