Health services effects of a reduced routine programme for antenatal care

Berglund, Anna; Lindmark, Gunilla

doi:10.1016/s0301-2115(97)00270-4

Cited by 33 publications

(60 citation statements)

References 14 publications

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“…The lack of ESE immigrants receiving such care may be a lingering effect of cutbacks in visits made in the antenatal care program during the 90s. 15,16 More than 80% of all neonatal deaths in the ESE group were potentially avoidable by adequate medical care, as compared to 28% in the Swedish group. ESE mothers and their infants experienced higher rates of inadequate CTG (cardiotocography) interpretation, late arrival of paediatricians, delayed transferral to neonatal intensive care units (NICU), and greater instances of inadequate medication to mother or premature infant (cortisone or surfactant).…”

Section: (C) Avoidable Perinatal Death Related To Sub-optimal Medicalmentioning

confidence: 99%

Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?

Essén

Bødker

Sjöberg

et al. 2002

BJOG

147

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Objective To test the hypothesis that suboptimal factors in perinatal care services resulting in perinatal deaths were more common among immigrant mothers from the Horn of Africa, when compared with Swedish mothers. Design A perinatal audit, comparing cases of perinatal deaths among children of African immigrants residing in Sweden, with a stratified sample of cases among native Swedish women. Population and setting Sixty‐three cases of perinatal deaths among immigrant east African women delivered in Swedish hospitals in 1990–1996, and 126 cases of perinatal deaths among native Swedish women. Time of death and type of hospital were stratified. Main outcome measures Suboptimal factors in perinatal care services, categorised as maternal, medical care and communication. Results The rate of suboptimal factors likely to result in potentially avoidable perinatal death was significantly higher among African immigrants. In the group of antenatal deaths, the odds ratio (OR) was 6.2 (95% CI 1.9–20); the OR for intrapartal deaths was 13 (95% CI 1.1–166); and the OR for neonatal deaths was 18 (95% CI 3.3–100), when compared with Swedish mothers. The most common factors were delay in seeking health care, mothers refusing caesarean sections, insufficient surveillance of intrauterine growth restriction (IUGR), inadequate medication, misinterpretation of cardiotocography (CTG) and interpersonal miscommunication. Conclusions Suboptimal factors in perinatal care likely to result in perinatal death were significantly more common among east African than native Swedish mothers, affording insight into socio‐cultural differences in pregnancy strategies, but also the suboptimal performance of certain health care routines in the Swedish perinatal care system.

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Section: (C) Avoidable Perinatal Death Related To Sub-optimal Medicalmentioning

confidence: 99%

Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?

Essén

Bødker

Sjöberg

et al. 2002

BJOG

147

View full text Add to dashboard Cite

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“…Berglund and Lindmark (6) assessed the effects of a reduction in the routine prenatal care program in Västerhås, Sweden. This retrospective study, although not a randomized controlled trial, is of interest because of its large sample size of 3,882 low‐risk pregnant women.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Panel members based their recommendations on expert opinion and extensive discussion and review of the available literature (3). More than a decade has passed since the publication of the reduced frequency prenatal visit schedule, with some research documenting its efficacy and safety (4–9). The studies of reduced frequency prenatal visits to date have shown equal effectiveness in improving maternal and infant outcomes and may increase client satisfaction (4–9).…”

Section: Introductionmentioning

confidence: 99%

Evidence‐based Prenatal Care Visits: When Less Is More

Walker

McCully²,

Vest³

2001

J Midwife Womens Health

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Traditionally, low-risk pregnant women in the United States who participate in prenatal care have been scheduled for approximately 14-16 prenatal visits, which is the schedule recommended by the American College of Obstetricians and Gynecologists. In 1989, an expert panel convened by the United States Department of Health and Human Services proposed a reduced frequency prenatal visit schedule for low-risk, healthy women based on the timing of specific tests or events that occur in pregnancy. Available evidence shows no adverse effect on maternal or neonatal outcomes for low-risk pregnant women who follow a reduced visit schedule, making it a highly important consideration for pregnant women and their health care providers. Other important aspects of prenatal care, especially related to adequacy and content, will be explored in-depth in a future segment of this series on evidence-based prenatal care.

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“…Although many observational epidemiological studies have demonstrated an inverse relationship between the number of antenatal visits and adverse perinatal outcomes, a number of randomized controlled trials have shown the opposite (Berglund and Lindmark, 1998;Carroli et al, 2001;Munjanja et al, 1996;Villar et al, 2001;Walker et al, 2001). Recent studies conducted by the WHO antenatal care trial research group also revealed that no significant differences were observed in the two branches of the trials when low birth weight, short gestational age, caesarean section, induction of labour, antepartum haemorrhage and postpartum haemorrhage were considered as outcome measures (Carroli et al, 2001;Villar et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

The role of Taiwan's national health insurance program in influencing adequate prenatal care

Liu

Chen

2004

Health Planning & Management

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This paper reviews achievements in the utilization of prenatal care by pregnant women in Taiwan by analysing the 1989 and 1996 National Maternal and Infant Health Survey data. More precisely, it identifies and examines the programmatic and non-programmatic factors that influence prenatal care utilization, thus determining the areas that require further attention from the programe. Logistic regression results show that the adequacy of prenatal care use was significantly associated with the implementation of the National Health Insurance (NHI). A higher likelihood of adequate care utilization was found among women who were married or employed, had a higher level of education, had more experience with regard to pregnancy and were at higher risk in terms of obstetrics. The effect of facility choice showed variations after the implementation of the NHI programme. Prior to NHI, no differences were noted between the use of clinics and hospitals. After the implementation of NHI, on the other hand, women who received most of their care from clinics had a higher likelihood of receiving more adequate prenatal care than those who received care from hospitals. Regional differences in seeking adequate prenatal care were also evident. Mothers who were living in southern areas were less likely to receive adequate prenatal care despite the implementation of NHI. The Bureau of NHI, therefore, still needs to work on mechanisms to ensure that more attention is given to the distribution of its medical resources and that additional health care accessibility is provided to pregnant women in these areas.

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Health services effects of a reduced routine programme for antenatal care

Cited by 33 publications

References 14 publications

Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?

Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?

Evidence‐based Prenatal Care Visits: When Less Is More

The role of Taiwan's national health insurance program in influencing adequate prenatal care

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