258435 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

Tuesday, October 30, 2012

Sai Liu, MPH , Master of Public Health 2012, Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA
Shin Margaret Chao, PhD, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Heejoo Jo, BS , Master of Public Health Candidate 2012, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
Chandra Higgins, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Marian Eldahaby , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Cindy Harding, MPH , Maternal, Child and Adolescent Health Program, County of Los Angeles Public Health, Los Angeles, CA
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.

Learning Areas:
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related laws, regulations, standards, or guidelines
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Evaluate the relationship between various Prenatal Care measures and Low Birth Weight; 2. Identify prevention and intervention strategies for improving birth outcome; 3. Describe health disparities in birth outcome among sub-populations;

Keywords: Low Birthweight, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently an MPH candidate with Epidemiology and Biostatistics track. I have been interning at the Los Angeles County Department of Public Health, Maternal Child and Adolescent Health Programs since 2011. My research interests include Maternal and Child Health, specifically low birth weight and prenatal care.
Any relevant financial relationships? No

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.