Blondel B, Mellier G
Unité de Recherches Epidémiologiques sur la Santé des Femmes et des Enfants, INSERM, Villejuif.
J Gynecol Obstet Biol Reprod (Paris). 1996;25(5):515-22.
Review of randomized controlled trials concerning home visits during pregnancy.
Trials were identified from two data bases. Seven trials were retained in two categories: trials on social support and trials focusing on medical surveillance.
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.
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.
回顾关于孕期家访的随机对照试验。
从两个数据库中识别试验。七项试验被保留在两类中:社会支持试验和侧重于医疗监测的试验。
侧重于社会支持的家访导致早产略有减少,几乎具有显著性。在孕期出现并发症的情况下,家庭监测并未降低早产率或住院次数。总体而言,家访在社会支持、健康行为和医疗问题知识方面对女性有积极影响。
对于有并发症的女性,对住院没有影响可能与医院科室和家庭监测单位之间缺乏协调有关。对于因心理社会因素而处于高危状态的女性,已发表的试验并未对所提出的问题提供令人满意的答案。应通过更好地整合社会支持对出生时健康状况和母婴关系影响的知识来评估家访。