Factors Associated with Failure to Attend a Postpartum Care Visit 21-56 Days Following A Live Birth at Thomas Jefferson University Hospital

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Presentation

Publication Date

4-22-2009

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Advisor: Jason Baxter, MD, Thomas Jefferson University, Philadelphia, PA.

Abstract

The goal of this study was to determine what maternal demographic and pregnancy-related factors are associated with failure to attend a postpartum care visit (PPCV) within 21-56 days following a live birth at Thomas Jefferson University Hospital (TJUH). A retrospective chart review was conducted of a random sample of 500 patients who had live births at TJUH between April 1 of 2007 and March 30 of 2008 and who received prenatal care from a provider affiliated with TJUH. 412 patients were included in final analysis, of which 186 (45%) did not attend a PPCV. Factors found to be associated with failure to attend a PPCV by univariate analysis using Chi square test for independence included age <25, parity>3, being umarried, being insured by Medicaid, having a positive smoking history and not having registered for prenatal care until the third trimester. (p<0.05). There was a trend toward decreased attendance at a PPCV for African American Race (p=0.059) Gestational or pre-existing diabetes and gestational or pre-existing hypertension were not associated with attendance at a PPCV. Estimated gestational age at delivery, birth weight, route of delivery, and neonatal intensive care unit admission were not associated with attendance at a PPCV. Following binary logistic regression analysis using all independent variables associated with the primary outcome at a p value of <0.1, Medicaid insurance and high parity remained significant predictors of failure to attend a PPCV. Efforts to improve compliance with the recommended PPCV following delivery at TJUH should target patients with risk factors that are associated with failure to attend a PPCV.

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