Prenatal and Infancy Nurse Home Visiting Effects on Mothers: 18-Year Follow-up of a Randomized Trial
| Autor: | Christian J. Hopfer, Gabriella Conti, David L. Olds, Michael D. Knudtson, Harriet Kitzman, Robert Cole, Elizabeth Anson, Ted R. Miller, Joyce A. Smith |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Time Factors Maternal Health Mothers Poison control Prenatal care Nurses Community Health Suicide prevention law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Pregnancy law 030225 pediatrics Injury prevention Humans Medicine Poverty Depression (differential diagnoses) business.industry Infant Newborn Infant Prenatal Care Articles medicine.disease Home Care Services House Calls Substance abuse Pediatrics Perinatology and Child Health Female business Follow-Up Studies Demography |
| Zdroj: | Pediatrics |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2018-3889 |
| Popis: | BACKGROUND:Prenatal and infancy home-visiting by nurses is promoted as a means of improving maternal life-course, but evidence of long-term effects is limited. We hypothesized that nurse-visitation would lead to long-term reductions in public-benefit costs, maternal substance abuse and depression, and that cost-savings would be greater for mothers with initially higher psychological resources.METHODS:We conducted an 18-year follow-up of 618 out of 742 low-income, primarily African-American mothers with no previous live births enrolled in an randomized clinical trial of prenatal and infancy home visiting by nurses. We compared nurse-visited and control-group women for public-benefit costs, rates of substance abuse and depression, and examined possible mediators of intervention effects.RESULTS:Nurse-visited women, compared with controls, incurred $17 310 less in public benefit costs (P = .03), an effect more pronounced for women with higher psychological resources ($28 847, P = .01). These savings compare with program costs of $12 578. There were no program effects on substance abuseor depression. Nurse-visited women were more likely to be married from child age 2 through 18 (19.2% vs 14.8%, P = .04), and those with higher psychological resources had 4.64 fewer cumulative years rearing subsequent children after the birth of the first child (P = .03). Pregnancy planning was a significant mediator of program effects on public benefit costs.CONCLUSIONS:Through child age 18, the program reduced public-benefit costs, an effect more pronounced for mothers with higher psychological resources and mediated by subsequent pregnancy planning. There were no effects on maternal substance abuse and depression. |
| Databáze: | OpenAIRE |
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