Author Interviews, JAMA, OBGYNE, Pediatrics / 08.07.2014
Nurse Visitation During Pregnancy and Infancy Reduced Maternal and Child Mortality
MedicalResearch.com Interview with:
David Olds, Ph.D.
Professor of Pediatrics and Director
Prevention Research Center for Family and Child Health
University of Colorado Department of Pediatrics
Aurora, Colorado 80045
Medical Research: What are the main findings of the study?
Dr. Olds: We’ve conducted a randomized controlled trial of a program of nurse home visiting for low-income women with no previous live firths during pregnancy and the first two years of the child’s life, with randomization of participants beginning in 1990. In our most recent follow-up of mothers and children in Memphis, those who received nurse-visitation were less likely to have died over a 2-decade period following the child’s birth than those in the control group. Death among mothers and children in these age ranges in the US is rare and extraordinarily important for what it tells us about the health of the population studied in this trial.
For children, the reduction in death was present for preventable causes, that is, sudden infant death syndrome, injuries, and homicide. All of the child deaths for preventable causes were in the control group, for whom the rate was 1.6%. None of the nurse-visited children died of preventable causes.
The reductions in maternal mortality were found for two nurse-visited groups combined for this report: one received prenatal and newborn visitation and a second received visitation during pregnancy and through child age two. Overall, mothers assigned to the control group were nearly 3 times more likely to die than those assigned to the two nurse-visited conditions. The relative reduction in maternal mortality was particularly pronounced for deaths linked to maternal behaviors -- suicide, drug overdose, injuries, and homicide; for these external causes of death, 1.7% of the mothers in the control group had died, compared to 0.2% of those visited by nurses.
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