Home visits during pregnancy and after birth for women with an alcohol or drug problem

Catherine Doggett; Sara L Burrett; David A Osborn

doi:10.1002/14651858.CD004456.pub2

Visitas domiciliarias durante el embarazo y el postparto para mujeres con problemas de alcohol o drogas

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Referencias

Referencias de los estudios incluidos en esta revisión

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estudios excluidos
estudios a la espera de valoración
otras referencias

Black MM, Nair P, Kight C, Wachtel R, Roby P, Schuler M. Parenting and early development among children of drug‐abusing women: effects of home intervention. Pediatrics 1994;94:440‐8.

Butz AM, Lears MK, O'Neil S, Lukk P. Home intervention for in utero drug‐exposed infants. Public Health Nursing 1998;15:307‐18.

Butz AM, Pulsifer M, Marano N, Belcher H, Lears MK, Royall R. Effectiveness of a home intervention for perceived child behavioral problems and parenting stress in children with in utero drug exposure. Archives of Pediatrics and Adolescent Medicine 2001;155:1029‐37.

Dakof GA, Quille TJ, Tejeda MJ, Alberga LR, Bandstra E, Szapocznik J. Enrolling and retaining mothers of substance‐exposed infants in drug abuse treatment. Journal of Consulting and Clinical Psychology 2003;71:764‐72.

Grant TM, Ernst CC, Streissguth AP. An intervention with high‐risk mothers who abuse alcohol and drugs: the Seattle Advocacy Model. American Journal of Public Health 1996;86:1816‐7.

Kartin D, Grant TM, Streissguth AP, Sampson PD, Ernst CC. Three‐year developmental outcomes in children with prenatal alchol and drug exposure. Pediatric Physical Therapy 2002;14:145‐53.

Quinlivan JA, Box H, Cooke S, Evans SF. What happens to adolescent mothers (WHAM) ‐ a randomised controlled trial of a home visiting intervention. Perinatal Society of Australia and New Zealand 4th Annual Congress; 2000 March 12‐15; Brisbane, Australia2000:14.

Google Scholar

Quinlivan JA, Box H, Evans SF. Postnatal home visits in teenage mothers: a randomised controlled trial. Lancet 2003;361:893‐900.

Kettinger LA, Nair P, Schuler ME. Exposure to environmental risk factors and parenting attitudes among substance‐abusing women. American Journal of Drug and Alcohol Abuse 2000;26:1‐11.

Nair P, Schuler ME, Kettinger L, Harrington D. Cumulative environmental risk in substance abusing women: parenting stress, child abuse potential, and development. Pediatric Research 2002;51:186A.

Google Scholar

Schuler ME, Nair P, Black MM. Ongoing maternal drug use, parenting attitudes, and a home intervention: effects on mother‐child interaction at 18 months. Journal of Developmental and Behavioral Pediatrics 2002;23:87‐94.

Schuler ME, Nair P, Black MM, Kettinger L. Mother‐infant interaction: effects of a home intervention and ongoing maternal drug use. Journal of Clinical Child Psychology 2000;29:424‐31.

Schuler ME, Nair P, Keane V. Developmental outcomes of drug‐exposed children: effects of a home intervention and ongoing maternal drug use at 3 years. Pediatric Research 2002;51:190A.

Google Scholar

Schuler ME, Nair P, Kettinger L. Drug‐exposed infants and developmental outcome: effects of a home intervention and ongoing maternal drug use. Archives of Pediatrics and Adolescent Medicine 2003;157:133‐8.

Referencias de los estudios excluidos de esta revisión

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Ammerman TR, Morrow AL, Putnam FW, Stevens J, Holleb LJ, Hulsmann JE, et al. Breastfeeding in first time mothers in home visitation. Pediatric Research 2004;55:196A.

Google Scholar

Armstrong KL, Fraser JA, Dadds MR, Morris J. A randomized, controlled trial of nurse home visiting to vulnerable families with newborns. Journal of Paediatrics and Child Health 1999;35:237‐44.

Armstrong KL, Fraser JA, Dadds MR, Morris J. Promoting secure attachment, maternal mood and child health in a vulnerable population: a randomized controlled trial. Journal of Paediatrics and Child Health 2000;36:555‐62.

Fraser JA, Armstrong KL, Morris JP, Dadds MR. Home visiting intervention for vulnerable families with newborns: follow‐up results of a randomized controlled trial. Child Abuse and Neglect 2000;24:1399‐429.

Barnes‐Boyd C. Effects of sustained nurse/mother contact on infant outcomes among low‐income African‐American families. Public Health Nursing 1995;12:378‐85.

Barnes‐Boyd C, Norr KF, Nacion KW. Evaluation of an interagency home visiting program to reduce postneonatal mortality in disadvantaged communities. Public Health Nursing 1996;13:201‐8.

Barnes‐Boyd C, Norr KF, Nacion KW. Promoting infant health through home visiting by a nurse‐managed community worker team. Public Health Nursing 2001;18:225‐35.

Belizan JM, Barros F, Langer A, Farnot U, Victora C, Villar J. Impact of health education during pregnancy on behavior and utilization of health resources. American Journal of Obstetrics and Gynecology 1995;173:894‐9.

Black MM, Dubowitz H, Hutcheson J, Berenson‐Howard J, Starr RH. A randomized clinical trial of home intervention for children with failure to thrive. Pediatrics 1995;95:807‐14.

Hutcheson JJ, Black MM, Talley M, Dubowitz H, Howard JB, Starr RH, et al. Risk status and home intervention among children with failure‐to‐thrive: follow‐up at age 4. Journal of Pediatric Psychology 1997;22:651‐68.

Black MM, Teti LO. Promoting mealtime communication between adolescent mothers and their infants through videotape. Pediatrics 1997;99:432‐7.

Black MM, Siegel EH, Abel Y, Bentley ME. Home and videotape intervention delays early complementary feeding among adolescent mothers. Pediatrics 2001;107:E67.

Brayden RM, Altemeier WA, Dietrich MS, Tucker DD, Christensen MJ, McLaughlin FJ, et al. A prospective study of secondary prevention of child maltreatment. Journal of Pediatrics 1993;122:511‐6.

Brooten D, Youngblut JM, Brown L, Finkler SA, Neff DF, Madigan E. A randomized trial of nurse specialist home care for women with high‐risk pregnancies: outcomes and costs. American Journal of Managed Care 2001;7:793‐803.

Google Scholar

Brumfield CG, Nelson KG, Stotser D, Yarbaugh D, Patterson P, Sprayberry NK. 24‐hour mother‐infant discharge with a follow‐up home health visit: results in a selected medicaid population. Obstetrics & Gynecology 1996;88:544‐8.

Burry CL. Evaluation of a training program for foster parents of infants with prenatal substance effects. Child Welfare 1999;78:197‐214.

Carroll KM, Chang G, Behr H, Clinton B, Kosten TR. Improving treatment outcome in pregnant, methadone‐maintained women. Results from a randomized clinical trial. American Journal of Addictions 1995;4:56‐9.

Chang G, Carroll KM, Behr HM, Kosten TR. Improving treatment outcome in pregnant opiate‐dependent women. Journal of Substance Abuse Treatment 1992;9:327‐30.

Burrell L, Fuddy L, Sia C, McFarlane E, Duggan A. RCT of home visiting to prevent child abuse. Pediatric Research 2002;51:185A.

Google Scholar

Duggan A, Higman S, Fuddy L, McFarlane E, Sia C. RCT of home visiting: Impact in promoting a medical home for environmentally at‐risk children. Pediatric Research 2002;51:184A.

Google Scholar

Duggan A, Windham A, McFarlane E, Fuddy L, Rohde C, Buchbinder S, et al. Hawaii's healthy start program of home visiting for at‐risk families: evaluation of family identification, family engagement, and service delivery. Pediatrics 2000;105:250‐9.

Stone KE, Duggan AK, Sia C, Burell L. Can home visitation in early childhood reduce injuries?. Pediatric Research 2004;55:348A.

Google Scholar

French ED, Pituch M, Brandt J, Pohorecki S. Improving interactions between substance abusing mothers and their substance‐exposed newborns. Journal of Obstetric, Gynecologic and Neonatal Nursing 1998;27:262‐9.

Giles W, Patterson T, Sanders F, Batey R, Thomas D, Collins J. Outpatient methadone programme for pregnant heroin using women. Australian and New Zealand Journal of Obstetrics and Gynaecology 1989;29:225‐9.

Graham AV, Frank SH, Zyzanski SJ, Kitson GC, Reeb KG. A clinical trial to reduce the rate of low birth weight in an inner‐city black population. Family Medicine 1992;24:439‐46.

Fitzpatrick P, Molloy B, Johnson Z. Community mothers' programme: extension to the travelling community in Ireland. Journal of Epidemiology and Community Health 1997;51:299‐303.

Johnson Z, Howell F, Molloy B. Community mothers' programme: randomised controlled trial of non‐professional intervention in parenting. BMJ 1993;306:1449‐52.

Johnson Z, Molloy B, Scallan E, Fitzpatrick P, Rooney B, Keegan T, et al. Community mothers programme‐‐seven year follow‐up of a randomized controlled trial of non‐professional intervention in parenting. Journal of Public Health Medicine 2000;22:337‐42.

King WJ, Klassen TP, LeBlanc J, Bernard‐Bonnin AC, Robitaille Y, Pham B, Coyle D, et al. The effectiveness of a home visit to prevent childhood injury. Pediatrics 2001;108:382‐8.

Kitzman H, Olds DL, Henderson CR, Hanks C, Cole R, Tatelbaum R, et al. Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. A randomized controlled trial. JAMA 1997;278:644‐52.

Kitzman H, Olds DL, Sidora K, Henderson CR, Hanks C, Cole R, et al. Enduring effects of nurse home visitation on maternal life course: a 3‐year follow‐up of a randomized trial. JAMA 2000;283:1983‐9.

Koniak‐Griffin D, Anderson NL, Brecht ML, Verzemnieks I, Lesser J, Kim S. Public health nursing care for adolescent mothers: impact on infant health and selected maternal outcomes at 1 year postbirth. Journal of Adolescent Health Care 2002;30:44‐54.

