Home Nurse Visits Cut Mother, Child Mortality
(HealthDay News) — Home visits by nurses may reduce premature deaths in mothers and children living in disadvantaged settings, according to research published online July 7 in JAMA Pediatrics.
David L. Olds, PhD, of the University of Colorado in Aurora, and colleagues randomly assigned mostly African-American women (participants) living in highly disadvantaged urban neighborhoods and their first-born children to one of four treatment groups. The groups were as follows: (1) transportation for prenatal care (166 participants); (2) transportation plus developmental screening for infants and toddlers (514 participants); (3) transportation plus prenatal/postpartum home visits (230 participants); and (4) transportation, screening, and prenatal/postpartum and infant/toddler home visits (228 participants).
The researchers found that the mean 21-year all-cause mortality rate was lower in mothers receiving prenatal/postpartum visits (treatment group 3: 0.4 ± 0.43%) and those receiving prenatal/postpartum and infant/toddler visits (treatment group 4: 2.2 ± 0.97%) than in those who did not receive any home visits (treatments groups 1 and 2 combined: 3.7 ± 0.74%). The maternal survival difference was significant for treatment group 3 and treatment groups 3 and 4 combined, but not treatment group 4, compared with treatment groups 1 and 2 combined. At child age 20 years, the preventable-cause mortality rate was significantly lower among those who received child/toddler home visits (treatment group 4: 0.0%, standard error not calculable) than among those who did not receive home visits (treatment group 2: 1.6 ± 0.57%; P=0.04).
"Prenatal and infant/toddler home visitation by nurses is a promising means of reducing all-cause mortality among mothers and preventable-cause mortality in their first-born children living in highly disadvantaged settings," the authors write.
Two authors disclosed financial ties to the center at which this study was conducted.