Published online June 1, 2007
PEDIATRICS Vol. 119 No. 6 June 2007, pp. 1145-1151 (doi:10.1542/peds.2006-2411)
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ARTICLE

Intensive Home Visiting Is Associated With Decreased Risk of Infant Death

Edward F. Donovan, MD, Robert T. Ammerman, PhD, John Besl, MS, Harry Atherton, MS, Jane C. Khoury, PhD, Mekibib Altaye, PhD, Frank W. Putnam, MD and Judith B. Van Ginkel, PhD

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio

OBJECTIVE. The goal was to test the hypothesis that participation in a community-based home-visiting program is associated with a decreased risk of infant death.

METHODS. A retrospective, case-control design was used to compare the risk of infant death among participants in Cincinnati's Every Child Succeeds program and control subjects matched for gestational age at birth, previous pregnancy loss, marital status, and maternal age. The likelihood of infant death, adjusted for level of prenatal care, maternal smoking, maternal education, race, and age, was determined with multivariate logistic regression. The interaction between race and program participation and the effect of home visiting on the risk of preterm birth were explored.

RESULTS. Infants whose families did not receive home visiting (n = 4995) were 2.5 times more likely to die in infancy compared with infants whose families received home visiting (n = 1665). Black infants were at least as likely to benefit from home visiting as were nonblack infants. No effect of program participation on the risk of preterm birth was observed.

CONCLUSION. The current study is consistent with the hypothesis that intensive home visiting reduces the risk of infant death.

Key Words: home visiting • infant death

Abbreviations: ECS—Every Child Succeeds • SIDS—sudden infant death syndrome • HFA—Healthy Families America • NFP—Nurse-Family Partnership

Accepted Jan 18, 2007.