Koniak‐Griffin D, Anderson NL, Verzemnieks I, Brecht ML. A public health nursing early intervention program for adolescent mothers: outcomes from pregnancy through 6 weeks postpartum. Nursing Research 2000;49:130‐8.

Koniak‐Griffin D, Verzemnieks IL, Anderson NL, Brecht ML, Lesser J, Kim S, et al. Nurse visitation for adolescent mothers: two‐year infant health and maternal outcomes. Nursing Research 2003;52:127‐36.

Marcenko MO, Spence M. Home visitation services for at‐risk pregnant and postpartum women: a randomized trial. American Journal of Orthopsychiatry 1994;64:468‐78.

Morrell CJ, Spiby H, Stewart P, Walters S, Morgan A. Costs and benefits of community postnatal support workers: a randomised controlled trial. Health Technology Assessment 2000;4:1‐100.

Morrell CJ, Spiby H, Stewart P, Walters S, Morgan A. Costs and effectiveness of community postnatal support workers: randomised controlled trial. BMJ 2000;9:593‐8.

Oettgen B, Holtrop T, Vincent JM, Milberger S, Mueller MC. Home visitation combined with a mobile pediatric clinic ‐ improving pediatric care for low income children. Pediatric Research 2004;55:259A.

Google Scholar

Eckenrode J, Ganzel B, Henderson CR, Smith E, Olds DL, Powers J, et al. Preventing child abuse and neglect with a program of nurse home visitation: the limiting effects of domestic violence. JAMA 2000;284:1385‐91.

Eckenrode J, Zielinski D, Smith E, Marcynyszyn LA, Henderson CR, Kitzman H, et al. Child maltreatment and the early onset of problem behaviors: can a program of nurse home visitation break the link?. Development and Psychopathology 2001;13:873‐90.

Olds D, Henderson CR, Cole R, Eckenrode J, Kitzman H, Luckey D, et al. Long‐term effects of nurse home visitation on children's criminal and antisocial behavior: 15‐year follow‐up of a randomized controlled trial. JAMA 1998;280:1238‐44.

Olds D, Henderson CR, Kitzman H, Cole R. Effects of prenatal and infancy nurse home visitation on surveillance of child maltreatment. Pediatrics 1995;95:365‐72.

Olds DL. Home visitation for pregnant women and parents of young children. American Journal of Public Health 1992;146:704‐8.

Google Scholar

Olds DL, Eckenrode J, Henderson CR, Kitzman H, Powers J, Cole R, et al. Long‐term effects of home visitation on maternal life course and child abuse and neglect. Fifteen‐year follow‐up of a randomized trial. JAMA 1997;278:637‐43.

Olds DL, Henderson CR, Chamberlin R, Tatelbaum R. Preventing child abuse and neglect: a randomized trial of nurse home visitation. Pediatrics 1986;78:65‐78.

Olds DL, Henderson CR, Kitzman H. Does prenatal and infancy nurse home visitation have enduring effects on qualities of parental caregiving and child health at 25 to 50 months of life?. Pediatrics 1994;93:89‐98.

Olds DL, Henderson CR, Phelps C, Kitzman H, Hanks C. Effect of prenatal and infancy nurse home visitation on government spending. Medical Care 1993;31:155‐74.

Olds DL, Henderson CR, Tatelbaum R. Intellectual impairment in children of women who smoke cigarettes during pregnancy. Pediatrics 1994;93:221‐7.

Olds DL, Henderson CR, Tatelbaum R. Prevention of intellectual impairment in children of women who smoke cigarettes during pregnancy. Pediatrics 1994;93:228‐33.

Olds DL, Henderson CR, Tatelbaum R, Chamberlin R. Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation. Pediatrics 1986;77:16‐28.

Olds DL, Henderson CR, Tatelbaum R, Chamberlin R. Improving the life‐course development of socially disadvantaged mothers: a randomized trial of nurse home visitation. American Journal of Public Health 1988;78:1436‐45.

Korfmacher J, O'Brien R, Hiatt S, Olds D. Differences in program implementation between nurses and paraprofessionals providing home visits during pregnancy and infancy: a randomized trial. American Journal of Public Health 1999;89:1847‐51.

Olds DL, Robinson J, O'Brien R, Luckey DW, Pettitt LM, Henderson CR, et al. Home visiting by paraprofessionals and by nurses: a randomized, controlled trial. Pediatrics 2002;110:486‐96.

Schuster MA, Wood DL, Duan N, Mazel RM, Sherbourne CD, Halfon N. Utilization of well‐child care services for African‐American infants in a low‐income community: results of a randomized, controlled case management/home visitation intervention. Pediatrics 1998;101:999‐1005.

Seitz V, Leventhal JM, Apfel NH, Johnson L, Bonilla A, Walls TA, et al. Post‐treatment effects of a volunteer mentoring program on the parenting practices of young, inner‐city mothers: a randomized trial. Pediatric Research 2004;55:71A.

Google Scholar

Strantz IH, Welch SP. Postpartum women in outpatient drug abuse treatment: correlates of retention/completion. Journal of Psychoactive Drugs 1995;27:357‐73.

Sundfaer A. 31 women with drug problems got children‐‐what happened after that?. [Norwegian]. Tidsskrift for Den Norske Laegeforening 2001;121:73‐5.

Super CM, Herrera MG, Mora JO. Long‐term effects of food supplementation and psychosocial intervention on the physical growth of Colombian infants at risk of malnutrition. Child Development 1990;61:29‐49.

Sweeney PJ, Schwartz RM, Mattis NG, Vohr B. The effect of integrating substance abuse treatment with prenatal care on birth outcome. Journal of Perinatology 2000;4:219‐24.

Clark RE, Teague GB, Ricketts SK, Bush PW, Xie H, McGuire TG, et al. Cost‐effectiveness of assertive community treatment versus standard case management for persons with co‐occurring severe mental illness and substance use disorders. Health Services Research 1998;33:1285‐308.

Drake RE, McHugo GJ, Clark RE, Teague GB, Xie H, Miles K, et al. Assertive community treatment for patients with co‐occurring severe mental illness and substance use disorder: a clinical trial. American Journal of Orthopsychiatry 1998;68:201‐15.

McHugo GJ, Drake RE, Teague GB, Xie H. Fidelity to assertive community treatment and client outcomes in the New Hampshire dual disorders study. Psychiatric Services 1999;50:618‐24.

Teague GB, Drake RE, Ackerson TH. Evaluating use of continuous treatment teams for persons with mental illness and substance abuse. Psychiatric Services 1995;46:689‐95.

Van Amerongen D. Trying to reach the pregnant substance‐abuser: learning from failure. HMO Practice 1996;10:80‐2.

Referencias de los estudios en espera de evaluación

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estudios incluidos
estudios excluidos
otras referencias

Bartu A, Ludlow J, Doherty D, Sharp J. Listening to drug and alcohol families. Perinatal Society of Australia and New Zealand 8th Annual Congress; 2004 March 14‐15; Sydney, Australia2004:PL9.

Google Scholar

Hankin J, Sokol R. Brief postpartum intervention protects previously born children from alcohol‐related developmental delay [abstract]. American Journal of Obstetrics and Gynecology 2003;189(6):S148.

Referencias adicionales

Ir a:

estudios incluidos
estudios excluidos
estudios a la espera de valoración

Anonymous. American Academy of Pediatrics. Committee on substance abuse and committee on children with disabilities. Fetal alcohol syndrome and alcohol‐related neurodevelopmental disorders. Pediatrics 2000;106:358‐61.

Belcher HM, Shapiro BK, Leppert M, Butz AM, Sellers S, Arch E, et al. Sequential neuromotor examination in children with intrauterine cocaine/polydrug exposure. Developmental Medicine and Child Neurology 1999;41:240‐6.

Besinger BA, Garland AF, Litrownik AJ, Landsverk JA. Caregiver substance abuse among maltreated children placed in out‐of‐home care. Child Welfare 1999;78:221‐39.

Clarke M, Oxman AD, editors. Cochrane Reviewers’ Handbook 4.2.0 [updated March 2003]. In: The Cochrane Library, Issue 2, 2003. Oxford: Update Software. Updated quarterly.

Coren E, Patterson J, Astin M, Abbott J. Home‐based support for socially disadvantaged mothers. Cochrane Database of Systematic Reviews 2003, Issue 1. [DOI: 10.1002/14651858.CD000107]

Eckenrode J, Ganzel B, Henderson CR, Smith E, Olds DL, Powers J, et al. Preventing child abuse and neglect with a program of nurse home visitation: the limiting effects of domestic violence. JAMA 2000;284:1385‐91.

Eriksson M, Jonsson B, Steneroth G, Zetterstrom R. Amphetamine abuse during pregnancy: environmental factors and outcome after 14‐15 years. Scandinavian Journal of Public Health 2000;28:154‐7.

Faden VB, Graubard BI. Maternal substance use during pregnancy and developmental outcome at age three. Journal of Substance Abuse Treatment 2000;12:329‐40.

Fares I, McCulloch KM, Raju TN. Intrauterine cocaine exposure and the risk for sudden infant death syndrome: a meta‐analysis. Journal of Perinatology 1997;17:179‐82.

Frank DA, Augustyn M, Knight WG, Pell T, Zuckerman B. Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review. JAMA 2001;285:1613‐25.

Gomby DS. Promise and limitations of home visitation. JAMA 2000;284:1430‐1.

Higgins K, Cooper‐Stanbury M, Williams P. Statistics on drug use in Australia 1998. AIHW cat. no. PHE 16. Canberra: AIHW (Drug Statistics Series)2000.

Google Scholar

Hulse GK, Milne E, English DR, Holman CD. Assessing the relationship between maternal cocaine use and abruptio placentae. Addiction 1997;92:1547‐51.

Hulse GK, English DR, Milne E, Holman CD, Bower CI. Maternal cocaine use and low birth weight newborns: a meta‐analysis. Addiction 1997;92:1561‐70.

Hulse GK, Milne E, English DR, Holman CD. The relationship between maternal use of heroin and methadone and infant birth weight. Addiction 1997;92:1571‐9.

Hulse GK, Milne E, English DR, Holman CD. Assessing the relationship between maternal opiate use and neonatal mortality. Addiction 1998;93:1033‐42.

