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American Journal of Public Health logoLink to American Journal of Public Health
. 1994 Jan;84(1):82–88. doi: 10.2105/ajph.84.1.82

Racial disparities in reported prenatal care advice from health care providers.

M D Kogan 1, M Kotelchuck 1, G R Alexander 1, W E Johnson 1
PMCID: PMC1614898  PMID: 8279618

Abstract

OBJECTIVES. The relationship between certain maternal behaviors and adverse pregnancy outcomes has been well documented. One method to alter these behaviors is through the advice of women's health care providers. Advice from providers may be particularly important in minority populations, who have higher rates of infant mortality and prematurity. This study examines racial disparities according to women's self-report of advice received from health care providers during pregnancy in four areas: tobacco use, alcohol consumption, drug use, and breast-feeding. METHODS. Health care providers' advice to 8310 White non-Hispanic and Black women was obtained from the National Maternal and Infant Health Survey. RESULTS. After controlling for sociodemographic, utilization, and medical factors, Black women were more likely to report not receiving advice from their prenatal care providers about smoking cessation and alcohol use. The difference between Blacks and Whites also approached significance for breast-feeding. No overall difference was noted in advice regarding cessation of drug use, although there was a significant interaction between race and marital status. CONCLUSIONS. These data suggest that Black women may be at greater risk for not receiving information that could reduce their chances of having an adverse pregnancy outcome.

