Early Home Visits and Health Outcomes in Low-Income Mothers and Offspring: 18-Year Follow-Up of a Randomized Clinical Trial
Authors' conclusion
In this clinical trial follow-up at offspring ages 12 and 18, nurse-visited female offspring had lower rates of obesity and mothers of females had lower rates of hypertension than control-group counterparts. These findings suggest that risks for chronic disease among mothers of females and their female offspring who live in extreme poverty may be prevented with prenatal and infant and toddler home visitations by nurses.
Study context
- Population
- Low-income women with no previous live births and ≥2 sociodemographic risk factors (unmarried, <12 years of education, unemployed), public health care system, Memphis, Tennessee, enrolled 1990–1991; 98% unmarried, 85% below federal poverty level; and their offspringrandomized
- Participants
- 742 women
- Comparison
- Prenatal and infancy nurse home visitation vs control
- Primary endpoint
- Maternal and offspring obesity and hypertension
- Follow-up
- Child ages 12 and 18 years
Methodological detailsfollow-up, masked outcome assessment, post-double selection lasso analysis, outcomes not hypothesized in original trial design, Outcomes assessed by staff masked to treatment
- Follow-up
- Masked outcome assessment
- Post-double selection lasso analysis
- Outcomes not hypothesized in original trial design
- Outcomes assessed by staff masked to treatment
Primary result
As reported in the abstract
Offspring obesity and maternal hypertension, ages 12 and 18 years combined · child ages 12 and 18 years combined
Nurse visitation vs ControlAdjusted relative risk (95% CI)P value
Obesity, female offspring
0.449(0.234–0.858)
P = 0.003Severe obesity, female offspring
0.185(0.046–0.748)
P < 0.001Stage 1 hypertension, mothers of females
0.613(0.440–0.855)
P = 0.001Stage 2 hypertension, mothers of females
0.217(0.081–0.582)
P < 0.001Further findings
- Self-reported maternal health aligned with program effects on hypertension
Original publication
Early Home Visits and Health Outcomes in Low-Income Mothers and Offspring: 18-Year Follow-Up of a Randomized Clinical Trial. JAMA Netw Open. Published 2 January 2024. doi:10.
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