Effect of an Intensive Nurse Home Visiting Program on Postpartum Contraceptive Use and Birth Spacing: A Randomized Controlled Trial
To evaluate the effect of an intensive nurse home visiting program on postpartum contraceptive use and birth spacing among individuals with a first pregnancy who were eligible for Medicaid insurance in South Carolina. We conducted a nonblinded, randomized controlled trial of the Nurse-Family Partner...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 2025-01, Vol.145 (1), p.3-12 |
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| container_title | Obstetrics and gynecology (New York. 1953) |
| container_volume | 145 |
| creator | Steenland, Maria W Oviedo, Dea Bates, Mary Ann Zhou, Annetta Zera, Chloe Baicker, Katherine McConnell, Margaret A |
| description | To evaluate the effect of an intensive nurse home visiting program on postpartum contraceptive use and birth spacing among individuals with a first pregnancy who were eligible for Medicaid insurance in South Carolina.
We conducted a nonblinded, randomized controlled trial of the Nurse-Family Partnership (NFP), an established intensive home visiting program that provides prenatal and postpartum home visits through 2 years after childbirth. The trial included patients who were eligible for Medicaid insurance with a first pregnancy at less than 28 weeks of gestation between April 1, 2016, and March 17, 2020, who were followed up through 2 years after childbirth. Participants were randomized 2:1 to NFP compared with standard of care treatment. The primary outcome was a birth interval of less than 21 months between the index pregnancy and a subsequent birth. The secondary outcomes were birth intervals of less than 15 and 24 months, receipt of a contraceptive implant or intrauterine device (IUD) immediately postpartum, any contraceptive use and receipt of a family planning visit (at both 6 weeks and 1 year postpartum), and IUD receipt at 1 year postpartum. We assessed outcomes using linked birth certificate records and Medicaid claims data.
A total of 4,932 trial participants (3,295 in the intervention group and 1,637 in the control group) were included in the study analysis. Within 21 months of the study index birth, 11.0% of individuals in the NFP group and 12.2% of the usual care group had a subsequent birth. The NFP did not have a statistically significant effect on birth intervals of less than 21 months (adjusted coefficient -1.1, 95% CI, -2.9 to 0.8). There were no statistically significant differences between the NFP and control groups for any of the study's eight secondary outcomes related to birth spacing and postpartum contraceptive use.
Home visits with a registered nurse did not affect postpartum contraceptive use or birth spacing.
ClinicalTrials.gov, NCT03360539. |
| doi_str_mv | 10.1097/AOG.0000000000005786 |
| format | Article |
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We conducted a nonblinded, randomized controlled trial of the Nurse-Family Partnership (NFP), an established intensive home visiting program that provides prenatal and postpartum home visits through 2 years after childbirth. The trial included patients who were eligible for Medicaid insurance with a first pregnancy at less than 28 weeks of gestation between April 1, 2016, and March 17, 2020, who were followed up through 2 years after childbirth. Participants were randomized 2:1 to NFP compared with standard of care treatment. The primary outcome was a birth interval of less than 21 months between the index pregnancy and a subsequent birth. The secondary outcomes were birth intervals of less than 15 and 24 months, receipt of a contraceptive implant or intrauterine device (IUD) immediately postpartum, any contraceptive use and receipt of a family planning visit (at both 6 weeks and 1 year postpartum), and IUD receipt at 1 year postpartum. We assessed outcomes using linked birth certificate records and Medicaid claims data.
A total of 4,932 trial participants (3,295 in the intervention group and 1,637 in the control group) were included in the study analysis. Within 21 months of the study index birth, 11.0% of individuals in the NFP group and 12.2% of the usual care group had a subsequent birth. The NFP did not have a statistically significant effect on birth intervals of less than 21 months (adjusted coefficient -1.1, 95% CI, -2.9 to 0.8). There were no statistically significant differences between the NFP and control groups for any of the study's eight secondary outcomes related to birth spacing and postpartum contraceptive use.
Home visits with a registered nurse did not affect postpartum contraceptive use or birth spacing.
