Predictors of Peripartum Care Attendance Among a Sample of African American Women at Increased Risk for Poor Prenatal Care Compliance

Prenatal and postpartum care are important for reducing maternal and infant morbidity. Racial and ethnic disparities are prevalent in maternal peripartum health and infant birth outcomes as well as peripartum care access and utilization. They highlight the need to identify and better understand correlates of poor prenatal and postpartum care compliance. While risk factors for low adherence to peripartum care have been identified, no studies have looked specifically at predictors of prenatal and postpartum care attendance in an at-risk sample of African American pregnant women. Using existing data from an RCT targeting maternal and infant health disparities and comparing a patient navigation/behavioral incentive intervention to treatment as usual, the present study sought to identify predictors of prenatal and postpartum care attendance. Participants were African American women at risk for poor prenatal care compliance, who participated in the RCT and had a documented live birth (n=123). Using hierarchical linear and logistic regression, the study identified predictors of prenatal and postpartum care attendance, respectively. The study found high-risk pregnancy (p \u3c .001) and fewer barriers to care (p = .013) significantly predicted better prenatal care attendance. Less than adequate prenatal care attendance significantly predicted postpartum visit nonattendance (p \u3c .001). In addition, given that study participants were limited to women who provided informed consent to RCT participation, the present study also examined representativeness of the clinical trial sample. Specifically, women who consented to the RCT (consenters; n=149) were compared to those who did not (non-consenters; n=122) on a variety of demographic and psychosocial variables using chi-square for categorical variables and t-tests for continuous variables. Consenters and non-consenters differed only on education level, with consenters more likely to have at least a high school education than non-consenters. The present study provides benchmark data on sample representativeness and predictors of peripartum care in a clinical trial of strategies to improve prenatal care compliance. These findings could have important implications for healthcare system changes and treatment interventions among this population