Document Detail


Variation in pregnancy outcomes following statewide implementation of a prenatal home visitation program.
MedLine Citation:
PMID:  21041588     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To examine, following statewide dissemination, the influence of an evidence-based home visitation program for first-time mothers on reductions of subsequent pregnancies across time and different locations.
DESIGN: Retrospective cohort study.
SETTING: Replication sites for the Nurse-Family Partnership (17 urban sites and 6 rural sites) across the Commonwealth of Pennsylvania between January 1, 2000, and December 31, 2007.
PARTICIPANTS: A total of 3844 Nurse-Family Partnership clients matched by propensity score to 10 938 local-area controls. Main Exposure  Program enrollment. Main Outcome Measure  Time to second pregnancy resulting in a live birth within 2 years of the first infant's birth.
RESULTS: There were no program effects on time to first pregnancy in the early years of the program (2000-2003), but clients whose first infants were born after 2003 had fewer second pregnancies compared with controls (hazard ratio = 0.87; 95% confidence interval, 0.80-0.96). This benefit occurred principally among mothers who were aged 18 years or younger (hazard ratio = 0.73, 95% confidence interval, 0.61-0.89) and was twice as strong among mothers aged 18 years or younger from rural locations (hazard ratio = 0.40; 95% confidence interval, 0.22-0.73) compared with those from urban locations (hazard ratio = 0.79; 95% confidence interval, 0.65-0.95).
CONCLUSIONS: Program effects on pregnancy planning emerged after an implementation period of 3 years in both urban and rural locations, but they were particularly strong in rural locations and among younger mothers.
Authors:
David M Rubin; Amanda L R O'Reilly; Xianqun Luan; Dingwei Dai; A Russell Localio; Cindy W Christian
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Publication Detail:
Type:  Journal Article     Date:  2010-11-01
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  165     ISSN:  1538-3628     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  198-204     Citation Subset:  AIM; IM    
Affiliation:
MSCE, Division of General Pediatrics, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, CHOP North, Room 1533, Philadelphia, PA 19104-4399. rubin@email.chop.edu.
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