Trends in Early Prenatal Care among Women with Pre-Existing Diabetes: Have Income Disparities Changed?

Khadijah Breathett, Jessica Filley, Madhaba Pandey, Nayanjot Rai, Pamela N. Peterson

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Women with pre-existing diabetes are at high maternal risk for comorbidities and death, particularly when early prenatal care is not received. Low income is a known barrier to early prenatal care. It is unknown whether recent policies to expand access to prenatal care have reduced income disparities. We hypothesized that income disparities would be minimized and that the odds of receipt of first trimester prenatal care among women with pre-existing diabetes would become similar across income strata over time. Material and Methods: Using the Colorado birth certificate registry from 2007 to 2014, receipt of prenatal care was assessed retrospectively in 2,497 women with pre-existing diabetes. Logistic regression was used to examine the association between high (>$50,000), medium ($25,000-50,000), and low (<$25,000) income strata and receipt of first trimester prenatal care by birth year, adjusted for demographics. Results: High, medium, and low income represented 29.5%, 19.0%, and 51.5% of the cohort, respectively. Women with high income were more likely to receive first trimester care than women with low income from 2007 [adjusted odds ratio, 95% confidence interval: 2.16 (1.18, 3.96)] through 2013 [1.66 (1.01, 2.73)], but significant differences were no longer observed in 2014 [1.59 (0.89, 2.84)]. The likelihood of receiving first trimester prenatal care was not significantly different between medium- and low-income strata from 2007 [1.07 (0.66, 1.74)] through 2014 [0.77 (0.48, 1.23)]. Conclusions: From 2007 to 2013, women in Colorado with diabetes were more likely to receive early prenatal care if they were in the highest income stratum than in the lowest stratum. In 2014, receipt of first trimester care became equitable across all income strata. Future work should examine national patterns of income with receipt of prenatal care and outcomes among women with pre-existing diabetes.

Original languageEnglish (US)
Pages (from-to)93-98
Number of pages6
JournalJournal of Women's Health
Volume27
Issue number1
DOIs
StatePublished - Jan 2018
Externally publishedYes

Keywords

  • policy
  • pregnancy
  • socioeconomic status

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint

Dive into the research topics of 'Trends in Early Prenatal Care among Women with Pre-Existing Diabetes: Have Income Disparities Changed?'. Together they form a unique fingerprint.

Cite this