title: Efforts to reduce low birth weight and preterm births: a statewide analysis (Virginia).
abstract: OBJECTIVE
  The purpose of this study was to ascertain the influence of evolving obstetric and public health care on the occurrence of low birth weight and preterm birth in a large population.
  
  
  METHODS
  Birth statistics of 2,049,970 live births (25.1% nonwhite) and 156,009 low-birth-weight infants (39.8% nonwhite) were analyzed.
  
  
  RESULTS
  Between 1967 to 1971 and 1977 to 1981 the incidence of infants weighing < or = 2500 gm declined from 85.5 to 74.4 per 1000 live births. The percentage of 500 to 1500 gm infants delivered at perinatal centers in Virginia increased from 41.8% in 1977 to 1981 to 64.9% in 1987 to 1991. In spite of regionalization, expanded maternity services, and increased use of tocolytic agents the incidence of low-birth-weight infants per 1000 live births in both white and nonwhite populations has remained comparatively stable since 1976, although the percentage of term infants weighing < or = 2500 gm has decreased. The incidence per 1000 live births of infants weighing 500 to 1500 gm has not changed statistically in 25 years (Student t test).
  
  
  CONCLUSIONS
  The data challenge the overall effectiveness of current programs, including the use of tocolytic agents, and indicate a need to restructure efforts to reduce low birth weight and preterm births.
authors.affiliation: Department of Obstetrics and Gynecology, University of Virginia Health Sciences Center, Charlottesville 22908.
authors.forename: G M
authors.initials: GM
authors.lastname: Harbert
mesh_terms: D000293:Adolescent; D000328:Adult; D001723:Birth Rate; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000517:prevention & control; D011247:Pregnancy; D011295:Prenatal Care; D014768:Virginia / Q000453:epidemiology; D014798:Vital Statistics