Skip to main content

Advertisement

SpringerLink
Log in

A Quasi-Experimental Design to Assess the Effectiveness of the Federal Healthy Start in Reducing Preterm Birth Among Obese Mothers

  • Original Paper
  • Published:
The Journal of Primary Prevention Aims and scope Submit manuscript

Abstract

We assessed the impact of Central Hillsborough Healthy Start (CHHS), a federally-funded program dedicated to improving maternal and infant outcomes in a population of high-risk obese mothers in the socio-economically challenged community of East Tampa in Florida on preterm birth and very preterm birth (VPTB). We utilized hospital discharge records linked to vital statistics data in Florida (2004–2007) to study obese women with a singleton birth, matching mothers in the CHHS catchment area with those from the rest of Florida. We conducted conditional logistic regression with the matched data. Obese mothers in the CHHS service area had a 61 % lower likelihood of having a VPTB infant than obese mothers in the rest of the state (AOR = 0.39, 95 % CI 0.21–0.70). Obese women of reproductive age may benefit from services from federal Healthy Start programs. Study findings underscore the need for further research to explore the impact of such programs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Alexander, G. R., & Kotelchuck, M. (1996). Quantifying the adequacy of prenatal care: A comparison of indices. Public Health Reports, 111(5), 408–419.

    PubMed Central  CAS  PubMed  Google Scholar 

  • Badura, M., Johnson, K., Hench, K., & Reyes, M. (2008). Healthy start lessons learned on interconception care. Womens Health Issues, 18(6 Suppl), S61–S66. doi:10.1016/j.whi.2008.07.010.

    Article  PubMed  Google Scholar 

  • Behrman, R. E., & Butler, A. S. (Eds.). (2006). Preterm birth: Causes, consequences and prevention. Washington, DC: The National Academies Press.

    Google Scholar 

  • Bhutta, Z. A., Darmstadt, G. L., Hasan, B. S., & Haws, R. A. (2005). Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: A review of the evidence. Pediatrics, 115(Supplement 2), 519–617. doi:10.1542/peds.2004-1441.

    PubMed  Google Scholar 

  • Castro, L. C., & Avina, R. L. (2002). Maternal obesity and pregnancy outcomes. Current Opinion in Obstetrics and Gynecology, 14(6), 601–606. doi:10.1097/01.gco.0000045486.15021.C9.

    Article  PubMed  Google Scholar 

  • Chang, H. C., Larson, J., Blencowe, H., Spong, C. Y., Howson, C. P., Cairns-Smith, S., et al. (2013). Preventing preterm births: Analysis of trends and potential reductions with interventions in 39 countries with very high human development index. The Lancet, 381(9862), 223–234. doi:10.1016/S0140-6736(12)61856-X.

    Article  Google Scholar 

  • Dehejia, R. H., & Wahba, S. (2002). Propensity score-matching methods for nonexperimental causal studies. Review of Economics and Statistics, 84(1), 151–161.

    Article  Google Scholar 

  • Djelantik, A. A., Kunst, A. E., van der Wal, M. F., Smit, H. A., & Vrijkotte, T. G. (2012). Contribution of overweight and obesity to the occurrence of adverse pregnancy outcomes in a multi-ethnic cohort: Population attributive fractions for Amsterdam. British Journal of Obstetrics and Gynaecology, 119(3), 283–290. doi:10.1111/j.1471-0528.2011.03205.x.

    Article  CAS  PubMed  Google Scholar 

  • Florida Department of Health. (2013). Fact sheet: Healthy start facts. http://www.floridahealth.gov/healthy-people-and-families/childrens-health/healthy-start/_documents/hsfactsheet2013.pdf. Retrieved January 14, 2014.

  • Goldenberg, R. L., & Culhane, J. F. (2005). Prepregnancy health status and the risk of preterm delivery. Archives of Pediatrics and Adolescent Medicine, 159(1), 89–90. doi:10.1001/archpedi.159.1.89.

    Article  PubMed  Google Scholar 

  • Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008). Epidemiology and causes of preterm birth. [Review]. The Lancet, 371(9606), 75–84. doi:10.1016/S0140-6736(08)60074-4.

