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Home Visits for Pregnant Adolescents

 


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Am Fam Physician. 2016 Jan 1;93(1):25-30.

Clinical Question

Do home visits for pregnant adolescents improve health outcomes?

Evidence-Based Answer

Nurse home visits for pregnant adolescents seem to improve resource utilization and prenatal clinic visit show rates. (Strength of Recommendation [SOR]: B, based on a randomized controlled trial [RCT] and cohort trial.) When nurse visits are continued for up to two years after delivery, there is a decrease in the likelihood of arrest or conviction among the children of these mothers. (SOR: B, based on a cohort trial.) There is conflicting evidence on the effect of prenatal home visits on gestational age and weight at birth.

An RCT of 400 predominantly white, unmarried, low-income adolescent mothers in the Elmira Nurse-Family Partnership assessed the effectiveness of nurse home visits on several outcomes of teen pregnancy.1 Those who received home visits had an average of nine (range = 0 to 16) visits during pregnancy. Those who received home visits had fewer preterm deliveries compared with the control group, which did not receive home visits (0% vs. 11%; P < .05) and had higher infant birth weights (mean = 3,423 g [7 lb, 9 oz] vs. 3,028 g [6 lb, 11

Address correspondence to Vince WinklerPrins, MD, at vjw6@georgetown.edu. Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.

REFERENCES

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1. Olds D, Henderson CR Jr, Tatelbaum R, Chamberlin R. Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation [published correction appears in Pediatrics. 1986;78(1):138]. Pediatrics. 1986;77(1):16–28....

2. Eckenrode J, Campa M, Luckey DW, et al. Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19-year follow-up of a randomized trial [published correction appears in Arch Pediatr Adolesc Med. 2010;164(5):424]. Arch Pediatr Adolesc Med. 2010;164(1):9–15.

3. Flynn L, Budd M, Modelski J. Enhancing resource utilization among pregnant adolescents. Public Health Nurs. 2008;25(2):140–148.

4. Nguyen J, Carson ML, Parris KM, Place P. A comparison pilot study of public health field nursing home visitation program interventions for pregnant Hispanic adolescents. Public Health Nurs. 2003;20(5):412–418.

5. Pinzon JL, Jones VF; Committee on Adolescence; Committee on Early Childhood. Care of adolescent parents and their children. Pediatrics. 2012;130(6):e1743–e1756.

Help Desk Answers provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review.

The complete database of evidence-based questions and answers is copyrighted by FPIN. If interested in submitting questions or writing answers for this series, go to http://www.fpin.org or e-mail: questions@fpin.org.

This series is coordinated by John E. Delzell, Jr., MD, MSPH, Assistant Medical Editor.



 

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