Preventing Low Birthweight: 25 years, prenatal risk, and the failure to reinvent prenatal care

Elizabeth E. Krans*, Matthew M. Davis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

43 Scopus citations

Abstract

In 2010, Preventing Low Birthweight celebrated it 25th anniversary. The report, one of the most influential policy statements ever issued regarding obstetric health care delivery, linked prenatal care to a reduction in low birthweight (LBW). Medicaid coverage for prenatal care services was subsequently expanded and resulted in increased prenatal care utilization. However, the rate of LBW failed to decrease. This well-intentioned expansion of prenatal care services did not change the structure of prenatal care. A single, standardized prenatal care model, largely ineffective in the prevention of LBW, was expanded to a heterogeneous group of patients with a variety of medical and psychosocial risk factors. Reinventing prenatal care as a flexible model, with content, frequency, and timing tailored to maternal and fetal risk, may improve adverse birth outcomes. Risk-appropriate prenatal care may improve the effectiveness of prenatal care for high-risk patients and the efficiency of prenatal care delivery for low-risk patients.

Original languageEnglish (US)
Pages (from-to)398-403
Number of pages6
JournalAmerican journal of obstetrics and gynecology
Volume206
Issue number5
DOIs
StatePublished - May 2012

Keywords

  • health care utilization
  • low birthweight
  • prenatal care
  • risk assessment

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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