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May 15, 2003


Emory Physician Receives Grant To Provide Care for Women With Poor Pregnancy Outcomes

ATLANTA -- Neonatologist Alfred W. Brann, Jr., MD, professor of pediatrics with the Emory University School of Medicine working in association with Grady Memorial Hospital, has received a $385,000 grant from Healthcare Georgia Foundation to initiate the Interpregnancy Care Project. The project will provide primary and specialized care, as well as social care, during the interpregnancy period (time between birth of a woman's infant and her next conception) to 300 women in Fulton and DeKalb counties who have delivered a very low-birth-weight infant (<3.3 lbs) at Grady Hospital. The project will be implemented by nurse case managers and resource mothers at Grady and at several of the Grady Health System neighborhood health centers.

Overall, the grant seeks to reduce infant mortality and morbidity for subsequent births of enrolled women by improving the woman's chance of having a full-term normal infant through improvement of the woman's health and child spacing. Information from the Interpregnancy Care Project will be disseminated regarding infant mortality and morbidity rates, racial disparities, the prevalence of medical and social problems contributing to very low birth rates in the program population, and the costs and measurable outcomes of effectiveness of care.

The Department of Gynecology and Obstetrics, the Department of Pediatrics, and the Department of Family and Preventive Medicine at Emory University School of Medicine and the Department of Obstetrics and Gynecology at Morehouse School of Medicine at Grady Hospital are leading the Interpregnancy Care Project.

The project will provide 24 months of comprehensive, integrated, primary health care, including mental health, social, and general medical and dental services; and enhanced case management, family planning and community outreach.

Data strongly links the previous birth of a very low-birth-weight infant and pre-term births (in singleton pregnancies) as the strongest predictor of women who are at risk for having another very low-birth-weight infant. According to data provided by the Task Force on the Georgia Prenatal Program, Georgia ranks among the 10 states with the highest infant mortality and low-birth-weight rates in the United States. Data also shows that very low-birth-weight babies who weigh 1,500 grams or less (about three-and-a-half pounds) account for 50 percent of Georgia's infant mortality rate. In addition, African-American women in Georgia have twice the rate of low-birth-weight babies (< five pounds) and a three-to-four-fold increase in very low-birth-weight babies compared to white women, resulting in twice the rate of infant mortality for African-Americans compared to whites. Very low-birth-weight infants who survive into childhood are at increased risks of having extremely disabling and expensive health problems, including cerebral palsy, vision problems and mental retardation.

The Interpregnancy Care project will first aim to identify specific medical and social risks that each high-risk woman may have, including past conditions such as anemia, genitourinary tract infections, sexually transmitted diseases, bacterial vaginosis, uterine or cervical abnormalities, hypertension and diabetes. The second strategy involves assisting the woman in achieving her reproductive goals, which may include a planned pregnancy with an interval of at least 18 to 20 months between children.

"Medicaid does not pay for primary care for women who are not pregnant," Dr. Brann noted. "This project is unique because of the partnership with Grady Health System, which stepped forward to supply the very critical missing link - coverage of primary health care for non-pregnant women who are at risk."

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