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Objective To determine if universal access to care for military beneficiaries improves timing of presentation to prenatal care (PNC) in adolescent and young adult (AYA) pregnancies, improving maternal and neonatal outcomes. Study Design Retrospective descriptive cohort study, which assessed PNC initiation in eligible military beneficiaries: dependent daughters, active-duty women, and active-duty spouses aged 13 to 26 between January 2015 and December 2019, and subsequent adverse maternal and neonatal outcomes. Results The cohort included 4,557 eligible pregnancies and 4,044 mothers aged 13 to 26. Late entry to PNC was not associated with gestational diabetes, prolonged rupture of membranes, pregnancy loss, elective abortion, substance use, or premature labor. Younger age was significantly associated with substance use, elective abortion, and sexually transmitted infection. There were 2,107 eligible newborns. There was no significant difference in gestational age at birth, incidence of prematurity, birthweight percentile, or occurrence of a neonatal intensive care unit admission based on maternal age. In comparison to published national outcomes, there was a significantly smaller occurrence of preterm (5.3% vs. 9.57-10.23%, 95% CI, 4.4-6.4%), small for gestational age (5.2% vs. 10-13%, 95% CI, 4.3-6.2%), and large for gestational age (4.8% vs. 9%, 95% CI, 4.0-5.8%) births, but a higher occurrence of neonatal intensive care unit admissions (16.9% vs. 7.8-14.4%, 95% CI, 15.4-18.6%) in infants born to military beneficiaries. Conclusions Our findings suggest that expanded universal access to health care may improve AYA pregnancy and delivery outcomes. Infants born to AYA military beneficiaries have improved neonatal outcomes compared to nationally published data. These results may correlate to improved maternal access within a free or low-cost healthcare system. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of this study is to assess the effect of age at adiposity rebound (AR) and changes in growth between birth and 6 months on growth status at 8–9 years in children born term and preterm. Age at AR is inversely correlated with risk for later obesity in children born full term, but has not been analyzed in children born preterm. METHODS: Birth anthropometrics, and weight and length/height data from age 6 months through 8–9 years were recorded for 175 children born in 2008 in the military health system. Calculated variables include body mass index (BMI, kg/m2), Z-scores, and age at AR. Results: Age at AR could be calculated for 150 children (32% preterm); average age was 5.4 years and 5.3 years for children born term and preterm, respectively (NS). For children born term and preterm, there was a significant correlation between younger age at AR and higher BMI Z-score at 8–9 years (r = – 0.685), and a direct relationship between weight Z-score change from birth to 6 months and weight Z-scores at 8–9 years (p = 0.034). CONCLUSIONS: Younger age at AR correlates with higher BMI Z-score at 8–9 years in children born both term and preterm. Weight gain from birth to 6 months correlates with weight Z-score at 8–9 years. These results emphasize the importance of younger age at AR in addition to greater early weight gain as an indicator of later obesity. [ABSTRACT FROM AUTHOR]