Randomized trial of comprehensive prenatal care for low-income women : effect on infant birth weight

• Published in: Pediatrics (Evanston) Vol. 89; no. 1; pp. 128 - 132
• Main Authors: MCLAUGHLIN, F. J, ALTEMEIER, W. A, CHRISTENSEN, M. J, SHERROD, K. B, DIETRICH, M. S, STERN, D. T
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL American Academy of Pediatrics 1992
• Subjects: Biological and medical sciences; Birth Weight; Birth weight, Low; Comprehensive Health Care; Female; Gynecology. Andrology. Obstetrics; Health aspects; Humans; Incidence; Infant; Infant, Newborn; Low birth weight; Management. Prenatal diagnosis; Medical sciences; Parity; Patient Care Team; Physiological aspects; Poverty; Pregnancy; Pregnancy. Fetus. Placenta; Prenatal care; Prenatal Care - methods; Prospective Studies; Regression Analysis; Social Support; Socioeconomic Factors; United States; North America; America; Pregnancy; Human; Prenatal; Sanitary program; Surveillance; Team work; Birth weight
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.89.1.128

The effect of comprehensive prenatal care on birth weight was examined using a prospective randomized design. A total of 428 pregnant women were randomly assigned to comprehensive prenatal care (n = 217) or standard prenatal care (n = 211). Comprehensive care was provided by a multidisciplinary team of nurse-midwives, social workers, a nutritionist, paraprofessional home visitors, and a psychologist. Standard prenatal care consisted of medical care provided by obstetric residents. Multiple regression analysis using behavioral, demographic, and medical variables showed a strong relationship between the set of predictors and birth weight. Comprehensive care was related to higher birth weights for primiparous but not multiparous mothers. Separate analyses of variance for primiparas and multiparas similarly showed a favorable effect of comprehensive care on birth weight for primiparous but not multiparous mothers.