Evidence of Trends, Risk Factors, and Intervention Strategies.

Experts believe that eliminating racial and ethnic disparities in birth outcomes is key to continued reduction in infant mortality in the United States. Healthy Start, a national initiative begun in 1991, is the largest program addressing disparities in birth outcomes. This paper provides an evidence base to support Healthy Start’s targeted interventions. It reviews risk factors that include prenatal care, folic acid use, periodontal care, infant sleeping position, breastfeeding, well-child care, interconceptional care, maternal smoking, alcohol and other drug use, adolescent pregnancy, perinatal depression, stress, domestic violence, and maternal birthweight.