Hulse GK, Milne E, English DR, Holman CD. Assessing the relationship between maternal opiate use and antepartum haemorrhage. Addiction 1998;93:1553‐8.

Jacobson SW, Chiodo LM, Sokol RJ. Jacobson JL. Validity of maternal report of prenatal alcohol, cocaine, and smoking in relation to neurobehavioral outcome. Pediatrics 2002;109:815‐25.

Jaudes PK, Ekwo EE. Outcomes for infants exposed in utero to illicit drugs. Child Welfare 1997;76:521‐34.

Kandall SR, Gaines J, Habel L, Davidson G, Jessop D. Relationship of maternal substance abuse to subsequent sudden infant death syndrome in offspring. Journal of Pediatrics 1993;123:120‐6.

Kearney MH, York R, Deatrick JA. Effects of home visits to vulnerable young families. Journal of Nursing Scholarship 2000;32:369‐76.

Kendrick D, Elkan R, Hewitt M, Dewey M, Blair M, Robinson J, et al. Does home visiting improve parenting and the quality of the home environment? A systematic review and meta analysis. Archives of Disease in Childhood 2000;82:443‐51.

Lutiger B, Graham K, Einarson TR, Koren G. Relationship between gestational cocaine use and pregnancy outcome: a meta‐analysis. Teratology 1991;44:405‐14.

McNaughton DB. Nurse home visits to maternal‐child clients: a review of intervention research. Public Health Nursing 2004;21:207‐19.

Nair P, Black MM, Schuler M, Keane V, Snow L, Rigney BA, et al. Risk factors for disruption in primary caregiving among infants of substance abusing women. Child Abuse and Neglect 1997;21:1039‐51.

Substance Abuse and Mental Health Services Administration. Summary of findings from the 2000 national household survey on drug abuse. Office of Applied Studies2001; Vol. NHSDA Series H‐13, DHHS Publication No. (SMA) 01‐3549. Rockville, MD.

Osborn DA, Cole MJ, Jeffery HE. Opiate treatment for opiate withdrawal in newborn infants. Cochrane Database of Systematic Reviews 2005, Issue 3. [DOI: 10.1002/14651858.CD002059.pub2]

Google Scholar

Osborn DA, Jeffery HE, Cole MJ. Sedatives for opiate withdrawal in newborn infants. Cochrane Database of Systematic Reviews 2005, Issue 3. [DOI: 10.1002/14651858.CD002053.pub2]

Google Scholar

Persily CA. Lay home visiting may improve pregnancy outcomes. Holistic Nursing Practice 2003;17:231‐8.

Taylor DJ. Clinical green top guidelines. Alcohol consumption in pregnancy. RCOG. Internet: http://www.rcog.org.uk/guidelines.asp?PageID=106&GuidelineID=11999.

Google Scholar

The Cochrane Collaboration. Review Manager (RevMan). Version 4.2 for Windows. Oxford, England: The Cochrane Collaboration, 2003.

Roberts I, Kramer MS, Suissa S. Does home visiting prevent childhood injury? A systematic review of randomised controlled trials. BMJ 1996;312:29‐33.

Singer LT, Arendt R, Minnes S, Farkas K, Salvator A. Kirchner HL, et al. Cognitive and motor outcomes of cocaine‐exposed infants. JAMA 2002;287:1952‐60.

Spencer JD, Latt N, Beeby PJ, Collins E, Saunders JB, McCaughan GW, et al. Transmission of hepatitis C virus to infants of human immunodeficiency virus‐negative intravenous drug‐using mothers: rate of infection and assessment of risk factors for transmission. Journal of Viral Hepatitis 1997;4:395‐409.

Characteristics of studies

Characteristics of included studies [ordered by study ID]

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estudios excluidos

Black 1994

Methods	Randomised: yes, prepartum, method not reported. Allocation concealment: unclear. Blinded intervention: no. Blinded measurement: yes, Bayley Scales performed blind to group of allocation. Unclear for other outcomes. Losses to follow up: yes, 17/60 = 28%. Losses: 11/31 treatment group; 6/29 control group. Intention to treat: yes.
Participants	Inclusion criteria: large metropolitan teaching hospital in Baltimore, primarily single, African‐American, low‐income, inner city, multiparous, polydrug users with incomplete schooling. Maternal cocaine or heroin use in pregnancy obtained from questionnaire. Enrolled prenatally. Exclusion criteria: non‐compliance with recruiting procedures.
Interventions	Treatment group (n = 31): two part‐time community health nurses experienced with women and children, and with drug‐abusing families provided 1 hour visits, home visitation pre and postpartum, armed escort. Biweekly home visits extending to 18 months. Two visits before birth. Caseload per nurse was 31 families. Formed alliance, addressed personal, family and environmental needs and facilitated child‐parent interaction. Provided information and advocacy for parents, incorporated the Carolina preschool curriculum and Hawaii Early Learning Program. Control group (n = 29): no home visits. Co‐interventions: both groups attended primary health care multidisciplinary clinic dedicated to treatment of infants born to substance abusing mothers and/or HIV infected. Nine clinic visits scheduled up to 18 months, given transportation costs and compensation for evaluation visits.
Outcomes	Reported primary outcome(s): promotion of positive behaviours and attitudes among drug using women and development in their children. Other outcomes: HOME score at 30 months, Bayley Scales of Infant Development at 6, 12 and 18 months, Child Abuse Potential Index, Parent Stress Index at 18 months, compliance with pediatric health visits and self reported drug and/or alcohol use.
Notes	Trial of predominately postpartum home visits up to 18 months by trained community health nurses for drug using women.
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Butz 1998

Methods	Randomised: yes, computer generated, envelopes used. Allocation concealment: yes. Blinded intervention: no. Blinded measurement: yes for Child Behaviour Checklist and Parental Stress Index. Unclear for other outcomes. Losses to follow up: yes, 87/204 lost to 36 month follow up, with 104/204 (52%) mother‐infant pairs with incomplete data at follow up. 117 mother‐infant pairs available for drug use and caregiver outcomes, and 100 for all outcomes .Losses: 59/108 treatment group; 58/96 control group. Intention to treat: yes.
Participants	Inclusion criteria: delivery at one of two urban hospitals, maternal age 19‐40 years, maternal use of opiates and/or cocaine in pregnancy (self reported or positive toxicology of maternal urine in labour or infant urine). Exclusion criteria: adolescent and older mothers, infants < 35 weeks gestation, admitted to NICU > 24 hours, discharged directly to foster care, born to mothers with major psychiatric diagnosis.
Interventions	Treatment group (n = 59): 16 community pediatric nurse specialist home visits from birth to 18 months. Provided emotional support, modelled positive parent‐child interactions, provided health monitoring of infant and parent education, parental skills training, used Hawaii Early Learning Profile and Carolina Preschool Curriculum. Supervised by Pediatric nurse practitioner. Control group (n = 58): no home visits (standard care including outpatient follow up). Description of standard care not given. Co‐interventions: none reported.
Outcomes	Reported primary outcome(s): Child Behaviour Checklist at 36 months. Other outcomes: self reported continued postnatal drug and alcohol use, caregiver status at 36 months, reporting of incidents of child abuse or neglect, losses to follow up, Child Behaviour Checklist, Parenting Stress Index at 2 and 3 years.
Notes	Trial of postnatal home visits to 18 months by trained community pediatric health nurses for drug using mothers.
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Low risk	A ‐ Adequate

Dakof 2003

Methods	Randomised: yes, postpartum, used an 'urn randomisation procedure' which included variables modality of treatment referred to, age, HIV status and extent of child welfare system sanctions. Allocation concealment: yes. Blinded intervention: no. Blinded measurement: not reported. Losses to follow up: none reported. Intention to treat: yes.
Participants	'Black' mothers (95% African‐American) referred after childbirth by hospital or from Department of Children and Families after a child abuse/neglect report. Inclusion criteria: 'black', female, >= 18 years old, toxicology of mother or infant positive for cocaine. Exclusion criteria: none reported.
Interventions	Treatment Group: Engaging Mums Program (n = 51): a manualized home based goal orientated program administered by trained 'black' specialists with prior experience in drug treatment services available 24 hours per day. Intervention contacts included 1 to 4 individual, family or case management sessions per week of varying lengths (20 mins to one hour). The goal was to enroll the mother in intervention services within 8 weeks. Control group (n = 52): community services as usual. Minimum intervention in control included in‐home psychosocial evaluation, referral to a drug treatment program, follow up phone call within a day of scheduled initial treatment appointment and drug treatment program if entered into. Co‐interventions: all had been reported to the State Child Welfare Department prior to study and had a psychosocial evaluation, drug treatment referral and a follow up call within a day of initial drug treatment visit.
Outcomes	Primary outcomes: enrolment in treatment program, 4 weeks and 90 day retention in treatment.
Notes	Trial of postnatal and childhood short‐term home‐based intervention program administered by trained counselors with aim of engagement and retention in drug abuse treatment program.
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Low risk	A ‐ Adequate

Grant 1996

Methods	Randomised: yes, prepartum, method not reported. Allocation concealment: unclear. Blinded intervention: yo. Blinded measurement: not reported. Losses to follow up: yes, 18/66 = 27%. Losses: 12/35 treatment group; 6/31 control group. Intention to treat: yes.
Participants	Hospital referred first day postpartum. Inclusion criteria: singleton birth, self report of heavy drug and/or alcohol use in pregnancy. Recruited within one month of delivery. Not successfully engaged with community services. Minimal or no prenatal care.
Interventions	Home visit group (n = 35): The Seattle Birth to 3 years Program ‐ a 3 year home visiting advocacy program by paraprofessional advocates with many similar life experiences. Weekly home visits for 6 weeks, then twice monthly or more to 3 years. Linked clients with health care, parenting classes, therapeutic child care and substance abuse treatment programs. Clients not required to obtain drug/alcohol treatment. No specific developmental intervention, but developmental assessment performed in intervention group at 4 months, 2 and 3 years with discussion of progress with parents. Control group (n = 31): access to community social and health services but no home visits or advocacy. Children evaluated at 3 years only.
Outcomes	Primary outcomes: Bayley Scales of Infant Development at 3 years. Other outcomes: growth in height, weight and head circumference at 3 years.
Notes	Trial of postnatal paraprofessional home visits in drug using women.
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

