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Journal Issue: U.S. Health Care for Children Volume 2 Number 2 Winter 1992

Effectiveness of Health Care Services for Pregnant Women and Infants
Authors: Andrew D. Racine Theodore J. Joyce Michael Grossman

Endnotes

  1. Edwards, L.N., and Grossman, M. The relationship between children's health and intellectual development. In Health: What is it worth?, S.J. Mushkin, and D.W. Dunlop, eds. Elmsford, NY: Pergamon Press, 1979, pp. 273–314.
  2. American College of Obstetricians and Gynecologists. Standards for obstetric-gynecologic services. 7th ed. Washington, DC: ACOG, 1989.
  3. U.S. Department of Health and Human Services. Caring for our future: The content of prenatal care. Washington, DC: U.S. DHHS, 1989.
  4. Wilson, J.G. Environment and birth defects. New York: Academic Press, 1973.
  5. Based on estimated rates of Down's syndrome among women of different ages (20 to 49 years) as reported by Hirschhorn, K. Prenatal disturbances. In Nelson textbook of pediatrics, 14th ed. R.E. Behrman, R.M. Kliegman, W.E. Nelson, and V.C. Vaughan, eds. Philadelphia: W.B. Saunders Company, 1992, p. 284. And 1989 distribution of live births by age of mother as reported in National Center for Health Statistics, U.S. Department of Health and Human Services. Advance report of final natality statistics, 1989. Monthly Vital Statistics Report, vol. 40, no. 8, supplement. Hyattsville, MD: Public Health Service, 1991.
  6. Antonarakis, S.E., Lewis, J.G., Adelsberger, P.A., et al. Parental origin of the extra chromosome in Trisomy 21 revisited: DNA polymorphism analysis suggests that in 95% of cases the origin is maternal. American Journal of Human Genetics (1990) 47:A 97.
  7. Schlesinger, M., and Kronebusch, K. The failure of prenatal care policy for the poor. Health Affairs (Winter 1990) 9,4:91–111.
  8. National Center for Health Statistics, U.S. Department of Health and Human Services. Advance report of final natality statistics, 1988. Monthly Vital Statistics Report, vol. 39, no. 4, supplement. Hyattsville, MD: Public Health Service, 1990.
  9. Singh, S., Torres, A., and Forrest, J.D. The need for prenatal care in the U.S.: Evidence from the 1980 National Natality Survey. Family Planning Perspectives (May-June 1985) 17,3:118–124.
  10. Public Health Service, U.S. Department of Health and Human Services. The 1990 health objectives for the nation: A midcourse review. Washington, DC: Office of Disease Prevention and Health Promotion, 1986.
  11. Institute of Medicine. Prenatal care: Reaching mothers, reaching infants. S.S. Brown, ed. Washington, DC: National Academy Press, 1988.
  12. The one exception was race. But this conclusion must be interpreted with caution because almost all of the studies reviewed were conducted on a race-specific basis or specified a fairly complex set of interactions among race, ethnicity, and poverty.
  13. Grossman, M., and Joyce, T.J. Unobservables, pregnancy resolutions, and birth weight production functions in New York City. Journal of Political Economy (October 1990) 98,5:983–1007.
  14. Joyce, T.J., and Grossman, M. Pregnancy wantedness and the early initiation of prenatal care. Demography (February 1990) 27,1:1–17.
  15. Howell, E.M., et al. A comparison of Medicaid and non-Medicaid obstetrical care in California. Health Care Financing Review (Summer 1991) 12,4:1–15.
  16. National Center for Health Statistics, U.S. Department of Health and Human Services. Advance report of final natality statistics, 1989. Monthly Vital Statistics Report, vol. 40, no. 8, supplement. Hyattsville, MD: Public Health Service, 1991.
  17. Office of Technology Assessment, U.S. Congress. Healthy children: Investing in the future. Washington, DC: U.S. Government Printing Office (OTA-H-345), 1988.
