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I. PRENATAL CARE AND NEWBORN HEALTH STATUS
Among the Early Head Start families who completed the third follow-up interview, 75 percent enrolled after their child was born and 25 percent enrolled while they were pregnant with the focus child. For infants born prior to enrollment, information on prenatal care and newborn health status was obtained at baseline using the Head Start Family Information System (HSFIS) application and enrollment forms. For infants born after enrollment, data were obtained from parents in the second follow-up interview (completed 16 months after enrollment, on average).
Like mothers nationally, almost all Early Head Start mothers (99 percent) received prenatal care at some time during their pregnancy with the focus child, and most (82 percent) initiated prenatal care during their first trimester of pregnancy (Table 7).9 Fourteen percent began receiving care during the second trimester, and 3 percent did not receive care until their third trimester. Mothers who enrolled while still pregnant were more likely to begin prenatal care in their first trimester (88 percent) than were mothers who enrolled after their child was born (80 percent). The high proportion of Early Head Start mothers beginning prenatal care in their first trimester of pregnancy may reflect the fact that many of the research programs recruited families in health care and WIC offices, where mothers were already receiving health care or referrals to health care providers.
| Percentage | |
|---|---|
| Prenatal Care Began in First Trimester | 81.6 |
| Prenatal Complications Reported | |
|
58.5 |
|
28.1 |
| Child Hospitalized at Birth Due to Medical Problems | 17.0 |
| Birthweight (in pounds) | |
|
8.3 |
|
1.0 |
|
(7.1) |
| Sample Sizeb | 917-945 |
| Source: Head Start Family Information System (HSFIS) application and enrollment forms, and parent services follow-up interviews (PSIs) completed 7, 16, and 28 months after enrollment, for families who completed the 28-month follow-up interview. | |
| aIn the HSFIS, mothers were asked to respond "yes" or "no" to a list of possible complications. In the PSI, mothers were asked whether or not they experienced any complications during their pregnancy. | |
| bRange reflects minimum and maximumsample sizes foritems in table except as indicated inlabel. | |
Data on prenatal complications experienced by mothers during their pregnancy with the focus child were collected differently depending on whether or not the mother was pregnant at the time of enrollment in Early Head Start. At the time of enrollment, mothers of infants born prior to enrollment were read a list of specific prenatal problems and asked to indicate if they had experienced each particular problem during their pregnancy. Mothers who were pregnant at the time of their enrollment were asked a more general question approximately 16 months after enrollment, “Did you have any complications during your pregnancy?” Because of these differences in the data, analysis of prenatal complications for mothers pregnant at the time of enrollment was conducted separately from mothers of infants born prior to enrollment.
The two approaches to asking mothers about pregnancy complications produced substantially different estimates of their incidence. Twenty-eight percent of the mothers of infants born after enrollment and 59 percent of the mothers of infants born prior to enrollment reported experiencing some complications during their pregnancy. The particular complications reported by mothers of infants born prior to enrollment included hypertension (13 percent), bleeding (14 percent), anemia (18 percent), sickle cell anemia (1 percent), diabetes (3 percent), premature labor (13 percent), and swelling (39 percent).
According to mothers, less than one-fifth of Early Head Start infants and toddlers (17 percent) required hospitalization for medical problems at birth. As with findings for mothers’ prenatal complications, newborns’ health status was not related to whether or not their mother began prenatal care in the first trimester.
Average birth weight was 7.1 pounds. Approximately 8.3 percent of Early Head Start infants were born at a low birth weight (under 5.5 pounds), and 1 percent were born at a very low birth weight (under 3.25 pounds). The rate of low birth weight among Early Head Start infants was similar to the national average of 7.6 percent in 1998 but considerably lower than the rate for African American infants (13.2 percent) (DHHS 2001).
Breastfeeding can promote healthy development and protect infants from illness, as well as promote maternal health and conserve family economic resources (American Academy of Pediatrics 1997). Information on breastfeeding is available for some Early Head Start children in the research sample who were born after enrollment and suggests that 60 percent of mothers breastfed their children.10 This rate of breastfeeding is comparable to the national rate of breastfeeding in 1995 (American Academy of Pediatrics 1997).
9 Nationally, in 2000, 83 percent of mothers reported receiving prenatal care during their first trimester of pregnancy, and 4 percent received prenatal care late or not at all (DHHS 2002). (back)
10 Data on breastfeeding were available for 185 children, out of the 269 who were born after enrollment and for whom PSI data are available (the HSFIS enrollment forms did not obtain information on breastfeeding for children who were born prior to enrollment). The measured characteristics of families with and without these data are very similar. (back)
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