To observe pregnancy prevalence and service delivery among foster youth and examine impact on prenatal care utilization by a state policy insurance change. This cohort study utilizes linked, state administrative data to analyze child welfare and Medicaid claims of 4721 female foster youth in Michigan. 38.3% had pregnancy-related charges, and 17% experienced at least one birth. Only 64% received adequate prenatal care. Geography (Urban vs rural), and type of health insurance are significant predictors of prenatal care access for youth in foster care with youth in the largest urban county and those enrolled in managed care Medicaid plans receiving less care than youth living in smaller counties and those enrolled in fee for service Medicaid plans. Number of placements and type of placement were not associated with prenatal care access. Pregnancy prevalence in foster youth is much greater than in non-foster youth. Type of insurance model and geographic area a youth resides in significantly affect adequate prenatal care. Although not significant, age and racial disparities were also trending towards significance in terms of prenatal care access. Younger pregnant foster youth and Black youth received less care. Our findings may be indicative of access to adequate prenatal care by foster youth in other states.

观察寄养青年的怀孕率和服务提供情况，并检查国家政策保险变更对产前保健利用的影响。这项队列研究利用相关的州行政数据来分析密歇根州 4721 名女性寄养青年的儿童福利和医疗补助计划。38.3% 有与怀孕有关的费用，17% 经历过至少一次分娩。只有 64% 的人接受了充分的产前护理。地理（城市与农村）和健康保险类型是寄养青少年获得产前护理的重要预测因素参加服务 Medicaid 计划的费用。安置数量和安置类型与产前保健的可及性无关。寄养青年的怀孕率远高于非寄养青年。年轻人居住的保险模式类型和地理区域显着影响充分的产前护理。虽然不显着，但年龄和种族差异在产前保健获得方面也趋于显着。年龄较小的怀孕寄养青年和黑人青年受到的照顾较少。我们的研究结果可能表明其他州的寄养青年可以获得足够的产前护理。