  18. Institute of Medicine. Preventing low birthweight. Washington, DC: National Academy Press, 1985, p. 146.
  19. To estimate the magnitude of the true effect of prenatal care on infant health, one must control for the impact of other determinants of newborn health outcomes which are themselves correlated with prenatal care. Otherwise one ends up attributing to prenatal care influences originating from some other source. The most effective way to isolate the prenatal care effect would be to perform a clinical trial in which a set of pregnant women would be divided at random into two groups: one that receives prenatal care in the first trimester and one that does not. Such an approach would ensure that the two groups of women would be as similar as possible in all respects other than their receipt of prenatal care. Thereafter, any observed differences in birth weight or infant survival between the two groups of women would be most likely due to differences in the receipt of early prenatal care.
  20. Joyce, T.J. Self selection, prenatal care, and birthweight among blacks, whites, and Hispanics in New York City. National Bureau of Economic Research Working Paper No. 3549, revised April 1991.
  21. The rate of decline was 3.1% per year annually compounded. Fuchs, Victor R. How we live: An economic perspective on Americans from birth to death. Cambridge, MA: Harvard University Press, 1983. National Center for Health Statistics, U.S. Department of Health and Human Services. Annual summary of births, marriages, divorces, and deaths, United States, 1990. Monthly Vital Statistics Report, vol. 39, no. 13. Hyattsville, MD: Public Health Service, 1991.
  22. Fuchs, V.R. Who shall live? Health, economics, and social choice. New York: Basic Books, 1974.
  23. McCormick, M.C. The contribution of low birth weight to infant mortality and childhood morbidity. New England Journal of Medicine (January 10, 1985) 312,2:82–90.
  24. Paneth, N. Technology at birth. American Journal of Public Health (July 1990) 80,7:791–92.
  25. Between 1955 and 1964, the rate of decline eased to less than 1% per year but then accelerated to 4.1% per year between 1964 and 1984. Corman, H., Joyce, T.J., and Grossman, M. Birth outcome production functions in the U.S. Journal of Human Resources (Summer 1987) 22,3:339–60.
  26. Wegman, M.E. Annual summary of vital statistics-1990. Pediatrics (December 1991)88,6:1081–92.
  27. Given the importance of neonatal mortality in total infant mortality, differences in the latter rate among groups in the population at a moment in time mirror differences in the former.
  28. U.S. Department of Health and Human Services. Report of the Secretary's Task Force on Black and Minority Health. Volume VI: Infant mortality and low birthweight. Washington, DC: U.S. Department of Health and Human Services, 1986.
  29. Marks, J.S., et al. Variations in state-specific infant mortality risks. Public Health Reports (March-April 1987) 102,2:146–50.
  30. National Commission to Prevent Infant Mortality. Troubling trends persist: Shortchanging America's next generation. Washington, DC: National Commission to Prevent Infant Mortality, 1992.
  31. Hilts, P.J. U.S. reports drop in infant deaths. New York Times, April 7, 1991, pp. 1, 8.
  32. National Center for Health Statistics, U.S. Department of Health and Human Services. Health U.S. 1990. DHHS Pub. No. (PHS) 90-1232. Hyattsville, MD: Public Health Service, 1991.
  33. National Center for Health Statistics, U.S. Department of Health and Human Services. Annual summary of births, marriages, divorces, and deaths, United States, 1990. Monthly Vital Statistics Report, vol. 39, no. 13. Hyattsville, MD: Public Health Service, 1991.
  34. Mayfield, J.A., et al. The relation of obstetrical volume and nursery level to perinatal mortality. American Journal of Public Health (July 1990) 80,7:819–23.
  35. The percent of nonwhite babies born in hospital exceed the percentage for white babies because fewer nonwhite infants underwent scheduled deliveries at home or in freestanding birthing centers. Birthing centers have recently been shown to be a safe, low-cost alternative to hospital delivery for suitably screened low-risk mothers. Rooks, J.P., Weatherby, N.L., Ernst, E.K.M., et al. Outcomes of care in birth centers: The national birth center study. New England Journal of Medicine (December 28, 1989) 321,26:1804–11.
  36. Goyert, C.L., Bottoms, S.F., Treadwell, M.C., and Nehra, P.C. The physician factor in cesarean birth rates. New England Journal of Medicine (1989) 320:706–709.
