Birth-Related Outcomes for Second Children Following Home Visiting Program Enrollment for New Parents of First Children.
Birth-Related Outcomes for Second Children Following Home Visiting Program Enrollment for New Parents of First Children.
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DOI：
10.1007/s10995-021-03365-3
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发表时间：
2022-04
影响因子：
2.3
通讯作者：
Sadler LS
中科院分区：
文献类型：
--
作者：
Holland ML;Condon EM;Rinne GR;Good MM;Bleicher S;Li C;Taylor RM;Sadler LS
家访 (HV) 计划旨在通过围产期干预促进儿童和家庭健康。 HV 可能通过改善随后的妊娠和分娩结果而使第二胎受益。然而，高压对第二个孩子出生结果的影响尚未在自然环境中得到检验。利用康涅狄格州培育家庭网络 (NFN) 2005 年至 2015 年登记家庭的家访计划数据，我们将第二个孩子 (n = 1758) 的出生相关结局（出生体重、早产、剖腹产、产前护理利用）与未登记在 NFN 的人口统计学相似的倾向得分匹配家庭 (n = 5200) 进行了比较。我们研究了 NFN 的影响是否因母亲年龄、种族和族裔或就诊模式而异。整个样本没有程序效应。 NFN 的效果并不因产妇年龄或就诊模式而异，但因产妇种族和民族而异。分别与对照组中的黑人和西班牙裔女性相比，NFN 中的黑人女性在第二次怀孕期间更有可能接受充分的产前护理（OR 1.05；95% CI 1.01，1.09），而 NFN 中的西班牙裔女性第二次分娩时通过剖腹产分娩的可能性较小（OR 0.97；95% CI 0.94，0.99）。对于第一胎早产的妇女，第二胎早产有保护性计划效果（OR 0.92；95% CI 0.85，0.996）。这些研究结果表明，高压病毒的益处延伸到了边缘化种族/族裔群体妇女随后的生育相关结果。 HV 可能有助于缓冲一些有害的健康社会决定因素。在线版本包含可在 10.1007/s10995-021-03365-3 获取的补充材料。
Home visiting (HV) programs aim to promote child and family health through perinatal intervention. HV may benefit second children through improving subsequent pregnancy and birth outcomes. However, HV impacts on birth outcomes of second children have not been examined in a naturalistic setting. Using data from Connecticut Nurturing Families Network (NFN) home visiting program of families enrolled from 2005 to 2015, we compared birth-related outcomes (birthweight, preterm birth, Cesarean section delivery, prenatal care utilization) of second children (n = 1758) to demographically similar propensity-score-matched families that were not enrolled in NFN (n = 5200). We examined whether the effects of NFN differed by maternal age, race and ethnicity, or visit attendance pattern. There was no program effect for the full sample. The effect of NFN did not differ by maternal age or visit attendance pattern but did differ by maternal race and ethnicity. Black women in NFN were more likely to receive adequate prenatal care during their second pregnancy (OR 1.05; 95% CI 1.01, 1.09) and Hispanic women in NFN were less likely to deliver by Cesarean section for their second birth (OR 0.97; 95% CI 0.94, 0.99), compared to Black and Hispanic women in the comparison group respectively. There was a protective program effect on prematurity of the second child (OR 0.92; 95% CI 0.85, 0.996) for women with a preterm first birth. These findings suggest that benefits of HV extend to subsequent birth-related outcomes for women from marginalized racial/ethnic groups. HV may help buffer some harmful social determinants of health. The online version contains supplementary material available at 10.1007/s10995-021-03365-3.
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DOI：
10.1136/bmj.e896
发表时间：
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期刊：
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