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[Home visits during pregnancy. Review of randomized studies and further questions]
1Unité de Recherches Epidémiologiques sur la Santé des Femmes et des Enfants, INSERM, Villejuif.
Objective:
Review of randomized controlled trials concerning home visits during pregnancy.
Methods:
Trials were identified from two data bases. Seven trials were retained in two categories: trials on social support and trials focusing on medical surveillance.
Results:
Home visits focusing on social support led to a slight reduction nearly significant in preterm deliveries. In case of complication during pregnancy, home surveillance did not reduce the rate of preterm deliveries nor the number of hospitalizations. In general, home visits had a positive effect on the women in terms of social support health behavior and knowledge of medical problems.
Conclusion:
For women with complications, the absence of an effect on hospitalizations may be related to lack of coordination between hospital units and home surveillance units. For women at high risk because of psychosocial factors, the published trials do not provide satisfactory answers to the questions raised. Home visits should be evaluated by better integrating the knowledge of the effects of social support on health status at birth and the mother-infant relationship.