  37. Haynes de Regt, R., Minkoff, H.L., Feldman, J., and Schwartz, R.H. Relation of private or clinic care to the cesarean birth rate. New England Journal of Medicine (1986) 315:619–24.
  38. Rudolph, C.S., and Borker, S.R. Regionalization: Issues in intensive care for high risk newborns and their families. New York: Praeger, 1987.
  39. National Committee on Perinatal Health. Toward improving the outcome of pregnancy: Recommendations for the regional development of maternal and perinatal health services. White Plains, NY: The National Foundation—March of Dimes, 1977.
  40. American Academy of Pediatrics/American College of Obstetricians and Gynecologists. Guidelines for perinatal care, 2d ed. Washington, DC, 1988.
  41. Gagnon, D., Allison-Cooke, S., and Schwartz, R.M. Perinatal care: The threat of deregionalization. Pediatric Annals (July 1988) 17,7:447–52.
  42. Ross Planning Associates. 1982 guide to centers providing perinatal and neonatal special care. Columbus, OH: Ross Laboratories, 1982.
  43. American Hospital Association. Hospital statistics. Chicago: American Hospital Association, 1980, 1989.
  44. Office of Technology Assessment, U.S. Congress. Neonatal intensive care for low birthweight infants: Costs and effectiveness. Washington, DC: U.S. Government Printing Office (OTA-HCS- 38), 1987.
  45. Hack, M., and Fanaroff, A.A. Outcomes of extremely-low-birth-weight infants between 1982 and 1988. New England Journal of Medicine (December 14, 1989) 321:1642–47.
  46. Cohen, R.S., Stevenson, D.K., Malachowski, N., et al. Favorable results of neonatal intensive care for very low-birth-weight infants. Pediatrics (May 1982) 69,5:621–25.
  47. Avery, M.E., Tooley, W.H., Keller, J.B., et al. Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Pediatrics (January 1987) 79,1:2630.
  48. Horbar, J.D., McAuliffe, T.L., Adler, S.M., et al. Variability in 28-day outcomes for very low birth weight infants: An analysis of 11 neonatal intensive care units. Pediatrics (October 1988) 82,4:554–59.
  49. Hack, M., Horbar, J.D., Malloy, M.H., et al. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Network. Pediatrics (May 1991) 87,5:587–97.
  50. Usher, R. Changing mortality rates with perinatal intensive care and regionalization. Seminars in Perinatology (July 1977) 1,3:309–19.
  51. Lee and others concluded that the major factor responsible for declining birth weight specific mortality over that period was improvement in perinatal medical care because the birth weight specific mortality rates did not change appreciably in the first 10 years of that period and from 1967–1975, a time when the birth weight distribution actually worsened somewhat and other important factors were unchanged, neonatal mortality declined 35%. Lee, K., et al. Neonatal mortality: An analysis of the recent improvement in the U.S. American Journal of Public Health (January 1980) 70,1:15–21.
  52. Harris, J.E. Prenatal medical care and infant mortality. In Economic Aspects of Health. V.R. Fuchs, ed. Chicago: University of Chicago Press, 1982, pp. 15–52.
  53. Harris controlled for gestational age, birth weight, prenatal care, mother's age, mother's education, marital status, and parity in arriving at the estimated effect.
  54. Joyce, T.J., Corman, H., and Grossman, M. A cost-effectiveness analysis of strategies to reduce infant mortality. Medical Care (April 1988) 26,4:348–60.
  55. Budetti, P., Barrand, N., McManus, P., et al. The costs and effectiveness of neonatal intensive care. Case study 10. In Background paper 2: Case studies of medical technologies. The implications of cost-effectiveness analysis of medical technology. Washington, DC: Office of Technology Assessment, August 1981.
  56. Walker, D.B., Feldman, A., Vohr, B., and Oh, W. Cost-benefit analysis of neonatal intensive care for infants weighing less than 1,000 grams at birth. Pediatrics (July 1984) 74,1:20–25.
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  58. See note no. 54, Joyce, et al., pp. 354–59.
  59. These figures are averages of the high and low estimates presented by Joyce, Corman, and Grossman (see note no. 54).
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