Prenatal hospitalization and compliance with guidelines for prenatal care

Objectives. This study examined the relationship between compliance with the US Public Health Service guidelines for prenatal care and the rate of prenatal hospitalization. Methods. For all women admitted to a Boston referral center during January and February 1993 with a pregnancy of at least 18 weeks gestation (n = 1400), a proportional hazards model was used to examine factors associated with prenatal hospitalization. Results. Prenatal hospitalization occurred during 248 (17.7%) pregnancies. The median length of stay for all prenatal admissions was 4 days; the median total charge was $5667. Prior medical and obstetrical problems were strongly associated with prenatal hospitalization. After adjustment for age, race, and medical and obstetrical complications, women who received less than 70% of the prenatal care recommended were significantly more likely to be hospitalized [relative risk [RR] = 2.14, 95% confidence interval [CI] = 1.50, 3.06). Conclusions. Prenatal hospitalization is a common, costly complication of pregnancy. Because of its association with compliance with the Public Health Service guidelines for the content of prenatal care, prenatal hospitalization may be a sentinel indicator of inadequate prenatal care amenable to intervention.