Providing Dyadic Care to Mothers and Infants to Improve Health Outcomes

In a new paper, “Dyadic care interventions and outcomes for mothers and their infants: a scoping review”, published today in Pediatrics, a research team at Yale School of Medicine describes mother-infant dyadic care interventions and outcomes around the world and the promise they show for improving maternal and post-natal health.

Researchers have known that dyadic care provided to mothers and infants often provides greater access to care, but the reach, implementation, and outcomes of this type of care were unknown. In their review, they examined diverse global maternal-infant dyadic intervention models and found that they frequently improved maternal and infant health outcomes.

Compared to peer nations, the United States has the highest maternal mortality rate and one of the highest infant mortality rates. Providing dyadic care to mothers and infants can help close an important gap: it is estimated that roughly 40% of mothers attend their postpartum healthcare visits but are much more likely to attend a newborn care visit. These provide numerous opportunities to provide potential dyadic care; the American Academy of Pediatrics recommends multiple care visits during the first two months after birth. Providing concurrent care for mothers and infants could optimize care for both patients.

Corresponding author, Julia Rosenberg, MD, MPH, assistant professor of pediatrics (general pediatrics), said, “Current healthcare often focuses on one member in isolation, a mother at her appointment, or an infant at theirs.”

Rosenberg and Molly McAdow, MD, PhD, FACOG, assistant professor of obstetrics, gynecology and reproductive sciences, also shared the importance of shifting to a more family-centered care model. They were inspired in part by a successful mother-baby mobile community healthcare initiative launched in 2020 in New Haven, CT that identified postpartum hypertension as a significant maternal health issue.

As reported in 2024, “Integral to the Mother and Infant Mobile Clinic services is the identification and prompt referral to escalated care for pregnancy related hypertension, pre-eclampsia, depression, abnormal bleeding, and mental health concerns. The Mother and Infant Mobile Clinic has sparked awareness and conversation locally and regionally, highlighting the value of mobile outreach and the value added to healthcare encounters centered on the mother infant dyad.”

McAdow explained that while dyadic care shows promise, there are many differences in where and how it’s implemented around the world. Things like health insurance coverage and access to family medicine practices can affect the positive outcomes that might be seen in one place and not in another.

The team reviewed 117 studies from eight countries to identify ten dyadic care models: Shared medical visits, provision of maternal care at pediatric appointments, group dyadic care, mother-baby psychiatric units, care for mothers in the Neonatal Intensive Care Unit (NICU), couplet care, home visits by medical professionals, home visits by community health workers, mobile device interventions, and nutritional supplementation during pregnancy.

These care models not only offer an opportunity to streamline healthcare services; they also help build trust between families and their healthcare providers. Future research will seek to improve dyadic care implementation and assess accessibility, cost-effectiveness, and impact on maternal and infant morbidity and mortality globally.

Josefa L. Martinez, PhD, MHS, Courtney Choy, MPH, PhD, and Alyssa Ann Grimshaw, MBA, MLIS, MPH also co-authored this piece through a team-science initiative in the Yale Center for Clinical Investigation (YCCI) Scholars Program. Read the full review in Pediatrics.