NICHD staff have worked continuously with sponsors and staff of the D.C. Better Babies Project on study design, training of service coordinators, form development, interventions, and obtaining data for evaluation. The Epidemiology and Biometry Research Program, NICHD, agreed to provide technical advice on the development of interventions and to evaluate the impact of the D.C. Better Babies Project to improve the use of prenatal care and reduce the incidence of low birth weight in a high risk pregnant population in the District of Columbia. Targeting an area with a low birth rate greater than 15%, the D.C. Better Babies will document the compliance with specific interventions and yield analyses of the effects of the interventions. With the support of a contractor, NICHD will follow the progress and outcome of pregnancies occurring to women participating in the project. Outcome variables will be compared to those available on vital records for nonparticipants in the target are a, similar areas of the District of Columbia and the city as a whole. Evaluation of smoking, alcohol, and nutritional interventions will be done by comparisons to women attending no more than two public health clinics in D.C.