Background Many of the individual components of antenatal care have been studied in randomised controlled trials, but few studies have compared whole programmes of antenatal care.
Our aim was to test the hypothesis that a new programme of antenatal care with fewer goal-oriented visits would give an equivalent or better result in the outcomes associated with pregnancy and delivery.
Methods In a randomised clinical trial in Harare, Zimbabwe, we compared a new programme of antenatal care with the standard programme.
The new programme consisted of fewer but more objectively oriented visits and fewer procedures per visit.
Seven primary care clinics were randomly assigned to the two programmes-three to the standard programme and four to the new programme.
Findings Over a 2-year period, 15 994 women were recruited into the study at the time they booked antenatal care. 97% of the women were followed up, 9394 who had followed the new programme, and 6138 from clinics with the standard one.
Women allocated to the new programme made, as planned, fewer visits than those in the standard programme (median 4 vs 6 visits, respectively).
The proportion of antenatal referrals was also lower (13.6 vs 15.3% : odds ratio 0.87 [95% CI 0.79-0.95]) because of significantly fewer referrals for pregnancy-induced hypertension (2.5 vs 3.8% : 0.66 [0.55-0.79]). Nevertheless, there were significantly fewer labour referrals for severe hypertension or eclampsia (2.1 vs 2.6% ; 0.81 [0.66-1.00]). (...)
Mots-clés Pascal : Programme scientifique, Gestation, Zimbabwe, Afrique, Surveillance, Homme, Femelle, Prénatal, Etude comparative
Mots-clés Pascal anglais : Scientific program, Pregnancy, Zimbabwe, Africa, Surveillance, Human, Female, Prenatal, Comparative study
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0380180
Code Inist : 002B20F01. Création : 10/04/1997.