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Title A New Method for Classifying Patterns of Prenatal Care Utilization Using Cluster Analysis
Edition Volume 8, Number 1
Call Number
ISBN/ISSN 1092-7875
Author(s) Rosenberg, Deborah
Handler, Arden
Furner, Sylvia
Series Title Maternal and Child Health Journal
GMD Electronic Journal
Language English
Publisher Springer Netherlands
Publishing Year 2004
Publishing Place Netherlands
Collation 12p
Abstract/Notes The objectives of this study were: to 1) define patterns of prenatal care utilization
using cluster analysis, 2) describe two alternative cluster solutions and compare these
groupings to the Adequacy of Prenatal Care Utilization Index (APNCU), 3) compare the
cluster solutions and the APNCU with respect to maternal age and prematurity, and 4) discuss
advantages and disadvantages of using cluster analysis to study prenatal care. Methods: The
study sample included 3544 women in the 1988 National Maternal and Infant Health Survey
for whom complete prenatal care visit data were available. Clustering was carried out in
two stages, first employing nearest centroid sorting (the k means method), a nonhierarchical
approach, and then using Ward’s Minimum Variance Method, a hierarchical clustering technique.
Results: Patterns of prenatal care defined by cluster analysis varied by timing of the
first visit, total number of visits, and the rate of accumulation of visits, but this variation was
different compared to that seen for the APNCU.While the cluster solutions and the APNCU
identified a similar normative pattern of care, other patterns identified were quite different.
In particular, the six-cluster solution differentiated among women who entered care at similar
times, but accumulated visits at differing rates and experienced differing rates of preterm
delivery. Conclusion: Cluster analysis is a new tool for studying prenatal care. Further studies
are needed to refine the method and test whether the alternative perspective it provides will
lead to new findings concerning the relationship of prenatal care and birth outcomes.
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