Prenatal Case Management of Pregnant Women: What Is the Evidence for Its Contribution to a Reduction of Disparities in Perinatal Outcomes?

  • L. Michele Issel
  • Jaime C. Slaughter
  • Sarah G. Forrestal


Women who are at high risk for adverse pregnancy outcomes often have inadequate personal, psychological, or financial resources to overcome their multiple social and/or medical risk factors. These women therefore need assistance, support, guidance and oversight from a health or social service professional who meets them “where they are” both geographically and personally. One type of program that provides such assistance and support is case management. Definitions of what constitutes case management vary (Lee, Mackenzie, Dudley-Brown, & Chin, 1998), but generally the definition includes interventions, other than medical or clinical care, that facilitate access to and utilization of health and social services by clients from vulnerable populations (Hall, Carswell, Walsh, Huber, & Jampoler, 2002).


Case Management Prenatal Care Birth Outcome Perinatal Outcome Neonatal Outcome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We wish to express great appreciation to Melissa Sherwin and Anna Wiencrot for their help in preparing this manuscript and to Arden Handler for her careful editing.


  1. American Nurses Association. (1997). Home care for mother, infant and family following birth. Accessed 3 July 2003, from
  2. Association of Maternal and Child Health Programs (AMCHP) (1999). FactSheet: Home visiting: An effective strategy for improving the health of mothers and children. Accessed 3 July 2003 from
  3. 21 Baldwin, L., Larson, E. H., Connell, F. A., Nordlund, D., Cain, K. C., Cawthon, M. L., et al. (1998). The effect of expanding Medicaid prenatal services on birth outcomes. American Journal of Public Health , 88, 1623–1629.CrossRefPubMedGoogle Scholar
  4. 9 Belizan, J., Barros, F., Langer, A., Farnot, U., Victora, C., Villar, J., et al., (1995). Impact of health education during pregnancy on behavior and utilization of health resources. American Journal of Obstetrics & Gynecology , 173, 894–899.CrossRefGoogle Scholar
  5. 10 Bradley, P. J., & Martin, J. (1994). The impact of home visits on enrollment patterns in pregnancy related services among low-income women. Public Health Nursing , 11, 392–398.CrossRefPubMedGoogle Scholar
  6. 30 Brooten, D., Youngblatt, J. M., Brown, L., Finkler, S. A., Neff, D. F., & Madigan, E. (2001). A randomized trial of nurse specialist home care for women with high-risk pregnancies: Outcomes and costs. American Journal of Managed Care , 7, 793–803.PubMedGoogle Scholar
  7. 7 Bryce, R. L., Stanley, F. J., & Garner, J. B. (1991). Randomized control trial of antenatal social support to prevent preterm birth. British Journal of Obstetrics & Gynaecology , 98, 1001–1008.Google Scholar
  8. 36 Carabin, H., Cowan, L. D., Beebe, L. A., Skaggs, V. J., Thompson, D., & Agbangla, C. (2005). Does participation in a nurse visitation programme reduce the frequency of adverse perinatal outcomes in first-time mothers? Pediatric and Perinatal Epidemiology , 19, 194–205.CrossRefPubMedGoogle Scholar
  9. Ciliska, D., Hayward, S., Thomas, H., Mitchell, A., Dobbins, M., Underwood, J., et al., (1996). A systematic overview of effectiveness of home visiting as a delivery strategy for public health nursing interventions. Canadian Journal of Public Health, 87(3), 193–198.Google Scholar
  10. Ciliska, D., Masgtrilli, P, Ploeg, J., Brunton, G., & Underwood, J. (2001). The effectiveness of home visiting as a delivery strategy for public health nursing interventions to clients in the prenatal and postnatal period: A systematic review. Primary Health Care Research and Demonstration , 2, 41–54.CrossRefGoogle Scholar
  11. Colorado State Board of Health (2000). Statement of basis and purpose and specific statutory authority: Nurse home visitor program rules. Accessed 3 July 2003 from
