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 wom en into the health care system and to determine whether pregnancy outc omes differ when compared with a non-solicited group. Methods: The Bal timore Project began in November 1989 and was continued until April 19 93 when it was supplanted by Baltimore's Healthy Start Project. Both p rojects involved the active recruitment of pregnant women into the hea lth care system. The catchment area was characterized by the highest i nfant mortality rate in Baltimore City, as identified by census tract data. During the study period 138 women who delivered at the Universit y 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 catchm ent area but delivered at the University of Maryland Hospital in the 2 years prior to the initiation of the project, The second, a contempor aneous group, was comprised from similar but adjacent census tracts, w ith deliveries occurring during the same time frame as the Baltimore P roject. Variables of interest included gestational age at the first pr enatal visit, gestational age at delivery, and birth weight. Statistic al analysis was performed using the Mann-Whitney U test. Results: The only statistically significant difference was noted for the gestationa l age at delivery between the case and historic control groups. This d ifference was a lower gestational age at delivery in the group receivi ng the intervention. Conclusion: A program that includes active recrui tment into the health care system appears to have no detectable impact on the number of prenatal visits, gestational age at delivery, or bir th weight in the population studied.