Quinlivan 2000

Methods	Randomised: yes, computer generated, envelopes used. Allocation concealment: yes. Blinded intervention: no. Blinded measurement: not reported. Losses to follow up: yes, home visit group 3/65 and control group 9/71 for knowledge outcomes (neonatal and foster care outcomes reported for these infants). Only 1/65 in home visit group withdrew consent and outcome unknown. Intention to treat: yes.
Participants	Teenagers attending first antenatal clinic appointment at an Australian public care teenage pregnancy clinic. Inclusion criteria: < 18 years, ability to speak English, intention to continue with pregnancy. Exclusion criteria: lived over 150 km from hospital or known fetal abnormality. Rates of alcohol use up to beginning of pregnancy were 79% in home visit group and 69% in control group. Rates of illicit drug use at beginning of pregnancy were 61% in home visit group and 51% in control group.
Interventions	Home visits group (n = 65): structured postnatal home visits by nurse midwife at 1 and 2 weeks, 1, 2, 4 and 6 months. Visits lasted 1‐4 hours. Obstetrician phone advice available. Interventions included lactation and mothercraft education and advice, general and obstetric health surveillance, contraception and child health advice, provided information on drug and alcohol use and services, education on parenting skills and confirmed appointments for vaccinations. Control group (n = 71): no structured home visits by midwives. Co‐interventions: all participants provided routine postnatal support, counseling and information services including standard domiciliary home‐visit services.
Outcomes	Primary outcomes: adverse neonatal outcomes, knowledge about contraception, vaccination schedules and breastfeeding. Other outcomes: non‐voluntary foster care (up to 12 months), breastfeeding rates, contraception usage, and completed vaccination schedules.
Notes	Neonatal deaths at 13 and 17 days and 4 months not documented as having received home visits. Trial of postnatal home visits by nurse midwives in adolescent women with high rate of drug and/or alcohol use.
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Low risk	A ‐ Adequate

Schuler 2000

Methods	Randomised: yes, 2 weeks postpartum, method not reported. Allocation concealment: unclear. Blinded intervention: no. Blinded measurement: yes. Losses to follow up: yes, 258 enrolled, 227 randomised at 2 weeks, 53/227 lost after 2 week visit, 174 (77%) seen at 18 months but outcomes reported for 131 (58%). Bayley Scales at 18 months reported for 108/227 (48%). Losses for Bayley Scales at 18 months: 60/114 treatment group; 59/113 control group. Intention to treat: yes.
Participants	Inclusion criteria: teaching hospital Baltimore, largely African‐American women, with positive urine toxicology at birth or history of recent drug use. Enrolled postpartum. Exclusion criteria: infants not discharged in care of biological mother, infants with serious developmental or congenital problems requiring special services.
Interventions	Treatment group (n = 114): Infant Health and Development Program comprising of a home‐based intervention in first year, child attendance at a child‐development centre and parent group meetings from the 2nd year. Weekly home visits from birth to 6 months, then biweekly to 18 months by lay African American women. Home visits had goal of increasing maternal empowerment and enhancing mother's ability to manage self‐identified problems using existing services and supports. Child component included Hawaii Early Learning Program. Control group (n = 113): short monthly home‐tracking visits by one African‐American lay home visitor. Average of 7.7 visits per client with mean time 18.5 minutes. Co‐interventions: all mothers given information on drug treatment programs but participation not mandatory. Mothers paid for evaluation visit and given tokens to get home.
Outcomes	Reported primary outcome(s): at 18 months observed mother‐infant interaction using Child Abuse Potential Inventory and observed mother child interaction using videotaped observations. Bayley Scales of Infant Development at 18 months. Other outcomes: continued self reported drug and alcohol use.
Notes	Trial of postnatal home visits by lay African‐American women in women with a positive drug screen at delivery.
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear

NICU: neonatal intensive care unit

Characteristics of excluded studies [ordered by study ID]

Ir a:

estudios incluidos

Study	Reason for exclusion
Ammerman 2004	Observational study of breastfeeding. Drug and alcohol rates not reported.
Armstrong 1999	Randomised study of postnatal child health nurse and social work home visitation in high‐risk families including those using drugs or alcohol. Prevalence of drug and/or alcohol use not reported.
Barnes‐Boyd 1995	Non‐random control study of postpartum nurse home visiting for high‐risk mothers. Prevalence of drug and alcohol problems not reported.
Barnes‐Boyd 1996	Non‐random control study of postpartum nurse home visiting for high‐risk mothers. Prevalence of drug and alcohol problems not reported.
Belizan 1995	Enrolled high‐risk women with 30% incidence of daily alcohol drinking.
Black 1995	Randomised study of community based lay home visiting of families with infants with non‐organic failure to thrive.
Black 1997	Randomised trial of home‐based videotape intervention in adolescent mothers.
Black 2001	Report of a nested randomised trial, part of a larger trial in adolescent mothers, of a home‐based lay worker and videotape intervention.
Brayden 1993	Trial of hospital based intensive care for high‐risk women (low‐income and screening questionnaire). Prevalence of drug and alcohol use not reported.
Brooten 2001	Enrolled pregnant women at high obstetric (not social) risk. Not women with a drug or alcohol problem.
Brumfield 1996	Trial of early postpartum hospital discharge. Substance using women excluded.
Burry 1999	Nonrandom study of foster parent training.
Carroll 1995	Random study of enhanced hospital based prenatal care, relapse prevention groups, urine toxicology and therapeutic child care in substance using pregnant women. Not a study of home visits.
Chang 1992	Non‐random assignment to enhanced hospital based prenatal care, relapse prevention groups, urine toxicology and therapeutic child care during visits in substance using pregnant women.
Duggan 2000	Randomised trial of extended postnatal home visitation by paraprofession people to high‐risk families. Maternal substance use documented for 19%.
French 1998	Trial of postpartum in hospital teaching of infant comforting and interacting techniques to substance abusing mothers.
Giles 1989	Nonrandom study of a hospital outpatient methadone program.
Graham 1992	Did not report rates of drug or alcohol use. Enrolled antenatally on basis of being high‐risk including low family function rating and at least one stressful life event (not specified as drug or alcohol related).
Johnson 1993	Randomised trial of lay mother home visitation in first time mothers.
King 2001	Randomised trial of a single home visit incorporating an injury prevention package in families with children < 8 years age.
Kitzman 1997	Randomised trial of antenatal and postpartum nurse home visitation to high‐risk pregnant women. Low rate of reported drug or alcohol use in population.
Koniak‐Griffin 2000	Randomised trial of nurse home visitation during pregnancy and early postpartum in adolescent women. Women with a chemical dependency excluded. Low rates of alcohol and marijuana use at baseline.
Marcenko 1994	Randomised trial of antenatal and postpartum home visiting by a team (nurse, indigenous home visitor and social worker) for high psychosocial risk women. Reported incidence of drug use 15% in last month.
Morrell 2000	Randomised trial of midwifery support worker home visitation for postpartum women. Incidence of drug and alcohol use not reported.
Oettgen 2004	Non randomised study of home visits combined with a pediatric mobile clinic.
Olds 1986	Randomised trial of antenatal and postnatal nurse home visitation in high psychosocial risk women. Not selected on basis of drug or alcohol use.
Olds 2002	Randomised trial of antenatal and postpartum paraprofessional versus nurse home visitation versus control in women. Rate of reported drug or alcohol use approximately 20%.
Schuster 1998	Randomised trial of case manager (degrees in social sciences) home visiting for low‐income mothers and infants. Prevalence of drug and alcohol use not reported.
Seitz 2004	Randomised trial of home visits to young women between 15‐24 years with no history of substance use by trained volunteers.
Strantz 1995	Randomised trial of intensive day treatment versus traditional outpatient treatment for postpartum women. No home visitation.
Sundfaer 2001	Observational study.
Super 1990	Enrolled socially disadvantaged infants in Columbia. Rates of drug and alcohol use not reported.
Sweeney 2000	Non‐random study of outpatient substance abuse treatment for pregnant women.
Teague 1995	Trial of continuous treatment teams of patients with a dual diagnosis. Community based services a component of the treatment team approach. Not a study of home visits.
van Amerongen 1996	Observational study.

