Being SGA at birth has a clinically significant impact on the academic achievement of a 10-year-old child.

Study objective: To determine the level of knowledge about pregnancy and childbirth in nulliparous pregnant women.Design: Survey using stratified randomised cluster sampling and confidential questionnaire analysis. Setting: Maternity health care clinics. Participants: Of a total eligible population of 1713 nulliparous pregnant women from a Finnish province, 1443 took part. Of the remainder, 131 were not informed of the study and 139 (8-8%) refused to participate. The distribution of occupation of the refusers was similar to the participants. Measurements and main results: Participants were questioned about their sociodemographic characteristics and about their knowledge of pregnancy and childbirth and psychomotor development in the infant, using 28 question sets (118 items). Results showed that, although social differences in the Finnish population are relatively small, there were still distinct differences in knowledge about childbearing in the different strata. The largest knowledge gaps were about health behaviour, particularly about alcohol intake and nutritional aspects of pregnancy and lactation, while knowledge of normal and abnormal delivery was relatively complete. When responses were divided into two groups with the median correct response rate as the cut offpoint, those with scores at or below the median were significantly more likely to have had modest education, to work in lower level employment, or to be very young or unemployed. Conclusions: Differences still occur in knowledge levels among nulliparous pregnant women and particular guidance and care is needed for less advantaged mothers to ensure that they deliver healthy full term babies.Primary prenatal care was organised rather systematically in Finland even before the second world war. In 1944, special legislation established it as a nationwide public health service provided free of charge. Antenatal examination before the 16th week of pregnancy was laid down as a prerequisite of eligibility for maternity benefits. In the course of the subsequent 20 years, the municipal maternity health care clinic system established its position and now enjoys the esteem and confidence of all social groups.The follow up ofthe expectant mother is carried out at the maternity health care clinic, a unit of the local community health care system. These clinics are responsible for the care of the mother during pregnancy and in the 3 month period following childbirth, and for the care of the newborn baby for the first 2 weeks of life. At present, 99-9% of pregnant women use these services and 99-9% ofbabies are born in treatment units providing care at specialist level. The infant mortality rate in Finland-5 8 per 1000 live born babies-is now the lowest in the world, and maternal deaths are practically non-existent.Mothers expect to receive individual high quality service and guidance about their own specific problems.2-5 Often, however, it is difficult to determine a mother's support needs and level of knowledge. Therefore all mothers are given the same st...

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