The lack of data from randomised trials assessing strategies in teenage pregnancy is important, since observational studies systematically yield greater estimates of treatment effect than do randomised trials with respect to adolescent pregnancy outcomes.15 Our aim was to assess the effect of a postnatal home-visiting service, undertaken by certified nurse-midwives, in reducing adverse neonatal outcomes and in improving knowledge about contraception, vaccination schedules, and breastfeeding in teenage mothers younger than age 18 years.