Jamila Mejdoubi1, Silvia C C M van den Heijkant2, Frank J M van Leerdam3, Matty Crone4, Alfons Crijnen5, Remy A HiraSing6. 1. EMGO+ Institute for Health and Care Research, VU University Medical Center, Department of Public and Occupational Health, Van Der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: j.mejdoubi@vumc.nl. 2. EMGO+ Institute for Health and Care Research, VU University Medical Center, Department of Public and Occupational Health, Van Der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: s.vandenheijkant@vumc.nl. 3. EMGO+ Institute for Health and Care Research, VU University Medical Center, Department of Public and Occupational Health, Van Der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: f.v.leerdam@igz.nl. 4. Leiden University Medical Center, Leiden, The Netherlands. Electronic address: m.r.crone@lumc.nl. 5. de Waag, Center for Forensic Services, Amsterdam, the Netherlands. Electronic address: crijnen@xs4all.nl. 6. EMGO+ Institute for Health and Care Research, VU University Medical Center, Department of Public and Occupational Health, Van Der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: ra.hirasing@vumc.nl.
Abstract
OBJECTIVE: antenatal smoking is more prevalent among young women with low socio-economic status. The aim of our study is to assess whether the VoorZorg programme, compared to usual care, is effective in reducing cigarette smoking among young high risk pregnant women. Furthermore, the effect of VoorZorg on pregnancy outcomes and on breast feeding will be described. DESIGN: a randomised controlled trial of VoorZorg, a nurse home visitation intervention, was undertaken over a 2½ year period from 2007 to 2009. Data were collected between 16 and 28 weeks gestation, 32 weeks gestation and at two months post partum on cigarette smoking status plus six months post partum for breastfeeding prevalence. Neonatal birth weight and gestation at birth were also collected. SETTING: participants living in 20 municipalities in the Netherlands. PARTICIPANTS: 460 pregnant women were recruited by different professionals. Inclusion criteria were age <26 years, ≤28 weeks pregnancy with the first child, low educational level and some knowledge of the Dutch language. INTERVENTIONS: women in the intervention group received, in addition to usual care, the VoorZorg programme which consisted of 40-60 home visits by specialised nurses from pregnancy until two years after birth. FINDINGS: the percentage of smokers was significantly lower in the intervention group (40%) compared to the control group (48%) during pregnancy (p=0.03) and at two months post birth (49% and 62%; p=0.02). During pregnancy the number of daily cigarettes smoked was reduced in both groups. After birth, the intervention group smoked 50% less cigarettes compared to the control group (C: 8±10; I: 4±7 (mean±standard deviation (SD)), p=0.01). Furthermore, women in the intervention group did not smoke near the baby (C: 2±5; I: 0±0 (mean±SD) p=0.03). Birth weight and gestational age were similar in both groups (C: 3147g, 40 weeks; I: 3144g, 39 weeks (p=0.94, p=0.17)). Significantly more women in the intervention group were still breast feeding their baby at six months post -birth (C: 6%; I: 13%, p=0.04). KEY CONCLUSIONS: VoorZorg seemed to be effective in reducing cigarette smoking and in increasing breastfeeding duration. No effect was found on pregnancy outcomes.
RCT Entities:
OBJECTIVE: antenatal smoking is more prevalent among young women with low socio-economic status. The aim of our study is to assess whether the VoorZorg programme, compared to usual care, is effective in reducing cigarette smoking among young high risk pregnant women. Furthermore, the effect of VoorZorg on pregnancy outcomes and on breast feeding will be described. DESIGN: a randomised controlled trial of VoorZorg, a nurse home visitation intervention, was undertaken over a 2½ year period from 2007 to 2009. Data were collected between 16 and 28 weeks gestation, 32 weeks gestation and at two months post partum on cigarette smoking status plus six months post partum for breastfeeding prevalence. Neonatal birth weight and gestation at birth were also collected. SETTING:participants living in 20 municipalities in the Netherlands. PARTICIPANTS: 460 pregnant women were recruited by different professionals. Inclusion criteria were age <26 years, ≤28 weeks pregnancy with the first child, low educational level and some knowledge of the Dutch language. INTERVENTIONS:women in the intervention group received, in addition to usual care, the VoorZorg programme which consisted of 40-60 home visits by specialised nurses from pregnancy until two years after birth. FINDINGS: the percentage of smokers was significantly lower in the intervention group (40%) compared to the control group (48%) during pregnancy (p=0.03) and at two months post birth (49% and 62%; p=0.02). During pregnancy the number of daily cigarettes smoked was reduced in both groups. After birth, the intervention group smoked 50% less cigarettes compared to the control group (C: 8±10; I: 4±7 (mean±standard deviation (SD)), p=0.01). Furthermore, women in the intervention group did not smoke near the baby (C: 2±5; I: 0±0 (mean±SD) p=0.03). Birth weight and gestational age were similar in both groups (C: 3147g, 40 weeks; I: 3144g, 39 weeks (p=0.94, p=0.17)). Significantly more women in the intervention group were still breast feeding their baby at six months post -birth (C: 6%; I: 13%, p=0.04). KEY CONCLUSIONS:VoorZorg seemed to be effective in reducing cigarette smoking and in increasing breastfeeding duration. No effect was found on pregnancy outcomes.
Authors: Alison McFadden; Anna Gavine; Mary J Renfrew; Angela Wade; Phyll Buchanan; Jane L Taylor; Emma Veitch; Anne Marie Rennie; Susan A Crowther; Sara Neiman; Stephen MacGillivray Journal: Cochrane Database Syst Rev Date: 2017-02-28
Authors: Margaret A McConnell; Slawa Rokicki; Samuel Ayers; Farah Allouch; Nicolas Perreault; Rebecca A Gourevitch; Michelle W Martin; R Annetta Zhou; Chloe Zera; Michele R Hacker; Alyna Chien; Mary Ann Bates; Katherine Baicker Journal: JAMA Date: 2022-07-05 Impact factor: 157.335
Authors: Nicole L A Catherine; Michael Boyle; Yufei Zheng; Lawrence McCandless; Hui Xie; Rosemary Lever; Debbie Sheehan; Andrea Gonzalez; Susan M Jack; Amiram Gafni; Lil Tonmyr; Lenora Marcellus; Colleen Varcoe; Ange Cullen; Kathleen Hjertaas; Caitlin Riebe; Nikolina Rikert; Ashvini Sunthoram; Ronald Barr; Harriet MacMillan; Charlotte Waddell Journal: CMAJ Open Date: 2020-10-27