Impact of the Healthy Baby campaign pilot program in 2004 on inadequate maternal weight gain among Colorado women in 2005

Inadequate prenatal weight gain is a major contributor to low birthweight in Colorado. A social marketing campaign, “A Healthy Baby is Worth the Weight,” was developed by the Colorado Department of Public Health and Environment to address this public health issue. Nine county health departments (in counties covering three-quarters of all Colorado births) received training on the Institute of Medicine's 1990 recommendations for prenatal weight gain and on strategies for implementation in a pilot program carried out between February and September 2004. Both providers and pregnant women were targeted. Women with prepregnancy body mass index <19.8 were a focus of the intervention. Pregnancy Risk Assessment Monitoring System (PRAMS) data were used to analyze changes in prenatal weight gain. In the year immediately following the pilot program, the statewide percentage of women with inadequate prenatal weight gain dropped from one out of four (24.8%) to fewer than one out of five (18.7%), a decline of 25% and a statistically significant change (p=.004). In the nine counties, the percentage of mothers with inadequate prenatal weight gain declined by 30%, from 25.0% to 17.5% (p =.004). Training was effective, but the impact was temporary. The improvements in prenatal weight gain in 2005 were not sustained in subsequent years. The study highlights the need for ongoing training and support to providers because they experience office turnover and care for new groups of pregnant women each year. The campaign addressed the social justice issue of improving health equity among pregnant women in Colorado.