Home visiting for first-time mothers and subsequent pregnancy spacing

OBJECTIVE: Determine association of home visiting with subsequent pregnancy outcomes STUDY DESIGN: Retrospective study of Ohio mothers delivering their first infant from 2007–2009. First, we compared mothers enrolled in home visiting to a matched eligible group. Second, we compared outcomes within home visiting based on program participation (low < 25% of recommended home visits, moderate 25–75%, high 75–100% and very high >100%). Time to subsequent pregnancy within 18 months was evaluated using Cox proportional hazards regression; logistic regression tested the likelihood of subsequent preterm birth. RESULT: Of 1,516 participants, 1,460 were matched 1:1 to a comparison mother (n=2,920). After multivariable adjustment, enrollment was associated with no difference in pregnancy spacing or subsequent preterm birth. Among those enrolled, moderate vs. low participants had reduced risk of repeat pregnancy over 18 months (hazard ratio 0.68, p=0.003). CONCLUSION: Increased pregnancy spacing is observed among women with at least moderate home visiting participation.