Length of Prenatal Participation in WIC and Risk of Delivering a Small for Gestational Age Infant: Florida, 1996–2004

Objective To assess the association between length of prenatal participation in WIC and a marker of infant morbidity. By focusing on small for gestational age, we consider one of the possible pathways through which prenatal nutrition affects fetal growth. Design/Methods The study sample consists of...

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Bibliographic Details
Published in:Maternal and child health journal 2009-07, Vol.13 (4), p.479-488
Main Authors: Gueorguieva, Ralitza, Morse, Steven B., Roth, Jeffrey
Format: Article
Language:English
Subjects:
Adult
Births
Female
Florida
Gestational Age
Gynecology
Humans
Infant, Low Birth Weight
Infant, Newborn
Infants
Maternal and Child Health
Medicaid
Medicine
Medicine & Public Health
Nutrition
Pediatrics
Population Economics
Poverty
Pregnancy
Pregnancy Outcome
Premature babies
Prenatal Care - utilization
Public Assistance
Public Health
Risk Assessment
Sociology
United States
Womens health
Young Adult
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Summary:Objective To assess the association between length of prenatal participation in WIC and a marker of infant morbidity. By focusing on small for gestational age, we consider one of the possible pathways through which prenatal nutrition affects fetal growth. Design/Methods The study sample consists of 369,535 matched mother-infant pairs drawn from all singleton live births in Florida hospitals from 1996 to 2004. All subjects received WIC and Medicaid-funded prenatal services during pregnancy. We controlled for selection bias on observed variables using a generalized propensity scoring approach and performed separate analyses by gestational age category to control for simultaneity bias. Results Ten percent increase in the percent of time in WIC was associated with 2.5% decrease (95% CI: 2.1–3.0%) in the risk of a full-term an SGA infant. The risk was also significantly decreased for very preterm and late preterm infants (29–33 and 34–36 weeks gestation) but not for extremely preterm infants (23–28 weeks gestation). Conclusions The observed small negative dose response relationship between percent of pregnancy spent in WIC and fetal growth restriction implies that longer participation in the program confers a small measure of protection against delivering an SGA infant.
ISSN:1092-7875
1573-6628
DOI:10.1007/s10995-008-0391-8