comparison of low birth weight among medicaid patients of public health departments and other providers of prenatal care in North Carolina and Kentucky

Matching of Medicaid and health department patients' files to birth certificates was used as a means of evaluating the effect of prenatal care given by public health departments on the birth weights of babies of women in Medicaid. Three years of live birth data from North Carolina and 2 years of birth data from Kentucky were used in the analysis. After controlling for other low birth weight risk factors (including the quantity of prenatal care) with logistic regression, women in Medicaid who received prenatal care outside public health departments were found to be substantially more likely than those who received care at health departments to have low weight infants. This association was especially strong for births under 1,500 grams. The authors suggest that the comprehensive prenatal care that is provided by the public health departments, which includes various nonmedical support services, may be responsible for this difference. These findings have important implications for proposed expansions of the Medicaid Program to cover more pregnant women in poverty.