New York: Mothers whose first child was taken into out-of-home care were found to have inadequate or no prenatal care during subsequent pregnancies, says a new study.

Out-of-home care is a temporary, medium or long-term living arrangement for children and young people who cannot live in their family home.

The study showed that the odds of having inadequate prenatal care were more than four times higher for women who had their first child placed in care than for women who did not have their first child placed in care.

It was conducted in the Canadian province of Manitoba, which has one of the highest rates of children in out-of-home care in developed countries.

About 3 per cent of children live in homes without parental caregivers compared with a rate of 1 per cent of children in most developed countries.

For the study, a total of 52,438 mothers were included, of whom 1,284 had their first child placed in out-of-home care before conceiving a second child.

These mothers were more likely to have a substance use disorder, live in low-income and urban neighbourhoods, receive income assistance and have diabetes.

They were also 46 per cent more likely to receive inadequate prenatal care than women whose children had not been taken into care, said the study published in Canadian Medical Association Journal.

"Previous research has identified a fear of detection or involvement with child protection services as an important barrier for at-risk pregnant women, potentially leading to disengagement from, avoidance of or delayed presentation to prenatal care," noted Elizabeth Wall-Wieler from Stanford University in the US.