Efforts to reduce low birth weight and preterm births: a statewide analysis (Virginia).

Abstract

The purpose of this study was to ascertain the influence of evolving obstetric and public health care on the occurrence of low birth weight and preterm birth in a large population. Birth statistics of 2,049,970 live births (25.1% nonwhite) and 156,009 low-birth-weight infants (39.8% nonwhite) were analyzed. Between 1967 to 1971 and 1977 to 1981 the incidence of infants weighing < or = 2500 gm declined from 85.5 to 74.4 per 1000 live births. The percentage of 500 to 1500 gm infants delivered at perinatal centers in Virginia increased from 41.8% in 1977 to 1981 to 64.9% in 1987 to 1991. In spite of regionalization, expanded maternity services, and increased use of tocolytic agents the incidence of low-birth-weight infants per 1000 live births in both white and nonwhite populations has remained comparatively stable since 1976, although the percentage of term infants weighing < or = 2500 gm has decreased. The incidence per 1000 live births of infants weighing 500 to 1500 gm has not changed statistically in 25 years (Student t test). The data challenge the overall effectiveness of current programs, including the use of tocolytic agents, and indicate a need to restructure efforts to reduce low birth weight and preterm births.