WIC Prenatal MICA - Variable Definitions

Optional variables

The particular WIC measures we provide data for in each MICA.

Indicators

Individual categories within an optional variable that are frequently requested. MICA provides the opportunity to look all categories of each optional variable, or to select individual indicators of interest.

All WIC Prenatal Participants

The WIC Prenatal MICA includes a record for each pregnancy with an estimated due date during a given calendar year. An individual mother may have more than one pregnancy during a single data year and thus may be counted twice because she would have received services twice.

Age

The participant’s age is calculated from her date of birth to her date of last normal menses. This is her age at conception. Ages less than 10 years or more than 64 years are considered to be biologically implausible values and are classified as unknown.

Drinking During Three Months Prior to Pregnancy

Alcohol consumption data are reported by the WIC participant as the average number of drinks per week during the three months prior to pregnancy and thus may be underreported.

Education

Education data are reported as the number of years of education which can be any whole number between 0 and 18 years. For mothers between the ages of 10 and 21, data are tested to ensure realistic education levels. Education status is classified as unknown if the difference between the mothers age and her education is less than four years (e.g. age 19 – 17 years of education = 2 years). This test is not required for mothers over the age of 21 as the possible years of education are all plausible using the stated formula. All reasonable education values are aggregated into the appropriate categories for MICA.

• MICA Education categories:
• Less than high school diploma
• 8th grade or less
• 9th to 11th grade
• High school diploma
• 13 to 15 years
• College degree plus
• Unknown

Food Stamps – receiving at WIC visit

Food Stamps, or the Supplemental Nutrition Assistance Program (SNAP), is administered by the Missouri Department of Social Services and provides food benefits to needy households. This indicator is a proxy for socioeconomic status and may be used to evaluate the impact of WIC referral services. To learn more about Food Stamps/SNAP, visit https://dss.mo.gov/fsd/fstamp/. Food Stamps data are unavailable for 2009.

Hematocrit/Hemoglobin (Anemia)

Hematocrit and hemoglobin categories are determined using the 1998 CDC Guidelines for WIC Hematocrit/Hemoglobin Values Adjusted for Altitude and Smoking. In MICA, 18.0 is used as a lower biologically implausible value for hematocrit, and 6.0 is used as a lower biologically implausible value for hemoglobin.

WIC Hematocrit Values Adjusted for Altitude* and Smoking†, 1998 CDC Guidelines

* No altitude adjustment required for Missouri
† Assuming 20 cigarettes per pack

WIC Hemoglobin Values Adjusted for Altitude* and Smoking†, 1998 CDC Guidelines

* No altitude adjustment required for Missouri
† Assuming 20 cigarettes per pack

Marital Status

MICA reports this indicator as married, not married, or unknown marital status. Individual responses such as single or divorced would result in numbers too small to report.

Medicaid – Receiving at WIC Visit

Medicaid, also known as MO HealthNet in Missouri, is administered by the Missouri Department of Social Services and provides medical services to persons who meet certain eligibility requirements. To learn more about Medicaid/MO HealthNet, please visit https://dss.mo.gov/fsd/msmed.htm. Medicaid status is reported at the time of the initial prenatal WIC visit. There may be participants who are not receiving Medicaid at the time of the initial WIC visit but receive Medicaid at some later point during their WIC participation; they are not included in the receiving data in the WIC Prenatal MICA. Medicaid status is collected on the MOWINS Income History tab. Data are unavailable for 2009 due to errors that occurred during conversion to the MOWINS system.

Multivitamin Consumption Prepregnancy

This indicator is used to estimate the proportion of women consuming the recommended amount of folic acid from supplements. MOWINS collects data on multivitamin consumption during the month prior to pregnancy. This field was not required until mid-2010. This indicator has been included in MICA since 2011. NOTE: The WIC MICA reports daily multivitamin consumption, which is defined as multivitamin consumption seven or more times per week. Other data sources may define this indicator differently.

Multivitamin Consumption During Pregnancy

This indicator is used to monitor adequate iron intake during pregnancy. The majority of women who report taking vitamins or minerals during pregnancy get the recommended dose of iron per day. This is a field in MOWINS but was not required until mid-2010. This indicator may be added to MICA for the 2011 data year. NOTE: The WIC MICA reports daily multivitamin consumption, which is defined as multivitamin consumption seven or more times per week. Other data sources may define this indicator differently.

Parity – See Prior Live Births.

