Low birth weight (LBW) infants are at increased risk of serious health problems and of infant mortality, and substantial disparities in the occurrence of LBW exist between Black and White women. Prenatal care programs offer strategies for improving outcomes and reducing these disparities. However, evaluations of such programs are often compromised by problems associated with linking program and birth outcomes and establishing an appropriate comparison group. These obstacles were addressed in an analysis of the Boston Healthy Start Initiative (BHSI), a federally funded program aimed at reducing poor birth outcomes in Boston .
Analyses: The data used included vitals data on Boston resident births between 1994 and 1996 to program participants and non-participants living in the BHSI project area. Chi-square and logistic regression analysis were used to estimate the relationship between LBW and program exposure.
Results: BHSI participants had only 59.7% the risk of LBW that nonparticipants experienced; 6.0% had a LBW baby versus 9.3% of nonparticipants. This difference was statistically significant both in crude analysis (OR=1.6; 95% CI=1.3,2.0) and after adjustment for potential confounders (OR=1.7; 95% CI=1.4-2.1). Adjustment variables included health insurance status, education, marital status, timing of entry into prenatal care, smoking, maternal risk factors, parity, and infant's gender, and in the overall model, maternal age and race/ethnicity.
This study supports the hypothesis that Boston's Healthy Start program reduces the risk of LBW births among high-risk women and emphasizes the need to control for risk factors when evaluating prenatal care programs.
Learning Objectives: At the conclusion of the presentation, all participants should be able to do the following: 1. Understand how a public health department can effectively evaluate an initiative to reduce low birth weight in newborns of high-risk mothers by linking birth certificate data to public health program data. 2. Understand the relationship between participation in Boston's Healthy Start Initiative during pregnancy and low birth weight incidence among Boston resident women
Keywords: Low Birthweight, Prenatal Interventions
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.