  12. Cooper, H. (1998). Synthesizing research (3rd ed.). Thousand Oaks, CA: Sage.Google Scholar
  13. 40 Cramer, M. E., Chen, L., Roberts, S., & Clue, D. (2007). Evaluating the social and economic impact of community based prenatal care.Public Health Nursing , 24, 329–336.CrossRefPubMedGoogle Scholar
  14. 4 Dawson, P., Van Doorninck, W. J., & Robinson, J. (1989). Effects of home-based, informal social support on child health. Developmental and Behavioral Pediatrics , 10, 63–67.CrossRefGoogle Scholar
  15. Dewa, C. S., Horgan, S., McIntyre, S., Robinson, G., Krupa, T., & Eastabrook, S. (2003). Direct and indirect time inputs and assertive community treatment. Community Mental Health Journal , 39, 17–32.CrossRefPubMedGoogle Scholar
  16. Dolan-Mullen, P., DiClemente, C. C., Velásquez, M. M., Timpson, S. C., Groff, J. Y., Carbonari, J. P., et al. (2006). Enhanced prenatal case management for low income smokers. Tobacco Control , 9, iii75–iii77.Google Scholar
  17. Downs, S. H., & Black, N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomized and non-randomized studies of health care interventions. Journal of Epidemiology and Community Health , 52, 377–387.CrossRefPubMedGoogle Scholar
  18. Fraser, J. A., Armstrong, K. L., Morris, J. P., & Dadds, M. R. (2000). Home visiting intervention for vulnerable families with newborns: Follow-up results of a randomized controlled trial. Child Abuse Neglect , 24, 1399–1349.CrossRefPubMedGoogle Scholar
  19. Goldfarb, N. I., Hillman, A. L., Eisenberg, J. M., Kelley, M. A., Cohen, A. V., & Dellheim, M. (1991). Impact of mandatory Medicaid case management program on prenatal care and birth outcomes. Medical Care , 29, 64–71.CrossRefPubMedGoogle Scholar
  20. Gomby, D. S., Culross, P. L., & Behrman, R. E. (1999). Home visiting: Recent program evaluations – Analysis and recommendations. The Future of Children , 9(1), 4–26.CrossRefPubMedGoogle Scholar
  21. 22 Gonzalez-Calvo, J., Jackson, J., Hanford, C., Woodman, C., & Remington, N. S. (1997). Nursing case management and its role in perinatal risk reduction: Development, implementation, and evaluation of a culturally competent model for African-American women. Public Health Nursing , 14, 190–206.CrossRefPubMedGoogle Scholar
  22. Graham, W., & Campbell, O. (1992). Maternal health and the measurement trap. Social Science and Medicine , 35, 967–977.CrossRefPubMedGoogle Scholar
  23. 8 Graham, A. V., Frank, S. H., Zyzanski, S. J., Kitson, G. C., & Reeb, K. G. (1992). A clinical trial to reduce the rate of low birth weight in an inner-city black population. Family Medicine , 24, 439–446.PubMedGoogle Scholar
  24. Hall, J. A., Carswell, C., Walsh, E., Huber, D. L., & Jampoler, J. S. (2002). Iowa case management: Innovative social work. Social Work , 47, 132–141.PubMedGoogle Scholar
  25. 1Hardy, J. B., King, T. M., & Repke, J. T. (1987). The Johns Hopkins adolescent pregnancy program: An evaluation. Obstetrics and Gynecology , 69, 300–306.PubMedGoogle Scholar
  26. 2 Heins, H. C., Nance, N. W., & Ferguson, J. E. (1987). Social support in improving perinatal outcome: The Resource mother program. Obstetrics & Gynecology , 70, 263–266.Google Scholar
  27. Hodnett, E. D., & Fredericks, S. (2003). Support during pregnancy for women at increased risk of low birthweight babies. The Cochrane Database of Systematic Reviews, CD000198.PubMedGoogle Scholar
  28. Issel, L. M. (2000). Women’s perceptions of outcomes from prenatal case management. Birth , 27, 120–126.CrossRefPubMedGoogle Scholar
  29. 33 Jackson, D. J., Lang, J. M., Swartz, W. H., Ganitas, T. G., Fullerton, J., Ecker, J., et al. (2003). Outcomes, safety, and resource utilization in a collaborative care birth center program compared with traditional physician-based perinatal care. American Journal of Public Health , 93, 999–1006.CrossRefPubMedGoogle Scholar
  30. 11 Julnes, G., Konefal, M., Pindur, W., & Kim, P. (1994). Community-based perinatal care for disadvantaged adolescents: Evaluation of the resource mothers program. Journal of Community Health , 19 (1), 41–53.CrossRefPubMedGoogle Scholar
