172932 Improving pregnancy outcomes in Domincan pregnant teenagers

Wednesday, October 29, 2008

Diana Forno-Batres, MD, MPH , Director of Research, Physicians for Peace, Norfolk, VA
Ramón A. López, MD , Director, The Americas, Physicians for Peace, Norfolk, VA
Pablo Wagner, MD , Sub-Director, Maternity San Lorenzo de Los Minas, Santo Domingo, Dominican Republic
Maria Frontini, MPH, MS, PhD , Epidemiology, Panamerican Health Organization, El Paso, TX
Frances D. Butterfoss, PhD , Coalitions Work, Yorktown, VA
Edward Karotkin, MD , Division of Neonatal-Perinatal Medicine, Children's Hospital of The King's Daughters, Norfolk, VA
PURPOSE: The Resource Mother (RM) program was initiated by a non-profit organization in 2006 to improve the maternal and child health of communities in Santo Domingo, Dominican Republic.

BACKGROUND: Neonatal, infant and maternal mortalities are high in this country (22, 31 and 178 deaths/100,000 live birth, respectively). These mortality rates are highest among babies born with low or very low birth weight and among babies with mothers less than 20 years old. One third of the pregnant teens who visit one of the largest public hospitals in the city, do not comply with the recommended number of prenatal visits.

METHODS: The 3-year RM program included 94 pregnant teens living in 5 communities surrounding a public hospital. Intervention group participants were mentored by a RM during the entire pregnancy and the first year of the baby's life. RMs received training on healthy pregnancy and infant care, provided weekly visits to clients, accompanied clients to prenatal and well child visits, and were available by telephone at all times.

RESULTS: When compared to control groups of pregnant teenagers who did not have RMs, the intervention group attended more prenatal visits and classes; intended to breastfeed, use contraceptives and return to school; reported higher prenatal vitamin use throughout pregnancy (93% vs. 73%); and delivered fewer low birth weight babies (18.5% vs. 34.78%).

CONCLUSIONS: The RM program improved pregnancy outcomes by increasing access to prenatal care, maternal health education and support.

Learning Objectives:
1. List three pregnancy outcomes that were improved in pregnant teenagers who had the assistance of a resource mother. 3. Describe the roles of a resource mother. 4. Recognize the value of a mentoring program for the improvement of pregnancy outcomes.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Frances Dunn Butterfoss is a health educator and President of Coalitions Work, a consulting group based in the Hampton Roads region of eastern Virginia that is dedicated to building coalitions and partnerships for community health. She previously held the EVMS Foundation Professorship in Pediatrics at Eastern Virginia Medical School (EVMS) in Norfolk, Virginia and directed its Division of Community Health and Research. Dr. Butterfoss teaches in the EVMS Masters in Public Health program and serves on its curriculum committee. She is the founding director and current board member of CINCH, a community child health partnership, and PIV, a state immunization coalition. These coalitions promote immunizations, access to insurance and health care, asthma management, obesity and injury prevention, and data-driven health assessment and research. From 1995-98, she directed the national Immunization Coalition Training Institute and now provides consultation and training across the country on how to develop, sustain and evaluate coalitions for health promotion and disease prevention. Dr. Butterfoss has received research support from many federal and foundation grants and has published widely in professional journals and textbooks. Fran is the Deputy Editor of Health Promotion Practice, and past President of the Society for Public Health Education (SOPHE). Her awards include SOPHE’s Health Education Mentor (2002), EVMS’ Woman in Medicine & Science Professional Achievement (2004), YWCA of South Hampton Roads’ Woman of Distinction (2006) and Norman B. Arnold Alumni Award (2006). She completed undergraduate and masters’ degrees from the University of Pennsylvania and her doctorate in health promotion and education from the School of Public Health at the University of South Carolina.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.