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Models of antenatal care to reduce and prevent preterm birth: a systematic review and meta-analysis

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Models of antenatal care to reduce and prevent preterm birth : a systematic review and meta-analysis. / Fernandez Turienzo, Cristina; Sandall, Jane; Peacock, Janet L.

In: BMJ open, Vol. 6, No. 1, e009044, 12.01.2016.

Research output: Contribution to journalArticle

Harvard

Fernandez Turienzo, C, Sandall, J & Peacock, JL 2016, 'Models of antenatal care to reduce and prevent preterm birth: a systematic review and meta-analysis', BMJ open, vol. 6, no. 1, e009044. https://doi.org/10.1136/bmjopen-2015-009044

APA

Fernandez Turienzo, C., Sandall, J., & Peacock, J. L. (2016). Models of antenatal care to reduce and prevent preterm birth: a systematic review and meta-analysis. BMJ open, 6(1), [e009044]. https://doi.org/10.1136/bmjopen-2015-009044

Vancouver

Fernandez Turienzo C, Sandall J, Peacock JL. Models of antenatal care to reduce and prevent preterm birth: a systematic review and meta-analysis. BMJ open. 2016 Jan 12;6(1). e009044. https://doi.org/10.1136/bmjopen-2015-009044

Author

Fernandez Turienzo, Cristina ; Sandall, Jane ; Peacock, Janet L. / Models of antenatal care to reduce and prevent preterm birth : a systematic review and meta-analysis. In: BMJ open. 2016 ; Vol. 6, No. 1.

Bibtex Download

@article{1c70f49143fb4366905f91c667bd9411,
title = "Models of antenatal care to reduce and prevent preterm birth: a systematic review and meta-analysis",
abstract = "OBJECTIVE: To assess the effectiveness of models of antenatal care designed to prevent and reduce preterm birth (PTB) in pregnant women.METHODS: We conducted a search of seven electronic databases and reference lists of retrieved studies to identify trials from inception up to July 2014 where pregnant women, regardless of risk factors for pregnancy complications, were randomly allocated to receive an alternative model of antenatal care or routine care. We pooled risks of PTB to determine the effect of alternative care models in all pregnant women. We also assessed secondary maternal and infant outcomes, women's satisfaction and economic outcomes.RESULTS: 15 trials involving 22 437 women were included. Pregnant women in alternative care models were less likely to experience PTB (risk ratio 0.84, 95{\%} CI 0.74 to 0.96). The subgroup of women randomised to midwife-led continuity models of antenatal care were less likely to experience PTB (0.78, 0.66 to 0.91) but there was no significant difference between this group and women allocated to specialised care (0.92, 0.76 to 1.12) (interaction test for subgroup differences p=0.20). Overall low-risk women in alternative care models were less likely to have PTB (0.74, 0.59 to 0.93), but this effect was not significantly different from that in mixed-risk populations (0.91, 0.79 to 1.05) (subgroup p=0.13).CONCLUSIONS: Alternative models of antenatal care for all pregnant women are effective in reducing PTB compared with routine care, but no firm conclusions could be drawn regarding the relative benefits of the two models. Future research should evaluate the impact of antenatal care models which include more recent interventions and predictive tests, and which also offer continuity of care by midwives throughout pregnancy.PROSPERO REGISTRATION NUMBER: CRD42014007116.",
author = "{Fernandez Turienzo}, Cristina and Jane Sandall and Peacock, {Janet L}",
note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/",
year = "2016",
month = "1",
day = "12",
doi = "10.1136/bmjopen-2015-009044",
language = "English",
volume = "6",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "1",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Models of antenatal care to reduce and prevent preterm birth

T2 - a systematic review and meta-analysis

AU - Fernandez Turienzo, Cristina

AU - Sandall, Jane

AU - Peacock, Janet L

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PY - 2016/1/12

Y1 - 2016/1/12

N2 - OBJECTIVE: To assess the effectiveness of models of antenatal care designed to prevent and reduce preterm birth (PTB) in pregnant women.METHODS: We conducted a search of seven electronic databases and reference lists of retrieved studies to identify trials from inception up to July 2014 where pregnant women, regardless of risk factors for pregnancy complications, were randomly allocated to receive an alternative model of antenatal care or routine care. We pooled risks of PTB to determine the effect of alternative care models in all pregnant women. We also assessed secondary maternal and infant outcomes, women's satisfaction and economic outcomes.RESULTS: 15 trials involving 22 437 women were included. Pregnant women in alternative care models were less likely to experience PTB (risk ratio 0.84, 95% CI 0.74 to 0.96). The subgroup of women randomised to midwife-led continuity models of antenatal care were less likely to experience PTB (0.78, 0.66 to 0.91) but there was no significant difference between this group and women allocated to specialised care (0.92, 0.76 to 1.12) (interaction test for subgroup differences p=0.20). Overall low-risk women in alternative care models were less likely to have PTB (0.74, 0.59 to 0.93), but this effect was not significantly different from that in mixed-risk populations (0.91, 0.79 to 1.05) (subgroup p=0.13).CONCLUSIONS: Alternative models of antenatal care for all pregnant women are effective in reducing PTB compared with routine care, but no firm conclusions could be drawn regarding the relative benefits of the two models. Future research should evaluate the impact of antenatal care models which include more recent interventions and predictive tests, and which also offer continuity of care by midwives throughout pregnancy.PROSPERO REGISTRATION NUMBER: CRD42014007116.

AB - OBJECTIVE: To assess the effectiveness of models of antenatal care designed to prevent and reduce preterm birth (PTB) in pregnant women.METHODS: We conducted a search of seven electronic databases and reference lists of retrieved studies to identify trials from inception up to July 2014 where pregnant women, regardless of risk factors for pregnancy complications, were randomly allocated to receive an alternative model of antenatal care or routine care. We pooled risks of PTB to determine the effect of alternative care models in all pregnant women. We also assessed secondary maternal and infant outcomes, women's satisfaction and economic outcomes.RESULTS: 15 trials involving 22 437 women were included. Pregnant women in alternative care models were less likely to experience PTB (risk ratio 0.84, 95% CI 0.74 to 0.96). The subgroup of women randomised to midwife-led continuity models of antenatal care were less likely to experience PTB (0.78, 0.66 to 0.91) but there was no significant difference between this group and women allocated to specialised care (0.92, 0.76 to 1.12) (interaction test for subgroup differences p=0.20). Overall low-risk women in alternative care models were less likely to have PTB (0.74, 0.59 to 0.93), but this effect was not significantly different from that in mixed-risk populations (0.91, 0.79 to 1.05) (subgroup p=0.13).CONCLUSIONS: Alternative models of antenatal care for all pregnant women are effective in reducing PTB compared with routine care, but no firm conclusions could be drawn regarding the relative benefits of the two models. Future research should evaluate the impact of antenatal care models which include more recent interventions and predictive tests, and which also offer continuity of care by midwives throughout pregnancy.PROSPERO REGISTRATION NUMBER: CRD42014007116.

U2 - 10.1136/bmjopen-2015-009044

DO - 10.1136/bmjopen-2015-009044

M3 - Article

C2 - 26758257

VL - 6

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 1

M1 - e009044

ER -

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