Does Antenatal Care Integrate with Home Visits Effect Perinatal Outcomes? A Randomized Control Trial.

objectivesThe aim of this study was to assess whether the combination of home visits and traditional antenatal care leads to better perinatal outcomes than standard antenatal care alone does and to assess the level of perinatal knowledge.

methodsA randomized controlled trial design was used in this study. The study was conducted with pregnant women in their first trimester who were registered at Family Health Centers (primary care) in a district of Istanbul. The study sample consisted of 32 women in the intervention group and 32 women in the control group. Pregnant women in the intervention group participated in an antenatal care program integrated with home visits, whereas those in the control group participated in a standard antenatal care program. The primary outcome of this randomized controlled trial was the change in perinatal knowledge score, which was assessed using a validated perinatal knowledge questionnaire administered before the intervention (pretest) and after program completion (posttest). Secondary outcomes included birth-related characteristics such as mode of delivery, maternal postpartum depressive symptoms as measured by the Edinburgh Postnatal Depression Scale, and breastfeeding self-efficacy as assessed by the Breastfeeding Self-Efficacy Scale.

resultsNo statistically significant difference was observed between the intervention and control groups in terms of sociodemographic characteristics. Following the intervention, perinatal knowledge scores significantly increased in both groups; however, the increase was significantly greater in the intervention group (P < .05). Whereas pretest knowledge scores were comparable between groups, posttest scores were significantly higher in the intervention group. Additionally, the quality and completeness of antenatal care received were markedly better among women in the intervention group. The rate of term deliveries (≥ 40 weeks) was significantly greater and the rate of preterm/early-term deliveries was significantly lower in the intervention group than in the control group (P < .05). Although there was a statistically significant relationship between group allocation and the planned mode of delivery, there were no significant differences between groups in terms of postpartum depression scores or breastfeeding self-efficacy levels. CONCLUSIONS FOR PRACTICE: Integrating structured home visits into routine antenatal care significantly improves the level of perinatal knowledge and quality of care received. This intervention increases maternal readiness and contributes to more informed and confident decision-making during pregnancy and childbirth. CLINICAL STUDY REGISTRATION: Since our research constituted a randomised controlled study, it was registered on the ClinicalTrials.gov website under ClinicalTrials ID No. NCT04628598.