388 - Dyadic care to improve postnatal outcomes of birthing people and their infants: A scoping review
Sunday, April 27, 2025
8:30am – 10:45am HST
Publication Number: 388.4874
Julia Rosenberg, Yale University, New Haven, CT, United States; Josefa L. Martinez-Brockman, Yale School of Medicine, New Haven, CT, United States; Courtney Choy, Yale School of Public Health, New Haven, CT, United States; Alyssa A. Grimshaw, Yale University, New Haven, CT, United States; Molly McAdow, Yale School of Medicine, New Haven, CT, United States
Assistant Professor of Pediatrics Yale University New Haven, Connecticut, United States
Background: Provision of dyadic care--where the birthing person and infant receive care together--may improve disparities in postnatal morbidity and mortality. The breadth of existing models of dyadic care and evaluations has not been synthesized. Objective: To summarize models of dyadic care globally; identify measures of maternal, infant, and dyadic health; and describe research and practice gaps related to dyadic care to reduce disparities in postnatal morbidity, mortality, and wellbeing. Design/Methods: Our interdisciplinary team (pediatrics, obstetrics, public health, epidemiology, library science) followed Joanna Briggs Institute and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols to complete a comprehensive search in nine databases from January 2023 – September 2024. Eligible studies included dyadic care instances for the birthing person and infant and reported clinical and/or intervention outcomes for at least one member of the dyad. We excluded studies describing management and/or quality metrics of labor and delivery. At least two team members screened, extracted, and synthesized data using Covidence, Qualtrics, and Excel, with disagreement resolved by a tiebreaking consensus. Results: We identified 6360 references meeting search criteria. After title and abstract screening, 311 full texts were evaluated, and 55 studies were included in the analysis (Figure 1), all of which were included after quality assessment. Half (47%) were conducted in the United States, most (65%) were published in 2016 or later, and 22% were randomized controlled trials (Table 1). Half of studies reported race/ethnicity for either member of the dyad, half involved home visits, and most (93%) were performed in the postpartum period (Table 2). Most (75%) interventions were shared medical and/or mental health, and half incorporated education and/or anticipatory guidance. Among the 26 US-based studies, dyadic models included home visitation (42%) and birthing person care during pediatric visits (25%) (Table 2). Commonly reported outcomes included maternal mental health (38%) and lactation (35%). Implementation was carried out by specialists from multiple disciplines, including nurses (36%), physicians (27%), and community health workers (20%).
Conclusion(s): We identified innovative practices and outcome assessments in birthing person-infant dyadic care. Amid a crisis of maternal-infant morbidity and mortality, dyadic care models and evaluation tools present opportunities in birthing person-, infant-, and dyadic-care instances to improve care delivery, care experiences, and outcomes for both members of the dyad.
