Effects of home visits for pregnant and postpartum women on premature birth, low birth weight and rapid repeat birth: a meta-analysis and systematic review of randomized controlled trials.
BACKGROUND
Home visits seem promising for improving the health of women and infants during pregnancy and postpartum. This review aimed to quantitatively analyse the effects of home visits delivered during pregnancy and postpartum on premature birth (PTB), low birth weight (LBW) and rapid repeat birth (RRB).


METHODS
Literature was retrieved from PubMed, EMBASE, Web of Science and the Cochrane Library from January 1960 to October 2018 and the references lists of related studies and reviews were also screened. Eligible papers were randomized controlled trials (RCTs) that focussed on home visits conducted with women during pregnancy or postpartum and reported at least one of the following results: PTB, LBW and RRB. Fixed- or random-effects models were used to analyse the pooled results.


RESULTS
Fourteen RCTs were included. Pooled estimates showed a beneficial effect on LBW (odds ratio (OR) = 0.83; P = 0.03; low-quality evidence) and RRB in the professional-visit subgroup (OR = 0.62; P = 0.003; moderate-quality evidence). However, there was insufficient evidence to support the favourable effects of home visits on PTB (OR = 0.96; P = 0.59, moderate-quality evidence) and RRB in the non-professional-visit subgroup (OR = 0.86; P = 0.53, moderate-quality evidence). The overall methodological quality was moderate. Egger's test suggested no publication bias for PTB and LBW.


CONCLUSION
This meta-analysis is the first to suggest that home visits can prevent and decrease LBW and RRB; however, it remains unclear whether home visits benefit PTB. Therefore, home visits can be an alternative and complementary part of primary health care for women, especially those with risk factors.
['Liu|Na|N|', 'Li|Ping|P|', 'Wang|Jie|J|', 'Chen|Dandan|D|', 'Sun|Weijia|W|', 'Zhang|Wei|W|']
D001723:Birth Rate D005260:Female D006792:House Calls D006801:Humans D007230:Infant, Low Birth Weight D007231:Infant, Newborn D011181:Postnatal Care D049590:Postpartum Period D011247:Pregnancy D047928:Premature Birth D011295:Prenatal Care D016032:Randomized Controlled Trials as Topic D040242:Risk Reduction Behavior
Home visits premature birth low birth weight rapid repeat birth meta-analysis systematic review