Study | Study groups/sample size | Effectiveness | Evidence of effectiveness: authors' conclusion/reviewer assessment | ||
---|---|---|---|---|---|
 |  | PTB outcome | Neonatal/infant mortality outcome | PTB | Neonatal/ infant mortality |
a) Interventions aimed at socioeconomically disadvantaged women | |||||
Home visiting/telephone support | |||||
Kafatos, 1991 | Florina intervention programme. 296 women attending one of the clinics cluster randomised to provide the interventions vs. 263 women attending one of the clinics randomised to provide normal care. | Unadjusted % PTB (<37 weeks): 3.7% vs. 8.3%, p < 0.04 | Neonatal deaths, n (%) (<27 days): 6 (2.1%) vs. 5 (2.0%) | Yes/Possibly | No/No |
Kitzman, 1997 | 518 women randomised to receive intensive nurse home-visitation services during pregnancy vs. 681 women randomised to receive normal care during pregnancy. | Unadjusted % PTB (<37 weeks): 11% vs. 13% Unadjusted % spontaneous PTB (<37 weeks): 8% vs. 9% Adjusted Odds Ratio (95% CI) for PTB (<37 weeks): 0.8 (0.6-1.2) Adjusted Odds Ratio (95% CI) for spontaneous PTB (<37 weeks): 0.8 (0.5-1.3) | N/A | No/No | N/A |
Maternity care coordination | |||||
Buescher, 1991 | 15,526 women who received maternity care coordination vs. 34,463 women who did not receive maternity care coordination. Not randomised | N/A | Unadjusted infant deaths per 1000 live births: 9.9 vs. 12.2, p = 0.02 Adjusted Odds Ratio (95% CI) for infant death: 1.20 (0.98-1.47) | N/A | Possibly/ Possibly |
b) Interventions aimed at or evaluated in socioeconomically disadvantaged women with additional risk factors for PTB/LBW | |||||
Home visits/telephone support | |||||
Bryce, 1991 | 981 women randomised to receive additional antenatal social support vs. 986 women randomised to receive standard antenatal care. | Stratified Odds Ratio (95% CI) for PTB (stratified by social class) 0.84 (0.65-1.09) Odds Ratios by social class: Professional: 0.59 (0.36-0.96) Clerical: 1.00 (0.64-1.56) Manual: 0.96 (0.59-1.56) | Neonatal deaths before hospital discharge: 1.4% vs. 0.6% Postneonatal deaths before hospital discharge: 0% vs. 0.2% | No/No | No conclusion stated/No |
Moore, 1998 | 775 women randomised to receive the nurse telephone intervention vs. 779 women randomised to receive usual care. | % PTB (<37 weeks) 9.7% vs. 11.0%; Relative Risk (RR) (95% CI): 0.87 (0.62-1.22), p = 0.415 Stratified analysis: Black women, aged < = 18 years: 11.0% vs. 7.9% RR: 1.39 (0.72,2.67), p = 0.039 Black women, aged > = 19 years: 8.7% vs. 15.4% RR: 0.56 (0.38-0.84), p = 0.004 White or other women, aged < = 18 years: 7.8% vs. 4.1% RR: 1.92 (0.61-6.02), p = 0.255 White or other women, aged > = 19 years: 19.6% vs. 6.6% RR: 2.99; (0.98-9.09), p = 0.041 | N/A | No*/No *Authors conclude intervention effective in subgroup of black women aged ≥19 | N/A |
Oakley 1990 | 255 women randomised to receive social support plus usual care vs. 254 women randomised to receive usual care | % PTB (<37 weeks): 18% vs. 19% % by gestational age: <28 weeks: 2% vs. 1% 28-32 weeks: 3% vs. 4% 33-36 weeks: 13% vs. 14% 37+ weeks: 82% vs. 81% | Neonatal deaths (%): 1% vs. 1% | No conclusion stated/No | No conclusion stated/No |
c) Interventions evaluated in other vulnerable/at risk groups | |||||
Higgins Nutrition Intervention Program | |||||
Dubois, 1997 | 1203 adolescents who participated in the Higgins Nutrition Intervention during pregnancy vs. 1203 adolescents (matched on site, year and age) who did not receive the intervention. Not randomized. | Unadjusted % PTB (<37 weeks): 8.2% vs. 12.8% Unadjusted % very preterm (<34 weeks): 2.3% vs. 5.1% Adjusted Odds Ratio (95% CI) for PTB (<37 weeks): 0.59 (0.45 - 0.78), p < = 0.001 Adjusted Odds Ratio (95% CI) for very preterm birth (<34 weeks) 0.53 (0.35 - 0.81), p < = 0.001 Odds ratios also reported for subsamples-pregravid weight <50 kg; pregravid weight 50 kg or more; 13-17 yrs; 18-19 yrs. | N/A | Yes/Possibly | N/A |