Prenatal Care

In this week’s post, one of our neighborhood ambassadors brings up the important issue of prenatal care and how the National Children’s Study (NCS) is focusing on this significant stage of a woman’s pregnancy:

If you listened closely, however, Rose also mentions how the NCS is going to “make mothers more aware of things that they weren’t aware before.” As in any study, a possible research bias may occur if study participants change their behavior simply because they are being studied. This is called the “Hawthorne Effect,” which bears the name of the Hawthorne Works factory outside of Chicago.

Now let’s take a closer look at prenatal care:

In its most basic definition, prenatal care is the health care that a doctor or clinic gives to a pregnant woman. The American Academy ofFamily Physicians and the American College of Obstetricians and Gynecologists recommend prenatal care visits take place at least:

• Once every four weeks during the first six months of being pregnant
• Once every two weeks during the seventh and eight months of being pregnant
• Once every week during the last month of being pregnant
• Or more often as directed by the doctor

In the state of Illinois 86 percent of mothers begin prenatal care in the first trimester. However, that number varies widely by race/ethnicity where Black and Latina mothers have lower rates than White moms. Even though the proportion of mothers receiving early prenatal care is at a record high in our increasingly diverse society, disparities in care and outcomes remain among racial and ethnic groups, presenting a host of challenges for many families. In addition, there are differences in the women’s stage of pregnancy when seeking prenatal care, as well as dissimilarities in the type of providers sought at various stages of pregnancy. Some women may not seek care until very close to birth, and the provider may be a hospital. The National Children’s Study will take all of these characteristics into account to seek a better understanding of important questions such as:

• Can good nutrition help overcome potential risks from other environmental exposures that can affect the fetus?
• How does infection at various times over the course of pregnancy impact the fetus? 
• How are exposures to environmental toxicants, stress, prenatal nutrition, and other factors, such as genes, linked to a child’s risk of autism, ADHD, and other developmental disorders?

Results from this effort can help revise standards of care for prenatal screening, as well as inform guidelines for the management of certain conditions during pregnancy, such as diabetes. While Rose was right to point out how the NCS may make participants aware of certain things, it is highly unlikely that a Hawthorne-type effect might be at play in terms of prenatal care.