Background
Poor birth outcomes increase the risk of infant mortality and morbidity, developmental
delays, and child maltreatment. This study assessed the effectiveness of a prenatal
home-visitation program in reducing adverse birth outcomes among socially disadvantaged
pregnant women and adolescents.
Design
As part of a larger RCT, this study examined the effects of home-visitation services
on low birth weight (LBW) deliveries.
Setting/participants
Pregnant women and adolescents eligible for Healthy Families New York (HFNY) were
recruited in three communities. Eligibility was based on socioeconomic factors such
as poverty, teen pregnancy, and the risk of child maltreatment. Two thirds of the
participants were black or Hispanic, and 90% were unmarried.
Intervention
Pregnant women and adolescents were randomized to either an intervention group that
received bi-weekly home-visitation services (n=236) or to a control group (n=265). Home visitors encouraged healthy prenatal behavior, offered social support,
and provided a linkage to medical and other community services. Services were tailored
to individual needs.
Main outcome measure
An LBW of <2500 grams on birth certificate files. Baseline and birth interviews were
conducted from 2000 to 2002, and birth records were collected in 2007. Analyses were
done from 2007 to 2008.
Results
The risk of delivering an LBW baby was significantly lower for the HFNY group (5.1%)
than for the control group (9.8%; AOR=0.43; 95% CI=0.21, 0.89). The risk was further
reduced for mothers who were exposed to HFNY at a gestational age of ≤24 weeks (AOR=0.32;
95% CI=0.14, 0.74).
Conclusions
A prenatal home-visitation program with focus on social support, health education,
and access to services holds promise for reducing LBW deliveries among at-risk women
and adolescents.
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© 2009 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
