OBJECTIVES: Very-low-birthweight (VLBW) delivery accounts for the majority of neonatal mortality and the black-white disparity in infant mortality. The risk of recurrent VLBW is highest for African-Americans of lower socioeconomic status. This study explores whether the provision of primary health care and social support following a VLBW delivery improves subsequent child spacing and pregnancy outcomes for low-income, African-American women. METHODS: This pilot study of mixed prospective-retrospective cohort design enrolled African-American women who qualified for indigent care and delivered a VLBW infant at a public hospital in Atlanta from November 2003 through March 2004 into the intervention cohort (n (1) = 29). The intervention consisted of coordinated primary health care and social support for 24 months following the VLBW delivery. A retrospective cohort was assembled from consecutive women meeting the same eligibility criteria who delivered a VLBW infant during July 2001 through June 2002 (n (2) = 58). The number of pregnancies conceived within 18 months of the index VLBW delivery and the number of adverse pregnancy outcomes for each cohort was compared with Poisson regression. RESULTS: Women in the control cohort had, on average, 2.6 (95% CI: 1.1-5.8) times as many pregnancies within 18 months of the index VLBW delivery and 3.5 (95% CI: 1.0-11.7) times as many adverse pregnancy outcomes as women in the intervention cohort. CONCLUSIONS: This small, pilot study suggests that primary health care and social support for low-income, African-American women following a VLBW delivery may enhance achievement of a subsequent 18-month interpregnancy interval and reduce adverse pregnancy outcomes.
OBJECTIVES: Very-low-birthweight (VLBW) delivery accounts for the majority of neonatal mortality and the black-white disparity in infant mortality. The risk of recurrent VLBW is highest for African-Americans of lower socioeconomic status. This study explores whether the provision of primary health care and social support following a VLBW delivery improves subsequent child spacing and pregnancy outcomes for low-income, African-American women. METHODS: This pilot study of mixed prospective-retrospective cohort design enrolled African-American women who qualified for indigent care and delivered a VLBW infant at a public hospital in Atlanta from November 2003 through March 2004 into the intervention cohort (n (1) = 29). The intervention consisted of coordinated primary health care and social support for 24 months following the VLBW delivery. A retrospective cohort was assembled from consecutive women meeting the same eligibility criteria who delivered a VLBW infant during July 2001 through June 2002 (n (2) = 58). The number of pregnancies conceived within 18 months of the index VLBW delivery and the number of adverse pregnancy outcomes for each cohort was compared with Poisson regression. RESULTS:Women in the control cohort had, on average, 2.6 (95% CI: 1.1-5.8) times as many pregnancies within 18 months of the index VLBW delivery and 3.5 (95% CI: 1.0-11.7) times as many adverse pregnancy outcomes as women in the intervention cohort. CONCLUSIONS: This small, pilot study suggests that primary health care and social support for low-income, African-American women following a VLBW delivery may enhance achievement of a subsequent 18-month interpregnancy interval and reduce adverse pregnancy outcomes.
Authors: J C Carey; M A Klebanoff; J C Hauth; S L Hillier; E A Thom; J M Ernest; R P Heine; R P Nugent; M L Fischer; K J Leveno; R Wapner; M Varner Journal: N Engl J Med Date: 2000-02-24 Impact factor: 91.245
Authors: P D Wadhwa; J F Culhane; V Rauh; S S Barve; V Hogan; C A Sandman; C J Hobel; A Chicz-DeMet; C Dunkel-Schetter; T J Garite; L Glynn Journal: Paediatr Perinat Epidemiol Date: 2001-07 Impact factor: 3.980
Authors: B M Sibai; S N Caritis; J C Hauth; C MacPherson; J P VanDorsten; M Klebanoff; M Landon; R H Paul; P J Meis; M Miodovnik; M P Dombrowski; G R Thurnau; A H Moawad; J Roberts Journal: Am J Obstet Gynecol Date: 2000-12 Impact factor: 8.661
Authors: Christine M Tucker; Kate Berrien; M Kathryn Menard; Amy H Herring; Julie Daniels; Diane L Rowley; Carolyn Tucker Halpern Journal: Matern Child Health J Date: 2015-11