Planning a WIC Research Agenda Workshop Summary (2011) / Chapter Skim
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2 WIC and Birth Outcomes
2 WIC and Birth Outcomes
Pages 11-24
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Research Background Increasingly, studies have linked periconceptional nutrition to reproductive outcomes. These outcomes include ovulatory infertility (Botto et al., 2004; Chavarro et al., 2006, 2007a,b,c, 2008a,b)
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trial found that preconceptional folate supplementation for at least 1 year was associated with a lower risk of spontaneous extreme preterm birth (20–28 weeks) and that the risk was inversely proportional to the duration of preconceptional folate supplementation.
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Outcomes to consider include meta bolic allostasis and allostatic load, postpartum weight retention, and breastfeeding. In closing, Lu said, "I think it is really time that we put the ‘W' back in WIC." THE IMPACT OF WIC ON BIRTH OUTCOMES Presenter: Theodore Joyce Joyce opened by saying that there is relatively weak evidence that WIC protects against adverse birth outcomes.
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A number of studies of low birth weight and preterm birth have used methods that introduce large biases. For example, gestational age bias may arise because women with longer-term pregnancies have more time to enroll in WIC as a prenatal participant.
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. FIGURE 2-3 Rate of low birth weight by race and week of prenatal WIC enroll ment (author's tabulations from North Carolina Pregnancy Nutrition Surveillance System, 1996–2003)
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In the same way that some entities are working to change unhealthful behaviors such as smoking, consider paying women to breastfeed rather than to bottle feed. Summarizing Thoughts Joyce concluded his presentation by suggesting that research should move away from a focus on birth outcomes and toward improving maternal health as the means to improve infant health.
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(2010) looked at the roll out of WIC at the county level and demonstrated statistically significant improvements in average birth weight and reductions in low birth weight among WIC participants.
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Although only one time series shown earlier by Joyce is consistent with the growth in WIC participation -- namely, the one depicting the rates of infants born who are small for their gestational age (Figure 2-4) , data from Catalano's hospital indicate that the adjusted average birth weight increased by 120 grams from 1975 to 2003.
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. FIGURE 2-5 Distribution of preterm births by gestational age, 1990–2005.
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Nonetheless, Catalano said, pregravid body mass index is the strongest predictor of adiposity of the newborn at birth, followed by gestational age and gestational weight gain; it also is the strongest predictor of the percentage of body fat at age 8 years. Research Proposals The dollar amount available for WIC research is relatively small.
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These suggestions included observational studies and nutritional interventions especially during the interconceptual period and an approach for conducting randomized controlled trials in the clinic setting to test carefully selected interventions. It was pointed out that there is a need for data collection that goes beyond WIC participation status and time of enrollment and for improved data linkages and public access to the data.
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2009. Does prenatal WIC participation improve birth outcomes?
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2009. Periconception folic acid supplementation, fetal growth and the risks of low birth weight and preterm birth: The Generation R Study.
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