Table 2

Nutritional and health outcomes associated with comprehensive food subsidy programs for pregnant/postpartum women
First Author, Year Intervention, Participants Nutritional outcomes Health outcomes
Bailey 1983[48] Dietary intake Perinatal outcomes
Standard WIC program Mean (SD) I C p Mean (SD)) I C p
Iron, mg 17 (10) 16 (6) NS Birth weight, g 3229 (546) 3276 (563) NS
Vitamin B6, mg 1.4 (1.1) 1.1 (0.7) NS Low birth weight, %(<2500g) 5 10 NS
Protein, g 90 (39) 105(39) <0.05
Pregnant women Folic acid, μg 264 (216) 239 (159) <0.05 Ponderal index, g/cm [3] 2.6 (1.2) 2.4 (0.3) NS
Energy, kcal 2390 (916) 2496 (879) <0.05 (Infant weight x100/length [3])
Biomarkers Birth weight
Smokers, g 3286 (515) 2976 (596)
Mean (SD) I C p Non-smokers, g 3218 (538) 3461 (520)
Serum iron, ug/dL 106 (44) 99 (42) NS p<0.05 for smoking status of control groups only
PlasmaVit. B6, ng/ml 4.6 (6.8) 3.3 (1.8) NS
Transferrin sat. % 37 (23) 23 (10) <0.05
Serum folate, ng/ml 14 (11) 26 (26) <0.05
RBC folate, ng/ml 353 (278) 602 (321) NS
Haematocrit, % 35 (3) 35 (3) NS
Metcoff 1985[42] Biomarkers Perinatal outcomes
Mean (SD) I C p Mean I C p
Standard WIC program Leukocyte protein synthesis**
Pregnant participants pMol 3H-leucine/h 126.6 (33.2) 115.2 (34.3) 0.009 Birth weight, g*
Results from 410 mother-baby pairs with complete data available All births† 3254 3163 0.040
Alanine** 334 (68.4) 350 (70.2) 0.046 Smokers >10 cig/day 3234(n=68) 3059 (n=53) 0.017
Cystine** 68 (13.7) 72 (11.7) 0.001 Low birth weight, % 8.7 6.9 0.40
**Adjusted for week of gestation for initial measurement, initial value, elapsed interval between measurements Maternal outcomes
Maternal wt gain, kg 16.1 14.7 0.19
Biceps skin fold, mm 16.2 14.7 0.059
*Adjusted for gestational age, sex of baby, prenatal care, smoking, interval since last pregnancy, race, history of previous LBW baby
†After adjusting for maternal weight at entry to study, the effect of WIC on all births was not statistically significant
Caan 1987[38] Perinatal outcomes
Mean (SE) I C p
Birthweight, g* 3468 (30.0) 3337 (31.1) 0.003
WIC program maintained for 6 months post-partum for non-lactating women instead of normal 0–2 months Ponderal index,002A g x 100/cm3 2.72 (0.03) 2.73 (0.02) NS
Low birth weight, % 3.2 5.1 0.08
Macrosomia, OR (95% CI) (I vs C) 1.30 (0.70-2.42) NS
Pregnant women in subsequent pregnancy Maternal outcomes
Mean (SE) I C p
Hb, g/dL** 12.43 (0.08) 12.14 (0.08) 0.02
Low Hb, OR (95%CI) (I vs C) 0.65 (0.45-1.07) 0.07
Mat. de Quetelets index lb/in [2] x100† 3.43 (0.36) 3.59 (0.36) 0.003
*Adjusted for parity, pregravid weight/height, infant sex, birth weight of last infant, race and smoking status
**Adjusted for race, parity, BMI, duration of gestation at time of measurement and anaemia status during 1st pregnancy
† Adjusted for race, age, interbirth interval, birth weight of first infant, weight status in first pregnancy, smoking status
Rush 1988a[44] Perinatal outcomes
Mean All births WIC births p
Standard WIC program Birth weight, g 3335 3358 <0.01
Pregnant women Low birth weight (<2500g), % 6.84 6.41 NS
Fetal mortality, >28 wk gest/1000 6.21 4.09 NS
Infant mortality/1000
0-27days, total 10.59 8.30 NS
28-364 days 3.77 4.46 NS
Duration of gestation, weeks 39.06 39.26 <0.05
Rush 1988b,c[45,47] Dietary intake* Perinatal outcomes*
Mean I C p Mean I C p
Protein, g 80.76 75.54 <0.01 Birth weight, g 3292 3285 NS
Low birth weight (<2501g), % 5.62 6.75 NS
Standard WIC program Calcium, mg 1003.7 871.0 <0.001 Duration gestation, days 279.0 279.3 NS
Iron, mg 17.22 14.06 <0.001 Preterm births, %
Pregnant women Vitamin A, mg 2.06 1.83 NS < 33 weeks 0.30 0.90 <0.05
Vitamin C, mg 134.11 111.68 <0.001 < 37 weeks 9.45 12.07 NS
Other macro- and micronutrients had statistically significant increases in WIC participants including energy, carbohydrate, fat, magnesium, phosphorus, vitamins B1, B2, B3, B6, B12 Head circumference, cm 34.13 33.95 <0.05