ClinicalTrials.gov, NCT03360539.</description><identifier>ISSN: 0029-7844</identifier><identifier>ISSN: 1873-233X</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/AOG.0000000000005786</identifier><identifier>PMID: 39671266</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Adult ; Birth Intervals ; CONTENTS ; Contraception ; Contraception Behavior - statistics & numerical data ; Family Planning Services ; Female ; House Calls - statistics & numerical data ; Humans ; Medicaid ; Original Research ; Postnatal Care ; Postpartum Period ; Pregnancy ; South Carolina ; United States ; Young Adult</subject><ispartof>Obstetrics and gynecology (New York. 1953), 2025-01, Vol.145 (1), p.3-12</ispartof><rights>Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1577-3b75fe1051ec6dd75c376f279556117f6d9f4fe45198dfaff7205a7608cf73b93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39671266$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Steenland, Maria W</creatorcontrib><creatorcontrib>Oviedo, Dea</creatorcontrib><creatorcontrib>Bates, Mary Ann</creatorcontrib><creatorcontrib>Zhou, Annetta</creatorcontrib><creatorcontrib>Zera, Chloe</creatorcontrib><creatorcontrib>Baicker, Katherine</creatorcontrib><creatorcontrib>McConnell, Margaret A</creatorcontrib><title>Effect of an Intensive Nurse Home Visiting Program on Postpartum Contraceptive Use and Birth Spacing: A Randomized Controlled Trial</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>To evaluate the effect of an intensive nurse home visiting program on postpartum contraceptive use and birth spacing among individuals with a first pregnancy who were eligible for Medicaid insurance in South Carolina.
We conducted a nonblinded, randomized controlled trial of the Nurse-Family Partnership (NFP), an established intensive home visiting program that provides prenatal and postpartum home visits through 2 years after childbirth. The trial included patients who were eligible for Medicaid insurance with a first pregnancy at less than 28 weeks of gestation between April 1, 2016, and March 17, 2020, who were followed up through 2 years after childbirth. Participants were randomized 2:1 to NFP compared with standard of care treatment. The primary outcome was a birth interval of less than 21 months between the index pregnancy and a subsequent birth. The secondary outcomes were birth intervals of less than 15 and 24 months, receipt of a contraceptive implant or intrauterine device (IUD) immediately postpartum, any contraceptive use and receipt of a family planning visit (at both 6 weeks and 1 year postpartum), and IUD receipt at 1 year postpartum. We assessed outcomes using linked birth certificate records and Medicaid claims data.
A total of 4,932 trial participants (3,295 in the intervention group and 1,637 in the control group) were included in the study analysis. Within 21 months of the study index birth, 11.0% of individuals in the NFP group and 12.2% of the usual care group had a subsequent birth. The NFP did not have a statistically significant effect on birth intervals of less than 21 months (adjusted coefficient -1.1, 95% CI, -2.9 to 0.8). There were no statistically significant differences between the NFP and control groups for any of the study's eight secondary outcomes related to birth spacing and postpartum contraceptive use.
Home visits with a registered nurse did not affect postpartum contraceptive use or birth spacing.
ClinicalTrials.gov, NCT03360539.</description><subject>Adult</subject><subject>Birth Intervals</subject><subject>CONTENTS</subject><subject>Contraception</subject><subject>Contraception Behavior - statistics & numerical data</subject><subject>Family Planning Services</subject><subject>Female</subject><subject>House Calls - statistics & numerical data</subject><subject>Humans</subject><subject>Medicaid</subject><subject>Original Research</subject><subject>Postnatal Care</subject><subject>Postpartum Period</subject><subject>Pregnancy</subject><subject>South Carolina</subject><subject>United States</subject><subject>Young Adult</subject><issn>0029-7844</issn><issn>1873-233X</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkVFvFCEUhYnR2LX2HxjDoy9TYRhg8MWsm9o2adpG28Y3wjKXLWYGpsA00Vf_uLPZ2rTyArmc79yTHITeUXJIiZIflxfHh-TJ4bIVL9CCtpJVNWM_XqIFIbWqZNs0e-hNzj9nERWKvUZ7TAlJayEW6M-Rc2ALjg6bgE9DgZD9PeDzKWXAJ3EAfOOzLz5s8GWKm2QGHAO-jLmMJpVpwKsYSjIWxrLlrmfKhA5_8anc4u-jsTP5CS_xt3kaB_8buh0R-35-XiVv-rfolTN9hoOHex9dfz26Wp1UZxfHp6vlWWUpl7Jia8kdUMIpWNF1klsmhaul4lxQKp3olGscNJyqtnPGOVkTbqQgrXWSrRXbR593vuO0HqCzsA3e6zH5waRfOhqvn_8Ef6s38V5TKhgRXM4OHx4cUrybIBc9-Gyh702AOGXNaCMkUS3ZSpud1KaYcwL3uIcSvS1QzwXq_wucsfdPMz5C_xpjfwGsw5hq</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>Steenland, Maria W</creator><creator>Oviedo, Dea</creator><creator>Bates, Mary Ann</creator><creator>Zhou, Annetta</creator><creator>Zera, Chloe</creator><creator>Baicker, Katherine</creator><creator>McConnell, Margaret