WIC Participation and Pregnancy Outcomes: Massachusetts Statewide Evaluation Project

American Journal of Public Health (Impact Factor: 4.55). 11/1984; 74(10):1086-92. DOI: 10.2105/AJPH.74.10.1086
Source: PubMed


The effects of WIC prenatal participation were examined using data from the Massachusetts Birth and Death Registry. The birth outcomes of 4,126 pregnant women who participated in the WIC program and gave birth in 1978 were compared to those of 4,126 women individually matched on maternal age, race, parity, education, and marital status who did not participate in WIC. WIC prenatal participants are at greater demographic risk for poor pregnancy outcomes compare to all women in the same community. WIC participation is associated with improved pregnancy outcomes, including, a decrease in low birthweight (LBW) incidence (6.9 per cent vs 8.7 per cent) and neonatal mortality (12 vs 35 deaths), an increase in gestational age (40.0 vs 39.7 weeks), and a reduction in inadequate prenatal care (3.8 per cent vs 7.0 per cent). Stratification by demographic subpopulations indicates that subpopulations at higher risk (teenage, unmarried, and Hispanic origin women) have more enhanced pregnancy outcomes associated with WIC participation. Stratification by duration of participation indicates that increased participation is associated with enhanced pregnancy outcomes. While these findings suggest that birth outcome differences are a function of WIC participation, other factors which might distinguish between the two groups could also serve as the basis for alternative explanations.

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Available from: Marlene Anderka, Mar 31, 2015
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    • "Most studies found that using adequate antenatal care was significantly associated with a reduced risk of LBW.[1819] In some of these studies, similar to the results of the present study, it is shown that local and national programs that provide education on nutrition, nutrient supplementation, and social and medical service referrals to pregnant women, and peer-centered prenatal education are effective in empowering women to make pregnancy safer and improving outcomes of pregnancy including decrease in the incidence of LBW.[20212223] "
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    ABSTRACT: Low birth weight (LBW) is considered as an important outcome of birth and pregnancy, which is associated with long-term consequences and health-care problems. Maternal lifestyle and health care during pregnancy are powerful predictors of BW of infants. The purpose of this study was to assess the effect of a self-care educational program based on the Health Belief Model (HBM) on reducing LBW among a sample of pregnant Iranian women. In this randomized controlled trial, we recruited 270 pregnant women referred to prenatal clinics in the south of Tehran, Iran. The participants were randomly allocated to two intervention and control groups. Women in the intervention group received an educational program to promote self-care behaviors during pregnancy. The control group received routine care. BW was compared between the two groups. Baseline demographic characteristics and knowledge and attitude scores before the intervention in both groups were compared using the Chi-square test for categorical variables. Logistic regression analysis was conducted to control the effect of demographic variables on BW. The results showed that LBW was reduced significantly in the intervention group at the follow-up measurement (5.6 vs. 13.2%, P = 0.03). After controlling for demographic characteristics, we found a significant decrease in the risk of LBW in the intervention group [odds ratio (OR): 0.333; 95% confidence interval (CI): 0.12-0.88, P = 0.02]. Implementation of a self-care educational program designed on the basis of an HBM on pregnant women was effective in reducing the rate of LBW.
    Full-text · Article · Jan 2014 · International journal of preventive medicine
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    • "The link between program participation and these outcomes has been of particular interest because low birth weight and premature birth have been associated with subsequent problems in children's health and development (see, for example, McCormick et al., 1992). The beneficial impact of maternal WIC participation during pregnancy on birth weight has been reported in a host of studies (Edozien et al., 1979; Kennedy et al., 1982; Devaney et al., 1992; Kowaleski-Jones & Duncan, 2000), and a few have reported increased gestational age and decreased incidence of preterm birth (Devaney et al., 1992; Kotelchuck et al., 1984). Studies also have found that participants had better pregnancy outcomes (Ekechuku, 1989). "
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    ABSTRACT: This study examines the relationship between WIC and Food Stamp Program participation and young children's health and maltreatment outcomes, utilizing a unique individual-level longitudinal database linking administrative datasets on WIC and Food Stamp Program (FSP) participation, Medicaid enrollment and claims, and child abuse and neglect reports in Illinois. Using Ordinary Least Square (OLS) methods, the data show that any of the three program participation types (joint WIC and FSP, WIC only, and FSP only) is associated with a lower risk of abuse and neglect reports, and of diagnosis of several nutrition related health problems such as anemia, failure to thrive, and nutritional deficiency. When we control for the possible selection bias using sibling fixed-effects models, the results were essentially unchanged suggesting no evidence of selection bias in the OLS results. The findings are significant indicators of the benefits of WIC and FSP participation among low-income young children. Furthermore, the findings about the lower risk of abuse and neglect is significant because it offers some evidence that participation in programs such as WIC and FSP that offer family supports not directly aimed at preventing child abuse and neglect may protect children.
    Full-text · Article · Feb 2007 · Children and Youth Services Review
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    • "In most observational studies researchers use statistical controls or matched samples to lessen contamination from selection bias. One criticism is that the set of covariates from administrative data and birth certificates is limited, which makes inferences vulnerable to omitted variable bias (Devaney, Bilheimer and Schore 1992; Schramm 1985; 1986; Stockbauer 1986; Stockbauer 1987; Kotelchuck et al. 1984). Studies with much more detailed information on maternal behavior and socio-economic status have obtained similar findings to studies with many fewer covariates (Gordon and Nelson 1996; Bitler and Currie forthcoming). "
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    ABSTRACT: We analyze the relationship between prenatal WIC participation and birth outcomes in New York City from 1988-2001. The analysis is unique for several reasons. First, we have over 800,000 births to women on Medicaid, the largest sample ever used to analyze prenatal participation in WIC. Second, we focus on measures of fetal growth distinct from preterm birth, since there is little clinical support for a link between nutritional supplementation and premature delivery. Third, we restrict the primary analysis to women on Medicaid who have no previous live births and who initiate prenatal care within the first four months of pregnancy. Our goal is to lessen heterogeneity between WIC and non-WIC participants by limiting the sample to highly motivated women who have no experience with WIC from a previous pregnancy. Fourth, we analyze a large sub-sample of twin deliveries. Multifetal pregnancies increase the risk of anemia and fetal growth retardation and thus may benefit more than singletons from nutritional supplementation. We find no relationship between prenatal WIC participation and measures of fetal growth among singletons. We find a modest pattern of association between WIC and fetal growth among U.S.-born Black twins. Our findings suggest that prenatal participation in WIC has had a minimal effect on adverse birth outcomes in New York City.
    Full-text · Article · Feb 2005 · Journal of Policy Analysis and Management
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