Prenatal care and low-birth-weight rates in urban and rural Wisconsin.

BACKGROUND The intent of this investigation was to study the distribution of obstetric providers and prenatal care utilization in Wisconsin and analyze the potential impact of these factors on the frequency of low birth weight. METHODS State perinatal vital statistics and physician professional association surveys were used to compare the frequency of low birth weight, physician distribution, and utilization of prenatal care in all 72 counties in Wisconsin. RESULTS Despite higher rates of suboptimal prenatal care utilization among women residing in rural counties, low-birth-weight rates were no different. Very-low-birth-weight rates were actually higher for residents of urban counties compared with those in rural counties. When low birth weight was examined based on the rate of suboptimal prenatal care, a positive association was found only for urban counties. In rural counties there was no increase in low-birth-weight rates as the use of prenatal care declined. CONCLUSIONS Inadequate prenatal care appears to be associated with low-birth-weight rates, but less so for women residing in rural counties when compared with those in urban counties.