Do home visiting services received during pregnancy improve birth outcomes? Findings from Virginia PRAMS 2007-2008.
OBJECTIVE
Reducing poor birth outcomes are national and state priorities. At the national level participation in home visiting services has gained momentum with the recent appropriation of federal funds for states to implement evidence-based maternal and child health home visiting programs. The effects of having a home visit are unknown at the state level.


METHODS
Using cross-sectional data from 2007 to 2008 Virginia Pregnancy Risk Assessment and Monitoring System (PRAMS), maternal and infant outcomes were examined. Women who had a home visit during pregnancy were assigned into the home visiting (HV) participation group and those who did not were assigned to the HV Comparison group and used for the analysis.


METHODS
Bivariate analyses, Rao-Scott chi square tests, and multivariate logistic regression measured and quantified the association between HV participation and outcomes.


RESULTS
The HV Participation group were 87.5% less likely to have a low birth weight infant (0.13, 95% CI: 0.020, 0.78), 4.5 times more likely to initiate breastfeeding (aOR: 4.5, 95% CI: 1.05, 19.54), and 39 times more likely to use contraceptives postpartum (aOR: 38.55, 95% CI: 3.14, 473.21).


CONCLUSIONS
Receiving home visiting services during pregnancy increased breastfeeding initiation and postpartum contraceptive use while reducing the risk of low birth weight.
Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
Monisha K
MK
Shah
Kristin R
KR
Austin
D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006302:Health Services Research; D006699:Home Care Services / Q000706:statistics & numerical data*; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008427:Maternal Health Services; D011247:Pregnancy; D011256:Pregnancy Outcome; D018570:Risk Assessment; D014768:Virginia; D055815:Young Adult
low birth weight; pregnancy; services