THE EFFICACY OF 2 COMPREHENSIVE PERINATAL PROGRAMS ON REDUCING ADVERSE PERINATAL OUTCOMES

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.