Title

Does Additional Prenatal Care in the Home Improve Birth Outcomes for Women with a Prior Preterm Delivery? A Randomized Clinical Trial

Date

2013

Author(s)

Melanie Lutenbacher, Patricia Temple Gabbe, Sharon M. Karp, Mary S. Dietrich, Deborah Narrigan, Lavenia Carpenter, and William Walsh

Type of Product

Journal publication

Model(s)

Description

Women with a history of a prior preterm birth (PTB) have a high probability of a recurrent preterm birth. Some risk factors and health behaviors that contribute to PTB may be amenable to intervention. Home visitation is a promising method to deliver evidence based interventions. We evaluated a system of care designed to reduce preterm births and hospital length of stay in a sample of pregnant women with a history of a PTB. Single site randomized clinical trial. Eligibility: >18 years with prior live birth ≥20–<37 weeks gestation; <24 weeks gestation at enrollment; spoke and read English; received care at regional medical center. All participants (N = 211) received standard prenatal care. Intervention participants (N = 109) also received home visits by certified nurse-midwives guided by protocols for specific risk factors (e.g., depressive symptoms, abuse, smoking). Data was collected via multiple methods and sources including intervention fidelity assessments. Average age 27.8 years; mean gestational age at enrollment was 15 weeks. Racial breakdown mirrored local demographics. Most had a partner, high school education, and 62 % had Medicaid. No statistically significant group differences were found in gestational age at birth. Intervention participants had a shorter intrapartum length of stay. Enhanced prenatal care by nurse-midwife home visits may limit some risk factors and shorten intrapartum length of stay for women with a prior PTB. This study contributes to knowledge about evidence-based home visit interventions directed at risk factors associated with PTB. (author abstract)

Data Collection Methods

  • Fidelity observations
  • Interviews
  • Program administrative record reviews

Status

Finished

For More Information

Lutenbacher, M., Gabbe, P. T., Karp, S. M., Dietrich, M. S., Narrigan, D., Carpenter, L., & Walsh, W. (2014). Does additional prenatal care in the home improve birth outcomes for women with a prior preterm delivery? A randomized clinical trial. Maternal and Child Health Journal, 18(5), 1142-1154.
Author Contact Information:
Melanie Lutenbacher
melanie.lutenbacher@vanderbilt.edu

Topics

  • Participant Characteristics
  • Participant, Family, and Program Outcomes