A RANDOMIZED TRIAL OF NURSE INTERVENTION TO REDUCE PRETERM AND LOW-BIRTH-WEIGHT BIRTHS

Objective: To test the effect of telephone calls from registered nurse s to low-income pregnant women on the rates of low birth weight (LBW) and preterm births. Methods: A total of 1554 women receiving prenatal care in a public clinic who met study criteria and who consented were assigned randomly to intervention and control groups. Women in the int ervention group received telephone calls from a registered nurse, one or two times weekly from 24 weeks' through 37 weeks' gestation. Relati ve risks (RRs) and 95% confidence intervals (CIs) were calculated. Res ults: Low birth weight rates were 10.9% in the intervention group and 14.0% in the control group (RR 0.75; 95% CI 0.55, 1.03; P = .072). For gestational age less than 37 weeks, rates were 9.7 in the interventio n group and 11.0 in the control group (RR .87; 95% CI 0.62, 1.22; P = .415). In the subgroup of low-income black women 19 years of age and o lder, a statistically significant difference was found in preterm birt h rates before 37 weeks (8.7% in the intervention group versus 15.4% i n the controls [RR 0.56; 95% CI 0.38, 0.84; P = .004]). Conclusion: Th ere was no difference in LBW or preterm births between intervention an d control groups in the total sample. In a secondary analysis of black subjects 19 years of age and older, there was a significant differenc e in preterm birth rates. (C) 1998 by The American College of Obstetri cians and Gynecologists.