LAUSR

initiating prenatal care in the first trimester. Uninsurance was also associated with an 18% and 7% increased risk of severe preterm delivery (<28 weeks) and low birth weight, respectively. CONCLUSION: Access to insurance prior to conception is associated with earlier initiation of prenatal care. Many screening and risk reducing interventions (such as genetic screening, teratogenic and environmental exposure avoidance, preterm birth risk factors), which are routinely performed in the first trimester, may be missed or delayed with later initiation of prenatal care. Future studies should focus how changes in preconception insurance coverage affect initiation of prenatal care and further explore the causal links between this association.