SOCIAL SUPPORT, CARE COORDINATION AND PREGNANCY OUTCOMES (INFANT MORTALITY, PRETERM BIRTHS).
Contributors: University of Pittsburgh.
Published: 1995
Number of pages: 220
Subjects: Health Sciences, Nursing.; Health Sciences, Public Health.; Sociology, Individual and Family Studies.; Women's Studies.; Health Sciences, Obstetrics and Gynecology.; Sociology, Public and Social Welfare.
Description: The purpose of this retrospective descriptive study was to examine the impact of care coordination on social support and pregnancy outcomes. The MOM Project, a care coordination provider, supplied services through home and telephone visitation. The women who received the services lived in urban Indianapolis, Indiana in an area with a history of the highest black infant mortality rates for large cities in the United States for 1984, 1985 and 1987.

Data were collected from the care coordination patient records of 373 women who delivered infants between January 1, 1992 through December 31, 1993. The MOM Project followed 305 women through delivery, a newborn/postpartum home visit, and reassessment for adequate support at the exit visit. The women were primarily black, single, had low education and low income levels, which qualified them for Medicaid services.

Major findings from the study were that the women were assessed at the initial visit to be at high risk for preterm birth (29%) of women and poor pregnancy outcomes (79.6%) of women. The majority (61.4%) of women were assessed by the care coordinator to have adequate informal social support at the initial visit and also were more likely to have improved support assessed at the newborn/postpartum visit. Those women assessed to have inadequate support initially had a 2.7 times greater chance of having a low birthweight infant compared to those assessed with adequate support levels. Women with incomes less than 100% of federal poverty level had a 3.6 times greater chance of having a preterm birth. The presence of the client's mother and father of the baby in her social support network were key factors.

In summary, social support, through care coordination did have a positive impact on pregnancy outcomes. In particular the level of social support did correlate with fewer low birthweight infants. The majority of infants (87.9%) had normal gestation rates. Neonatal and postneonatal mortality rates were found to be 3.27 and 3.28 per 1000 live births respectively. A reduction in reported smoking was also experienced among (51%) of subjects in the project and 11.6% quit smoking altogether.
Notes: Source: Dissertation Abstracts International, Volume: 56-11, Section: B, page: 6040.

Thesis (PH.D.)--UNIVERSITY OF PITTSBURGH, 1995.

School code: 0178.