Relationship between Perceived Quality of Prenatal Care and Maternal/Infant Health Outcomes

The authors examine the relationship among perceived quality of prenatal care, birth outcomes, and postpartum depression. Through linear and logistic regression analysis, they test the following hypotheses: higher perceived quality of prenatal care will have a positive association with a likelihood of vaginal delivery and normal birth weight outcomes and a negative association with a likelihood of preterm birth; and higher perceived quality of prenatal care will have a negative association with a likelihood of postpartum depression risk. Abstract Objectives Studies have shown that quality of care affects patient health outcomes and well-being. In this study, we examine the relationship between perceived quality of prenatal care, birth outcomes, and postpartum depression (PPD). Methods We use data from the third wave of the Listening to Mothers dataset (2013). After removing missing data, the analytic sample size included 2168 women. Through linear and logistic regression analyses, we test the following hypotheses: higher perceived quality of prenatal care will have a positive association with a likelihood of vaginal delivery and normal birth weight outcomes, and a negative association with a likelihood of preterm birth; and higher perceived quality of prenatal care will have a negative association with a likelihood of PPD risk. Results Women who perceived higher quality of prenatal care were significantly less likely to have a preterm birth relative to women who reported lower quality care. Women who reported (any) medical jargon during their prenatal visits were less likely to have a normal birth weight baby. Women who reported provider use of medical jargon, lower perceived quality of interaction with a prenatal care provider, and lower perceived quality of US maternity care in general were more likely to be at risk for PPD. Conclusions Negative prenatal care experiences may exacerbate adverse patient outcomes. Positive prenatal care experiences may buffer/improve adverse outcomes. Quality of care measures were most consistently predictive of PPD outcomes. Providers should focus on improving the quality of prenatal care as one of the means to improve maternal and infant health and well-being.