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Nurse home visits to low income, first time mothers reduced pregnancy induced hypertension and childhood injuries

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Question Do prenatal and postnatal home visits by nurses improve maternal and child outcomes?

Design

Randomised controlled trial with ≤2 years follow up.

Setting

Public obstetrics clinic in Memphis, Tennessee, USA.

Participants

1139 women (mean age 18 y, 92% African-American) who were <29 weeks gestation, had no previous live births, no chronic illnesses, and ≥2 sociodemographic risk factors (unmarried, <12 y education, and unemployed). Most were unmarried (98%), ≤18 years (64%), and had incomes at or below poverty guidelines (85%).

Intervention

Stratified by maternal race, age, gestational age, employment status, and geographic region, women were allocated to 1 of 4 treatment groups: (1) transportation to prenatal care (n=166); (2) treatment 1 plus developmental screening at 6, 12, and 24 months (n=515); (3) treatment 2 plus prenatal nurse home visits (mean 7 visits) (n=230); or (4) treatment 3 plus 2 years of postpartum home visits (mean 26 visits) (n=228). Groups 2 and 4 were followed up for 2 years (90% follow up based on completed office assessments); groups 1 and 3 were followed up until delivery (95% follow up based …

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