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박순우 ( Park Soon-Woo ) - 대구가톨릭대학교 의과대학 예방의학교실
박정한 ( Park Jung-Han ) - 대구가톨릭대학교 의과대학 예방의학교실
이주영 ( Lee Ju-Young ) - 대구가톨릭대학교 의과대학 예방의학교실
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Abstract
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Various prenatal care indices are used in research and policy development, but their comparability has not been explored. This study was conducted to compare five different kinds of prenatal care indices and to assess the relationship between these indices and the pregnancy outcomes.
Data was collected by a birth cohort observation. Birth cohort observation was conducted on 344 subjects who delivered at one of five major hospitals in Pohang city between 1 September and 31 October 1999 and could be interviewed by telephone from 5 November to 6 December 1999.
Five prenatal care indices were compared: (1) the modified Institute of Medicine(Kessner) index, (2) the graduated index (GINDEX), (3) Revised -GINDEX (R-GINDEX), (4) a variation of IOM index using the full American College of Obstetrics and Gynecology visit recommendation (OB-Rec), and (5) the Adequacy of Prenatal Care Utilization(APNCU) index.
Kessner index classified 84.3% of pregnant women as adequate, 9.0% as intermediate, and 5.5% as inadequate, and GINDEX classified 4.7% as intensive, 79.6% as adequate, 12.0% as intermediate and 2.6% as inadequate, showing a similar distribution. Also R-GINDEX and OB-Rec classified the women similarly in each category. APNCU assigned similar percentage of women(58.0%) to the adequate prenatal care use category with R-GINDEX and OB-Rec, and also assigned similar percentage of women(13.4%) to the intermediate
care use category with Kessner index and GINDEX. But APNCU classified a much higher proportion of women (21.6%) as the intensive category than GINDEX (4.7%) and R-GINDEX (3.8%) , and also classified a slightly smaller proportion of women(5.8%) as inadequate than R-GINDEX(7.3%) and OB-Rec(7.3%).
Four indices except Kessner index classified a higher percentage of the women who were told by her doctor of abnormal signs in herself or fetus (abnormal pregnancy group) as intensive and adequate care group than the women who were not told of such signs(normal pregnancy group). Among normal pregnancy group the percentage of women who were classified as intensive and adequate care groups were higher for the primiparous women than the multiparous women in all of five indices. However, such difference was not observed in the abnormal pregnancy group.
These findings suggested that R-GINDEX and APNCU which are based on the AGOG recommendation were acceptable for assessing prenatal care utilization. Further study with an adequate sample size is warranted to develop the measures for assessing not only prenatal care visit frequency but also the content and quality of prenatal care.
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KeyWords
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prenatal care utilization indices, pregnancy outcome
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원문 및 링크아웃 정보
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등재저널 정보
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