Prenatal counseling may aid black women's health
NEW YORK (Reuters Health) - Counseling on smoking cessation and other health issues during pregnancy may have lasting benefits for low-income African-American women, a study suggests.
Researchers found that among black women recruited from six urban prenatal care clinics, those who were given a few behavioral counseling sessions during pregnancy were more likely to cut out health risks like smoking, both before and after giving birth.
The findings suggest that it is possible to encourage healthy changes with just a few counseling sessions -- something that should be manageable as part of routine prenatal care, according to the researchers.
"This intervention was delivered within the constraints of the existing prenatal care delivery system and confirms the willingness of high-risk, urban minority populations to participate in such interventions," the researchers report in the journal Obstetrics & Gynecology.
Dr. Ayman A. E. El-Mohandes, of George Washington University Medical Center in Washington, DC, led the study. It included 1,070 African-American women receiving care at one of six Washington prenatal clinics. All reported at least one of the health risks the researchers were interested in studying: smoking, exposure to second-hand tobacco smoke, depression, and domestic abuse.
Roughly half of the women were randomly assigned to receive behavioral counseling, while the rest received standard prenatal care. Women in the counseling group attended an average of four half-hour sessions during pregnancy, and one after giving birth.
All of the study participants were interviewed several times during the study to gauge the effectiveness of the counseling sessions, with the final interview conducted 10 weeks after they gave birth.
Overall, El-Mohandes and his colleagues found, there were significant reductions in the number of women with health risk factors between the beginning and end of the study period.
At the outset, 83 percent of the women said they were exposed to secondhand smoke, compared with 55 percent 10 weeks after giving birth. The percentage with depression symptoms fell from 51 percent to 27 percent, and the percentage reporting abuse from their partner dropped from 37 percent to 10 percent.
In general, the researchers found, women in the counseling group were more successful at reducing these risks. They were 86 percent more likely than those in the comparison group to have "resolved" all of their risks by the study's end, and 60 percent more likely to have dealt with at least one.
The findings, according to the researchers, suggest that counseling during pregnancy could bring long-term health benefits to mothers, as well as their children. Offering counseling through existing social service programs, they note, could allow more women to receive similar help.
SOURCE: Obstetrics & Gynecology, September 2008.
