Epidemiological analyses of perinatal outcome data from Healthy Babies are Worth the Wait

Healthy Babies are Worth the Wait/HBWW, a March of Dimes, Johnson & Johnson Pediatric Institute, and Kentucky Department for Public Health partnership, is a 3-year (2007-2009), ecological design, national model to prevent preterm birth (PTB). Kentucky was selected as it met specific eligibility criteria: high rates of PTB, large increases in late PTB (34-36 weeks) in the preceding decade, high rates of modifiable PTB risk factors, demonstrated collaboration of MCH agencies, a willingness for targeted clinical sites and their respective local health departments to work together, and the ease and availability of obtaining extant data in a timely fashion for evaluation from the state Department for Public Health. HBWW engaged perinatal providers, public health workers, and community partners to provide information and bundled, evidence-based care to promote healthy, term pregnancies in the 3 intervention sites. Epidemiological analyses of perinatal outcomes from the birth certificate files for the eligible deliveries (singleton, inborn) in the 3 intervention (~11,000) and 3 comparison (~11,000) sites were conducted focusing on the changes in rates from baseline (2007) to follow-up (2009) and the difference between intervention and comparison sites for the following outcomes: PTB, late PTB, inductions, cesarean sections, and smoking in pregnancy. Data were analyzed in 6 month intervals and stratified by selected maternal factors including parity, maternal age, onset of prenatal care, smoking status, previous history of PTB, mode of delivery. Multivariate analyses were also conducted and a summary of key findings with implications for MCH programs and public health policy will be presented.