Home visits following hospital discharge for families with preterm and low-birthweight infants.
Solange Durao, Natasha R Gloeck, Willem A Odendaal et al.
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In 30 seconds
This Cochrane systematic review and meta-analysis assessed randomised trials of home visits after discharge for families of preterm or low-birthweight infants. It included 35 trials; 28 contributed data, and 21 contributed to meta-analyses. Compared with no home visits, visits likely increased the proportion of infants breastfeeding at six months (RR 1.26, 95% CI 1.16 to 1.37; 4 studies, 1217 participants). Effects on several other outcomes were uncertain or showed little to no difference. More intensive visits incorporating community-initiated kangaroo mother care likely reduced mortality at six months (HR 0.75, 95% CI 0.60 to 0.93; 1 study, 8402 participants).
Key findings
- Compared with no home visits, visits likely increased breastfeeding at six months (RR 1.26, 95% CI 1.16 to 1.37; 4 studies, 1217 participants).
- Home visits may have little to no effect on cognitive development (SMD 0.06, 95% CI -0.17 to 0.29; 3 studies, 287 participants).
- More intensive visits with community-initiated kangaroo mother care likely reduced all-cause mortality at six months (HR 0.75, 95% CI 0.60 to 0.93; 1 study, 8402 participants).
- Evidence for mortality at one year with home visits versus no visits was very uncertain (RR 3.08, 95% CI 0.13 to 73.27; 1 study, 79 participants).
Why it matters
Post-discharge support for preterm and low-birthweight infants is widely used, but this review finds that effects vary by outcome and by the intensity and content of visits. The breastfeeding and mortality findings may inform how programmes are evaluated and designed, while uncertain or minimal effects on other outcomes caution against assuming that home visits improve all aspects of infant health and development.
What to keep in mind
The certainty of evidence ranged from moderate to very low, with risk of bias and imprecision cited. Visit content, timing, duration, and frequency varied widely, and most studies were from high-income countries.