Adequacy of Prenatal Care Utilization


Public Health Informatics annually publishes an Adequacy of Prenatal Care Utilization (APNCU) Index, utilizing information readily available on the Kansas birth certificate (number of prenatal care visits, month prenatal care began, and gestational length of pregnancy). The APNCU Index combines information on the adequacy of initiation of prenatal care and the adequacy of received services to characterize adequacy of pregnancy-related health services provided to an expectant mother between conception and delivery.

Prenatal care has long been endorsed as a major means to identify and reduce the risks of bearing infants who are low birth weight, are stillborn, or die within the first year of life. Therefore, the APNCU categorizes care as inadequate, intermediate, adequate or adequate plus in an attempt to measure progress toward reducing such risks. The index does not assess quality of the prenatal care that is delivered, only its utilization. Click here for more information on the components of the Adequacy of Prenatal Care Utilization Index.

Reports on the APNCU Index are available from 1998 to present. The Kansas Information for Communities Query System allows users to review APNCU values on births back to 1990. You will need Acrobat Reader to view the reports. If you have questions, please e-mail Kansas.Health.Statistics@kdheks.gov.

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2012 APNCU Report 2011 APNCU Report 2010 APNCU Report 2009 APNCU Report 2008 APNCU Report
2007 APNCU Report 2006 APNCU Report 2005 APNCU Report 2004 APNCU Report 2003 APNCU Report
2002 APNCU Report 2001 APNCU Report 2000 APNCU Report 1999 APNCU Report 1998 APNCU Report

Components of Adequacy of Prenatal Care Utilization

I. Month prenatal care began (Adequacy of Initiation of Prenatal Care)

  •  Adequate Plus: 1st or 2nd month
  •  Adequate: 3rd or 4th month
  •  Intermediate: 5th or 6th month
  •  Inadequate: 7th month or later, or no prenatal care

II. Proportion of the number of visits recommended by the American College of Obstetricians and Gynecologists (ACOG) received from the time prenatal care began until delivery (Adequacy of Received Services)

  •  Adequate Plus: 110% or more
  •  Adequate: 80% - 109%
  •  Intermediate: 50% - 79%
  •  Inadequate: less than 50%

III. Summary Adequacy of Prenatal Care Utilization Index

  •   Adequate Plus: Prenatal care begun by the 4th month and 110% or more of recommended visits received
  •   Adequate: Prenatal care begun by the 4th month and 80% - 109% of recommended visits received
  •   Intermediate: Prenatal care begun by the 4th month and 50% - 79% of recommended visits received
  •   Inadequate: Prenatal care begun after the 4th month or less than 50% of recommended visits received

NOTE: The APNCU Index requires the use of the following data elements reported on the live birth certificate: number of prenatal care visits, month prenatal care  began, and gestational length of pregnancy.

APNCU Reference: Kotelchuck M. An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index. American Journal of Public Health, 1994;84:1414-1420.

Children & Families Section, Bureau for Children, Youth, and Families, KDHE, 785-296-1306

Office of Health Assessment, Bureau of Public Health Informatics, KDHE, 785-296-5644

Adequacy of Prenatal Care Index Matrix