    Article  Google Scholar 

  • Hamilton, B. E., Martin, J. A., & Ventura, S. J. (2011). Births: Preliminary data for 2010. National Vital Statistics Reports, 60(2), 1–26.

    PubMed  Google Scholar 

  • Hildingsson, I., & Thomas, J. (2012). Perinatal outcomes and satisfaction with care in women with high body mass index. Journal of Midwifery and Women’s Health, 57(4), 336–344. doi:10.1111/j.1542-2011.2011.00141.x.

    Article  PubMed  Google Scholar 

  • Iams, J. D., Romero, R., Culhane, J. F., & Goldenberg, R. L. (2008). Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth. The Lancet, 371(9607), 164–175. doi:10.1016/S0140-6736(08)60108-7.

    Article  Google Scholar 

  • Jiang, M., Foster, E. M., & Gibson-Davis, C. M. (2011). Breastfeeding and the child cognitive outcomes: A propensity score matching approach. Maternal and Child Health Journal, 15(8), 1296–1307. doi:10.1007/s10995-010-0677-5.

    Article  PubMed  Google Scholar 

  • Kanadys, W. M., Leszczyńska-Gorzelak, B., Jedrych, M., & Oleszczuk, J. (2012). Maternal pre-pregnancy obesity and the risk of preterm birth: A systematic overview of cohort studies with meta-analysis. Ginekologia Polska, 83(4), 270–279.

    PubMed  Google Scholar 

  • Kothari, C. L., Wendt, A., Liggins, O., Overton, J., & Sweezy Ldel, C. (2011). Assessing maternal risk for fetal–infant mortality: A population-based study to prioritize risk reduction in a healthy start community. Maternal and Child Health Journal, 15(1), 68–76. doi:10.1007/s10995-009-0561-3.

    Article  PubMed  Google Scholar 

  • McCowan, L. M., North, R. A., Kho, E. M., Black, M. A., Chan, E. H., Dekker, G. A., et al. (2011). Paternal contribution to small for gestational age babies: A multicenter prospective study. Obesity, 19(5), 1035–1039. doi:10.1038/oby.2010.279.

    Article  PubMed  Google Scholar 

  • McDonald, S. D., Han, Z., Mulla, S., & Beyene, J. (2010). Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: Systematic review and meta-analyses. British Medical Journal. doi:10.1136/bmj.c3428.

    Google Scholar 

  • Morgenstern, H. (1995). Ecologic studies in epidemiology: Concepts, principles, and methods. Annual Review of Public Health, 16(1), 61–81.

    Article  CAS  PubMed  Google Scholar 

  • Oteng-Ntim, E., Varma, R., Croker, H., Poston, L., & Doyle, P. (2012). Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: Systematic review and meta-analysis. BMC Medicine, 10, 47. doi:10.1186/1741-7015-10-47.

    Article  PubMed Central  PubMed  Google Scholar 

  • Reece, E. A. (2008). Perspectives on obesity, pregnancy and birth outcomes in the United States: The scope of the problem. American Journal of Obstetrics and Gynecology, 198(1), 23–27. doi:10.1016/j.ajog.2007.06.076.

    Article  PubMed  Google Scholar 

  • Reyes, E., Martinez, N., Parra, A., Castillo-Mora, A., & Ortega-Gonzalez, C. (2012). Early intensive obstetric and medical nutrition care is associated with decreased prepregnancy obesity impact on perinatal outcomes. Gynecologic and Obstetric Investigation, 73(1), 75–81. doi:10.1159/000329899.

    Article  PubMed  Google Scholar 

  • Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1), 41–55.

    Article  Google Scholar 

  • Rosenberg, T. J., Garbers, S., Lipkind, H., & Chiasson, M. A. (2005). Maternal obesity and diabetes as risk factors for adverse pregnancy outcomes: Differences among 4 racial/ethnic groups. American Journal of Public Health, 95(9), 1545–1551. doi:10.2105/Ajph.2005.065680.

