Assessing the impact of group antenatal care on gestational length in Rwanda: A cluster-randomized trial.
Assessing the impact of group antenatal care on gestational length in Rwanda: A cluster-randomized trial.
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DOI：
10.1371/journal.pone.0246442
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Walker D
中科院分区：
文献类型：
--
作者：
Sayinzoga F;Lundeen T;Musange SF;Butrick E;Nzeyimana D;Murindahabi N;Azman-Firdaus H;Sloan NL;Benitez A;Phillips B;Ghosh R;Walker D
对低收入和中等收入情况下的集体产前护理的研究表明，可接受性很高，初步实施成功。我们研究了集体产前护理对卢旺达妇女出生时胎龄的影响，假设参与会增加平均孕长。在这项非盲群随机试验中，36个健康中心被配对并随机；一半继续个人产前护理(对照)，一半实施集体产前护理(干预)。在2017年5月至2018年12月期间开始产前护理的妇女被邀请参加分析，如果她们在怀孕24周前提出，至少参加了两次探视，并获得了她们的出生结果。我们使用了一个广义估计方程模型进行分析。总共有18个对照组的4091名妇女和18个干预组的4752名妇女被纳入分析。平均而言，妇女总共参加了三次产前检查。干预组和对照组的孕周长度相当(39.3周(SD 1.6)和39.3周(SD 1.5))。两组之间的次生结局没有显著差异，除了控制点有更多的妇女参加产后护理访问(40.1%对29.7%，p=0.003)和干预点有更多的妇女参加至少三次产前护理访问(80.7%对71.7%，p=0.003)。没有观察到任何危害。产前护理不会导致两组间孕期长度的差异。这可能是由于干预剂量较低所致。我们建议对早产风险较高的妇女进行高剂量集体产前护理的有效性和成本的研究。我们观察到由于机构工作人员短缺对集体护理的威胁；我们建议进行研究，在探视期间将产前护理提供者专门分配给集体产前护理。临床试验.gov NCT03154177
Research on group antenatal care in low- and middle-income contexts suggests high acceptability and preliminary implementation success. We studied the effect of group antenatal care on gestational age at birth among women in Rwanda, hypothesizing that participation would increase mean gestational length. For this unblinded cluster randomized trial, 36 health centers were pair-matched and randomized; half continued individual antenatal care (control), half implemented group antenatal care (intervention). Women who initiated antenatal care between May 2017 and December 2018 were invited to participate, and included in analyses if they presented before 24 weeks gestation, attended at least two visits, and their birth outcome was obtained. We used a generalized estimating equations model for analysis. In total, 4091 women in 18 control clusters and 4752 women in 18 intervention clusters were included in the analysis. On average, women attended three total antenatal care visits. Gestational length was equivalent in the intervention and control groups (39.3 weeks (SD 1.6) and 39.3 weeks (SD 1.5)). There were no significant differences between groups in secondary outcomes except that more women in control sites attended postnatal care visits (40.1% versus 29.7%, p = 0.003) and more women in intervention sites attended at least three total antenatal care visits (80.7% versus 71.7%, p = 0.003). No harms were observed. Group antenatal care did not result in a difference in gestational length between groups. This may be due to the low intervention dose. We suggest studies of both the effectiveness and costs of higher doses of group antenatal care among women at higher risk of preterm birth. We observed threats to group care due to facility staff shortages; we recommend studies in which antenatal care providers are exclusively allocated to group antenatal care during visits. ClinicalTrials.gov NCT03154177
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DOI：
10.1016/s0091-2182(97)00117-1
发表时间：
1998-01-01
期刊：
JOURNAL OF NURSE-MIDWIFERY
影响因子：
--
作者：
Rising, SS
通讯作者：
Rising, SS
影响因子：
3.1
作者：
Patil CL;Klima CS;Leshabari SC;Steffen AD;Pauls H;McGown M;Norr KF
通讯作者：
Norr KF
影响因子：
3.7
作者：
Grenier, Lindsay;Suhowatsky, Stephanie;Smith, Jeffrey M.
通讯作者：
Smith, Jeffrey M.
影响因子：
3.1
作者：
Lori, Jody R.;Ofosu-Darkwah, Henrietta;Adanu, Richard M. K.
通讯作者：
Adanu, Richard M. K.
影响因子：
2.7
作者：
Sayinzoga, Felix;Lundeen, Tiffany;Walker, Dilys
通讯作者：
Walker, Dilys