Impacts of the Healthy Families, Healthy Babies (HFHB) Targeted Prenatal Program on Pregnancy, Birth and Early Life Nutritional and Developmental Outcomes in New Brunswick
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Date
2025-06-11
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Publisher
New Brunswick Institute for Research, Data and Training
Abstract
The perinatal period is a critical time in life. Experiences and exposures during pregnancy and in the first years after birth are found to have far-reaching implications for early childhood development and health over the life course.
To support healthy pregnancies and childhood development, targeted public health programs are available, with families enrolled prenatally or postnatally and followed throughout pregnancy and the first years of the child’s life. Typically, these programs are offered to families having a baby for the first time who are at high risk of poorer outcomes as a strategy to mitigate negative impacts from poverty and early childhood adversity.
Each Canadian province and territory offer a targeted public health perinatal program, with several programs currently undergoing program review. Yet, limited research evidence is available to inform these efforts. Targeted public health perinatal programs are shown to have benefits for program participants and service providers; however, their longer-term impacts have not been properly evaluated among Canadian populations.
In the province of New Brunswick (NB), the Healthy Families, Healthy Babies (HFHB) public health program provides targeted services to first-time families at higher risk of poor outcomes, with prenatal home visits provided until birth and postnatal program services from birth to the age of two. Most prenatal visits are provided by Public Health dietitians, and most postnatal visits and services are provided by Public Health nurses. The New Brunswick Institute for Research, Data and Training (NB-IRDT) has been supporting a review of the HFHB program, with a previous study on the early life impacts of the targeted HFHB postnatal program component.
The overall goal of this study is to evaluate the early life impacts of the targeted HFHB prenatal program component, with a specific focus on pregnancy, birth and early childhood nutritional and developmental outcomes. Overall, the results of this research will contribute to the ongoing program review of the HFHB program in NB.
A matched retrospective cohort study of all live births in NB, Canada, between April 1, 2012, and March 31, 2020, among individuals parenting for the first-time was developed using population-based administrative data accessible at NB-IRDT. Several linkable administrative data sets were used to define the study cohort, HFHB prenatal program participation, pregnancy, birth and early childhood nutritional and developmental outcomes, as well as a number of confounding variables.
A propensity score matching (PSM) methodology was used to select a matched group of families that did not participate in the targeted HFHB program who were similar to those who participated. Multivariable regression models were used to provide statistically adjusted estimates of the differences in outcomes between groups while accounting for relevant confounding variables.
A birth cohort of 20 832 individuals parenting for the first time was established and followed longitudinally from birth to 18 months; 2000 participated in the HFHB prenatal home visiting program, and 2000 non-participating families were matched to HFHB prenatal program participants.