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ABSTRACT
Objective: To assess whether poor geographic accessibility to prenatal care, as indicated by long distance trips to prenatal care, produced high blood pressure (HPB) during pregnancy.
Methods: Using the 2007 Los Angeles Mommy and Baby Study for women without hypertension prior to pregnancy (n = 3405), we compared self-reported HBP by travel distance to prenatal care controlling for age, race/ethnicity, marital status, education, household income, weight status, and physical activity.
Results: Results of the multilevel logistic regression shows traveling more than 50 mi to prenatal care is associated with an increased odds for having HPB during pregnancy (odds ratio [OR] = 2.867, 95% confidence interval [CI] = 1.079,7.613), as compared with a travel distance shorter than 5 mi. Traveling 5–14 mi (OR = 0.917, 95% CI = 0.715–1.176), 15–29 mi (OR = 0.955, 95% CI = 0.634–1.438), or 30–50 mi (OR = 1.101, 95% CI = 0.485–2.499) were not significantly associated with more risk of HBP during pregnancy.
Conclusion: To our knowledge, no previous studies have examined the association between poor geographic accessibility to care and the possible harms of travel burdens for pregnant women. Future research that replicates these findings can assist in developing recommendations for pregnant women and health-care accessibility.
Funding
This project is partially supported by the Natural Science Foundation of Zhejiang Province, China (Grant Number LY15H040012) and (Grant Number. 81501280) from the Natural Science Foundation of China.