Category: Prenatal

prenatal

The BIH intervention program contributed to the observed lower rates of very preterm and VLBW outcomes. The content and characteristics of the intervention are important to the discussion of study results. The BIH intervention program was funded by the California legislature in 1989 to improve the health of African-American women, infants, and children, thereby reducing African-American infant mortality. The guiding principles for the program were: participant self-empowerment, community involvement and ownership of the response to the problem, and partnership among the State Health Department, Maternal and Child Health Branch, local BIH projects, and aca-demia. It was implemented in the 16 health jurisdictions (17 separate sites in cities and counties) throughout the state where 97% of the African-American live births and infant deaths occurred.

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Profiles

Comparison of the risk profiles of women who stayed in BIH and had a singleton birth (n=2031) with those who dropped out of the program (n=l,060, 28% of 3,834 enrolled women) shows that BIH retained the women with the highest risk profiles (Table 1). Table 1 shows that women who remained in the program were more likely to have current health and previous pregnancy problems (p<0.01). Risk for any previous poor pregnancy outcome is between 1.66 (LBW), and 3.00 (previous neonatal death). The risk for PTB is 1.78. Furthermore, the risk for any current health problem for women who remained is between 2.07 (urinary tract infection) and 3.44 (pregnancy-induced hypertension).

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A prospective observational study design with a comparison group was used. BIH participants with a delivery recorded between July 1996 and September 1998 and who had entered the BIH Program prior to 32 weeks’ gestation, were included in the birthweight (BW) and PTB analyses. These outcomes for BIH participants (n=l,553) were compared to those of all African-American women in the BIH Program’s targeted ZIP codes (n=l 1,633). Some descriptive data on the entire BIH population was analyzed in order to provide a context for the study.

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prenatal interventions

The toll of infant morbidity and mortality associated with low birthweight (LBW) and preterm birth (PTB) has been investigated in numerous studies over the last 40 years. Associated factors, such as demographics, pregnancy history, personal behaviors, and access to prenatal care, are addressed repeatedly in the literature. However, there is still a less-than-adequate understanding of the biologic and social factors underlying their association with neonatal outcomes.

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