HJAR May/Jun 2025

10 MAY / JUN 2025 I  HEALTHCARE JOURNAL OF ARKANSAS   ABSTRACT Objectives: This study examines prenatal care utilization differences in Arkansas. Methods: Birth records data from the National Center for Health Statistics were used. The study population consisted of singleton live births in Arkansas from 2014 to 2022. Primary outcomes included number of prenatal visits, fewer than the recommended number of prenatal visits, late prenatal care, and no prenatal care. Summary statistics were computed, and adjusted rates ratios were calculated adjusting for maternal age, maternal edu- cation, and parity for payer, race/ethnicity, and rural/urban residence. Results: Mothers with a Medicaid-covered birth had 0.90 times fewer prenatal care visits and were 1.26 times more likely to have fewer than the recommended number of visits, 1.60 times more likely to initiate prenatal care late, and 1.46 times more likely to have reported no prenatal visits at all. Number of prenatal care visits was lower for all racial/ethnic groups relative to white mothers and for mothers living in rural areas. The largest differences were for Native Hawaiian and Pacific Islander (NHPI) mothers, who reported almost half the number of visits (ARR = 0.67, 95 % CI [0.64, 0.70]). Having no prenatal care was more prevalent among NHPI (ARR = 3.68, 95 % CI [2.66, 5.10]) and Black (ARR = 1.47, 95 % CI [1.34, 1.61]) mothers. Racially/ethnically minoritized groups were more likely to have late prenatal care and fewer than the recommended number of prenatal visits, with the greatest difference for NHPI. Conclusions: Findings document disparities in prenatal care utilization related to payer, race/ethnicity, and rural/urban residence. areas (Maron, 2017). For example, Black women have nearly three times the rates of severe maternal morbidity and maternal mortality than white women (Hoyert, 2024). Some studies suggest pregnant women of all races/ethnicities who live in rural areas have nearly double the maternal morbidity and mortality than women in large urban areas (Maron, 2017). Rural and racially and ethnically minoritized families also face dis- proportionately higher rates of infant mor- tality and preterm births (Kozhimannil et al., 2018; Laurore et al., 2020). Babies born in rural areas have a 20–40 % higher rate of preterm birth (Kozhimannil et al., 2018). Black infants experience 60 % higher rates of preterm birth and almost double the risk of infant mortality in their first year Originally published in Preventive Medicine Reports vol. 51 (March 2025): https://doi.org/10.1016/j.pmedr.2025.102983 © 2025 The Authors. Published by Elsevier Inc. under Creative Commons BY 4.0 Licensing. https://creativecommons.org/licenses/by/4.0/ 1. INTRODUCTION The United States (U.S.) has higher rates of maternal morbidity and mortality than other high-income nations (Tikkanen et al., 2022). Racially and ethnically minoritized women and women living in rural areas have higher rates of maternal morbidity and mortality compared to white women (Hoyert, 2024) and women living urban Sociodemographic factors associated with prenatal care utilization in Arkansas, United States AUTHORS Pearl A. McElfish College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale Aaron Caldwell Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale Donya Watson College of Medicine, University of Arkansas for Medical Sciences, Little Rock and South Arkansas Regional Hospital, El Dorado Jonathan Langner Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, Springdale Jennifer Callaghan-Koru College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale Austin Porter Arkansas Department of Health, Little Rock Don E. Willis College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale Jennifer A. Andersen College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale Nicola L. Hawley Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT James P. Selig Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale Amir Forati Heartland Forward, Bentonville Maria R. Alcala Heartland Forward, Bentonville Lanita White Community Health Centers of Arkansas, Little Rock Enrique Gomez-Pomar College of Medicine, University of Arkansas for Medical Sciences, Little Rock and Neonatology, St. Bernards Regional Medical Center, Jonesboro Clare C. Brown Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock