Online Program

A comparison of maternal and neonatal health outcomes: Women enrolled and not enrolled in an evidence-based nurse home visitation program

Monday, November 4, 2013 : 11:05 a.m. - 11:20 a.m.

Melanie Lutenbacher, PhD, MSN, FAAN, Schools of Nursing and Medicine (General Pediatrics), Vanderbilt University, Nashville, TN
Mary S. Dietrich, PhD, Schools of Nursing and Medicine (Biostatistics, Psychiatry, Vanderbilt Ingram Cancer Center), Vanderbilt University, Nashville, TN
Deborah Narrigan, MSN, CNM, School of Nursing, Vanderbilt University, Nashville, TN
Amy Picklesimer, MD, MSPH, Department of Obstetrics and Gynecology, University of South Carolina School of Medicine - Greenville, Greenville, SC
Background : The Nurse Family Partnership (NFP) program is an evidence based model designed for low income first time mothers widely implemented across the US. We compared two groups of pregnant women: women enrolled in NFP and women eligible but not enrolled to determine if NFP would improve maternal and neonatal health outcomes. Methods: A comparison group design with a matched sampling plan (i.e., age, race, initiation of prenatal care) was used. Sample of 119 women enrolled in NFP and 230 not enrolled who received prenatal care at one regional prenatal clinic in South Carolina. Data was abstracted from medical records and birth certificate worksheets including: socio-demographics, risk factors (e.g., smoking, mental health), obstetrical history, number of prenatal visits, birth outcome, payment type, triage visits and admissions, intrapartum complications, infant gestational age, and birthweight. Results: No differences between groups for prenatal risk factors, infant gestational age or birthweight, or contraception use or attendance at the 6 week postpartum visit emerged. Statistically significant findings included: NFP group began prenatal care earlier, had higher rates of enrollment in WIC and fewer hospital and triage calls than the non-NFP group and more use of epidurals at delivery. Approximately two-thirds of all women had spontaneous vaginal births. Conclusions: This study contributes to evaluation of home visitation program efforts for at risk pregnant women. Similar to prior studies, no differences between groups in infant gestational ages emerged. Differences did emerge that may impact health care utilization and costs, and indirectly improve health outcomes.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Public health or related nursing
Public health or related research

Learning Objectives:
Describe three possible health outcomes for pregnant women participating in a nurse home visitation program.

Keyword(s): Home Visiting, Pregnancy Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctorally prepared nurse researcher with over 30 years of maternal and child health experience. I have been the principal investigator on multiple funded projects related to delivering care to pregnant women in the home.
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.