A case-control study of low birthweight among residents of high risk areas of Alameda County was conducted in 1983. The relation of 13 variables to low birthweight was assessed using a multiple logistic regression analysis. A six-fold increase in the risk of low birthweight was found in association with financial problems during the current pregnancy, controlling for differences in race, certain poor health habits, complications of pregnancy, and several other factors between cases and controls. (Am J Public Health 1987; 77:505-506.) IntroductionDespite declines in infant mortality, probably brought

If the ultimate success of efforts to improve pregnancy outcome depends on assurance that prenatal care begins in the first trimester, it is important to identify potentially modifiable factors associated with the start of care as well as the groups in which it is most likely to be late. This topic was explored in a population-based study of low birthweight in 766 black women and 462 white women who gave birth in Alameda County, California, in 1987. Variables related to insurance coverage and financial status showed the greatest difference between early and late attenders at prenatal care in both groups. At virtually every level of almost every variable studied, black women were less likely than white women to begin prenatal care in the first trimester. The data suggested that some of the difference in the timing of prenatal care may be due to lack of awareness of, or failure to pay attention to, the signs of early pregnancy. We conclude that, although addressing problems of insurance coverage and financial status is critical to the solution of the problem of late initiation of prenatal care, as financing difficulties are solved, attention should be paid to women's internal factors such as depression and denial as modifiers of the earliness of seeking prenatal care.