Relation of the Content of Prenatal Care to the Risk of Low Birth Weight: Maternal Reports of Health Behavior Advice and Initial Prenatal Care Procedures

Abstract

OBJECTIVE: Numerous studies have found a relationship between the quantity of prenatal care received and birth outcomes. Few studies have had the opportunity to examine the content of prenatal care. This study examined the relationship between two components of the content of prenatal care: maternal reports of health behavior advice received and initial prenatal care procedures performed during the first two visits and low birth weight in a national sample of women. Advice and initial procedures were categorized based on the recommendations of the US Public Health Service Expert Panel on the Content of Prenatal Care. DESIGN: Interview survey of a nationally representative sample of women who had live births in 1988. PARTICIPANTS: A total of 9394 women, with data from the National Maternal and Infant Health Survey. MAIN OUTCOME MEASURE: Low birth weight (< 2500 g) as reported on the birth certificate. RESULTS: After controlling for other sociodemographic, utilization, medical, and behavioral factors, women who reported not receiving all the types of advice recommended by the Expert Panel on the Content of Prenatal Care were more likely to have a low-birth-weight infant compared with women who reported receiving the optimal level of advice (odds ratio = 1.38; 95% confidence interval, 1.18 to 1.60). There were no differences between women who reported receiving all the recommended initial prenatal care procedures and those who reported not receiving all recommended prenatal care (odds ratio = 1.00; 95% confidence interval, 0.87 to 1.14). CONCLUSION: These data suggest that women who report receiving sufficient health behavior advice as part of their prenatal care are at lower risk of delivering a low-birth-weight infant.