Social Support and the Relationship of Gestation Jeopardizing Behaviors and Prenatal Care
Gestation jeopardizing behaviors (GJB) of substance use or risky sex practices may negatively affect the use of prenatal care and birth outcomes. Both GJBs and late or no prenatal care increase health risks for both the mother and infant. The associations between GJBs and prenatal care and whether or not social support modifies the association between GJBs and prenatal care have not been adequately studied. The purpose of this study was to assess the association between GJBs and adequacy of prenatal care (APC) and initiation of prenatal care (IPC) and to assess the effects of positive and negative social support on the associations. The problem behavior theory was used as the guiding framework in studying the modifying effects of social support. Secondary data from the Pregnancy Risk Assessment Monitoring System (PRAMS) were used to assess the modifying effects of social support on the associations between GJBs and APC. Hierarchical binomial logistic regression and multinomial logistic regression were used for examining the modifying effects of social support on the associations between GJBs and APC. The results showed the most significant associations in the inadequate group of the multinomial model (OR = .323, 95% CI .275-.379) to (OR = 4.777, 95% CI 3.258-7.003) and for adequate care in the binomial model (OR = .667, CI .520-.856) to (OR = 5.651, CI 4.384-7.284). Positive social support did affect the odds of getting inadequate prenatal care in the multinomial model but not in the binomial model, while negative social support affected the odds in both models. These findings reinforce the role of social support for organizations and policymakers seeking more ways to promote adequate prenatal care among at-risk, pregnant populations.