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July 10, 1996

Frequency of Prenatal Care Visits and Perinatal Outcome-Reply

Author Affiliations

Kaiser Foundation Health Plan of Colorado Denver
University of Colorado Health Sciences Center Denver

JAMA. 1996;276(2):101. doi:10.1001/jama.1996.03540020023016

In Reply.  —We thank Dr Zalar for his interest in our article.We appreciate his acknowledgment of the "good science" in our methodology and would like to take this opportunity to address his concerns.First, we do agree that we included some maternal outcomes that might not be affected by the number of prenatal care visits. We provided these for completeness. We believe that these outcomes occur among low-risk as well as high-risk women.We differ with Zalar's interpretation of our rates of adverse outcomes. First, we did not believe that the use of the Expert Panel on the Context of Prenatal Care schedule would decrease perinatal morbidity and mortality. Second, while all women were low risk at enrollment, some developed complications of pregnancy that resulted in preterm births and low-birth-weight neonates. Women with complications were not excluded from analysis. These complications included multiple gestation and placenta previa. Although Zalar objects to