  31. 35 Keeton, K., Saunders, S., & Koltun, D. (2004). The effect of the family case management program on 1996 birth outcomes in Illinois. Journal of Women’s Health , 13, 207–215.CrossRefPubMedGoogle Scholar
  32. Kendrick, D., Elkan, R., Hewitt, M., Dewey, M., Blair, M., Robinson, J., et al. (2000). Does home visiting improve parenting and the quality of the home environment? A systematic review and meta-analysis. Archives of Disease in Childhood , 82, 443–451.CrossRefPubMedGoogle Scholar
  33. 18 Kitzman, H., Olds, D. L., Henderson, C. R., Hanks, C., Cole, R., Tatelbaum, R., et al. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. Journal of American Medical Association , 278, 644–652.CrossRefGoogle Scholar
  34. 18 Kitzman, H., Olds, D. L., Sidora, K., Henderson, C. R., Hanks, C., Cole, R., et al. (2000). Enduring effects of nurse home visitation on maternal life course: A 3-year follow-up of a randomized trial. Journal of the American Medical Association , 283, 1983–1989.CrossRefPubMedGoogle Scholar
  35. 28 Koniak-Griffin, D., Anderson, N. L. R., Verzemnieks, I., & Brecht, M. L. (2000). A public health nursing early intervention program for adolescent mothers: Outcomes from pregnancy through 6 weeks postpartum. Nursing Research , 49, 130–138.CrossRefPubMedGoogle Scholar
  36. 5 Korenbrot, C., Gill, A., & Zoe-Patterson, E. (1995). Evaluation of California’s statewide implementation of enhanced prenatal services as Medicaid benefits. Public Health Reports , 110, 125–133.PubMedGoogle Scholar
  37. Korenbrot, C. C., Showstack, J., Loomis, A., & Brindis, C. (1989). Birth weight outcomes in a teenage pregnancy case management program. Journal of Adolescent Health Care , 10, 97–104.CrossRefPubMedGoogle Scholar
  38. Korfmacher, J., O’Brien, R., Hyatt, S., & Olds, D. (1999). Differences in program implementation between nurses and paraprofessionals providing home visits during pregnancy and infancy: A randomized trial. American Journal of Public Health , 89, 1847–1851.CrossRefPubMedGoogle Scholar
  39. Landis, M., & Willems Van Dijk, J. (2006). Facts on the effectiveness of prenatal care coordination: To what extent does evidence suggest enhanced prenatal care services contribute to producing healthy birth outcomes? Unpublished report from Department of Health and Family Services, WI, USA.Google Scholar
  40. 9 Langer, A., Victora, C., Victora, M., Barros, F., Farnot, U., Balizan, J., et al. (1993). The Latin American trial of psychosocial support during pregnancy: A social intervention evaluated through an experimental design. Social Science and Medicine , 36, 495–507.CrossRefPubMedGoogle Scholar
  41. 23 Lear, D., Schall, L. C., Marsh, G. M., Liu, K. S., & Yao, Y. (1998). Identification and case management in an HMO of patients as risk of preterm labor. American Journal of Managed Care , 4, 865–871.PubMedGoogle Scholar
  42. Lee, D. T. F., Mackenzie, A. E., Dudley-Brown, S., & Chin, T. M. (1998). Case management: A review of the definitions and practices. Journal of Advanced Nursing , 27, 933–939.CrossRefPubMedGoogle Scholar
  43. 32 Little, M., Saul, G. D., Testa, K., & Gaziano, C. (2002). Improving pregnancy outcome and reducing avoidable clinical resource utilization through telephonic perinatal care coordination. Lippincott’s Case Management , 7, 103–112.CrossRefPubMedGoogle Scholar
  44. Loda, F. A., Speizer, I. S., Martin, K. L., Skatrud, J. D., & Bennett, T. A. (1997). Programs and services to prevent pregnancy, childbearing, and poor birth outcomes among adolescents in rural areas of the Southeastern United States. Journal of Adolescent Health , 21, 157–166.CrossRefPubMedGoogle Scholar
  45. 24 Lowry, L. W., & Beikirch, P. (1998). Effect of comprehensive care on pregnancy outcome. Applied Nursing Research, 11(2), 55–61.CrossRefPubMedGoogle Scholar
  46. Lumley, J. (1991). Preventing and managing prematurity. International Journal of Technology Assessment in Health Care , 7, 460–477.CrossRefPubMedGoogle Scholar