Data and analyses

Open in table viewer

Comparison 1. Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]
Open in figure viewer Analysis 1.1 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 1 Continued illicit drug use.
1.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 Intervention after delivery only	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]
1.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]
Open in figure viewer Analysis 1.2 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 2 Continued alcohol use.
2.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Intervention after delivery only	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]
2.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Failure to enrol in drug treatment program Show forest plot	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]
Open in figure viewer Analysis 1.3 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 3 Failure to enrol in drug treatment program.
3.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 Intervention after delivery only	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]
3.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Failure to remain in drug treatment at 4 weeks Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
Open in figure viewer Analysis 1.4 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 4 Failure to remain in drug treatment at 4 weeks.
4.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Intervention after delivery only	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
4.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Failure to remain in drug treatment at 90 days Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
Open in figure viewer Analysis 1.5 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 5 Failure to remain in drug treatment at 90 days.
5.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Intervention after delivery only	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
5.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Not breastfeeding at 6 months Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
Open in figure viewer Analysis 1.6 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 6 Not breastfeeding at 6 months.
6.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Intervention after delivery only	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
6.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Incomplete 6 month infant vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
Open in figure viewer Analysis 1.7 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 7 Incomplete 6 month infant vaccination schedule.
7.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Intervention after delivery only	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
7.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
Open in figure viewer Analysis 1.8 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 8 Failure to keep scheduled appointments (infant primary care).
8.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.2 Intervention after delivery only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.3 Intervention both during pregnancy and after delivery	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
9 Significant cognitive delay (Bayley MDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
Open in figure viewer Analysis 1.9 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 9 Significant cognitive delay (Bayley MDI >= 2sd below population mean).
9.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Intervention after delivery only	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
9.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
Open in figure viewer Analysis 1.10 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean).
10.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.2 Intervention after delivery only	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
10.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Cognitive development (Bayley MDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]
Open in figure viewer Analysis 1.11 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 11 Cognitive development (Bayley MDI) at latest time measured.
11.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.2 Intervention after delivery only	2	156	Mean Difference (IV, Fixed, 95% CI)	3.92 [‐0.56, 8.41]
11.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	‐1.80 [‐11.36, 7.76]
12 Psychomotor development (Bayley PDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]
Open in figure viewer Analysis 1.12 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 12 Psychomotor development (Bayley PDI) at latest time measured.
12.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.2 Intervention after delivery only	2	156	Mean Difference (IV, Fixed, 95% CI)	3.22 [‐0.01, 6.44]
12.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	0.70 [‐17.75, 19.15]
13 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
Open in figure viewer Analysis 1.13 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 13 Behavioural problems.
13.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Intervention after delivery only	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
13.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
Open in figure viewer Analysis 1.14 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 14 Child Behaviour Checklist total score.
14.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.2 Intervention after delivery only	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
14.3 Intervention both during pregnancy and after delivery	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Infant not in care of biological mother Show forest plot	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
Open in figure viewer Analysis 1.15 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 15 Infant not in care of biological mother.
15.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.2 Intervention after delivery only	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
15.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Child abuse or neglect: non‐accidental injury Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
Open in figure viewer Analysis 1.16 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 16 Child abuse or neglect: non‐accidental injury.
16.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.2 Intervention after delivery only	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
16.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
Open in figure viewer Analysis 1.17 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 17 Non‐accidental injury and non‐voluntary foster care.
17.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.2 Intervention after delivery only	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
17.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
Open in figure viewer Analysis 1.18 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 18 Involvement with child protective services.
18.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.2 Intervention after delivery only	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
18.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
19 Child abuse potential inventory (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
Open in figure viewer Analysis 1.19 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 19 Child abuse potential inventory (z score).
19.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.2 Intervention after delivery only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
20 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
Open in figure viewer Analysis 1.20 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 20 Child domain of parenting stress index at 18 months (z score).
20.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.2 Intervention after delivery only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
21 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
Open in figure viewer Analysis 1.21 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 21 HOME score.
21.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.2 Intervention after delivery only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
22 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]
Open in figure viewer Analysis 1.22 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 22 No use of postpartum contraception.
22.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.2 Intervention after delivery only	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]
22.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
23 Cognitive development (Bayley MDI) at latest time measured Show forest plot	1	108	Mean Difference (IV, Fixed, 95% CI)	4.42 [‐0.82, 9.65]
Open in figure viewer Analysis 1.23 Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 23 Cognitive development (Bayley MDI) at latest time measured.
23.4 Infants of mothers with no ongoing drug use (intervention after birth only)	1	36	Mean Difference (IV, Fixed, 95% CI)	13.0 [3.39, 22.61]
23.5 Infants of mothers with ongoing drug use (intervention after birth only)	1	72	Mean Difference (IV, Fixed, 95% CI)	0.80 [‐5.44, 7.04]

Open in table viewer

Comparison 2. Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]
Open in figure viewer Analysis 2.1 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 1 Continued illicit drug use.
1.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 Intervention > 6 months	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]
2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]
Open in figure viewer Analysis 2.2 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 2 Continued alcohol use.
2.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Intervention > 6 months	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]
3 Failure to enrol in drug treatment program Show forest plot	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]
Open in figure viewer Analysis 2.3 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 3 Failure to enrol in drug treatment program.
3.1 Intervention <= 6 months	1	103	Risk Ratio (M‐H, Random, 95% CI)	0.22 [0.10, 0.48]
3.2 Intervention > 6 months	1	108	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.63, 1.12]
4 Failure to remain in drug treatment at 4 weeks Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
Open in figure viewer Analysis 2.4 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 4 Failure to remain in drug treatment at 4 weeks.
4.1 Intervention <= 6 months	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
4.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Failure to remain in drug treatment at 90 days Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
Open in figure viewer Analysis 2.5 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 5 Failure to remain in drug treatment at 90 days.
5.1 Intervention <= 6 months	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
5.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Not breastfeeding at 6 months Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
Open in figure viewer Analysis 2.6 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 6 Not breastfeeding at 6 months.
6.1 Intervention <= 6 months	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
6.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Incomplete 6 month infant vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
Open in figure viewer Analysis 2.7 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 7 Incomplete 6 month infant vaccination schedule.
7.1 Intervention <= 6 months	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
7.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
Open in figure viewer Analysis 2.8 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 8 Failure to keep scheduled appointments (infant primary care).
8.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.2 Intervention > 6 months	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
9 Significant cognitive delay (Bayley MDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
Open in figure viewer Analysis 2.9 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 9 Significant cognitive delay (Bayley MDI >= 2sd below population mean).
9.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Intervention > 6 months	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
Open in figure viewer Analysis 2.10 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean).
10.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.2 Intervention > 6 months	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
11 Cognitive development (Bayley MDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]
Open in figure viewer Analysis 2.11 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 11 Cognitive development (Bayley MDI) at latest time measured.
11.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.2 Intervention > 6 months	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]
12 Psychomotor development (Bayley PDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]
Open in figure viewer Analysis 2.12 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 12 Psychomotor development (Bayley PDI) at latest time measured.
12.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.2 Intervention > 6 months	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]
13 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
Open in figure viewer Analysis 2.13 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 13 Behavioural problems.
13.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Intervention > 6 months	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
14 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
Open in figure viewer Analysis 2.14 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 14 Child Behaviour Checklist total score.
14.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.2 Intervention > 6 months	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
15 Infant not in care of biological mother Show forest plot	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
Open in figure viewer Analysis 2.15 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 15 Infant not in care of biological mother.
15.1 Intervention <= 6 months	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.18 [0.02, 1.47]
15.2 Intervention > 6 months	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.61, 1.77]
16 Child abuse or neglect: non‐accidental injury Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
Open in figure viewer Analysis 2.16 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 16 Child abuse or neglect: non‐accidental injury.
16.1 Intervention <= 6 months	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
16.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
Open in figure viewer Analysis 2.17 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 17 Non‐accidental injury and non‐voluntary foster care.
17.1 Intervention <= 6 months	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
17.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
Open in figure viewer Analysis 2.18 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 18 Involvement with child protective services.
18.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.2 Intervention > 6 months	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
19 Child abuse potential inventory (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
Open in figure viewer Analysis 2.19 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 19 Child abuse potential inventory (z score).
19.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.2 Intervention > 6 months	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
20 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
Open in figure viewer Analysis 2.20 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 20 Child domain of parenting stress index at 18 months (z score).
20.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.2 Intervention > 6 months	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
21 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
Open in figure viewer Analysis 2.21 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 21 HOME score.
21.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.2 Intervention > 6 months	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
22 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]
Open in figure viewer Analysis 2.22 Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 22 No use of postpartum contraception.
22.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.2 Intervention > 6 months	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]

Open in table viewer

Comparison 3. Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]
Open in figure viewer Analysis 3.1 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 1 Continued illicit drug use.
1.1 Intervention at least weekly	1	131	Risk Ratio (M‐H, Fixed, 95% CI)	1.20 [0.79, 1.85]
1.2 Intervention < weekly	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.61, 1.05]
2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]
Open in figure viewer Analysis 3.2 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 2 Continued alcohol use.
2.1 Intervention at least weekly	1	131	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.75, 1.35]
2.2 Intervention < weekly	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.26 [0.74, 2.13]
3 Failure to enrol in drug treatment program Show forest plot	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]
Open in figure viewer Analysis 3.3 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 3 Failure to enrol in drug treatment program.
3.1 Intervention at least weekly	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]
3.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Failure to remain in drug treatment at 4 weeks Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
Open in figure viewer Analysis 3.4 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 4 Failure to remain in drug treatment at 4 weeks.
4.1 Intervention at least weekly	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
4.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Failure to remain in drug treatment at 90 days Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
Open in figure viewer Analysis 3.5 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 5 Failure to remain in drug treatment at 90 days.
5.1 Intervention at least weekly	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
5.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Not breastfeeding at 6 months Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
Open in figure viewer Analysis 3.6 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 6 Not breastfeeding at 6 months.
6.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Intervention < weekly	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
7 Incomplete 6 month infant vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
Open in figure viewer Analysis 3.7 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 7 Incomplete 6 month infant vaccination schedule.
7.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Intervention < weekly	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
8 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
Open in figure viewer Analysis 3.8 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 8 Failure to keep scheduled appointments (infant primary care).
8.1 Intervention at least weekly	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
8.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Significant cognitive delay (Bayley MDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
Open in figure viewer Analysis 3.9 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 9 Significant cognitive delay (Bayley MDI >= 2sd below population mean).
9.1 Intervention at least weekly	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
9.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
Open in figure viewer Analysis 3.10 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean).
10.1 Intervention at least weekly	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
10.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Cognitive development (Bayley MDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]
Open in figure viewer Analysis 3.11 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 11 Cognitive development (Bayley MDI) at latest time measured.
11.1 Intervention at least weekly	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]
11.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Psychomotor development (Bayley PDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]
Open in figure viewer Analysis 3.12 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 12 Psychomotor development (Bayley PDI) at latest time measured.
12.1 Intervention at least weekly	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]
12.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
Open in figure viewer Analysis 3.13 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 13 Behavioural problems.
13.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Intervention < weekly	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
14 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
Open in figure viewer Analysis 3.14 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 14 Child Behaviour Checklist total score.
14.1 Intervention at least weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.2 Intervention < weekly	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
15 Infant not in care of biological mother Show forest plot	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
Open in figure viewer Analysis 3.15 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 15 Infant not in care of biological mother.
15.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.2 Intervention < weekly	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
16 Child abuse or neglect: non‐accidental injury Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
Open in figure viewer Analysis 3.16 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 16 Child abuse or neglect: non‐accidental injury.
16.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.2 Intervention < weekly	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
17 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
Open in figure viewer Analysis 3.17 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 17 Non‐accidental injury and non‐voluntary foster care.
17.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.2 Intervention < weekly	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
18 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
Open in figure viewer Analysis 3.18 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 18 Involvement with child protective services.
18.1 Intervention at least weekly	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
18.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
19 Child abuse potential inventory (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
Open in figure viewer Analysis 3.19 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 19 Child abuse potential inventory (z score).
19.1 Intervention at least weekly	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
19.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
Open in figure viewer Analysis 3.20 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 20 Child domain of parenting stress index at 18 months (z score).
20.1 Intervention at least weekly	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
20.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
Open in figure viewer Analysis 3.21 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 21 HOME score.
21.1 Intervention at least weekly	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
21.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
22 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]
Open in figure viewer Analysis 3.22 Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 22 No use of postpartum contraception.
22.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.2 Intervention < weekly	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]

