{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:53:22Z","timestamp":1759971202181,"version":"build-2065373602"},"reference-count":31,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,2,19]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To examine the temporal trend and risk factors associated with lack of prenatal care and the association between lack of prenatal care and adverse outcomes in pregnancies complicated by syphilis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study using US vital statistic data (2016\u20132022). We included non-anomalous, singleton live births delivered by pregnancies complicated by syphilis at 24\u201342 weeks of gestation in a hospital. The exposure variable was prenatal care (had care vs no care). We used Adequacy of Prenatal Care Utilization Index. Adverse outcomes were examined. The annual per cent change (APC) was calculated to assess the trend of lacking prenatal care. Multivariable Poisson regression models with robust error variance were used to examine the association. Adjusted relative risks (aRR) with 95% CIs were calculated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the study population of 38\u2009583 live births, 2417 (6.3%) lacked prenatal care. The rate of lacking prenatal care increased over time (APC=11.4; 95%\u2009CI 4.7 to 18.5). Maternal education, insurance, nulliparity, prepregnancy body mass index, prior preterm birth, smoking, diabetes, hepatitis C and year of delivery were associated with lacking prenatal care. Compared with individuals with prenatal care, those without care were associated with a higher risk of preterm birth &lt;37 weeks (aRR 2.57; 95%\u2009CI 2.40 to 2.74) and &lt;34 weeks (aRR 3.56; 95%\u2009CI 3.13 to 4.05). Compared with patients with adequate care, those without care were associated with a higher risk of preterm birth &lt;37 weeks (aRR 5.07; 95%\u2009CI 4.59 to 5.60) and &lt;34 weeks (aRR 6.42; 95%\u2009CI 5.32 to 7.75). Similar associations were shown in other adverse outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among pregnancies complicated by syphilis in the USA, there was an upward trend in lack of prenatal care from 2016 to 2022. Modifiable factors of lacking prenatal care were identified. The risks of adverse outcomes were higher among individuals without prenatal care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/sextrans-2024-056453","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T12:45:15Z","timestamp":1741697115000},"page":"386-394","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Lack of prenatal care in pregnancies complicated by syphilis: trend, risk factors and outcomes"],"prefix":"10.1136","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-1440","authenticated-orcid":false,"given":"Han-Yang","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology & Reproductive Sciences, University of Texas Health Science Center, McGovern Medical School, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2803-7329","authenticated-orcid":false,"given":"Irene A","family":"Stafford","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology & Reproductive Sciences, University of Texas Health Science Center, McGovern Medical School, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"2025082809551092000_101.6.386.1","doi-asserted-by":"crossref","unstructured":"Gregory ECW , Ely DM . Trends and Characteristics in Maternal Syphilis Rates during Pregnancy: United States, 2016\u20132022. NCHS Data Brief, 2024:1\u20138.","DOI":"10.15620\/cdc:145590"},{"key":"2025082809551092000_101.6.386.2","unstructured":"Centers for Disease Control and Prevention . Sexually transmitted disease surveillance. Available: https:\/\/cdc.gov\/std\/statistics\/2022\/default.htm [Accessed 4 Sep 2024]."},{"key":"2025082809551092000_101.6.386.3","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7246e1"},{"key":"2025082809551092000_101.6.386.4","doi-asserted-by":"crossref","first-page":"100442","DOI":"10.1016\/j.ajogmf.2021.100442","article-title":"Geographic barriers to prenatal care access and their consequences","volume":"3","author":"Holcomb","year":"2021","journal-title":"Am J Obstet Gynecol MFM"},{"key":"2025082809551092000_101.6.386.5","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2020.8712"},{"key":"2025082809551092000_101.6.386.6","doi-asserted-by":"publisher","DOI":"10.18043\/ncm.82.1.7"},{"key":"2025082809551092000_101.6.386.7","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12649"},{"key":"2025082809551092000_101.6.386.8","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2017.04.008"},{"key":"2025082809551092000_101.6.386.9","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1316439"},{"key":"2025082809551092000_101.6.386.10","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15303"},{"key":"2025082809551092000_101.6.386.11","unstructured":"Centers for Disease Control and Prevention, Vital Statistics Online Data Portal . National center for health statistics. period linked birth-infant death data files, 2016-2022. Available: https:\/\/www.cdc.gov\/nchs\/data_access\/vitalstatsonline.htm [Accessed 1 Nov 2024]."},{"key":"2025082809551092000_101.6.386.12","first-page":"1","article-title":"Expanded data from the new birth certificate, 2008","volume":"59","author":"OstermanMJ","year":"2011","journal-title":"Natl Vital Stat Rep"},{"key":"2025082809551092000_101.6.386.13","unstructured":"National Center for Health Statistics . Guide to completing the facility worksheets for the certificate of live birth and report of fetal death. 2003. Available: https:\/\/www.cdc.gov\/nchs\/data\/dvs\/GuidetoCompleteFacilityWks.pdf"},{"key":"2025082809551092000_101.6.386.14","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000345"},{"key":"2025082809551092000_101.6.386.15","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z"},{"key":"2025082809551092000_101.6.386.16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7497.960"},{"key":"2025082809551092000_101.6.386.17","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.84.9.1414"},{"key":"2025082809551092000_101.6.386.18","unstructured":"Standards for Obstetric-Gynecologic Services . American college of obstetricians and gynecologists, committee on professional standards 6th. Washington, DC, 1985."},{"key":"2025082809551092000_101.6.386.19","first-page":"1","article-title":"Changes in Prenatal Care Utilization:United States, 2019-2021","volume":"72","author":"Martin","year":"2023","journal-title":"Natl Vital Stat Rep"},{"key":"2025082809551092000_101.6.386.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"2025082809551092000_101.6.386.21","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.127140"},{"key":"2025082809551092000_101.6.386.22","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003644"},{"key":"2025082809551092000_101.6.386.23","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6908a1"},{"key":"2025082809551092000_101.6.386.24","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir196"},{"key":"2025082809551092000_101.6.386.25","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001588"},{"key":"2025082809551092000_101.6.386.26","doi-asserted-by":"publisher","DOI":"10.1177\/0033354920928454"},{"key":"2025082809551092000_101.6.386.27","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001311"},{"key":"2025082809551092000_101.6.386.28","first-page":"1","article-title":"Assessing the quality of medical and health data from the 2003 birth certificate revision: results from two states","volume":"62","author":"Martin","year":"2013","journal-title":"Natl Vital Stat Rep"},{"key":"2025082809551092000_101.6.386.29","first-page":"1","article-title":"Assessing the Quality of Medical and Health Data From the 2003 Birth Certificate Revision: Results From New York City","volume":"68","author":"Gregory","year":"2019","journal-title":"Natl Vital Stat Rep"},{"key":"2025082809551092000_101.6.386.30","first-page":"1","article-title":"Trends and Characteristics of Sexually Transmitted Infections During Pregnancy: United States, 2016-2018","volume":"69","author":"Gregory","year":"2020","journal-title":"Natl Vital Stat Rep"},{"key":"2025082809551092000_101.6.386.31","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/dom.13926","article-title":"Propensity score methods in real-world epidemiology: A practical guide for first-time users","volume":"22 Suppl 3","author":"Loke","year":"2020","journal-title":"Diabetes Obes Metab"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2024-056453","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T13:03:59Z","timestamp":1759928639000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2024-056453"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,6]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,8,28]]},"published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1136\/sextrans-2024-056453"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2024-056453","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"type":"print","value":"1368-4973"},{"type":"electronic","value":"1472-3263"}],"subject":[],"published":{"date-parts":[[2025,3,6]]}}}