RT Journal Article SR Electronic T1 Prenatal care of women who give birth to children with fetal alcohol spectrum disorder in a universal health care system: a case–control study using linked administrative data JF CMAJ Open JO CMAJ FD Canadian Medical Association SP E63 OP E72 DO 10.9778/cmajo.20180027 VO 7 IS 1 A1 Deepa Singal A1 Marni Brownell A1 Elizabeth Wall-Wieler A1 Dan Chateau A1 Ana Hanlon-Dearman A1 Sally Longstaffe A1 Leslie L. Roos YR 2019 UL http://www.cmajopen.ca/content/7/1/E63.abstract AB Background: Few studies have investigated prenatal care use among women who use alcohol during pregnancy. The objective of this study was to investigate rates of prenatal care usage of women who have given birth to children with fetal alcohol spectrum disorder (FASD).Methods: We conducted a case–control study of women with children born in Manitoba between Apr. 1, 1984, and Mar. 31, 2012, with follow-up until 2013, using linkable administrative data. The study group included women whose child(ren) was (were) diagnosed with FASD (n = 702) between Apr. 1, 1999, and Mar. 31, 2012, at a centralized diagnostic clinic. The comparison group included women whose child(ren) did not have an FASD diagnosis (n = 2097), exact matched on the index child’s birthdate, postal code and socioeconomic status. Adequacy of prenatal care was defined using the Revised Graduated Prenatal Care Utilization Index.Results: Women in the study group had lower socioeconomic status than women in the comparison group and were more likely to have mental disorders and involvement with the child welfare system. Rates of inadequate prenatal care were higher among women in the study group (adjusted relative risk 2.47, 95% confidence interval [CI] 2.08–2.94), as were rates of no prenatal care (adjusted relative risk 3.55, 95% CI 2.42–5.22). In the study group, 41% of women accessed inadequate or no prenatal care, and 59% received intermediate, adequate or intensive prenatal care.Interpretation: Women who give birth to children with FASD have higher rates of inadequate prenatal care and significant social complexities. Socioeconomic disparities in the use of prenatal care should be addressed; multisector interventions are needed that facilitate the uptake of prenatal care by high-risk women who use alcohol.