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The intent of this study was to explore the relationship of patient knowledge about the signs and symptoms of preterm labor and low birth weight. To this end, 538 women were interviewed in the postpartum period. Five aspects of preterm labor knowledge (abdominal tightness, vaginal discharge, cramping, diarrhea, and bleeding) were sought, along with standard demographic information. Data were analyzed as dichotomous variables and compared using odds ratios. Logistic regression was chosen to calculate adjusted odds ratios, including only those factors found to be associated with low birth weight. Patient knowledge of each varied from 46 to 87% for the five items. Only one third knew all five areas. Knowledge of the importance of abdominal tightness, vaginal discharge, and cramping were associated with a reduction in low birth weight, as was knowledge of all five aspects. However, regression analysis failed to support a significant association with any of the five areas alone or when considered as a group. The low sensitivity of the relationship between patient knowledge and low birth weight and the lack of correlation after regression suggest that programs focusing on enhanced patient education may have limited benefits.