Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2014 Mar 13;9(3):e91292.
doi: 10.1371/journal.pone.0091292. eCollection 2014.

A comparative analysis of prenatal care and fetal growth in eight South American countries

Cristina Woodhouse  1 , Jorge Lopez Camelo  2 , George L Wehby  3
Affiliations
Comparative Study

A comparative analysis of prenatal care and fetal growth in eight South American countries

Cristina Woodhouse et al. PLoS One. .

Abstract

There has been little work that comprehensively compared the relationship between prenatal care and infant health across multiple countries using similar data sources and analytical models. Such comparative analyses are useful for understanding the background of differences in infant health between populations. We evaluated the association between prenatal care visits and fetal growth measured by birth weight (BW) in grams or low birth weight (<2500 grams; LBW) adjusted for gestational age in eight South American countries using similarly collected data across countries and the same analytical models. OLS and logistic regressions were estimated adjusting for a large set of relevant infant, maternal, and household characteristics and birth year and hospital fixed effects. Birth data were acquired from 140 hospitals that are part of the Latin American Collaborative Study of Congenital Malformations (ECLAMC) network. The analytical sample included 56,014 live-born infants (∼69% of total sample) with complete data born without congenital anomalies in the years 1996-2011 in Brazil, Argentina, Chile, Venezuela, Ecuador, Colombia, Bolivia, and Uruguay. Prenatal care visits were significantly (at p<.05) and positively associated with BW and negatively associated with LBW for all countries. The OLS coefficients ranged from 9 grams per visit in Bolivia to 36 grams in Uruguay. The association with LBW was strongest for Chile (OR = 0.87 per visit) and lowest for Argentina and Venezuela (OR = 0.95). The association decreased in the recent decade compared to earlier years. Our findings suggest that estimates of association between prenatal care and fetal growth are population-specific and may not be generalizable to other populations. Furthermore, as one of the indicators for a country's healthcare system for maternal and child health, prenatal care is a highly variable indicator between countries in South America.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Sample construction chart.
See this image and copyright information in PMC

References

    1. Cox RG, Zhang L, Zotti ME, Graham J (2011) Prenatal care utilization in Mississippi: racial disparities and implications for unfavorable birth outcomes. Matern Child Health J 15: 931–942. - PubMed
    1. Zhang L, Cox RG, Graham J, Johnson D (2011) Association of maternal medical conditions and unfavorable birth outcomes: findings from the 1996–2003 Mississippi linked birth and death data. Matern Child Health J 15: 910–920. - PubMed
    1. Carvalho Padilha PD, Accioly E, Chagas C, Portela E, Da Silva CL, et al. (2009) Birth weight variation according to maternal characteristics and gestational weight gain in Brazilian women. Nutr Hosp 24: 207–212. - PubMed
    1. Ferri CP, Mitsuhiro SS, Barros MC, Chalem E, Guinsburg R, et al. (2007) The impact of maternal experience of violence and common mental disorders on neonatal outcomes: a survey of adolescent mothers in Sao Paulo, Brazil. BMC Public Health 7: 209. - PMC - PubMed
    1. VanderWeele TJ, Lantos JD, Siddique J, Lauderdale DS (2009) A comparison of four prenatal care indices in birth outcome models: comparable results for predicting small-for-gestational-age outcome but different results for preterm birth or infant mortality. J Clin Epidemiol 62: 438–445. - PubMed

Publication types