Katherine Yun1, Arina Chesnokova, Meredith Matone, Xianqun Luan, A Russell Localio, David M Rubin. 1. Katherine Yun and David Rubin are with PolicyLab and the Division of General Pediatrics, The Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. Arina Chesnokova and Meredith Matone are with PolicyLab, The Children's Hospital of Philadelphia. Xianqun Luan is with the Health Analytic Unit, The Children's Hospital of Philadelphia. A. Russell Localio is with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine.
Abstract
OBJECTIVES: We examined the impact of a maternal-child home visitation program on birth spacing for first-time Latina mothers, focusing on adolescents and women who identified as Mexican or Puerto Rican. METHODS: This was a retrospective cohort study. One thousand Latina women enrolled in the Pennsylvania Nurse-Family Partnership between January 1, 2003, and December 31, 2007, were matched to nonenrolled Latina women using propensity scores. The primary outcome was the time to second pregnancy that resulted in a live birth (interpregnancy interval). Proportional hazards models and bootstrap methods compared the time to event. RESULTS: Home visitation was associated with a small decrease in the risk of a short interpregnancy interval (≤ 18 months) among Latina women (hazards ratio [HR] = 0.86; 95% confidence interval [CI] = 0.75, 0.99). This effect was driven by outcomes among younger adolescent women (HR = 0.80; 95% CI = 0.65, 0.96). There was also a trend toward significance for women of Mexican heritage (HR = 0.74; 95% CI = 0.49, 1.07), although this effect might be attributed to individual agency performance. CONCLUSIONS: Home visitation using the Nurse-Family Partnership model had measurable effects on birth spacing in Latina women.
OBJECTIVES: We examined the impact of a maternal-child home visitation program on birth spacing for first-time Latina mothers, focusing on adolescents and women who identified as Mexican or Puerto Rican. METHODS: This was a retrospective cohort study. One thousand Latina women enrolled in the Pennsylvania Nurse-Family Partnership between January 1, 2003, and December 31, 2007, were matched to nonenrolled Latina women using propensity scores. The primary outcome was the time to second pregnancy that resulted in a live birth (interpregnancy interval). Proportional hazards models and bootstrap methods compared the time to event. RESULTS: Home visitation was associated with a small decrease in the risk of a short interpregnancy interval (≤ 18 months) among Latina women (hazards ratio [HR] = 0.86; 95% confidence interval [CI] = 0.75, 0.99). This effect was driven by outcomes among younger adolescent women (HR = 0.80; 95% CI = 0.65, 0.96). There was also a trend toward significance for women of Mexican heritage (HR = 0.74; 95% CI = 0.49, 1.07), although this effect might be attributed to individual agency performance. CONCLUSIONS: Home visitation using the Nurse-Family Partnership model had measurable effects on birth spacing in Latina women.
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