Blog Post

Study Suggests Parents of Preterm Infants Miss More Postpartum Care

LDI Researchers Recommend Integrating Maternal Health Care into the NICU

April 21, 2025

By:

Christine Weeks

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More than half of maternal deaths occur after childbirth—yet one in three postpartum patients—a highly vulnerable group—goes without essential follow-up care. The period immediately after birth presents a critical window to detect and treat health conditions that can lead to serious complications or even death. When postpartum care is missed, so are life-saving opportunities.

The stakes are even higher for birthing parents whose infants are admitted to the neonatal intensive care unit (NICU), where the focus on newborn health may overshadow urgent maternal needs.

A recent study, led by LDI Associate Fellow Kristan Scott, along with LDI Senior Fellow Heather Burris and colleagues, investigated whether the intensive focus on neonatal care for preterm infants may come at the expense of critical maternal follow-up. They examined whether birthing parents of preterm infants—those born before 35 weeks’ gestation and routinely admitted to the NICU—are less likely to receive postpartum care compared to parents of infants born after 35 weeks.

Their analysis of 99,370 births in two Philadelphia hospitals between 2010 and 2019 found that 68% of patients received postpartum care and nearly one-third—21,867 individuals (32.2%)—did not. Several factors were significantly associated with lower rates of follow-up care, including younger age (under 25 years), multiple pregnancies, elevated body mass index, non-Hispanic Black race, Hispanic ethnicity, public or no insurance, lower educational attainment, absence of hypertension or diabetes, vaginal delivery, and living in areas with higher neighborhood deprivation.

Preterm Birth Raises the Risk of Missing Care

Preterm birth was also associated with a higher risk of parents missing postpartum care. Among parents of preterm infants—those born before 35 weeks and all admitted to the NICU—41% missed postpartum care compared to 32% of parents whose infants were born after 35 weeks. The difference was most striking among parents of extremely preterm infants (born before 24 weeks), where more than half did not receive postpartum care.

A New Site for Postpartum Care

Given the elevated risk of morbidity among birthing parents of preterm infants—particularly those facing prolonged hospitalizations—the NICU may serve as a promising and underused setting for establishing postpartum care.

Emerging evidence suggests that integrating certified nurse midwives into the NICU is both feasible and welcomed, as these parents often prioritize staying at their infant’s bedside over seeking care elsewhere. To meet their unique needs, collaborative models that include care navigators, community health workers, and doulas—working with maternal health clinicians—could bridge gaps in care, improve follow-up, and ultimately enhance maternal health outcomes.

The study, “Postpartum Care Receipt Among Parents of Preterm Infants Admitted to the NICU,” was published online March 1, 2025 in the American Journal of Obstetrics and Gynecology Maternal Fetal Medicine by Kristan Scott, Rachel F. Ledyard, Niesha Darden, Celeste Durnwald, Sara C. Handley, Timothy D. Nelin, Maggie Power, Taneisha R. Sinclair, and Heather H. Burris.