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

Am J Obstet Gynecol. 2012 May;206(5):398-403. doi: 10.1016/j.ajog.2011.06.082. Epub 2011 Jun 29.


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.

MeSH terms

  • Female
  • Health Policy
  • Humans
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Medicaid / legislation & jurisprudence
  • Practice Guidelines as Topic
  • Pregnancy
  • Prenatal Care / legislation & jurisprudence
  • Prenatal Care / standards*
  • Prenatal Care / statistics & numerical data
  • Prenatal Care / trends
  • Preventive Health Services / legislation & jurisprudence
  • Preventive Health Services / standards*
  • Preventive Health Services / statistics & numerical data
  • Preventive Health Services / trends
  • Risk Assessment
  • Risk Factors
  • United States