Langer A, García C, Leis T, Reynoso S, Hernández B
Centro de Investigaciones en Salud Pública, Instituto Nacional de Salud Pública, México.
Rev Invest Clin. 1993 Jul-Aug;45(4):317-28.
In this project we developed a social support and health education intervention meant to answer whether or not a program of this kind, within the present medical system, can improve perinatal outcomes. A multicenter randomized controlled trial was conducted in four Latin American countries. In Mexico, the project was carried out in a third level obstetric hospital. Patients were screened between the 15th and 22nd week of gestation. Inclusion criteria were factors associated with high risk of low birthweight. A total of 620 women were recruited, randomized and followed up during pregnancy and up to the 40th day post partum. Women in the intervention group were visited four to six times during pregnancy, could use a telephone hot line and a consultation service. A poster and a pamphlet meant to reinforce health education were handed out in the first visit. A "guided tour" for women at the end of pregnancy was organized periodically. Outcomes were measured in both groups at the 36th week of gestation, post partum and 40 days after delivery. Neonatal outcomes were obtained by blind interviewers from the clinical records. Neither in the multicenter nor in the Mexican sample were we able to modify the incidence of low birthweight and prematurity. However, in Mexico we obtained positive effects on birthweight and gestational age in the whole sample and in some specific strata. These results strongly suggest the convenience of replicating the study in Mexico.
在本项目中,我们开展了一项社会支持与健康教育干预措施,旨在探究在当前医疗体系内,此类项目能否改善围产期结局。在四个拉丁美洲国家进行了一项多中心随机对照试验。在墨西哥,该项目在一家三级产科医院开展。在妊娠第15至22周对患者进行筛查。纳入标准为与低出生体重高风险相关的因素。共招募了620名妇女,在孕期及产后直至第40天进行随机分组并随访。干预组的妇女在孕期接受了四至六次家访,可使用电话热线和咨询服务。首次家访时发放了一张用于强化健康教育的海报和一本小册子。定期为孕晚期妇女组织“导览”活动。在妊娠第36周、产后及分娩后40天对两组的结局进行测量。新生儿结局由盲法调查员从临床记录中获取。无论是在多中心样本还是墨西哥样本中,我们均未能改变低出生体重和早产的发生率。然而,在墨西哥,我们在整个样本以及一些特定亚组中,观察到了对出生体重和孕周的积极影响。这些结果有力地表明了在墨西哥重复该研究的可行性。