YSPH to Lead National Effort to Improve Birth Outcomes

United Health Foundation grant of more than $4 million will fund a program to improve prenatal care

The Yale School of Public Health will lead a national project to improve birth outcomes with a grant of more than $4 million from the United Health Foundation to fund the development and implementation of a new model of group prenatal care to promote healthier pregnancies.

Pre-term births in the United States currently account for more than one-third of U.S. health care spending for infants, or about $26.2 billion. Babies born prematurely have a number of potentially life-threatening health complications and, on average, the medical costs to care for them is 10 times greater than it is for babies who are full term.

The incidence of preterm and low birth weight babies has remained almost unchanged for more than three decades. More than 12 percent of babies are born prematurely and more than 9 percent have low birth weight.

“The opportunity to work with United Health Foundation to take this new model of group prenatal care to scale nationally is an incredible opportunity,” said principal investigator Jeannette Ickovics, professor at the Yale School of Public Health. “This is ‘real public health’ – bringing evidence from more than a decade of our randomized clinical trials to a nationwide audience. With our partners, we will integrate cutting edge information technology and a social networking approach to reduce risk and improve birth outcomes, nurturing healthy women, healthy babies, healthy families and healthy futures.”

Ickovics and colleagues have been working on reproductive health for teens and young women since her arrival at Yale in 1989. Earlier work has documented a 33 percent reduction in preterm delivery and a 50 percent reduction in rapid repeat pregnancy. This new, evidenced-based model, known as “Expect with Me,” builds on these successes to improve birth outcomes. The focus will be on group prenatal care, which will be implemented in select communities at high risk for adverse perinatal outcomes along with rigorous evaluations of its effects. 

“With more than four million births annually in the United States and intractable rates of preterm delivery and low birth rate, the potential impact for the health of women and their families is substantial,” Ickovics said.

The School of Public Health will work with Vanderbilt University Medical Center, Doctors Hospital at Renaissance in Texas and Detroit Medical Center on the new model.

YSPH Dean Paul Cleary noted that pre-term births are also an important predictor of infant mortality, which is unacceptably high and reflects health disparities in the United States.

 “Dr. Ickovics has been working on this issue for more than two decades, and this grant from the United Health Foundation will allow her to disseminate and implement a successful approach to this seemingly intractable problem,” Cleary said.  “I am confident that this project will show the large benefit that could be derived from broader use of this program.”

Kate Rubin, president of United Health Foundation, said that the model has the potential to dramatically improve prenatal care, leading to healthier pregnancies, healthier moms and healthier babies.

“United Health Foundation is committed to helping build healthier communities. The impact of this program – and in fact, the outcomes that have already been realized – are truly amazing,” she said.


This article was submitted by Denise L Meyer on July 1, 2013.