Antenatal care packages with reduced visits and perinatal mortality: a secondary analysis of the WHO antenatal care trial - Comentary: routine antenatal visits for healthy pregnant women do make a difference
Antenatal care packages with reduced visits and perinatal mortality: a secondary analysis of the WHO antenatal care trial - Comentary: routine antenatal visits for healthy pregnant women do make a difference
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DOI：
10.1186/1742-4755-10-20
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发表时间：
2013-04-12
影响因子：
3.4
通讯作者：
Hodnett, Ellen D.
中科院分区：
文献类型：
--
作者：
Hofmeyr, G. Justus;Hodnett, Ellen D.
在过去的一个世纪里，对健康孕妇进行常规产前检查的做法和时机是武断的，而且没有有效的证据，这种做法已经在产科实践中根深蒂固。2001年，世卫组织进行的大型集群随机产前保健试验得出结论，以目标为导向的产前保健一揽子计划减少了就诊次数，似乎对孕产妇和围产期结局没有影响。减少访问的一揽子计划已在若干国家实施。目前的重新分析发现，在调整潜在的混杂因素后，减少就诊包中发生的围产期死亡率显着增加。世卫组织产前保健试验从一项随机试验中提供了第一个证据，证明在妊娠晚期进行传统的高频率常规就诊可以很好地降低围产期死亡率。
The practice and timing of routine antenatal visits for healthy pregnant women, introduced arbitrarily and without evidence of effectiveness, have become entrenched in obstetric practice over the last century. In 2001 the large, cluster randomized WHO Antenatal Care Trial concluded that a goal-orientated package of antenatal care with reduced visits seemed not to affect maternal and perinatal outcomes. The reduced visit package has been implemented in several countries. The current re-analysis finds that the significantly increased perinatal mortality which occurred in the reduced visit package persists after adjustment for potential confounding factors. The WHO Antenatal Care Trial provided the first evidence from a randomized trial that the traditional high frequency of routine visits in the third trimester may well reduce perinatal mortality.