Prenatal care rising,
but results raise more questions

By Brenda C. Coleman, AP Medical Writer
Copyright 1998 The Associated Press
May 26, 1998

CHICAGO (May 26, 1998 5:03 p.m. EDT -- The percentage of U.S. women getting prenatal care has risen markedly since 1980, which should be good news, but the overall rate of babies being born with low weight has worsened, federal researchers said.

Simply offering more prenatal care services without evaluating their effects may fail to improve overall health, researchers said in Wednesday's Journal of the American Medical Association.

The researchers, led by Michael D. Kogan of the National Center for Health Statistics in Hyattsville, Md., analyzed records of 54 million live births from 1981 to 1995 using two statistical yardsticks.

One yardstick indicates that prenatal-care use rose from 32.7 percent of births in 1981 to 47.1 percent in 1995; by the other yardstick, use rose from 18.4 per to 28.8 percent over the same interval, researchers said.

However, according to the National Center for Health Statistics, 7.3 percent of babies were classified as low birthweight in 1995, the latest year for which figures were available. The percentage was the same for 1994, when it was the highest reported since 1976.

Experts not involved in the study said care may be increasing most among women who need it least -- whites and the affluent, who are least likely to bear premature or dangerously small babies. Some of the study's numbers suggest that higher-risk pregnant women -- blacks and the poor -- get no more care than previously, the experts said in an editorial accompanying the study.

The researchers found an increase in the rate at which low-risk women got "intensive" prenatal care, defined as more than the number of recommended visits. The rate of such care rose from 8.5 percent to 22.8 percent, they said.

Also, higher-risk women may have long-standing maladies such as asthma or diabetes that short-term care can't keep from hurting their newborns, said the editorial, by Dawn P. Misra and Dr. Bernard Guyer of Johns Hopkins University School of Hygiene and Public Health.

The authors and the editorial writers both called for more study.

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