Pregnancy Spacing (Interpregnancy Interval)

This indicator is calculated by subtracting the Last Menstrual Period Start Date from the Last Pregnancy Ended date. Both of these fields are collected on the Prenatal record. Following a literature review, the WIC Data Group approved the use of interval ranges from an article in the February 2012 Journal of Community Health, which cites 18-23 months as ideal, with significant risk at less than six months and additional risk after 60 months. The USDA justification for WIC also defines 18 months as optimal. The denominator for the spacing indicators only includes mothers who are known to have a prior pregnancy and have known duration between pregnancies. Unknown status cannot be reliably determined because blank Last Pregnancy Ended date could mean unknown end date or that the current pregnancy is the mother’s first.1

1. Salihu, H. M., et. al. (2012 February). The impact of birth spacing on subsequent feto-infant outcomes among community enrollees of a federal healthy start project. Journal of Community Health, 37(1), 37-42.

Prepregnancy Weight/Prepregnancy BMI

This indicator is calculated by converting prepregnancy height and weight from the pregnancy record to BMI. Calculations were done in accordance with the 2009 recommendations from the Institute of Medicine.2

• Categories using 2009 Institute of Medicine ranges:
• Underweight: BMI is greater than 10.0 but less than 18.5.
• Normal weight: BMI is at least 18.5 but is no greater than 25.0.
• Overweight: BMI is greater than 25.0 but is not more than 30.0.
• Obese: BMI is greater than 30.0 but is no more than 80.0.
• Unknown: A record is considered to have unknown prepregnancy weight for height in the following situations.
• The prepregnancy weight field is blank or includes a biologically implausible value of less than 50 lbs or more than 500 lbs.
• The prepregnancy height field is blank or includes a biologically implausible value of less than 101.6 cm or greater than 212.9 cm.
• The calculated BMI field includes a biologically implausible value of less than 10.0 or greater than 80.0.

2. Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009. Retrieved from http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12584.

Prior Live Births

The number of prior live births is used as a proxy for parity. Parity is defined by CDC as the number of times a woman has been pregnant for 20 or more weeks regardless of whether the infant is dead or alive at birth. Parity does not include the current pregnancy. MICA reported indicators for Prior Live Births include: 0, 1, 2, 3, and 4+. Data are unavailable for 2009.

Race/Ethnicity

Race and ethnicity information are added on each participant’s Demographics record in MOWINS. This is a required field and should not be blank. MICA reports race data for White, Black/African-American, and All Races on main tables. The expanded race option can be used to view data for the American Indian/Alaska Native, Asian/Native Hawaiian/Pacific Islander, Multiracial and Unknown categories. In MOWINS no other categories can be entered except Multiracial. Also, MOWINS does not allow for Unknown race. Hispanic and Non-Hispanic are reported as Ethnicity categories. To view data for combinations of race/ethnic categories, such as White/Non-Hispanic, make the specific race and ethnicity selections as part of your query in the data step of the MICA page or select race and ethnicity as the row and column variables when building your table.

Smoking

All smoking data are self-reported and are assumed to be underreported.

Smoking During Three Months Prior to Pregnancy

This indicator is calculated by comparing the fields Cigarette Usage (Average Number) Per Day – Three Months Prior to Pregnancy and Smoking Change on the Prenatal record.

Smoking During Pregnancy, as of WIC Prenatal Visit

This indicator is calculated from the field Cigarette Usage Per Day – Current, which contains average number of cigarettes currently smoked as recorded on the Prenatal record.

Quit Smoking by First WIC Prenatal Visit

This indicator represents the number of women who smoked during the three months prior to pregnancy but reported that they had stopped smoking as of their first prenatal WIC visit. It is calculated by comparing the field Cigarette Usage Per Day – Current to the fields Cigarette Usage (Average Number) Per Day – Three Months Prior to Pregnancy and Smoking Change on the Prenatal record. The denominator for the quit smoking indicators includes only those mothers who were smoking prepregnancy and have known smoking status as of the WIC prenatal visit.

TANF – Receiving at WIC Visit

The Temporary Assistance for Needy Families (TANF) program is administered by the Missouri Department of Social Services. This program provides temporary assistance to needy families with children. This indicator is a proxy for socioeconomic status and may be used to evaluate the impact of WIC referral services. Data are unavailable for 2009. To learn more about TANF, visit https://dss.mo.gov/fsd/tempa.htm.

WIC Prenatal Entry/WIC Enrollment

Trimester in which pregnant woman enrolled in WIC. This indicator is calculated as the difference between the Last Menstrual Period Date and the WIC Start Date.
WIC Enrollment categories use CDC definitions for Low Hematocrit/Low Hemoglobin Trimesters, which begins the calculation of weeks starting with the first day of the last menstrual period:

• 1st trimester: 0-91 days (0-13 weeks)
• 2nd trimester: 92-182 days (14-26 weeks)
• 3rd trimester: 183-336 days (27-48 weeks) – day range extends past 40 weeks to cover postterm pregnancies