Open in table viewer

Comparison 4. Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]
Open in figure viewer Analysis 4.1 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 1 Continued illicit drug use.
1.1 Intervention by nurse	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.61, 1.05]
1.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.4 Intervention by trained lay worker	1	131	Risk Ratio (M‐H, Fixed, 95% CI)	1.20 [0.79, 1.85]
1.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]
Open in figure viewer Analysis 4.2 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 2 Continued alcohol use.
2.1 Intervention by nurse	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.26 [0.74, 2.13]
2.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.4 Intervention by trained lay worker	1	131	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.75, 1.35]
2.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Failure to enrol in drug treatment program Show forest plot	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]
Open in figure viewer Analysis 4.3 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 3 Failure to enrol in drug treatment program.
3.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.3 Intervention by trained counsellor	1	103	Risk Ratio (M‐H, Random, 95% CI)	0.22 [0.10, 0.48]
3.4 Intervention by trained lay worker	1	108	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.63, 1.12]
3.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Failure to remain in drug treatment at 4 weeks Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
Open in figure viewer Analysis 4.4 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 4 Failure to remain in drug treatment at 4 weeks.
4.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Intervention by trained counsellor	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
4.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Failure to remain in drug treatment at 90 days Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
Open in figure viewer Analysis 4.5 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 5 Failure to remain in drug treatment at 90 days.
5.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Intervention by trained counsellor	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
5.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Not breastfeeding at 6 months Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
Open in figure viewer Analysis 4.6 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 6 Not breastfeeding at 6 months.
6.1 Intervention by nurse	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
6.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Incomplete 6 month infant vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
Open in figure viewer Analysis 4.7 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 7 Incomplete 6 month infant vaccination schedule.
7.1 Intervention by nurse	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
7.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
Open in figure viewer Analysis 4.8 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 8 Failure to keep scheduled appointments (infant primary care).
8.1 Intervention by nurse	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
8.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Significant cognitive delay (Bayley MDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
Open in figure viewer Analysis 4.9 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 9 Significant cognitive delay (Bayley MDI >= 2sd below population mean).
9.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.4 Intervention by trained lay worker	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
9.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
Open in figure viewer Analysis 4.10 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean).
10.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.4 Intervention by trained lay worker	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
10.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Cognitive development (Bayley MDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]
Open in figure viewer Analysis 4.11 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 11 Cognitive development (Bayley MDI) at latest time measured.
11.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	‐1.80 [‐11.36, 7.76]
11.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.4 Intervention by trained lay worker	2	156	Mean Difference (IV, Fixed, 95% CI)	3.92 [‐0.56, 8.41]
11.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Psychomotor development (Bayley PDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]
Open in figure viewer Analysis 4.12 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 12 Psychomotor development (Bayley PDI) at latest time measured.
12.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	0.70 [‐17.75, 19.15]
12.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.4 Intervention by trained lay worker	2	156	Mean Difference (IV, Fixed, 95% CI)	3.22 [‐0.01, 6.44]
12.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
Open in figure viewer Analysis 4.13 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 13 Behavioural problems.
13.1 Intervention by nurse	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
13.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
Open in figure viewer Analysis 4.14 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 14 Child Behaviour Checklist total score.
14.1 Intervention by nurse	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
14.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.4 Intervention by trained lay worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Infant not in care of biological mother Show forest plot	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
Open in figure viewer Analysis 4.15 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 15 Infant not in care of biological mother.
15.1 Intervention by nurse	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
15.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Child abuse or neglect: non‐accidental injury Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
Open in figure viewer Analysis 4.16 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 16 Child abuse or neglect: non‐accidental injury.
16.1 Intervention by nurse	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
16.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
Open in figure viewer Analysis 4.17 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 17 Non‐accidental injury and non‐voluntary foster care.
17.1 Intervention by nurse	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
17.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.3 ntervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
Open in figure viewer Analysis 4.18 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 18 Involvement with child protective services.
18.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.4 Intervention by trained lay worker	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
18.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
19 Child abuse potential inventory (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
Open in figure viewer Analysis 4.19 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 19 Child abuse potential inventory (z score).
19.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
19.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.4 Intervention by trained lay worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
Open in figure viewer Analysis 4.20 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 20 Child domain of parenting stress index at 18 months (z score).
20.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
20.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.4 Intervention by trained lay worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
Open in figure viewer Analysis 4.21 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 21 HOME score.
21.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
21.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.4 Intervention by trained lay worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
22 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]
Open in figure viewer Analysis 4.22 Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 22 No use of postpartum contraception.
22.1 Intervention by nurse	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]
22.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Open in table viewer

Comparison 5. Home visits for pregnant substance or alcohol using women (studies with a developmental intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]
Open in figure viewer Analysis 5.1 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 1 Continued illicit drug use.
2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]
Open in figure viewer Analysis 5.2 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 2 Continued alcohol use.
3 Failure to enrol in drug treatment program Show forest plot	1	108	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.63, 1.12]
Open in figure viewer Analysis 5.3 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 3 Failure to enrol in drug treatment program.
4 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
Open in figure viewer Analysis 5.4 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 4 Failure to keep scheduled appointments (infant primary care).
5 Cognitive development at latest time measured (Bayley MDI) Show forest plot	2	151	Mean Difference (IV, Fixed, 95% CI)	3.13 [‐1.46, 7.72]
Open in figure viewer Analysis 5.5 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 5 Cognitive development at latest time measured (Bayley MDI).
6 Psychomotor development at latest time measured (Bayley PDI) Show forest plot	2	151	Mean Difference (IV, Fixed, 95% CI)	4.14 [0.79, 7.50]
Open in figure viewer Analysis 5.6 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 6 Psychomotor development at latest time measured (Bayley PDI).
7 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
Open in figure viewer Analysis 5.7 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 7 Behavioural problems.
8 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
Open in figure viewer Analysis 5.8 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 8 Child Behaviour Checklist total score.
9 Infant not in care of biological mother Show forest plot	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.61, 1.77]
Open in figure viewer Analysis 5.9 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 9 Infant not in care of biological mother.
10 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
Open in figure viewer Analysis 5.10 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 10 Involvement with child protective services.
11 Child abuse potential inventory (z score) Show forest plot	1	43	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.73 [‐1.35, ‐0.11]
Open in figure viewer Analysis 5.11 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 11 Child abuse potential inventory (z score).
12 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
Open in figure viewer Analysis 5.12 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 12 Child domain of parenting stress index at 18 months (z score).
13 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
Open in figure viewer Analysis 5.13 Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 13 HOME score.

Open in table viewer

Comparison 6. Home visits for pregnant substance or alcohol using women (studies of good methodology)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Failure to enrol in drug treatment program Show forest plot	1	103	Risk Ratio (M‐H, Random, 95% CI)	0.22 [0.10, 0.48]
Open in figure viewer Analysis 6.1 Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 1 Failure to enrol in drug treatment program.
2 Failure to remain in drug treatment Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 6.2 Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 2 Failure to remain in drug treatment.
2.1 At 4 weeks	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
2.2 At 90 days	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
3 Failed to maintain feeding regime Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
Open in figure viewer Analysis 6.3 Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 3 Failed to maintain feeding regime.
3.1 Not breastfeeding at 6 months	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
4 Incomplete vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
Open in figure viewer Analysis 6.4 Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 4 Incomplete vaccination schedule.
4.1 Incomplete 6 month infant vaccination schedule	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
5 Infant not in care of biological mother Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.18 [0.02, 1.47]
Open in figure viewer Analysis 6.5 Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 5 Infant not in care of biological mother.
6 Child abuse or neglect Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
Open in figure viewer Analysis 6.6 Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 6 Child abuse or neglect.
6.1 Non‐accidental injury	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
7 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
Open in figure viewer Analysis 6.7 Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 7 Non‐accidental injury and non‐voluntary foster care.
8 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]
Open in figure viewer Analysis 6.8 Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 8 No use of postpartum contraception.

Analysis 1.1

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 1 Continued illicit drug use.

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Analysis 1.2

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 2 Continued alcohol use.

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Analysis 1.3

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 3 Failure to enrol in drug treatment program.

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Analysis 1.4

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 4 Failure to remain in drug treatment at 4 weeks.

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Analysis 1.5

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 5 Failure to remain in drug treatment at 90 days.

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Analysis 1.6

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 6 Not breastfeeding at 6 months.

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Analysis 1.7

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 7 Incomplete 6 month infant vaccination schedule.

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Analysis 1.8

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 8 Failure to keep scheduled appointments (infant primary care).

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Analysis 1.9

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 9 Significant cognitive delay (Bayley MDI >= 2sd below population mean).

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Analysis 1.10

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean).

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Analysis 1.11

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 11 Cognitive development (Bayley MDI) at latest time measured.

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Analysis 1.12

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 12 Psychomotor development (Bayley PDI) at latest time measured.

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Analysis 1.13

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 13 Behavioural problems.

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Analysis 1.14

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 14 Child Behaviour Checklist total score.

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Analysis 1.15

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 15 Infant not in care of biological mother.

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Analysis 1.16

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 16 Child abuse or neglect: non‐accidental injury.

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Analysis 1.17

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 17 Non‐accidental injury and non‐voluntary foster care.

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Analysis 1.18

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 18 Involvement with child protective services.

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Analysis 1.19

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 19 Child abuse potential inventory (z score).

