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
MSU Digital Commons Citation
McGaughey, Patty; Howland, Renata E.; and Dragan, Kacie L., "Variation in Preterm Birth Rates Across Prenatal Care Sites in New York" (2024). School of Nursing Faculty Scholarship and Creative Works. 37.
https://digitalcommons.montclair.edu/nursing-facpubs/37
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.