PEDIATRICS Vol. 89 No. 1 January 1992, pp. 128-132
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Randomized Trial of Comprehensive Prenatal Care for Low-Income Women: Effect on Infant Birth Weight

F. Joseph McLaughlin PhD1, William A. Altemeier MD1, Myra J. Christensen MS1, Kathryn B. Sherrod PhD1, Mary S. Dietrich MS1, and David T. Stern MD1

1 From Vanderbilt University and Metropolitan Nashville General Hospital, Nashville, TN.

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.

Key Words: prenatal care • birth weight • low-income women

Submitted on June 3, 1991
Accepted on August 29, 1991




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