TY  - JOUR
PY  - 2019//
TI  - Prenatal and infancy nurse home visiting effects on mothers: 18-year follow-up of a randomized trial
JO  - Pediatrics
A1  - Olds, David L.
A1  - Kitzman, Harriet
A1  - Anson, Elizabeth
A1  - Smith, Joyce A.
A1  - Knudtson, Michael D.
A1  - Miller, Ted R.
A1  - Cole, Robert
A1  - Hopfer, Christian Jean
A1  - Conti, Gabriella
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Prenatal and infancy home-visiting by nurses is promoted as a means of improving maternal life-course, but evidence of long-term effects is limited. We hypothesized that nurse-visitation would lead to long-term reductions in public-benefit costs, maternal substance abuse and depression, and that cost-savings would be greater for mothers with initially higher psychological resources. <br><br>METHODS: We conducted an 18-year follow-up of 618 out of 742 low-income, primarily African-American mothers with no previous live births enrolled in an randomized clinical trial of prenatal and infancy home visiting by nurses. We compared nurse-visited and control-group women for public-benefit costs, rates of substance abuse and depression, and examined possible mediators of intervention effects. <br><br>RESULTS: Nurse-visited women, compared with controls, incurred $17 310 less in public benefit costs (<i>P</i> =.03), an effect more pronounced for women with higher psychological resources ($28 847, <i>P</i> =.01). These savings compare with program costs of $12 578. There were no program effects on substance abuseor depression. Nurse-visited women were more likely to be married from child age 2 through 18 (19.2% vs 14.8%, <i>P</i> =.04), and those with higher psychological resources had 4.64 fewer cumulative years rearing subsequent children after the birth of the first child (<i>P</i> =.03). Pregnancy planning was a significant mediator of program effects on public benefit costs. <br><br>CONCLUSIONS: Through child age 18, the program reduced public-benefit costs, an effect more pronounced for mothers with higher psychological resources and mediated by subsequent pregnancy planning. There were no effects on maternal substance abuse and depression.<br><br>Copyright © 2019 by the American Academy of Pediatrics.<p />  <p>Language: en</p>
LA  - en
SN  - 0031-4005
UR  - http://dx.doi.org/10.1542/peds.2018-3889
ID  - ref1
ER  -