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Length of Prenatal Participation in WIC and Risk of Delivering a Small for Gestational Age Infant: Florida, 1996–2004

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Abstract

Objective To assess the association between length of prenatal participation in WIC and a marker of infant morbidity. By focusing on small for gestational age, we consider one of the possible pathways through which prenatal nutrition affects fetal growth. Design/Methods The study sample consists of 369,535 matched mother-infant pairs drawn from all singleton live births in Florida hospitals from 1996 to 2004. All subjects received WIC and Medicaid-funded prenatal services during pregnancy. We controlled for selection bias on observed variables using a generalized propensity scoring approach and performed separate analyses by gestational age category to control for simultaneity bias. Results Ten percent increase in the percent of time in WIC was associated with 2.5% decrease (95% CI: 2.1–3.0%) in the risk of a full-term an SGA infant. The risk was also significantly decreased for very preterm and late preterm infants (29–33 and 34–36 weeks gestation) but not for extremely preterm infants (23–28 weeks gestation). Conclusions The observed small negative dose response relationship between percent of pregnancy spent in WIC and fetal growth restriction implies that longer participation in the program confers a small measure of protection against delivering an SGA infant.

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Acknowledgments

This study was supported in part by a grant from the National Science Foundation (#0338740), and contracts from the Florida Agency for Health Care Administration and Children’s Medical Services, Florida Department of Health. The authors wish to thank Debbie Eibeck, Karen Freeman, Meade Grigg, Jane Menges, Florida Department of Health; Ed Feaver, Charles Mahan, Chiles Center, University of South Florida; Jason Campbell, Regina Wiggins, Cliff Schmidt, Florida Agency of Health Care Administration; Debby Walters, Association of Maternal and Child Health Programs; Mario Ariet, Rajeeb Das, P.V. Rao, Michael Resnick, Maternal Child Health and Education Research and Data Center, University of Florida for their assistance, cooperation, and advice.

Human Participation Protection

This study was approved by the University of Florida Health Science Center Institutional Review Board (Project #257-2007). All personally identifiable information about subjects was removed from the linked records and a de-identified file was prepared for the researchers by the data custodians of the Maternal and Child Health and Education Research and Data Center, University of Florida.

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Authors and Affiliations

  1. Division of Biostatistics, Department of Epidemiology and Public Health, Yale University, 60 College St, Room 201, New Haven, CT, 06520-8034, USA

    Ralitza Gueorguieva

  2. Division of Neonatology, Department of Pediatrics, University of Florida, P.O. Box 100296, Gainesville, FL, 32610-0296, USA

    Steven B. Morse

  3. Division of Neonatology, Department of Pediatrics, University of Florida, P.O. Box 100296, Gainesville, FL, 32610-0296, USA

    Jeffrey Roth

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  1. Ralitza Gueorguieva
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  2. Steven B. Morse
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Correspondence to Jeffrey Roth.

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Gueorguieva, R., Morse, S.B. & Roth, J. Length of Prenatal Participation in WIC and Risk of Delivering a Small for Gestational Age Infant: Florida, 1996–2004. Matern Child Health J 13, 479–488 (2009). https://doi.org/10.1007/s10995-008-0391-8

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