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

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.