PRENATAL FACTORS AND BIRTH OUTCOMES IN THE PUBLIC-HEALTH SERVICE - A RURAL URBAN COMPARISON/

To determine whether predictors of birth outcomes differ for women in rural versus urban areas, data were obtained from the health records o f women who received prenatal care through the Public Health Departmen ts of a rural (N = 364) and urban (N = 415) setting. The rural group w as more apt to be single, less educated, African-American, and have a lower income than the urban group. Rural women also had a higher incid ence of low birth weight infants, which may be related to poor nutriti on and low weight gain during pregnancy. Urban women had more maternal and neonatal complications, which may be related to a higher incidenc e of drug use and smoking. Membership in a rural or urban population d id not predict low birth weight. Race, weeks gestation at first prenat al visit, number of total visits, and adequacy of diet and weight gain were significant predictors of birth weight. Neonatal complications w ere higher in the urban group and best predicted by poor diet, alcohol intake, and race. Both rural and urban women received inadequate pren atal care, as indicated by late entry into care and total number of vi sits. Alternative models of care which explore strategies to individua lize care, while providing comprehensive care, should be investigated. (C) 1997 John Wiley & Sons, Inc.