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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?


Randomised controlled trial with ≤2 years follow up.


Public obstetrics clinic in Memphis, Tennessee, USA.


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%).


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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  • Sources of funding: National Institute of Nursing Research; Bureau of Maternal and Child Health; Administration for Children and Families; Office of the Assistant Secretary for Planning and Evaluation; National Center for Child Abuse and Neglect; Robert Wood Johnson Foundation; Carnegie Corporation; Pew Charitable Trusts; William T Grant Foundation.

  • For article reprint: Dr D L Olds, University of Colorado Health Sciences Center, 1825 Main Street, Denver, CO 80218, USA. Fax +1 303 864 5236.

  • A modified version of this abstract appears in Evidence-Based Mental Health 1998 May and Evidence-Based Medicine 1998 May-June.