Promising practices in preconception care for women at risk for poor health and pregnancy outcomes.
OBJECTIVE
Two programs targeting urban African-American women are presented as promising models for preconception care, which includes interconception care.


METHODS
The Grady Memorial Hospital Interpregnancy Care (IPC) Program in Atlanta, Georgia, and the Magnolia Project in Jacksonville, Florida, are described. The IPC program aims to investigate whether IPC can improve the health status, pregnancy planning and child spacing of women at risk of recurrent very low birthweight (VLBW). The Magnolia Project aims to reduce key risks in women of childbearing age, such as lack of family planning and repeat sexually transmitted diseases (STDs), through its case management activities.


RESULTS
Seven out of 21 women in the IPC were identified as having a previously unrecognized or poorly managed chronic disease. 21/21 women developed a reproductive plan for themselves, and none of the 21 women became pregnant within nine months following the birth of their VLBW baby. The Magnolia Project had a success rate of greater than 70% in resolving the key risks (lack of family planning, repeat STDs) among case management participants. The black to white infant mortality (IM) ratio was better for the babies born to women managed in the Magnolia Project compared to the same ration for the United States.


CONCLUSIONS
Preconception care targeted to African-American women at risk for poor birth outcomes appears to be effective when specific risk factors are identified and interventions are appropriate. Outreach to women at risk and case management can be effective in optimizing the woman's health and subsequent reproductive health outcomes.
Biermann
Janis
J
March of Dimes, 1275 Mamaroneck Avenue, White Plains, NY, 10605, USA. jbiermann@marchofdimes.com
Dunlop
Anne Lang
AL
Brady
Carol
C
Dubin
Cynthia
C
Brann
Alfred
A
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D005193:Family Planning Services / Q000458:organization & administration*; D005260:Female; D005431:Florida; D005845:Georgia; D006265:Health Care Coalitions; D006786:Hospitals, Urban; D006801:Humans; D008429:Maternal Welfare / Q000208:ethnology*; D016742:Preconception Care / Q000458:organization & administration*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D018566:Pregnancy, High-Risk / Q000208:ethnology; D015397:Program Evaluation; D011635:Public Health Administration; D012306:Risk; D019037:Urban Health Services / Q000458:organization & administration*