title: Home visiting for first-time mothers and subsequent pregnancy spacing.
abstract: The objective of the study was to determine the association of home visiting with subsequent pregnancy outcomes.
  
  
  
  Retrospective study of Ohio mothers delivering their first infant from 2007 to 2009. First, we compared mothers enrolled in home visiting with a matched eligible group. Second, we compared outcomes within home visiting based on program participation (low <25% of recommended home visits, moderate 25 to 75%, high 75 to 100% and very high >100%). Time to subsequent pregnancy within 18 months was evaluated using Cox proportional hazards regression; logistic regression tested the likelihood of subsequent preterm birth.
  
  
  
  Of 1516 participants, 1460 were matched 1:1 to a comparison mother (n=2920). After multivariable adjustment, enrollment was associated with no difference in pregnancy spacing or subsequent preterm birth. Among those enrolled, moderate vs low participants had reduced risk of repeat pregnancy over 18 months (hazard ratio 0.68, P=0.003).
  
  
  
  Increased pregnancy spacing is observed among women with at least moderate home visiting participation.
authors.affiliation: Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: N K
authors.initials: NK
authors.lastname: Goyal
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: A T
authors.initials: AT
authors.lastname: Folger
authors.affiliation: Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: E S
authors.initials: ES
authors.lastname: Hall
authors.affiliation: Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Greenberg
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Van Ginkel
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: R T
authors.initials: RT
authors.lastname: Ammerman
mesh_terms: D000293:Adolescent; D000328:Adult; D001721:Birth Intervals / Q000706:statistics & numerical data*; D005260:Female; D006699:Home Care Services / Q000458:organization & administration; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D009035:Mothers; D015999:Multivariate Analysis; D009820:Ohio / Q000453:epidemiology; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055815:Young Adult