Insufficient prenatal care in Finland and Baden-Wurttemberg - Characteristics of women and infant outcome

The amount of prenatal care and the relationship between insufficient prenatal care, mothers' characteristics and infant outcome were studied in Finland and in Baden-Wurttemberg, Germany. The main sources of data were the Finnish Medical Birth Register (N=193,659) and the Perinatal Survey of Baden-Wurttemberg (N=307,152) in 1991-1993. Insufficient prenatal care was defined as no visits, 1 or 2 visits or late attendance. Most of the women - also those in the risk groups for low use of care (foreigners, young mothers, grand multiparas, single mothers and women with a poor social status) - were using prenatal care extensively. The proportion of women having insufficient care was 3.4% in Finland and 8.1% in Baden-Wurttemberg, most of them being late attenders. Among women with insufficient care, 39% in Finland and 55% in Baden-Wurttemberg were from the risk groups identified. Foreign nationals contributed 10% of the women with insufficient care in Finland and 44% in Baden-Wurttemberg. The group of women with insufficient prenatal care was heterogeneous and it could not be defined by using traditional risk factors only. Infants of mothers with few prenatal visits had poorer outcomes, but the attributable proportion of insufficient prenatal care to infant outcome was small.