Protocol - Adequacy of Prenatal Care
Description
Dates of prenatal care visits are abstracted from medical record or birth certificate data.
Specific Instructions
The abstractor should determine the gestational age at the time of the first visit. Estimated due date, used to determine gestational age, can be calculated with online calculators (example at http://perinatology.com/calculators/Due-Date.htm)
Abstraction of two crucial dates obtained from birth certificate or medical chart data: initial prenatal care visit (initiation), and the total number of prenatal visits from when prenatal care began until date of delivery (received services).
Availability
Protocol
- Month of initiation of care:
[ ] 7-9 or no care
[ ] 5-6
[ ] 3-4
[ ] 1-2
- % of recommended visits received
[ ] 0-49 - inadequate
[ ] 50-79 - intermediate
[ ] 80-109 - adequate
[ ] 110+ - adequate plus
Personnel and Training Required
None
Equipment Needs
None
Requirements
| Requirement Category | Required |
|---|---|
| Major equipment | No |
| Specialized training | No |
| Specialized requirements for biospecimen collection | No |
| Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Medical record abstraction
Lifestage
Adolescent, Adult, Pregnancy
Participants
Pregnant women
Selection Rationale
Prenatal care is important to the health of both mothers and babies. The earlier a mother/baby receives prenatal care the better. Inadequate prenatal care is related to low birth weight and other negative outcomes.
Compared to other utilization of care indexes, the Kotelchuck Index is preferable because it includes a category for women who receive more than the recommended amount of care (adequate plus, or intensive utilization).
Language
English, Spanish
Standards
| Standard | Name | ID | Source |
|---|---|---|---|
| Human Phenotype Ontology | Prenatal maternal abonrmality | HP:0002686 | HPO |
| Human Phenotype Ontology | Abnormality of prenatal development or birth | HP:0001197 | HPO |
| caDSR Form | PhenX PX240101 - Adequacy Of Prenatal Care | 6930178 | caDSR Form |
Derived Variables
None
Process and Review
Not applicable.
Protocol Name from Source
Kotelchuck Index (Adequacy of Prenatal Care Utilization (APNCU))
Source
Kotelchuck, M. (1994). The Adequacy of Prenatal Care Utilization Index: Its US distribution and association with low birthweight. American Journal of Public Health, 84(9), 1486-1489.
Certification for the Spanish translation can be found here.
General References
Alexander, G. R., & Cornely, D. A. (1987). Prenatal care utilization: Its measurement and relationship to pregnancy outcome. American Journal of Preventive Medicine, 3(5), 243-253.
The two indices and others are compared in:
Alexander, G. R., & Kotelchuck, M. (1996). Quantifying the adequacy of prenatal care: A comparison of indices. Public Health Reports, 111(5), 408-418; discussion 419.
Kotelchuck, M. (1994). An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index. American Journal of Public Health, 84(9), 1414-1420.
Protocol ID
240101
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX240101_Adequacy_Prenatal_Care_Initiation | ||||
| PX240101010000 | Month of initiation of care | N/A | ||
| PX240101_Adequacy_Prenatal_Care_Percentage | ||||
| PX240101020000 | Percent of recommended visits received | N/A | ||
Measure Name
Adequacy of Prenatal Care
Release Date
January 31, 2017
Definition
Adequacy of prenatal care assessed by the month of the initial visit in the pregnancy and total number of prenatal visits.
Purpose
To determine the adequacy of prenatal care with the month at which the initial prenatal care visit occurred in a pregnancy and the total prenatal care visits through delivery with that number being calculated as a percentage of recommended visits.
Keywords
pregnancy, prenatal care, doctor visits, Kotelchuck Index, Adequacy of Prenatal Care Utilization, APNCU
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 240101 | Adequacy of Prenatal Care |
Publications
There are no publications listed for this protocol.