142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

307666
Improving pregnancy outcomes in the underserved: An assessment of the impact of prenatal skilled nursing home visits in a predominantly Latino population

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014

Sonali Tatapudy, B.A. , Icahn School of Medicine at Mount Sinai, New York, NY
Katie Taylor, B.A., M.F.A. , Icahn School of Medicine at Mount Sinai, NY, NY
John Doucette, M.Phil, Ph.D , Department of Preventative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
Dorothy Calvani, RN, MSN, C-GNP , Department of Home Nursing /Certified Home Health Agency (CHHA), Little Sisters of the Assumption Family Health Service, New York, NY
Susanne Lachapelle , East Harlem Partnership for Diabetes Prevention, Little Sisters of the Assumption, New York, NY
Elizabeth J. Garland, MD, MS , Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
Background:  Hispanic race is associated with gestational diabetes (GDM), preeclampsia and obesity, which are risk factors for poor birth outcomes. The Maternity Outreach Program (MOP) of Little Sisters of the Assumption Family Health Service (LSA) works with low-income, predominantly immigrant Latino women. LSA provides culturally sensitive, family- centered prenatal and postpartum skilled nursing home visits (SNHV) in East Harlem in order to improve pregnancy outcomes in this population.

Methods: This retrospective cohort study reviewed charts of women receiving postpartum SNHV by LSA’s MOP from 2008-2012. Chi-squared analyses assessed: differences in low birth-weight and preterm birth between women receiving postpartum SNHV (n=295) versus prenatal and postpartum visits (n=325). A subset of women in MOP between 2011 and 2012 (2011: n=147; 2012: n=125) were analyzed for risks related to GDM, preeclampsia and BMI.

Results: Primary language (Mixteco and Spanish) and race (Hispanic/Latino) were significantly associated with receipt of prenatal SNHV (p<0.001). Women receiving prenatal SNHV were significantly (p<0.001) more likely to have insufficient income, social isolation, substandard housing, inadequate food, and less than 9th grade education or age less than 17 years. Prenatal SNHV were associated with full-term birth (p=0.02) and birth weight > 6 lbs (p=0.04). GDM and BMI > 25 were associated with increased preterm birth in both cohorts; preeclampsia was associated with increase in preterm birth in women who received only postpartum visits (p=0.02).

Conclusion: Prenatal SNHV preventive care in addition to postpartum SNHV can help improve birth outcomes in high-risk, predominantly Latino populations.

Learning Areas:

Implementation of health education strategies, interventions and programs
Public health or related nursing

Learning Objectives:
Identify the sociodemographic and health risk factors present in the predominantly Latino community served by Little Sisters of the Assumption Family Health Service, in East Harlem, NY. Describe the sociodemographic characteristics of women who received prenatal skilled nursing home visits by Little Sisters' Maternity Outreach Program Compare the birth outcomes of women who received both prenatal and postpartum skilled nursing home visits versus women who received only postpartum skilled nursing home visits with Little Sisters' Maternity Outreach Program.

Keyword(s): Birth Outcomes, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the co-principal of this project, funded by the Global Health Program of the Icahn School of Medicine at Mount Sinai. Our interest has been understanding the impact of prenatal and postpartum care on birth outcomes in women from underserved communities.
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.