Reference Catalog

Maternal and Child Mortality: Analysis of Nurse Home Visiting in 3 RCTs

Nancy S. Donelan-McCall, Michael D. Knudtson, and David L. Olds

• Nurse-Family Partnership (NFP)

Introduction: The impact of intensive prenatal and infant/toddler nurse home visiting on low-income mothers’ and children’s survival was examined in 3 RCTs following participants over 2- decade periods after trial registration during pregnancy (data gathered between 1978 and 2015 and analyzed between 2016 and 2020). Methods: All-cause and external-cause maternal mortality and preventable-cause child mortality were examined using National Death Index data. Survival rates were calculated for all the 1,138 mothers randomized and 1,076 live-born children in the second RCT (conducted in Memphis, TN) and for all the 1,135 mothers randomized and 1,087 live-born children in the first and third RCTs combined (conducted in Elmira, NY and Denver, CO). Results: There were no significant nurse home visiting−control differences in maternal mortality in Memphis or Elmira and Denver. Posthoc analysis, combining all 3 trials, suggested a reduction in external-cause maternal mortality among nurse-visited mothers (p=0.054). There was a marginally significant nurse home visiting−control difference in preventable-cause child mortality (p=0.09) in Memphis. Conclusions: These results support examining maternal and child mortality in additional nurse home visiting trials with larger samples living in disadvantaged contexts. Intensive prenatal and infant/toddler home visiting by nurses for mothers and children living in poverty may decrease premature death. (author abstract)

Finished

• Participant, Family, and Program Outcomes