  47. 31 Margolis, P. A., Stevens, R., Bordley, W. C., Stuart, J., Harlan, C., Keyes-Elstein, L., et al. (2001). From concept to application: The impact of community-wide intervention to improve the delivery of preventive services to children. Pediatrics, 108(3); URL:
  48. 25 Moore, M. L., Meis, P. J., Ernest, J. M., Wells, H. B., Zaccaro, D. J., & Terrell, T. (1998). A randomized trial of nurse intervention to reduce preterm and low birth weight births. Obstetrics & Gynecology , 91, 656–661.CrossRefGoogle Scholar
  49. Mueser, K. T., Bond, G. R., Drake, R. E., & Resnick, S. G. (1998). Models of community care for severe mental illness: a review of research on case management. Schizophrenia Bulletin , 24, 37–74.PubMedGoogle Scholar
  50. 26 Newschaffer, C. J., Cocroft, J., Hauck, W. W., Fanning, T., & Turner, B. J. (1998). Improved birth outcomes associated with enhanced Medicaid prenatal care in drug-using women infected with the human immunodeficiency virus. Prenatal Care in HIV-Infected Drug Users , 91, 885–891.Google Scholar
  51. 34 Nguyen, J. D., Carson, M. L., Parris, K. M., & Place, P. (2003). A comparison pilot study of public health field nursing home visitation program interventions for pregnant Hispanic adolescents. Public Health Nursing , 20, 412–418.CrossRefPubMedGoogle Scholar
  52. 14 Norbeck, J. S., Dejoseph, J. F., & Smith, R. T. (1996). A randomized trial of an empirically-derived social support intervention to prevent low birthweight among African American women. Social Science Medicine , 43, 947–954.CrossRefPubMedGoogle Scholar
  53. Northeast Florida Healthy Start Coalition, Inc. (n.d.). The Magnolia Project: Empowering women’s health and wellness. Accessed 20 July 2006 from∼jwill/Magnolia%20Final%20Report%201999–2001.pdf.
  54. Nurse Family Partnership. (n.d.). Accessed 9 September 2010 from www.nursefamilypatnership/about/fact-sheets.
  55. 6 Oakley, A., Rajan, L., & Grant, A. (1990). Social support and pregnancy outcome. British Journal of Obstetrics and Gynaecology , 97, 155–162.PubMedGoogle Scholar
  56. 3 Olds, D. L., Eckenrode, J., Henderson, C. R., Kitzman, H., Powers, J., Cole, R., et al. (1997). Long-term effects of home visitation on maternal life course and child abuse and neglect. Journal of the American Medical Association , 278, 637–643.CrossRefPubMedGoogle Scholar
  57. 3 Olds, D. L., Henderson, C. R., Tatelman, R., & Chamberlin, R. (1986). Improving the delivery of prenatal care and outcomes of pregnancy: A randomized trial of nurse home visitation. Pediatrics , 77, 16–28.PubMedGoogle Scholar
  58. 3 Olds, D. L., Henderson, C. R., Tatelman, R., & Chamberlin, R. (1988). Improving the life-course development of socially disadvantaged mothers: A randomized trial of nurse home visitation. American Journal of Public Health , 78, 1436–1445.CrossRefPubMedGoogle Scholar
  59. Olds, D. L., & Kitzman, H. (1990). Can home visitation improve the health of women and children at environmental risk? Pediatrics , 86, 108–116.PubMedGoogle Scholar
  60. Olds, D., & Korfmacher, J. (1997). The evolution of a program of research on prenatal and early childhood home visitation: Special issue introduction. Journal of Community Psychology , 25, 1–7.CrossRefGoogle Scholar
  61. Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Petitt, L. M., Henderson, C. R., et al., (2003). Home visiting by paraprofessionals and nurses: A randomized, controlled trial. Pediatrics , 110, 286–496.Google Scholar
  62. 15 Piper, M., Mitchel, E. F., & Ray, W. A. (1996). Evaluation of a program for prenatal care case management. Family Planning Perspective , 28, 65–68.CrossRefGoogle Scholar
  63. Poland, M. L., Giblin, P. T., Waller, J. B., & Bayer, I. S. (1991). Development of a paraprofessional home visiting program for low-income mothers and infants. American Journal of Preventive Medicine , 7, 204–207.PubMedGoogle Scholar