Fetal mortality/1000 5.09 9.54 NS
Nutrient intake as % of RDA*
Mean I C *Adjusted for duration of gestation and 35 other maternal characteristics including smoking status, age, race, family income and size, woman and partner′s educational and employment status, social security benefits/program participation
(%) (%) Maternal outcomes*
Energy (2400kcal) 84 79 Mean I C p
Protein (74g) 109 102 Initial weight, kg 65.17 65.89 <0.05
Calcium (1200mg) 84 73 Follow-up weight, kg 72.17 72.17 NS
Magnesium (450mg) 60 54 (36 weeks gestation)
Vitamin B6 (2.6mg) 73 60 WIC group women initially lighter than control women had caught up with control women by 36 weeks gestation
Phosphorus, Vitamins A, B1, B2, B3, B12 and C were all 95%-180% of RDA at baseline and follow-up in both WIC and control groups. RDA for pregnant women aged 19–22 years old No clinical (or statistically) significant difference in haemoglobin at baseline or follow-up. Data not shown
*Adjusted for duration of gestation, conception weight and 35 other maternal characteristics as above
*Adjusted for duration of gestation, initial intake, 35 other maternal characteristics including smoking status, age, race, family income and size, woman and partner′s educational and employment status, social security benefits and program participation
181 of the 711 controls had enrolled in WIC before follow-up. The diet intake data for this group were analysed separately and were similar to the WIC intervention group
No difference in nutrient intake for groups at baseline
Rush 1988c,d[45,46] Food purchases*†
Mean (SD) I C p
Total expenditures, $
Standard WIC program Recall 48.28 52.07 (33.34) <0.001
Pregnant women Diary 61.20 62.85 (39.44) NS
Groceries, $
Recall 38.30 39.95 (22.97) <0.05
Diary 50.50 49.15 (35.68) NS
Meals away from home, $
Recall 3.84 4.94 (6.44) <0.001
Diary 10.93 13.69 (16.20) <0.001
* Adjusted for family size, income, ethnicity, presence of father in household, maternal education, amount of food stamps and free school meals, number of guests and baseline expenditure
†Baseline food expenditures differed with WIC families spending significantly less on total food, groceries and meals away from home
Pehrsson 2001[43] Dietary intake Maternal outcomes
Iron No data presented. No significant differences between groups. All intakes <74% RDA (15mg/day) Mean (SD) I C p
Haemoglobin, mmol/L* 8.01 (0.82) 7.63 (0.82) <0.05
Standard WIC program continued for 6 months post-partum g/dL 12.8 (1.31) 12.2 (1.31)
Vitamin C No data presented. No significant differences between groups. All intakes >150% RDA (60mg/day) Anaemia, % * 17 51 <0.05
(Hb<7.45mmol/L or 12g/dL)
Postpartum women Biomarkers* *Results at 6 month follow-up
Mean (SD) I C p
Ferritin, ug/L 36 (20.1) 35 (20.3) NS
Transferrin receptor, mg/L 6.1 (2.1) 6.5 (2.1) NS
*Results at 6 month follow-up
Currie 2008[49] Perinatal outcomes
Change in low birth weight
% (SD) All parity First birth Teen mum
Standard Food Stamp program White −0.014 (1.05) 0.062 (1.00) (0.92)* 0.27
Pregnant women Black 0.47 (1.64) 0.26 (1.43) (1.58) 0.175
*p<0.05
Fertility outcomes*
% increase in births All parity First birth Teen mum
White 3.0 13.0 6.9
Black 12 9.0 24.6
*Statistically significant for blacks in all categories and white first births and teen births
Hoynes 2009[18] Perinatal outcomes
Standard WIC program Mean All births WIC births
Pregnant participants Birth weight, g 3316
Change in birth weight, g 2.7 29 (estimated)
Low birth weight, % 7.2
Change in low birth weight 0 (−0.0784- 0.0784)
%, 95% CI
Fertility rates No statistically significant difference after WIC introduction

Black et al.

Black et al. BMC Public Health 2012 12:1099   doi:10.1186/1471-2458-12-1099

Open Data