A randomized controlled trial of the provision of a social support service during pregnancy: the South Manchester Family Worker Project

Abstract

Summary A pilot scheme was introduced in Manchester to provide additional social support to pregnant women at above average risk of giving birth to a low‐birthweight baby. The help of lay workers, known as family workers, was made available to eligible women. The effect on infant birthweight of offering the help of a family worker was assessed by a randomized controlled trial. No significant differences were observed between the experimental and control group, but on a number of grounds the interpretation of this finding is not straightforward, and further research is recommended.

Le soutien social de l’intervenante tel que perçu par les participantes d’un programme de prévention en périnatalité en milieu d’extrême pauvreté

“…McLaughlin et al (1992) ont également observé une augmentation significative du poids à la naissance chez le groupe de primipares à la suite d'interventions de soutien social. Par contre, dans d'autres programmes (Dawson et al, 1989 ;Heins et al, 1990 ;Oakley et al, 1988cité dans Olds et al, 1990Spencer et al, 1989), on n'a pu observer d'effet significatif quant au poids à la naissance. Toutefois, Oakley et al (1988) ont observé une meilleure utilisation du réseau de soutien et des services ainsi qu'une diminution des dépressions par rapport au groupe contrôle.…”

Preventing and Managing Prematurity

“…The first two used concurrent matched controls rather than randomized allocation. In the English study, women at high risk of preterm delivery or low birth weight, on social grounds or because of their prior reproductive history, were offered a "family worker" who would give practical help and support in any way that the pregnant woman wished (91). No reduction in preterm birth rates could be detected in any of the four studies, although there was an association with lower rates of low birth weight in South Carolina.…”

An evidence synthesis of qualitative and quantitative research on component intervention techniques, effectiveness, cost-effectiveness, equity and acceptability of different versions of health-related lifestyle advisor role in improving health.

“…The study by McLaughlin et al 340 was excluded from our review as they provided support with a multidisciplinary team that included laywomen, so the impact of the lay advisors alone was impossible to extract. Spencer et al 339 was not included in our review, as the study focused only on infant health. Hodnett et al 336 concluded that while programmes that offer additional support during pregnancy are unlikely to prevent the pregnancy from resulting in a low-birthweight or preterm baby, they may be helpful in reducing the likelihood of caesarean birth.…”

“…One review 336 examined interventions for women at risk of preterm or low-birthweight babies, but identified only two studies 339,340 that assessed lay advisors. They state that the results of these two studies were consistent with the other interventions assessed.…”

“…One review 335 examined traditional birth attendants, one 336 examined interventions for women at risk of preterm or low-birthweight babies (including lay advisors), one 337 examined interventions for pregnant or post partum women with drug or alcohol problems (including lay advisors), and two 338,339 examined interventions to support breastfeeding (including lay advisors). Three reviews assessed random or quasirandomised trials, 336-338 one 335 assessed experimental or quasiexperimental designs.…”