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To investigate the relationship between gestational weight gain (GWG) and birthweight outcomes among a low-income population in Hawaii using GWG recommendations from the 2009 Institute of Medicine (IOM) guidelines. Data were analyzed for 19,130 mother-infant pairs who participated in Hawaii's Special Supplemental Nutrition Program for Women, Infants, and Children from 2003 through 2005. GWG was categorized as inadequate, adequate, or excessive on the basis of GWG charts in the guidelines. Generalized logit models assessed the relationship between mothers' GWG and their child's birthweight category (low birthweight [LBW: Keywords WIC * Gestational weight gain * LBW * HBW * IOM guideline, Introduction Low birthweight (LBW, < 2,500 g) is associated with infant mortality [1-3] and infant and childhood morbidity, including neurodevelopmental sequelae, mental retardation, and lower respiratory conditions [1-6]. LBW is [...]

Nearly a half million infants in the United States are born preterm or with low birth weight each year. Providing women who have had a prior adverse birth outcome with access to family planning can help reduce the incidence of subsequent high-risk pregnancies and adverse outcomes. One effective option to prevent unintended pregnancy for women with a prior adverse birth outcome who either do not use contraception consistently or whose contraception fails is emergency contraception (EC). The purpose of our study was to understand willingness to use EC among African-American women who recently had an adverse birth outcome. The Healthy Births Healthy Communities (HBHC) Interconceptional Care Project (ICCP) targeted high-risk African-American women from two low-income Chicago neighborhoods who recently had an adverse birth outcome. The aim of HBHC ICCP was to improve participants' future birth outcomes by providing medical and social services and helping women to clarify their reproductive life goals. Information about participants' pregnancy intentions and willingness to use EC was measured in an interview shortly after enrollment into the study. Over 90% of the 131 women in our study either did not want to become pregnant or did not know if they wanted to become pregnant within the next 2 years. These women had 4.4 times higher odds of reporting willingness to use EC as compared to women who reported a desire to become pregnant within the next 2 years (75.6 vs. 50.0%, respectively; AOR: 4.4; 95% CI 1.1, 17.6). EC is an essential part of the reproductive toolkit for women at high risk of adverse birth outcomes who are not intending pregnancy, along with reproductive life planning and use of effective contraception. Keywords Contraception * Unintended pregnancy * Emergency contraception * Plan B * Poor birth outcome, Introduction Nearly a half million infants in the United States--1 out of every 9--are born preterm or with low birth weight each year. Complications related to these adverse birth outcomes [...]

To assess whether a measure of prenatal case management (PCM) dosage is more sensitive than a dichotomous PCM exposure measure when evaluating the effect of PCM on low birthweight (LBW) and preterm birth (PTB). We constructed a retrospective cohort study (N = 16,657) of Iowa Medicaid-insured women who had a singleton live birth from October 2005 to December 2006; 28% of women received PCM. A PCM dosage measure was created to capture duration of enrollment, total time with a case manager, and intervention breadth. Propensity score (PS)-adjusted odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated to assess the risk of each outcome by PCM dosage and the dichotomous PCM exposure measure. PS-adjusted ORs of PTB were 0.88 (95% CI 0.70-1.11), 0.58 (95% CI 0.47-0.72), and 1.43 (95% CI 1.23-1.67) for high, medium, and low PCM dosage, respectively. For LBW, the PS-adjusted ORs were 0.76 (95% CI 0.57-1.00), 0.64 (95% CI 0.50-0.82), and 1.36 (95% CI 1.14-1.63), for high, medium, and low PCM dosage, respectively. The PCM dichotomous participation measure was not significantly associated with LBW (OR = 0.95, 95% CI 0.82-1.09) or PTB (0.97, 95% CI 0.87-1.10). The reference group in each analysis is No PCM. PCM was associated with a reduced risk of adverse pregnancy outcomes for Medicaid-insured women in Iowa. PCM dosage appeared to be a more sensitive measure than the dichotomous measure of PCM participation. Keywords Prenatal case management * Prenatal home visiting * Birth outcomes * Dose-response relationships, Introduction Over the years, numerous evaluations of prenatal case management (PCM) have been conducted. PCM is a community-based health related service offered to medically and/or socially vulnerable pregnant women to [...]