161135 Evaluation of a program to prevent prematurity and low birth-weight deliveries in a low income population

Monday, November 5, 2007: 3:10 PM

Kathryn Luchok, PhD , The Southern Institute on Children and Families, Columbia, SC
Marie C. Meglen, MS, CNM , Prematurity Prevention Partnership, Palmetto Healthy Start, Columbia, SC
Marlene Mackey, PhD, RN, FAAN , College of Nursing, University of South Carolina, Columbia, SC
Jong-Deuk Baek, PhD , HPSM, University of South Carolina, Columbia, SC
Winifred W. Thompson, PhD, MSW , Department of Behavioral Sciences and Health Education Rollins School of Public Health, Emory University Winship Cancer Institute at Grady Health System, Atlanta, GA
Kimberly Alston , Director, Palmetto Healthy Start, Columbia, SC
Background: The March of Dimes-funded Prematurity Prevention Partnership (PPP) holistically approached improving birth outcomes by considering psychosocial and medical risk factors in developing individualized service plans for participants. Palmetto Healthy Start (PHS) Resource Mothers and Social Workers implemented these plans, providing supportive interactions and referrals. Outcome evaluation focused on assessing program effectiveness in reducing the incidence of prematurity and low birth weight [LBW].

Methods: We compared PHS/PPP prematurity and LBW ratios across time as well as compared PHS/PPP ratios to county and state ratios for 2003-2005, using t-tests and X2 for comparisons. We examined overall ratios and African-American-specific ratios.

Results: From June 2003-August 2006, LBW and prematurity ratios have dramatically declined for PHS/PPP participants (N=1,326) from 26.5% of LBW births and 24.5% premature (< 37 weeks) to 9.3% LBW and 13.1% premature. This is a 65% decline for LBW and a 47% decline for prematurity in this predominately African-American (85%) population. Over the same period, ratios for the county and state were rising. Births at less than < 32 weeks gestation declined 80% for African-American PHS/PPP participants (from 12.24% to 2.38%) and stayed around 4% for African-Americans in the county and state over the same period.

Conclusion: The PPP emphasized prematurity prevention for PHS staff and participants; over time there has been a substantial reduction in LBW and prematurity for participants, which is not seen in the general state or county pregnant population. PPP appears to have had a profound effect on improving birth outcomes in this high-risk population.

Learning Objectives:
After the presentation, those in attendance will be able to: 1. Describe the incidence of low birth weight and prematurity in this low-income largely minority population. 2. Describe the changes in prevalence over time, within this population, and compare these ratios to state and county data. 3. Evaluate how a holistic program can lead to better health outcomes for this high risk pregnant population.

Keywords: Maternal and Child Health, Pregnancy Outcomes

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.