Active recruitment into health care and its effect on birth weight and gestational age at delivery

Objective: To analyze the effect of active recruitment of pregnant women into the health care system and to determine whether pregnancy outcomes differ when compared with a non-solicited group. Methods: The Baltimore Project began in November 1989 and was continued until April 1993 when it was supplanted by Baltimore's Healthy Start Project. Both projects involved the active recruitment of pregnant women into the health care system. The catchment area was characterized by the highest infant mortality rate in Baltimore City, as identified by census tract data. During the study period 138 women who delivered at the University of Maryland Hospital had been contacted by the Baltimore Project and comprised the case group. Two comparison groups were identified. The first, a historic group, was derived from the same census tract catchment area but delivered at the University of Maryland Hospital in the 2 years prior to the initiation of the project. The second, a contemporaneous group, was comprised from similar but adjacent census tracts, with deliveries occurring during the same time frame as the Baltimore Project. Variables of interest included gestational age at the first prenatal visit, gestational age at delivery, and birth weight. Statistical analysis was performed using the Mann-Whitney U test. Results: The only statistically significant difference was noted for the gestational age at delivery between the case and historic control groups. This difference was a lower gestational age at delivery in the group receiving the intervention. Conclusion: A program that includes active recruitment into the health care system appears to have no detectable impact on the number of prenatal visits, gestational age at delivery, or birth weight in the population studied.