Variation in Preterm Birth Rates Across Prenatal Care Sites in New York

Document Type

Article

Publication Date

1-2024

Journal / Book Title

Journal of Obstetric, Gynecologic & Neonatal Nursing

Abstract

Abstract

Objective

To investigate variation in preterm birth rates by the site at which prenatal care was received.

Design

Cross-sectional cohort study.

Setting

New York State.

Participants

Claims and encounter data on singleton live births that were covered by New York Medicaid (N= 154,377).

Methods

We analyzed data from New York Medicaid and the American Community Survey. We established sites of prenatal care using geocoded billing addresses for prenatal visits. We calculated descriptive statistics and conducted logistic regression analyses to determine variation in crude and risk-adjusted preterm birth rates by prenatal care site.

Results

The crude preterm birth rates averaged 7.8% (range = 2.0%–18.7%) by prenatal care site. The adjusted preterm birth rate was 8.0% (range = 2.8%–18.5%) by prenatal care site. Risk-adjusted preterm birth site-level rates at the 90th percentile were 2.7 times higher than those in the 10th percentile. The variation in risk-adjusted preterm birth site-level rates was not fully explained by birth volume, rural site location, or racial and ethnic composition of the patients who received prenatal care at the site.

Conclusion

Wide variation in risk-adjusted preterm birth rates across prenatal care sites exists, and factors beyond known individual demographics and medical factors contribute to the variation. Further research is warranted to identify why receiving care at some prenatal sites is associated with higher risk of preterm birth than receiving care at others.

DOI

10.1016/j.jogn.2023.10.002

Journal ISSN / Book ISBN

1552-6909

Published Citation

McGaughey, P., Howland, R. E., & Dragan, K. L. (2024). Variation in Preterm Birth Rates Across Prenatal Care Sites in New York. Journal of Obstetric, Gynecologic & Neonatal Nursing, 53(1), 46-56.

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