Adequacy of prenatal care and stillbirth

BACKGROUND: There is limited literature on adequacy of prenatal care during pregnancy especially in case of stillbirth. METHODS: This retrospective study consisted of 103 patients with stillbirths and 197 patients with live births. The Adequacy of Prenatal Care Utilization Index (APNCU) was used to determine prenatal care adequacy (Canadian Task Force Classification II-2). RESULTS: Among high-risk patients, the APNCU categories of inadequate (OR=3.81, 95% CI: 1.16-12.57, P<0.05) and adequate plus (OR=2.58, 95% CI: 1.23-5.38, P<0.05) were each significantly associated with greater odds for stillbirth. Diabetes, multifetal gestations, and fetal anomalies were each significantly associated with increased odds for stillbirth. CONCLUSIONS: Our findings emphasize the importance of clinicians in the role of providing appropriate prenatal care in the prevention of stillbirth. Clinicians also should realize that even with the best care approach of adequate plus prenatal care, certain high-risk patients will still be at risk for stillbirth.