An evaluation of Prenatal Care Utilization, Prenatal Care Content, Prenatal Care Satisfaction and Low Birth Weight (LBW) in Los Angeles County (LAC): Findings from the 2007 Los Angeles Mommy and Baby (LAMB) Project

Background Evidence of the effectiveness of Prenatal Care (PNC) in reducing LBW births is limited because of incomplete measures of PNC indicators. Our goal was to evaluate the relationship between various PNC measures and LBW births.

Method LAMB is a population-based, mail sample survey based on multistage clustered design, containing information on mothers' PNC experience during pregnancy. We defined receiving six recommended National Guidelines for PNC tests, PNC Utilization, and PNC Satisfaction, as three PNC indicators. Multivariate logistic regressions with confounders and interaction terms were analyzed. Sampling weights were used to represent all LAC live births in 2007.

Results The overall LBW births rate was 7.3% based on weighted responses of 6,176 women with PNC (56% response rate). After adjusting for race/ethnicity, medical conditions during pregnancy, social support, and stress level, women without adequate PNC utilization or those who did not receive all recommended PNC tests were 1.82 (p<0.001) and 1.24 (p<0.05) times more likely to experience LBW births. Compared to White women, African American women were 1.52 (p=0.02) times more likely to have LBW births. Mothers with medical conditions during pregnancy were 1.51 (p<0.001) times more likely to have LBW births than mothers without medical conditions during pregnancy. There was no interaction among three PNC indicators.

Conclusions To lower the rates of LBW births, local health departments should continue to emphasize PNC utilization, and prenatal providers should encourage women, particularly African American women and those with high-risk medical conditions, to receive all recommended PNC tests during pregnancy.