The impact of prenatal care coordination on birth outcome.

Objective: Care coordination is a Medicaid benefit program designed to assist low-income women in gaining access to pregnancy related services. This study examines the relationship between prenatal care coordination and its impact on access to prenatal services and birth outcome.Methods: Ninety-four women who received prenatal care coordination and gave birth at Wishard Memorial Hospital in 1996 comprised the study population. A control group of 190 non care coordination participants was obtained from women who gave birth immediately before and after the women who was a care coordination participant. The prenatal and birth records from both groups were retrospectively reviewed. Data collected included information on birth weight, gestational age at delivery, WIC participation, number of prenatal visits, smoking and substance abuse. Perinatal complications were also recorded. Statistics was by t test and chi(2) with significance at.05.Results: Women enrolled in care coordination received 10 prenatal visits versus 8 for controls (P =.0005). Preterm labor occurred in 1.1% of women in care coordination compared to 5.8% of controls (P =.063). There was no difference in birth weight or the incidence of birth weight <2500 g between care coordination and controls. WIC participation was greater in the care coordination group, 95.7% versus 78% for controls, P <.05. In addition, women with care coordination were less likely to smoke during pregnancy.Conclusions: Care coordination does improve access to prenatal services as evidenced by an increase in prenatal visits and enrollment in WIC services. However, this study failed to demonstrate a direct relationship between care coordination and improved birth outcome.

Duke Scholars

Author Haywood Laverne Brown Obstetrics and Gynecology, Maternal Fetal Medicine