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Analysis 1.20

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 20 Child domain of parenting stress index at 18 months (z score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.21

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 21 HOME score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.22

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 22 No use of postpartum contraception.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.23

Comparison 1 Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention), Outcome 23 Cognitive development (Bayley MDI) at latest time measured.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 1 Continued illicit drug use.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 2 Continued alcohol use.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 3 Failure to enrol in drug treatment program.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.4

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 4 Failure to remain in drug treatment at 4 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.5

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 5 Failure to remain in drug treatment at 90 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.6

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 6 Not breastfeeding at 6 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.7

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 7 Incomplete 6 month infant vaccination schedule.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.8

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 8 Failure to keep scheduled appointments (infant primary care).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.9

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 9 Significant cognitive delay (Bayley MDI >= 2sd below population mean).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.10

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.11

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 11 Cognitive development (Bayley MDI) at latest time measured.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.12

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 12 Psychomotor development (Bayley PDI) at latest time measured.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.13

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 13 Behavioural problems.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.14

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 14 Child Behaviour Checklist total score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.15

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 15 Infant not in care of biological mother.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.16

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 16 Child abuse or neglect: non‐accidental injury.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.17

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 17 Non‐accidental injury and non‐voluntary foster care.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.18

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 18 Involvement with child protective services.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.19

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 19 Child abuse potential inventory (z score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.20

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 20 Child domain of parenting stress index at 18 months (z score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.21

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 21 HOME score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.22

Comparison 2 Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention), Outcome 22 No use of postpartum contraception.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 1 Continued illicit drug use.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 2 Continued alcohol use.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.3

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 3 Failure to enrol in drug treatment program.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.4

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 4 Failure to remain in drug treatment at 4 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.5

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 5 Failure to remain in drug treatment at 90 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.6

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 6 Not breastfeeding at 6 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.7

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 7 Incomplete 6 month infant vaccination schedule.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.8

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 8 Failure to keep scheduled appointments (infant primary care).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.9

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 9 Significant cognitive delay (Bayley MDI >= 2sd below population mean).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.10

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.11

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 11 Cognitive development (Bayley MDI) at latest time measured.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.12

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 12 Psychomotor development (Bayley PDI) at latest time measured.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.13

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 13 Behavioural problems.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.14

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 14 Child Behaviour Checklist total score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.15

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 15 Infant not in care of biological mother.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.16

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 16 Child abuse or neglect: non‐accidental injury.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.17

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 17 Non‐accidental injury and non‐voluntary foster care.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.18

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 18 Involvement with child protective services.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.19

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 19 Child abuse potential inventory (z score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.20

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 20 Child domain of parenting stress index at 18 months (z score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.21

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 21 HOME score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.22

Comparison 3 Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention), Outcome 22 No use of postpartum contraception.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.1

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 1 Continued illicit drug use.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.2

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 2 Continued alcohol use.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.3

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 3 Failure to enrol in drug treatment program.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.4

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 4 Failure to remain in drug treatment at 4 weeks.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.5

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 5 Failure to remain in drug treatment at 90 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.6

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 6 Not breastfeeding at 6 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.7

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 7 Incomplete 6 month infant vaccination schedule.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.8

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 8 Failure to keep scheduled appointments (infant primary care).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.9

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 9 Significant cognitive delay (Bayley MDI >= 2sd below population mean).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.10

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.11

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 11 Cognitive development (Bayley MDI) at latest time measured.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.12

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 12 Psychomotor development (Bayley PDI) at latest time measured.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.13

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 13 Behavioural problems.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.14

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 14 Child Behaviour Checklist total score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.15

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 15 Infant not in care of biological mother.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.16

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 16 Child abuse or neglect: non‐accidental injury.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.17

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 17 Non‐accidental injury and non‐voluntary foster care.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.18

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 18 Involvement with child protective services.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.19

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 19 Child abuse potential inventory (z score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.20

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 20 Child domain of parenting stress index at 18 months (z score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.21

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 21 HOME score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.22

Comparison 4 Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor), Outcome 22 No use of postpartum contraception.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.1

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 1 Continued illicit drug use.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.2

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 2 Continued alcohol use.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.3

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 3 Failure to enrol in drug treatment program.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.4

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 4 Failure to keep scheduled appointments (infant primary care).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.5

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 5 Cognitive development at latest time measured (Bayley MDI).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.6

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 6 Psychomotor development at latest time measured (Bayley PDI).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.7

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 7 Behavioural problems.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.8

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 8 Child Behaviour Checklist total score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.9

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 9 Infant not in care of biological mother.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.10

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 10 Involvement with child protective services.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.11

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 11 Child abuse potential inventory (z score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.12

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 12 Child domain of parenting stress index at 18 months (z score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.13

Comparison 5 Home visits for pregnant substance or alcohol using women (studies with a developmental intervention), Outcome 13 HOME score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.1

Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 1 Failure to enrol in drug treatment program.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.2

Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 2 Failure to remain in drug treatment.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.3

Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 3 Failed to maintain feeding regime.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.4

Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 4 Incomplete vaccination schedule.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.5

Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 5 Infant not in care of biological mother.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.6

Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 6 Child abuse or neglect.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.7

Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 7 Non‐accidental injury and non‐voluntary foster care.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.8

Comparison 6 Home visits for pregnant substance or alcohol using women (studies of good methodology), Outcome 8 No use of postpartum contraception.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1. Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]

1.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 Intervention after delivery only	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]
1.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]

2.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Intervention after delivery only	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]
2.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Failure to enrol in drug treatment program Show forest plot	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]

3.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 Intervention after delivery only	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]
3.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Failure to remain in drug treatment at 4 weeks Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]

4.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Intervention after delivery only	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
4.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Failure to remain in drug treatment at 90 days Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]

5.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Intervention after delivery only	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
5.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Not breastfeeding at 6 months Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]

6.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Intervention after delivery only	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
6.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Incomplete 6 month infant vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]

7.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Intervention after delivery only	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
7.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]

8.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.2 Intervention after delivery only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.3 Intervention both during pregnancy and after delivery	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
9 Significant cognitive delay (Bayley MDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]

9.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Intervention after delivery only	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
9.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]

10.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.2 Intervention after delivery only	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
10.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Cognitive development (Bayley MDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]

11.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.2 Intervention after delivery only	2	156	Mean Difference (IV, Fixed, 95% CI)	3.92 [‐0.56, 8.41]
11.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	‐1.80 [‐11.36, 7.76]
12 Psychomotor development (Bayley PDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]

12.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.2 Intervention after delivery only	2	156	Mean Difference (IV, Fixed, 95% CI)	3.22 [‐0.01, 6.44]
12.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	0.70 [‐17.75, 19.15]
13 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]

13.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Intervention after delivery only	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
13.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]

14.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.2 Intervention after delivery only	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
14.3 Intervention both during pregnancy and after delivery	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Infant not in care of biological mother Show forest plot	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]

15.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.2 Intervention after delivery only	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
15.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Child abuse or neglect: non‐accidental injury Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]

16.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.2 Intervention after delivery only	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
16.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]

17.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.2 Intervention after delivery only	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
17.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]

18.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.2 Intervention after delivery only	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
18.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
19 Child abuse potential inventory (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]

19.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.2 Intervention after delivery only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
20 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]

20.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.2 Intervention after delivery only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
21 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]

21.1 Intervention during pregnancy only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.2 Intervention after delivery only	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.3 Intervention both during pregnancy and after delivery	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
22 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]

22.1 Intervention during pregnancy only	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.2 Intervention after delivery only	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]
22.3 Intervention both during pregnancy and after delivery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
23 Cognitive development (Bayley MDI) at latest time measured Show forest plot	1	108	Mean Difference (IV, Fixed, 95% CI)	4.42 [‐0.82, 9.65]

23.4 Infants of mothers with no ongoing drug use (intervention after birth only)	1	36	Mean Difference (IV, Fixed, 95% CI)	13.0 [3.39, 22.61]
23.5 Infants of mothers with ongoing drug use (intervention after birth only)	1	72	Mean Difference (IV, Fixed, 95% CI)	0.80 [‐5.44, 7.04]

Comparison 1. Home visits versus no home visits during pregnancy or after delivery (subgroups by timing of intervention)

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Comparison 2. Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]

1.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 Intervention > 6 months	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]
2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]

2.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Intervention > 6 months	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]
3 Failure to enrol in drug treatment program Show forest plot	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]

3.1 Intervention <= 6 months	1	103	Risk Ratio (M‐H, Random, 95% CI)	0.22 [0.10, 0.48]
3.2 Intervention > 6 months	1	108	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.63, 1.12]
4 Failure to remain in drug treatment at 4 weeks Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]

4.1 Intervention <= 6 months	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
4.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Failure to remain in drug treatment at 90 days Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]

5.1 Intervention <= 6 months	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
5.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Not breastfeeding at 6 months Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]

6.1 Intervention <= 6 months	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
6.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Incomplete 6 month infant vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]

7.1 Intervention <= 6 months	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
7.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]

8.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.2 Intervention > 6 months	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
9 Significant cognitive delay (Bayley MDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]

9.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Intervention > 6 months	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]

10.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.2 Intervention > 6 months	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
11 Cognitive development (Bayley MDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]

11.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.2 Intervention > 6 months	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]
12 Psychomotor development (Bayley PDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]

12.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.2 Intervention > 6 months	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]
13 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]

13.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Intervention > 6 months	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
14 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]

14.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.2 Intervention > 6 months	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
15 Infant not in care of biological mother Show forest plot	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]

15.1 Intervention <= 6 months	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.18 [0.02, 1.47]
15.2 Intervention > 6 months	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.61, 1.77]
16 Child abuse or neglect: non‐accidental injury Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]

16.1 Intervention <= 6 months	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
16.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]

17.1 Intervention <= 6 months	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
17.2 Intervention > 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]

18.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.2 Intervention > 6 months	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
19 Child abuse potential inventory (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]

19.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.2 Intervention > 6 months	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
20 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]

20.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.2 Intervention > 6 months	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
21 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]

21.1 Intervention <= 6 months	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.2 Intervention > 6 months	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
22 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]

22.1 Intervention <= 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.2 Intervention > 6 months	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]

Comparison 2. Home visits versus no home visits during pregnancy or after delivery (subgroups by duration of intervention)

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Comparison 3. Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]

1.1 Intervention at least weekly	1	131	Risk Ratio (M‐H, Fixed, 95% CI)	1.20 [0.79, 1.85]
1.2 Intervention < weekly	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.61, 1.05]
2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]

2.1 Intervention at least weekly	1	131	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.75, 1.35]
2.2 Intervention < weekly	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.26 [0.74, 2.13]
3 Failure to enrol in drug treatment program Show forest plot	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]

