Va. Perkocha et al., THE EFFICACY OF 2 COMPREHENSIVE PERINATAL PROGRAMS ON REDUCING ADVERSE PERINATAL OUTCOMES, American journal of preventive medicine, 11(3), 1995, pp. 21-29
Through the collaboration among University of California at Berkeley S
chool of Public Health, Samuel Merritt College, and a private nonprofi
t, community-based medical center, the adequacy of two perinatal progr
ams was assessed based on the pregnancy outcomes of teenaged Medi-Cal
clients. Historical data from June 1991 to June 1992 were compiled on
the pregnancy outcomes of 312 Medi-Cal clients, 12-18 years of age, de
livering at the study medical center in Oakland, California. The effec
t of enrollment in two special perinatal programs, Comprehensive Perin
atal Services Program (CPSP) and a school-based program, the Comprehen
sive Teenage Pregnancy and Parenting Program (CTAPPP), on the occurren
ce of adverse perinatal outcomes was examined. Adverse perinatal outco
mes were defined as the occurrence of one of the following: low birthw
eight (< 2,500 grams), gestational age less than 37 weeks, or admissio
n to the neonatal intensive care unit (NICU), not related to congenita
l syphilis. The percentage of teens experiencing adverse perinatal out
comes was 10.9% at the study hospital. No significant association was
observed between CTAPPP enrollment and reduced adverse perinatal outco
mes, but CPSP enrollment was associated with reduced adverse perinatal
outcomes. This association persisted after controlling for potential
confounders, including substandard prenatal care,which were also found
to be risk factors for adverse perinatal outcomes. Enrollment in both
programs simultaneously was not associated with a reduction in advers
e outcomes. The significant association between CPSP enrollment and re
duced adverse perinatal outcomes indicates that a more comprehensive p
renatal program may be beneficial in improving birth outcomes, specifi
cally among high-risk teenage populations. Linking data on birth outco
mes among Medi-Cal clients to data on program participation may help b
etter assess the efficacy and coverage of these programs.