Document Detail

Specialised antenatal clinics for women with a multiple pregnancy for improving maternal and infant outcomes.
MedLine Citation:
PMID:  22895946     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Regular antenatal care for women with a multiple pregnancy is accepted practice, and while most women have an increase in the number of antenatal visits, there is no consensus as to what constitutes optimal care. 'Specialised' antenatal clinics have been advocated as a way of improving outcomes for women and their infants.
OBJECTIVES: To assess, using the best available evidence, the benefits and harms of 'specialised' antenatal clinics compared with 'standard' antenatal care for women with a multiple pregnancy.
SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (11 April 2012).
SELECTION CRITERIA: All published, unpublished, and ongoing randomised controlled trials with reported data that compared outcomes in mothers and babies with a multiple pregnancy who received antenatal care specifically designed for women with a multiple pregnancy (as defined by the trial authors) with outcomes in controls who received 'standard' antenatal care (as defined by the trial authors).
DATA COLLECTION AND ANALYSIS: Both review authors independently assessed trials for inclusion and trial quality. Both review authors extracted data. Data were checked for accuracy.
MAIN RESULTS: There were data available from one study included in the review involving 162 women with a multiple pregnancy. For the only reported primary outcome, perinatal mortality, there were no statistically significant differences identified between specialised antenatal care and standard care (risk ratio (RR) 1.02; 95% confidence interval (CI) 0.26 to 4.03). Women receiving specialised antenatal care were significantly more likely to birth by caesarean section (RR 1.38; 95% CI 1.06 to 1.81). Data was not reported in the study on the following primary outcomes: small-for-gestational age, very preterm birth or maternal death. There were no statistically significant differences identified between specialised antenatal care and standard care for other secondary outcomes examined: postnatal depression (RR 0.48; 95% CI 0.19 to 1.20), breastfeeding (RR 0.63; 95% CI 0.24 to 1.68), still birth (RR 0.68; 0.12 to 4.04) or neonatal death (RR 2.05; 95% CI 0.19 to 22.39).
AUTHORS' CONCLUSIONS: There is currently limited information available from randomised controlled trials to assess the role of 'specialised' antenatal clinics for women with a multiple pregnancy compared with 'standard' antenatal care in improving maternal and infant health outcomes. The value of 'specialised' multiple pregnancy clinics in improving health outcomes for women and their infants requires evaluation in appropriately powered and designed randomised controlled trials.
Jodie M Dodd; Caroline A Crowther
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2012-08-15
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  8     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2012  
Date Detail:
Created Date:  2012-08-16     Completed Date:  2012-09-26     Revised Date:  2014-06-20    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD005300     Citation Subset:  IM    
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MeSH Terms
Cesarean Section / utilization
Infant Welfare*
Infant, Newborn
Maternal Welfare*
Perinatal Mortality
Pregnancy Outcome*
Pregnancy, Multiple*
Pregnancy, Twin
Prenatal Care / methods,  standards*
Randomized Controlled Trials as Topic
Grant Support
10/4001/02//Department of Health; SRP/10/4001/02//Department of Health
Update Of:
Cochrane Database Syst Rev. 2007;(2):CD005300   [PMID:  17443582 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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