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Selected References

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  1. Alexander G. R., Cornely D. A. Racial disparities in pregnancy outcomes: the role of prenatal care utilization and maternal risk status. Am J Prev Med. 1987 Sep-Oct;3(5):254–261. [PubMed] [Google Scholar]
  2. Bergsjø P., Hoffman H. J., Davis R. O., Goldenberg R. L., Lindmark G., Jacobsen G., Cutter G., Markestad T., Nelson K. G., Bakketeig L. S. Preliminary results from the Collaborative Alabama and Scandinavian Study of Successive Small-for-Gestational Age Births. Acta Obstet Gynecol Scand. 1989;68(1):19–25. doi: 10.3109/00016348909087683. [DOI] [PubMed] [Google Scholar]
  3. Berkowitz G. S. An epidemiologic study of preterm delivery. Am J Epidemiol. 1981 Jan;113(1):81–92. doi: 10.1093/oxfordjournals.aje.a113068. [DOI] [PubMed] [Google Scholar]
  4. Britt H., Harris M., Driver B., Bridges-Webb C., O'Toole B., Neary S. Reasons for encounter and diagnosed health problems: convergence between doctors and patients. Fam Pract. 1992 Jun;9(2):191–194. doi: 10.1093/fampra/9.2.191. [DOI] [PubMed] [Google Scholar]
  5. Casey R., Rieckhoff M., Beebe S. A., Pinto-Martin J. Obstetric and perinatal events: the accuracy of maternal report. Clin Pediatr (Phila) 1992 Apr;31(4):200–204. doi: 10.1177/000992289203100402. [DOI] [PubMed] [Google Scholar]
  6. Cherukuri R., Minkoff H., Feldman J., Parekh A., Glass L. A cohort study of alkaloidal cocaine ("crack") in pregnancy. Obstet Gynecol. 1988 Aug;72(2):147–151. [PubMed] [Google Scholar]
  7. Feldman Y., Koren G., Mattice K., Shear H., Pellegrini E., MacLeod S. M. Determinants of recall and recall bias in studying drug and chemical exposure in pregnancy. Teratology. 1989 Jul;40(1):37–45. doi: 10.1002/tera.1420400106. [DOI] [PubMed] [Google Scholar]
  8. Handler A., Kistin N., Davis F., Ferré C. Cocaine use during pregnancy: perinatal outcomes. Am J Epidemiol. 1991 Apr 15;133(8):818–825. doi: 10.1093/oxfordjournals.aje.a115961. [DOI] [PubMed] [Google Scholar]
  9. Heins H. C., Jr, Nance N. W., McCarthy B. J., Efird C. M. A randomized trial of nurse-midwifery prenatal care to reduce low birth weight. Obstet Gynecol. 1990 Mar;75(3 Pt 1):341–345. [PubMed] [Google Scholar]
  10. Jacobson S. W., Jacobson J. L., Sokol R. J., Martier S. S., Ager J. W., Kaplan M. G. Maternal recall of alcohol, cocaine, and marijuana use during pregnancy. Neurotoxicol Teratol. 1991 Sep-Oct;13(5):535–540. doi: 10.1016/0892-0362(91)90062-2. [DOI] [PubMed] [Google Scholar]
  11. Jones K. L., Smith D. W. Recognition of the fetal alcohol syndrome in early infancy. Lancet. 1973 Nov 3;302(7836):999–1001. doi: 10.1016/s0140-6736(73)91092-1. [DOI] [PubMed] [Google Scholar]
  12. Kessel S. S., Kleinman J. C., Koontz A. M., Hogue C. J., Berendes H. W. Racial differences in pregnancy outcomes. Clin Perinatol. 1988 Dec;15(4):745–754. [PubMed] [Google Scholar]
  13. Kessel S. S., Villar J., Berendes H. W., Nugent R. P. The changing pattern of low birth weight in the United States--1970 to 1980. JAMA. 1984 Apr 20;251(15):1978–1982. [PubMed] [Google Scholar]
  14. Kleinman J. C., Madans J. H. The effects of maternal smoking, physical stature, and educational attainment on the incidence of low birth weight. Am J Epidemiol. 1985 Jun;121(6):843–855. doi: 10.1093/oxfordjournals.aje.a114055. [DOI] [PubMed] [Google Scholar]
  15. Kleinman J. C., Pierre M. B., Jr, Madans J. H., Land G. H., Schramm W. F. The effects of maternal smoking on fetal and infant mortality. Am J Epidemiol. 1988 Feb;127(2):274–282. doi: 10.1093/oxfordjournals.aje.a114803. [DOI] [PubMed] [Google Scholar]
  16. Kline J., Shrout P., Stein Z., Susser M., Warburton D. Drinking during pregnancy and spontaneous abortion. Lancet. 1980 Jul 26;2(8187):176–180. doi: 10.1016/s0140-6736(80)90062-8. [DOI] [PubMed] [Google Scholar]
  17. Little R. E. Moderate alcohol use during pregnancy and decreased infant birth weight. Am J Public Health. 1977 Dec;67(12):1154–1156. doi: 10.2105/ajph.67.12.1154. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Ockene J. K., Kristeller J., Goldberg R., Amick T. L., Pekow P. S., Hosmer D., Quirk M., Kalan K. Increasing the efficacy of physician-delivered smoking interventions: a randomized clinical trial. J Gen Intern Med. 1991 Jan-Feb;6(1):1–8. doi: 10.1007/BF02599381. [DOI] [PubMed] [Google Scholar]
  19. Sanderson M., Placek P. J., Keppel K. G. The 1988 National Maternal and Infant Health Survey: design, content, and data availability. Birth. 1991 Mar;18(1):26–32. doi: 10.1111/j.1523-536x.1991.tb00050.x. [DOI] [PubMed] [Google Scholar]
  20. Seidman D. S., Slater P. E., Ever-Hadani P., Gale R. Accuracy of mothers' recall of birthweight and gestational age. Br J Obstet Gynaecol. 1987 Aug;94(8):731–735. doi: 10.1111/j.1471-0528.1987.tb03717.x. [DOI] [PubMed] [Google Scholar]
  21. Sexton M., Hebel J. R. A clinical trial of change in maternal smoking and its effect on birth weight. JAMA. 1984 Feb 17;251(7):911–915. [PubMed] [Google Scholar]
  22. Shiono P. H., Klebanoff M. A. Ethnic differences in preterm and very preterm delivery. Am J Public Health. 1986 Nov;76(11):1317–1321. doi: 10.2105/ajph.76.11.1317. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Stewart P. J., Dunkley G. C. Smoking and health care patterns among pregnant women. CMAJ. 1985 Nov 15;133(10):989–994. [PMC free article] [PubMed] [Google Scholar]
  24. Walpole I., Zubrick S., Pontré J. Confounding variables in studying the effects of maternal alcohol consumption before and during pregnancy. J Epidemiol Community Health. 1989 Jun;43(2):153–161. doi: 10.1136/jech.43.2.153. [DOI] [PMC free article] [PubMed] [Google Scholar]

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