Interpregnancy primary care and social support for African-American women at risk for recurrent very-low-birthweight delivery: a pilot evaluation.

Autor: Dunlop AL; Department of Family & Preventive Medicine, Emory University School of Medicine, 735 Gatewood Road NE, Atlanta, GA, 30322, USA. amlang@emory.edu, Dubin C, Raynor BD, Bugg GW Jr, Schmotzer B, Brann AW Jr
Jazyk: angličtina
Zdroj: Maternal and child health journal [Matern Child Health J] 2008 Jul; Vol. 12 (4), pp. 461-8. Date of Electronic Publication: 2007 Aug 22.
DOI: 10.1007/s10995-007-0279-z
Abstrakt: Objectives: Very-low-birthweight (VLBW) delivery accounts for the majority of neonatal mortality and the black-white disparity in infant mortality. The risk of recurrent VLBW is highest for African-Americans of lower socioeconomic status. This study explores whether the provision of primary health care and social support following a VLBW delivery improves subsequent child spacing and pregnancy outcomes for low-income, African-American women.
Methods: This pilot study of mixed prospective-retrospective cohort design enrolled African-American women who qualified for indigent care and delivered a VLBW infant at a public hospital in Atlanta from November 2003 through March 2004 into the intervention cohort (n (1) = 29). The intervention consisted of coordinated primary health care and social support for 24 months following the VLBW delivery. A retrospective cohort was assembled from consecutive women meeting the same eligibility criteria who delivered a VLBW infant during July 2001 through June 2002 (n (2) = 58). The number of pregnancies conceived within 18 months of the index VLBW delivery and the number of adverse pregnancy outcomes for each cohort was compared with Poisson regression.
Results: Women in the control cohort had, on average, 2.6 (95% CI: 1.1-5.8) times as many pregnancies within 18 months of the index VLBW delivery and 3.5 (95% CI: 1.0-11.7) times as many adverse pregnancy outcomes as women in the intervention cohort.
Conclusions: This small, pilot study suggests that primary health care and social support for low-income, African-American women following a VLBW delivery may enhance achievement of a subsequent 18-month interpregnancy interval and reduce adverse pregnancy outcomes.
Databáze: MEDLINE
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