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国家妇女、婴儿和儿童营养补充计划评估:妇女、婴儿和儿童特别补充食品计划评估。三、妊娠结局的历史研究。

The National WIC Evaluation: evaluation of the Special Supplemental Food Program for Women, Infants, and Children. III. Historical study of pregnancy outcomes.

作者信息

Rush D, Alvir J M, Kenny D A, Johnson S S, Horvitz D G

机构信息

Department of Pediatrics, Albert Einstein College of Medicine, New York, NY.

出版信息

Am J Clin Nutr. 1988 Aug;48(2 Suppl):412-28. doi: 10.1093/ajcn/48.2.412.

Abstract

We related perinatal outcome and quality of prenatal care between 1972 and 1980 to WIC benefits to pregnant women among 11,154,673 births in 1392 counties in 19 states and the District of Columbia, adjusted for time change and between-county variability. WIC was associated with increased first trimester prenatal care (4.1%, p less than 0.001), decreased inadequate prenatal care (-5.0%, p less than 0.001), longer duration of gestation (0.20 d, p less than 0.05), decreased preterm delivery (-0.92%, p less than 0.05) and increased birth weight (23 g, p less than 0.01). After autocorrelation was accounted for, significance levels for birth weight and frequency of preterm delivery were 0.05 less than p less than 0.10. Including counties with incomplete time series data, the estimated effect on birth weight was 23.9 g (p = 0.004) and on decreased fetal mortality was -2.3/1000 (p = 0.04). Among those with less than 12 y schooling, whites had a 1.8% reduction in preterm birth (p less than 0.05) and blacks a 2.0% reduction (p less than 0.05). The estimated effect on birth weight for less-educated whites was 46.6 g (p less than 0.001). The predominant effects of WIC were on improved physiologic status of the mother and fetus.

摘要

我们将1972年至1980年围产期结局和产前护理质量与19个州及哥伦比亚特区1392个县11154673例出生的孕妇所获得的妇女、婴儿与儿童营养补充计划(WIC)福利相关联,并针对时间变化和县域差异进行了调整。WIC与孕早期产前护理增加(4.1%,p<0.001)、产前护理不足减少(-5.0%,p<0.001)、妊娠期延长(0.20天,p<0.05)、早产减少(-0.92%,p<0.05)以及出生体重增加(23克,p<0.01)相关。在考虑自相关因素后,出生体重和早产频率的显著性水平为0.05<p<0.10。纳入时间序列数据不完整的县后,对出生体重的估计影响为23.9克(p=0.004),对胎儿死亡率降低的影响为-2.3/1000(p=0.04)。在受教育年限不足12年的人群中,白人早产率降低了1.8%(p<0.05),黑人降低了2.0%(p<0.05)。对受教育程度较低的白人出生体重的估计影响为46.6克(p<0.001)。WIC的主要作用是改善母亲和胎儿的生理状况。

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