Public health nutrition practices to prevent low birth weight in eight southeastern states

This study was conducted to identify current public health nutrition practices for the prevention and treatment of low-birth-weight (LBW) infants in eight southeastern states. Nutrition personnel (n = 1,054) were mailed a 51-item questionnaire with three parts that sought information on the respondents' professional backgrounds and employment status and on practice and standards of care for women before and during pregnancy and of LBW infants. Results based on a 62% response rate indicated 73% had worked in public health nutrition for 2 to 9 years, 56% were direct care providers, and 51% had bachelor's degrees. Only 40% of respondents indicated that their agencies had prepregnancy nutrition intervention protocols, whereas 89% indicated that they had high-risk pregnancy screening protocols and 91% indicated that they had high-risk treatment protocols. More than 91% indicated that their treatment protocols included guidelines for weight gain, preparation of nutrition care plans, and assessment of dietary and biochemical factors, health behavior, and obstetric history. Only 73% indicated inclusion of assessment of educational level. Nutritionists saw high-risk pregnant women (or those at risk for preterm labor) slightly more frequently during pregnancy than they saw low-risk women; however, the range (0.9 to 3.8 vs 0.5 to 2.3) and average (2.0 vs 1.2) number of visits for both groups differed only slightly. Nutritionists counseled women and charted in the medical record more frequently than they used nutrition care plans. To reduce LBW, nutritionists should implement treatment protocols and monitor high-risk women closely. The relationship between pre-pregnancy nutrition interventions and birth weight should be investigated.