    Article  PubMed Central  PubMed  Google Scholar 

  • Salihu, H. M., Alio, A. P., Wilson, R., Sharma, P. P., Kirby, R. S., & Alexander, G. R. (2008). Obesity and extreme obesity: New insights into the black–white disparity in neonatal mortality. Obstetrics and Gynecology, 111(6), 1410–1416.

    Article  PubMed  Google Scholar 

  • Salihu, H. M., Luke, S., Alio, A. P., Wathington, D., Mbah, A. K., Marty, P. J., et al. (2009a). The superobese mother and ethnic disparities in preterm birth. [Research Support, Non-U.S. Gov’t]. Journal of the National Medical Association, 101(11), 1125–1131.

    PubMed  Google Scholar 

  • Salihu, H. M., Mbah, A. K., Jeffers, D., Alio, A. P., & Berry, L. (2009b). Healthy start program and feto-infant morbidity outcomes: Evaluation of program effectiveness. Maternal and Child Health Journal, 13(1), 56–65. doi:10.1007/s10995-008-0400-y.

    Article  PubMed  Google Scholar 

  • Siega-Riz, A.-M., & Laraia, B. (2006). The implications of maternal overweight and obesity on the course of pregnancy and birth outcomes. Maternal and Child Health Journal, 10, 153–156. doi:10.1007/s10995-006-0115-x.

    Article  PubMed Central  Google Scholar 

  • Simmons, L. E., Rubens, C. E., Darmstadt, G. L., & Gravett, M. G. (2010). Preventing preterm birth and neonatal mortality: Exploring the epidemiology, causes, and interventions. Seminars in Perinatology, 34(6), 408–415.

    Article  PubMed  Google Scholar 

  • Smith, J., & Todd, P. (2005). Does matching overcome LaLonde’s critique of nonexperimental estimators? Journal of Econometrics, 125(1–2), 305–353.

    Article  Google Scholar 

  • Swamy, G. K., Ostbye, T., & Skjaerven, R. (2008). Association of preterm birth with long-term survival, reproduction, and next-generation preterm birth. Journal of the American Medical Association, 299(12), 1429–1436. doi:10.1001/jama.299.12.1429.

    Article  CAS  PubMed  Google Scholar 

  • Torloni, M. R., Betran, A. P., Daher, S., Widmer, M., Dolan, S. M., Menon, R., et al. (2009). Maternal BMI and preterm birth: A systematic review of the literature with meta-analysis. Journal of Maternal-Fetal and Neonatal Medicine, 22(11), 957–970. doi:10.3109/14767050903042561.

    Article  PubMed  Google Scholar 

  • Tucker, J., & McGuire, W. (2004). Epidemiology of preterm birth. British Medical Journal, 329(7467), 675–678. doi:10.1136/bmj.329.7467.675.

    Article  PubMed Central  PubMed  Google Scholar 

  • US Department of Health and Human Services, Health Resources and Services Administration. (2014). Healthy start. http://mchb.hrsa.gov/programs/healthystart/. Retrieved January 13, 2014.

  • Zeger, S. L., & Liang, K. Y. (1986). Longitudinal data analysis for discrete and continuous outcomes. Biometrics, 42(1), 121–130.

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs, MDC56, Tampa, FL, 33612, USA

    Euna M. August, Hamisu M. Salihu & Alfred K. Mbah

  2. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, FL, USA

    Hamisu M. Salihu

  3. Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA

    Cara Z. de la Cruz

  4. Department of Community and Preventive Medicine, University of Rochester, Rochester, NY, USA

    Amina P. Alio

  5. REACHUP, Incorporated, Tampa, FL, USA

    Estrellita Lo Berry

Authors
  1. Euna M. August
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hamisu M. Salihu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cara Z. de la Cruz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alfred K. Mbah
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amina P. Alio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Estrellita Lo Berry
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hamisu M. Salihu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

August, E.M., Salihu, H.M., de la Cruz, C.Z. et al. A Quasi-Experimental Design to Assess the Effectiveness of the Federal Healthy Start in Reducing Preterm Birth Among Obese Mothers. J Primary Prevent 36, 205–212 (2015). https://doi.org/10.1007/s10935-015-0389-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10935-015-0389-0

Keywords

Search

Navigation