An innovative postnatal risk assessment and corresponding care pathways in Preventive Child Healthcare.
Minke R C Van Minde, Jacqueline Lagendijk, Hein Raat and 2 others
PMID 34590735WHAT IT FOUND
Catch-up growth was lower, 14.9% versus 19.5% in historical controls, when well-baby nurses and physicians used a postnatal risk assessment plus care pathways.
Professionals found it manageable but not clearly easier.
Key findings
01Catch-up growth was 14.9% in the intervention cohort and 19.5% in the historical cohort.
02After matching for nationality and postal code, the odds of catch-up growth were 0.957 (0.938 to 0.976) in the intervention cohort compared with the historical cohort.
03Among 74 PCHC professionals, 47.3% found the postnatal R4 U easy to work with, 43.2% disagreed that it made certain topics easier to address to parents, and 50% disagreed that it made referral to other healthcare professionals easier.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The comparison was with historical controls from earlier years, not a concurrent randomised group, so changes in care, awareness, or infant formula over time could affect the result. The intervention cohort included 3,210 children, but 1,953 remained for analysis, below the 3,120 children planned after loss to follow-up. The 41-item postnatal R4 U and the tailored care pathways were given together, so the contribution of any single component cannot be separated. Many maternal and birth variables were missing in the historical cohort, so some baseline differences could not be fully checked. The professional questionnaire was newly developed and not psychometrically tested.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not conclude that the postnatal R4 U alone caused the lower catch-up growth. It was implemented together with tailored care pathways, and the comparison was with historical controls rather than a concurrent randomised group, so changes over time could also explain the difference.