  64. 29 Prozialeck, L. L., & Pesole, L. (2000). Performing a program evaluation in a Family Case Management Program: Determining outcomes for low birthweight deliveries. Public Health Nursing , 12(3), 195–201.CrossRefGoogle Scholar
  65. Ramey, C. T., & Ramey, S. L. (1993). Home visiting programs and the health and development of young children. The Future of Children , 3, 129–139.CrossRefGoogle Scholar
  66. 16 Reichman, N. E., & Florio, M. J. (1996). The effects of enriched prenatal care services on Medicaid birth outcomes in New Jersey. Journal of Health Economics , 15, 455–476.CrossRefPubMedGoogle Scholar
  67. 37 Ricketts, S. A., Murray, E. K., & Schwalberg, R. (2005). Reducing low birthweight by resolving risks: Results from Colorado’s Prenatal Plus Program. American Journal of Public Health , 95, 1952–1957.CrossRefPubMedGoogle Scholar
  68. Roberts, I., Kramer, M. S., & Suisse, S. (1996). Does home visiting prevent childhood injury? A systematic review of randomized controlled trials. British Medical Journal , 312(7022), 29–33.PubMedGoogle Scholar
  69. 17 Rogers, M. M., Peoples-Sheps, M. D., & Suchindran, C. (1996). Impact of a social support program on teenage prenatal care use and pregnancy outcomes. Journal of Adolescent Health , 19, 132–140.CrossRefPubMedGoogle Scholar
  70. 38 Sangalang, B. B., Barth, R. P., & Painter, J. S. (2006). First-birth outcomes and timing of second births: A statewide case management program for adolescent mothers. Health and Social Work , 31(1), 55–63.Google Scholar
  71. 39 Silva, R., Thomas, M., Caetano, R., & Araganki, C. (2006). Preventing low birth weight in Illinois: Outcomes of the Family Case Management Program. Maternal and Child Health Journal , 10(6), 481–488.CrossRefPubMedGoogle Scholar
  72. 20 Spencer, B., Thomas, H., & Morris, J. (1989). A randomized control trial of the provision of a social support service during pregnancy: the South Manchester Family Worker Project. British Journal of Obstetrics and Gynaecology , 96, 281–288.PubMedGoogle Scholar
  73. Stankaitis, J. A., Brill, H. R., & Walker, D. M. (2005). Reduction in neonatal intensive care unit admission rates in Medicaid Managed Care program. The American Journal of Managed Care , 11, 166–172.PubMedGoogle Scholar
  74. Stevens-Simons, C., & Orleans, M. (1999). Low-birthweight prevention programs: The enigma of failure. Birth Issues in Perinatal Care , 26, 184–191.Google Scholar
  75. St. Pierre, R., & Layzer, J. I. (1999). Using home visits for multiple purposes: The comprehensive Child Development Program. The Future of Children , 9, 134–151.CrossRefGoogle Scholar
  76. 19 Tessaro, I., Campbell, M., O’Meara, C., Herrick, H., Buescher, P., Meyer, R., et al. (1997). State health department and university evaluation of North Carolina’s Maternal Outreach Worker Program. Research Linkages Between Academia and Public Health Practice , 13(Suppl 2), 38–44.Google Scholar
  77. 27 Thompson, M., Curry, M. A., & Burton, D. (1998). The effect of nursing case management on the utilization of prenatal care by Mexican-Americans in rural Oregon. Public Health Nursing , 15, 82–90.CrossRefPubMedGoogle Scholar
  78. 9 Villar, J., Farnot, U., Barros, F., Victoria, C., Langer, A., & Balizan, J. (1992). A randomized trial of psychosocial support during high-risk pregnancies. New England Journal of Medicine , 327, 1266–1271.CrossRefPubMedGoogle Scholar
  79. Zimmer-Gembeck, M. J., & Helfan, M. (1995). Low birthweight in a public prenatal care program: Behavioral and psychosocial risk factors and psychosocial intervention. Social Science Medicine , 43, 187–197.CrossRefGoogle Scholar
  80. 12 Zotti, M. E., & Zahner, S. J. (1995). Evaluation of public health nursing home visits to pregnant women on WIC.Public Health Nursing ,12, 294–304.CrossRefPubMedGoogle Scholar

Copyright information

© Springer US 2011

Authors and Affiliations

  • L. Michele Issel
    • 1
  • Jaime C. Slaughter
  • Sarah G. Forrestal
  1. 1.School of Public Health, Community Health SciencesUniversity of IllinoisChicagoUSA

Personalised recommendations