A</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20250101</creationdate><title>Effect of an Intensive Nurse Home Visiting Program on Postpartum Contraceptive Use and Birth Spacing: A Randomized Controlled Trial</title><author>Steenland, Maria W ; Oviedo, Dea ; Bates, Mary Ann ; Zhou, Annetta ; Zera, Chloe ; Baicker, Katherine ; McConnell, Margaret A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1577-3b75fe1051ec6dd75c376f279556117f6d9f4fe45198dfaff7205a7608cf73b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adult</topic><topic>Birth Intervals</topic><topic>CONTENTS</topic><topic>Contraception</topic><topic>Contraception Behavior - statistics & numerical data</topic><topic>Family Planning Services</topic><topic>Female</topic><topic>House Calls - statistics & numerical data</topic><topic>Humans</topic><topic>Medicaid</topic><topic>Original Research</topic><topic>Postnatal Care</topic><topic>Postpartum Period</topic><topic>Pregnancy</topic><topic>South Carolina</topic><topic>United States</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Steenland, Maria W</creatorcontrib><creatorcontrib>Oviedo, Dea</creatorcontrib><creatorcontrib>Bates, Mary Ann</creatorcontrib><creatorcontrib>Zhou, Annetta</creatorcontrib><creatorcontrib>Zera, Chloe</creatorcontrib><creatorcontrib>Baicker, Katherine</creatorcontrib><creatorcontrib>McConnell, Margaret A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Steenland, Maria W</au><au>Oviedo, Dea</au><au>Bates, Mary Ann</au><au>Zhou, Annetta</au><au>Zera, Chloe</au><au>Baicker, Katherine</au><au>McConnell, Margaret A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of an Intensive Nurse Home Visiting Program on Postpartum Contraceptive Use and Birth Spacing: A Randomized Controlled Trial</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>145</volume><issue>1</issue><spage>3</spage><epage>12</epage><pages>3-12</pages><issn>0029-7844</issn><issn>1873-233X</issn><eissn>1873-233X</eissn><abstract>To evaluate the effect of an intensive nurse home visiting program on postpartum contraceptive use and birth spacing among individuals with a first pregnancy who were eligible for Medicaid insurance in South Carolina.
We conducted a nonblinded, randomized controlled trial of the Nurse-Family Partnership (NFP), an established intensive home visiting program that provides prenatal and postpartum home visits through 2 years after childbirth. The trial included patients who were eligible for Medicaid insurance with a first pregnancy at less than 28 weeks of gestation between April 1, 2016, and March 17, 2020, who were followed up through 2 years after childbirth. Participants were randomized 2:1 to NFP compared with standard of care treatment. The primary outcome was a birth interval of less than 21 months between the index pregnancy and a subsequent birth. The secondary outcomes were birth intervals of less than 15 and 24 months, receipt of a contraceptive implant or intrauterine device (IUD) immediately postpartum, any contraceptive use and receipt of a family planning visit (at both 6 weeks and 1 year postpartum), and IUD receipt at 1 year postpartum. We assessed outcomes using linked birth certificate records and Medicaid claims data.
A total of 4,932 trial participants (3,295 in the intervention group and 1,637 in the control group) were included in the study analysis. Within 21 months of the study index birth, 11.0% of individuals in the NFP group and 12.2% of the usual care group had a subsequent birth. The NFP did not have a statistically significant effect on birth intervals of less than 21 months (adjusted coefficient -1.1, 95% CI, -2.9 to 0.8). There were no statistically significant differences between the NFP and control groups for any of the study's eight secondary outcomes related to birth spacing and postpartum contraceptive use.
Home visits with a registered nurse did not affect postpartum contraceptive use or birth spacing.
ClinicalTrials.gov, NCT03360539.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>39671266</pmid><doi>10.1097/AOG.0000000000005786</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Obstetrics and gynecology (New York. 1953), 2025-01, Vol.145 (1), p.3-12 |
| issn | 0029-7844 1873-233X 1873-233X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11630657 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Birth Intervals CONTENTS Contraception Contraception Behavior - statistics & numerical data Family Planning Services Female House Calls - statistics & numerical data Humans Medicaid Original Research Postnatal Care Postpartum Period Pregnancy South Carolina United States Young Adult |
| title | Effect of an Intensive Nurse Home Visiting Program on Postpartum Contraceptive Use and Birth Spacing: A Randomized Controlled Trial |
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