3.1 Intervention at least weekly	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]
3.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Failure to remain in drug treatment at 4 weeks Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]

4.1 Intervention at least weekly	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
4.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Failure to remain in drug treatment at 90 days Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]

5.1 Intervention at least weekly	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
5.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Not breastfeeding at 6 months Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]

6.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Intervention < weekly	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
7 Incomplete 6 month infant vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]

7.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Intervention < weekly	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
8 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]

8.1 Intervention at least weekly	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
8.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Significant cognitive delay (Bayley MDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]

9.1 Intervention at least weekly	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
9.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]

10.1 Intervention at least weekly	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
10.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Cognitive development (Bayley MDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]

11.1 Intervention at least weekly	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]
11.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Psychomotor development (Bayley PDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]

12.1 Intervention at least weekly	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]
12.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]

13.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Intervention < weekly	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
14 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]

14.1 Intervention at least weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.2 Intervention < weekly	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
15 Infant not in care of biological mother Show forest plot	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]

15.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.2 Intervention < weekly	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
16 Child abuse or neglect: non‐accidental injury Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]

16.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.2 Intervention < weekly	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
17 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]

17.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.2 Intervention < weekly	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
18 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]

18.1 Intervention at least weekly	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
18.2 Intervention < weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
19 Child abuse potential inventory (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]

19.1 Intervention at least weekly	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
19.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]

20.1 Intervention at least weekly	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
20.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]

21.1 Intervention at least weekly	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
21.2 Intervention < weekly	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
22 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]

22.1 Intervention at least weekly	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.2 Intervention < weekly	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]

Comparison 3. Home visits versus no home visits during pregnancy or after delivery (subgroups by frequency of intervention)

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Comparison 4. Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]

1.1 Intervention by nurse	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.61, 1.05]
1.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.4 Intervention by trained lay worker	1	131	Risk Ratio (M‐H, Fixed, 95% CI)	1.20 [0.79, 1.85]
1.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]

2.1 Intervention by nurse	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.26 [0.74, 2.13]
2.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.4 Intervention by trained lay worker	1	131	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.75, 1.35]
2.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Failure to enrol in drug treatment program Show forest plot	2	211	Risk Ratio (M‐H, Random, 95% CI)	0.45 [0.10, 1.94]

3.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.3 Intervention by trained counsellor	1	103	Risk Ratio (M‐H, Random, 95% CI)	0.22 [0.10, 0.48]
3.4 Intervention by trained lay worker	1	108	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.63, 1.12]
3.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Failure to remain in drug treatment at 4 weeks Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]

4.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Intervention by trained counsellor	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
4.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Failure to remain in drug treatment at 90 days Show forest plot	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]

5.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Intervention by trained counsellor	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
5.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Not breastfeeding at 6 months Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]

6.1 Intervention by nurse	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
6.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Incomplete 6 month infant vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]

7.1 Intervention by nurse	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
7.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]

8.1 Intervention by nurse	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]
8.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Significant cognitive delay (Bayley MDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]

9.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.4 Intervention by trained lay worker	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	1.36 [0.41, 4.45]
9.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Significant psychomotor delay (Bayley PDI >= 2sd below population mean) Show forest plot	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]

10.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.4 Intervention by trained lay worker	1	48	Risk Ratio (M‐H, Fixed, 95% CI)	3.26 [1.00, 10.59]
10.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Cognitive development (Bayley MDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	2.89 [‐1.17, 6.95]

11.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	‐1.80 [‐11.36, 7.76]
11.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.4 Intervention by trained lay worker	2	156	Mean Difference (IV, Fixed, 95% CI)	3.92 [‐0.56, 8.41]
11.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Psychomotor development (Bayley PDI) at latest time measured Show forest plot	3	199	Mean Difference (IV, Fixed, 95% CI)	3.14 [‐0.03, 6.32]

12.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	0.70 [‐17.75, 19.15]
12.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.4 Intervention by trained lay worker	2	156	Mean Difference (IV, Fixed, 95% CI)	3.22 [‐0.01, 6.44]
12.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]

13.1 Intervention by nurse	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]
13.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]

14.1 Intervention by nurse	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]
14.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.4 Intervention by trained lay worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Infant not in care of biological mother Show forest plot	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]

15.1 Intervention by nurse	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.39]
15.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Child abuse or neglect: non‐accidental injury Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]

16.1 Intervention by nurse	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
16.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]

17.1 Intervention by nurse	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]
17.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.3 ntervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]

18.1 Intervention by nurse	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.4 Intervention by trained lay worker	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]
18.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
19 Child abuse potential inventory (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]

19.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐1.61, ‐0.19]
19.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.4 Intervention by trained lay worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]

20.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]
20.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.4 Intervention by trained lay worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]

21.1 Intervention by nurse	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]
21.2 Intervention by trained social worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.3 Intervention by trained counsellor	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.4 Intervention by trained lay worker	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.5 Intervention by multidisciplinary team	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
22 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]

22.1 Intervention by nurse	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]
22.2 Intervention by trained social worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.3 Intervention by trained counsellor	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.4 Intervention by trained lay worker	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.5 Intervention by multidisciplinary team	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. Home visits versus no home visits during pregnancy or after delivery (subgroups by home visitor)

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Comparison 5. Home visits for pregnant substance or alcohol using women (studies with a developmental intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Continued illicit drug use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.75, 1.20]

2 Continued alcohol use Show forest plot	2	248	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.83, 1.41]

3 Failure to enrol in drug treatment program Show forest plot	1	108	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.63, 1.12]

4 Failure to keep scheduled appointments (infant primary care) Show forest plot	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.66]

5 Cognitive development at latest time measured (Bayley MDI) Show forest plot	2	151	Mean Difference (IV, Fixed, 95% CI)	3.13 [‐1.46, 7.72]

6 Psychomotor development at latest time measured (Bayley PDI) Show forest plot	2	151	Mean Difference (IV, Fixed, 95% CI)	4.14 [0.79, 7.50]

7 Behavioural problems Show forest plot	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.21, 1.01]

8 Child Behaviour Checklist total score Show forest plot	1	100	Mean Difference (IV, Fixed, 95% CI)	‐3.10 [‐7.26, 1.06]

9 Infant not in care of biological mother Show forest plot	1	117	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.61, 1.77]

10 Involvement with child protective services Show forest plot	1	171	Risk Ratio (M‐H, Fixed, 95% CI)	0.38 [0.20, 0.74]

11 Child abuse potential inventory (z score) Show forest plot	1	43	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.73 [‐1.35, ‐0.11]

12 Child domain of parenting stress index at 18 months (z score) Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐0.78, ‐0.22]

13 HOME score Show forest plot	1	43	Mean Difference (IV, Fixed, 95% CI)	3.70 [‐0.06, 7.46]

Comparison 5. Home visits for pregnant substance or alcohol using women (studies with a developmental intervention)

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Comparison 6. Home visits for pregnant substance or alcohol using women (studies of good methodology)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Failure to enrol in drug treatment program Show forest plot	1	103	Risk Ratio (M‐H, Random, 95% CI)	0.22 [0.10, 0.48]

2 Failure to remain in drug treatment Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

2.1 At 4 weeks	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.35, 0.84]
2.2 At 90 days	1	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.69, 1.25]
3 Failed to maintain feeding regime Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]

3.1 Not breastfeeding at 6 months	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.81, 1.23]
4 Incomplete vaccination schedule Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]

4.1 Incomplete 6 month infant vaccination schedule	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.58, 1.96]
5 Infant not in care of biological mother Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.18 [0.02, 1.47]

6 Child abuse or neglect Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]

6.1 Non‐accidental injury	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.36 [0.02, 8.77]
7 Non‐accidental injury and non‐voluntary foster care Show forest plot	1	136	Risk Ratio (M‐H, Fixed, 95% CI)	0.16 [0.02, 1.23]

8 No use of postpartum contraception Show forest plot	1	124	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.20, 0.82]

Comparison 6. Home visits for pregnant substance or alcohol using women (studies of good methodology)

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Referencias

Referencias de los estudios incluidos en esta revisión

Black 1994 {published data only}

Butz 1998 {published data only}

Dakof 2003 {published data only}

Grant 1996 {published data only}

Quinlivan 2000 {published data only}

Schuler 2000 {published data only}

Referencias de los estudios excluidos de esta revisión

Ammerman 2004 {published data only}

Armstrong 1999 {published data only}

Barnes‐Boyd 1995 {published data only}

Barnes‐Boyd 1996 {published data only}

Belizan 1995 {published data only}

Black 1995 {published data only}

Black 1997 {published data only}

Black 2001 {published data only}

Brayden 1993 {published data only}

Brooten 2001 {published data only}

Brumfield 1996 {published data only}

Burry 1999 {published data only}

Carroll 1995 {published data only}

Chang 1992 {published data only}

Duggan 2000 {published data only}

French 1998 {published data only}

Giles 1989 {published data only}

Graham 1992 {published data only}

Johnson 1993 {published data only}

King 2001 {published data only}

Kitzman 1997 {published data only}

Koniak‐Griffin 2000 {published data only}

Marcenko 1994 {published data only}

Morrell 2000 {published data only}

Oettgen 2004 {published data only}

Olds 1986 {published data only}

Olds 2002 {published data only}

Schuster 1998 {published data only}

Seitz 2004 {published data only}

Strantz 1995 {published data only}

Sundfaer 2001 {published data only}

Super 1990 {published data only}

Sweeney 2000 {published data only}

Teague 1995 {published data only}

van Amerongen 1996 {published data only}

Referencias de los estudios en espera de evaluación

Bartu 2001 {published data only}

Hankin {published data only}

Referencias adicionales

AAP 2000

Belcher 1999

Besinger 1999

Clarke 2003

Coren 2001

Eckenrode 2000

Eriksson 2000

Faden 2000

Fares 1997

Frank 2001

Gomby 2000

Higgins 2000

Hulse 1997a

Hulse 1997b

Hulse 1997c

Hulse 1998a

Hulse 1998b

Jacobson 2002

Jaudes 1997

Kandall 1993

Kearney 2000

Kendrick 2000

Lutiger 1991

McNaughton 2004

Nair 1997

NHSDA 2000

Osborn 2005a

Osborn 2005b

Persily 2003

RCOG 1999