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Through the collaboration among University of California at Berkeley School of Public
Health, Samuel Merritt College, and a private nonprofit, community-based medical center,
the adequacy of two perinatal programs was assessed based on the pregnancy outcomes
of teenaged Medi-Cal clients. Historical data from June 1991 to June 1992 were compiled
on the pregnancy outcomes of 312 Medi-Cal clients, 12–18 years of age, delivering
at the study medical center in Oakland, California. The effect of enrollment in two
special perinatal programs, Comprehensive Perinatal Services Program (CPSP) and a
school-based program, the Comprehensive Teenage Pregnancy and Parenting Program (CTAPPP),
on the occurrence of adverse perinatal outcomes was examined. Adverse perinatal outcomes
were defined as the occurrence of one of the following: low birthweight (< 2,500 grams),
gestational age less than 37 weeks, or admission to the neonatal intensive care unit
(NICU), not related to congenital syphilis. The percentage of teens experiencing adverse
perinatal outcomes was 10.9% at the study hospital. No significant association was
observed between CTAPPP enrollment and reduced adverse perinatal outcomes, but CPSP
enrollment was associated with reduced adverse perinatal outcomes. This association
persisted after controlling for potential confounders, including substandard prenatal
care, which were also found to be risk factors for adverse perinatal outcomes. Enrollment
in both programs simultaneously was not associated with a reduction in adverse outcomes.
The significant association between CPSP enrollment and reduced adverse perinatal
outcomes indicates that a more comprehensive prenatal program may be beneficial in
improving birth outcomes, specifically among high-risk teenage populations. Linking
data on birth outcomes among Medi-Cal clients to data on program participation may
help better assess the efficacy and coverage of these programs.
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© 1995 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
