Blondel B, Bréart G
Epidemiological Research Unit on Women's and Children's Health, INSERM, Paris, France.
Semin Perinatol. 1995 Aug;19(4):263-71. doi: 10.1016/s0146-0005(05)80040-0.
This review of eight randomized controlled trials assessed two different types of home visits during pregnancy: (1) those offering social support to high-risk women; and (2) those providing medical care to women with complications. In both categories, pregnancy outcome was not improved when women received home visits. The summary odds ratio for preterm delivery (< 37 weeks) was 1.0 (95% CI: 0.8 to 1.1). Nor did the home visits decrease the rate of hospital admission for women with complications (mainly threatened preterm labor or toxemia); the corresponding summary odds ratio was 0.9 (95% CI: 0.7 to 1.2). Nevertheless in some trials home visits had positive effects on women (medical knowledge, support levels, health habits, and satisfaction). The randomized controlled trials provide little evidence that programs offering home visits are effective in improving either pregnancy outcome or the use of health services. A better integration of hospital and home services might allow a more rational use of health services for women with complications. In addition, we need to define more precisely the content of home visits providing social support. For this, further research is required on how emotional support, health education, and advice influence the health of women and infants and mother-child interactions.
（1）为高危女性提供社会支持的家访；（2）为有并发症的女性提供医疗护理的家访。在这两类家访中，女性接受家访时妊娠结局并未得到改善。早产（<37周）的汇总比值比为1.0（95%CI：0.8至1.1）。家访也未降低有并发症（主要是先兆早产或子痫前期）女性的住院率；相应的汇总比值比为0.9（95%CI：0.7至1.2）。然而，在一些试验中，家访对女性（医学知识、支持水平、健康习惯和满意度）有积极影响。随机对照试验几乎没有证据表明提供家访的项目在改善妊娠结局或卫生服务利用方面有效。更好地整合医院和家庭服务可能会使有并发症的女性更合理地利用卫生服务。此外，我们需要更精确地界定提供社会支持的家访内容。为此，需要进一步研究情感支持、健康教育和建议如何影响妇女和婴儿的健康以及母婴互动。
