Effects of Nurse Home-Visiting on Maternal Life Course and Child Development: Age 6 Follow-Up Results of a Randomized Trial

Olds, David L.; Kitzman, Harriet; Cole, Robert E.; Robinson, JoAnn; Sidora, Kimberly; Luckey, Dennis W.; Henderson, Charles; Hanks, Carole; Bondy, Jessica; Holmberg, John

doi:10.1542/peds.2004-0962

Cited by 436 publications

(355 citation statements)

References 34 publications

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“…Social support is a concept that is perhaps less familiar to physicians. However, randomized trials of the provision of social support to new parents have shown lasting positive impacts for children, at least when done by nurses [49][50][51]. At this point, it seems reasonable to recommend an opportunistic approach of awareness, screening as much as possible, and intervening where leverage is available, based on physician, patient, and local resources.…”

Section: Discussionmentioning

confidence: 99%

Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety

Rhodes

Iwashyna

2007

Matern Child Health J

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Objective: In several populations, maternal depression has been associated with reduced child safety. In an urban pediatric Emergency Department, we examined the relationship between parental depression, social support, and domestic conflict and child safety behaviors.Methods: We studied consecutive patients in an Emergency Department. Trained interviewers used a structured instrument to assess patient, primary caregiver, and household demographics, socio-economic status, psychosocial factors, child safety behaviors (whether a gun was in the home, poisons were locked, a functioning smoke detector was present, and use of carseats or seatbelts), and whether the home was smokefree. 1,116 patients provided adequate data.Results: Depression was associated with a modest and not statistically significant reduction in child safety behaviors in this population. Lack of social support and the presence of domestic conflict were robustly, independently, and statistically significantly associated with less safe homes. Domestic conflict was associated with more smoking in the home.Conclusion: In our population, child safety was associated less with depression and more with parental lack of social support and domestic conflict. These can be assessed in a Emergency Department and may be amenable to intervention. Abstract Objective: In several populations, maternal depression has been associated with reduced child safety. In an urban pediatric Emergency Department, we examined the relationship between parental depression, social support, and domestic conflict and child safety behaviors.Methods: We studied consecutive patients in an Emergency Department. Trained interviewers used a structured instrument to assess patient, primary caregiver, and household demographics, socio-economic status, psychosocial factors, child safety behaviors (whether a gun was in the home, poisons were locked, a functioning smoke detector was present, and use of carseats or seatbelts), and whether the home was smoke-free. 1,116 patients provided adequate data.Results: Depression was associated with a modest and not statistically significant reduction in child safety behaviors in this population. Lack of social support and the presence of domestic conflict were robustly, independently, and statistically significantly associated with less safe homes. Domestic conflict was associated with more smoking in the home.Conclusion: In our population, child safety was associated less with depression and more with parental lack of social support and domestic conflict. These can be assessed in a Emergency Department and may be amenable to intervention.

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Section: Discussionmentioning

confidence: 99%

Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety

Rhodes

Iwashyna

2007

Matern Child Health J

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“…For example, the Nurse-Family Partnership 46 provided services to low-income, first-time mothers to improve their health and behaviours while pregnant and strengthen parenting skills when children were infants. All other interventions targeted both parents and children to simultaneously enhance protection and reduce family and individual risks.…”

Section: The Science Of Preventionmentioning

confidence: 99%

Worldwide application of prevention science in adolescent health

et al. 2012

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The burden of morbidity and mortality from non-communicable disease has risen worldwide and is accelerating in low-income and middle-income countries, whereas the burden from infectious diseases has declined. Since this transition, the prevention of non-communicable disease as well as communicable disease causes of adolescent mortality has risen in importance. Problem behaviours that increase the short-term or long-term likelihood of morbidity and mortality, including alcohol,

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“…53 Second, women we identified as high risk because of pregnancy complications may be eligible for postpartum home visits aimed at improving newborn care and outcomes, but which could aid their successful transition into outpatient care and prevent ER use. In fact, studies in socially or medically complicated women have demonstrated that a benefit of postpartum home visits is a reduction in maternal acute care visits, postpartum hospital stays, costs, 54 repeat pregnancies, [55][56] and months on Medicaid. 57 The Affordable Care Act's Maternal, Infant, and Early Childhood Home Visiting Program was recently expanded, presenting an opportunity to link maternal and child care to improve outcomes for both.…”

Section: Commentsmentioning

confidence: 99%

Emergency Room Utilization After Medically Complicated Pregnancies: A Medicaid Claims Analysis

Harris

Chang

Wang

et al. 2015

Journal of Women's Health

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Background: Women with pregnancy complications benefit from closer monitoring postpartum and beyond. Increased postpartum emergency room (ER) use may indicate unmet need for outpatient obstetrics and primary care. The purpose of this study was to evaluate whether women with pregnancy complications (gestational diabetes [GDM], gestational hypertension, and preeclampsia) have increased ER use in the first 6 months postpartum, compared with women without these complications. Methods: We conducted a retrospective population-based cohort study using a 2003-2010 Maryland Medicaid managed care claims data set, linked with U.S. Census data. Data included claims for outpatient and ER visits for women aged 12-45 years who were continuously enrolled in Medicaid for at least 100 days of pregnancy and 90 days postpartum. We used logistic regression to calculate the association between pregnancy complications and having ‡1 ER visit in the 6 months postpartum. Results: We identified 26,074 pregnancies, of which 20% were complicated by GDM, gestational hypertension, or preeclampsia. Of these complicated pregnancies, 42.1% had GDM, 35.4% had gestational hypertension, and 42.5% had preeclampsia (diagnoses were not mutually exclusive). In the 6 months postpartum, 25% of women had ‡1 ER visits. Of the complicated pregnancy group, 27.7% had ‡1 ER visit, versus 23.6% of the comparison group ( p < 0.0001). In adjusted analyses, women with a pregnancy complication were more likely to have ‡1 ER visit compared with women without these complications (odds ratio [OR]1.14, 95% confidence interval [CI] 1.05-1.23). The strength of association was highest in women under age 25 (OR 1.20, 95% CI 1.09-1.33). Preconception medical comorbidities (type 2 diabetes, chronic hypertension, obesity, asthma, mental health, and substance abuse diagnoses) were also strongly associated with postpartum ER use (OR 1.61, 95% CI 1.51-1.73). Conclusions: Pregnancy complications increased ER utilization during the 6 months postpartum, especially among women under age 25 years. Interventions that improve discharge planning and early postpartum care may decrease ER use.

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Effects of Nurse Home-Visiting on Maternal Life Course and Child Development: Age 6 Follow-Up Results of a Randomized Trial

Abstract: This program of prenatal and infancy home-visiting by nurses continued to improve the lives of women and children at child age 6 years, 4 years after the program ended.

Cited by 436 publications

References 34 publications

Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety

Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety

Worldwide application of prevention science in adolescent health

Emergency Room Utilization After Medically Complicated Pregnancies: A Medicaid Claims Analysis

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