Abstract / Summary
Abstract Early intervention could improve outcomes for parents and children. This quasi-experimental study investigated the effectiveness and costs of a perinatal parenting programme, ‘Baby Steps’. Using the Born in Bradford’s Better Start (BiBBS) interventional family cohort study data, propensity score matching created intervention and pseudo-control groups. Baby Steps did not have a meaningful impact on maternal-infant relationships, via warmth and invasion [ B =0.62, -0.79-2.03; and B =0.57, -0.67-1.82], nor reducing risk of early gestation and low birthweight [OR=0.33, 0.07 to 1.59; OR=0.63, 0.25-1.61]. Baby Steps reduced depression and anxiety [ B =-0.74, -1.56-0.07; B =0.50, -1.28-0.28], particularly for those with antenatal depression, and increased odds of non-vaginal deliveries [OR=2.18, 1.35-3.51]. Baby Steps had minimal impact on overall service use related costs [−£96.6, -835.8 to 642.6]. Disaggregated analysis suggested that participation increased mothers healthcare use [+£265.1, -268.6 to 798.7], via delivery-related and inpatient care, and decreased infant healthcare use [−£361.6, -793.4 to 70.1], via reduced inpatient admissions. Baby Steps was delivered successfully in real-world practice, and engaged underserved families. Baby Steps showed promise for maternal mental health, and additional healthcare for mothers may have reduced infant inpatient needs. Mechanisms underpinning birth outcomes, maternal sensitivity and healthcare costs remain uncertain. Baby Steps is a viable, promising intervention for embedding within a wider, systemic support system.