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Are four prenatal visits enough?

Date:
April 12, 2013
Source:
BioMed Central Limited
Summary:
Reanalysis of the World Health Organization’s  Antenatal Care Trial (WHOACT) shows that there is an increased risk of fetal death at between 32 and 36 weeks for women who have a reduced prenatal care package. Original analysis of the WHOACT concluded that reducing prenatal visits of low risk women from eight to four was not detrimental to their or their babies’ health and could cut costs. Based on this advice some countries have lowered the number of routine prenatal visits . However, in light of the 2010 Cochrane review, which suggested that reduced prenatal visits was in fact detrimental to health, the WHOACT data was reanalyzed by an international group of researchers. Once the data was adjusted for maternal risk (such as smoking, age, education) the group found that there was an increased risk of fetal death for the women who had reduced numbers of prenatal visits.

Reanalysis of the World Health Organization's Antenatal Care Trial (WHOACT) shows that there is an increased risk of fetal death at between 32 and 36 weeks for women who have a reduced antenatal care package, finds research published in BioMed Central's open access journal Reproductive Health.

Original analysis of the WHOACT concluded that reducing antenatal visits of low risk women from eight to four was not detrimental to their or their babies' health and could cut costs. Based on this advice some countries have lowered the number of routine antenatal visits .

However, in light of the 2010 Cochrane review, which suggested that reduced antenatal visits was in fact detrimental to health, the WHOACT data was reanalyzed by an international group of researchers. Once the data was adjusted for maternal risk (such as smoking, age, education) the group found that there was an increased risk of fetal death for the women who had reduced numbers of antenatal visits. Specifically, for high risk women the risk of fetal death at 36 weeks of less was 80% higher while for low risk women it increased by 50%.

The increase risk of fetal death was highest between 32 and 36 weeks. Discussing the impact of their results Dr Joshua P Vogel from the World Health Organization explained, "This increased risk of fetal death is linked to a reduced number of antenatal visits, but this may be due to differences in settings, content and quality of care. The timing and quality of visits is also important -- reduced numbers of visits may miss important windows when fetuses are still at risk."

"After a century of blind faith, this paper provides probably the first direct evidence from a randomized trial that routine antenatal visits for healthy pregnant women do make a difference" finds Prof Justus Hofmeyr from University of the Witwatersrand/Fort Hare. He continued, "An increased number of routine visits may detect asymptomatic conditions such as pre-eclampsia, fetal growth restriction or reduced fetal movements earlier, allowing more timely intervention. The importance of the content and quality of routine antenatal care should not be lost to policymakers when decisions about numbers of visits with the available resources are being made."


Story Source:

The above story is based on materials provided by BioMed Central Limited. Note: Materials may be edited for content and length.


Journal References:

  1. Joshua P Vogel, Habib Abu Ndema, Joγo Paulo Souza, Metin A Gόlmezoglu, Therese Dowswell, Guillermo Carroli, Hassan S Baaqeel, Pisake Lumbiganon, Gilda Piaggio, Olufemi T Oladapo. Antenatal care packages with reduced visits and perinatal mortality: a secondary analysis of the WHO Antenatal Care Trial. Reproductive Health, 2013; 10 (1): 19 DOI: 10.1186/1742-4755-10-19
  2. G Justus Hofmeyr, Ellen D Hodnett. 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. Reproductive Health, 2013; 10 (1): 20 DOI: 10.1186/1742-4755-10-20

Cite This Page:

BioMed Central Limited. "Are four prenatal visits enough?." ScienceDaily. ScienceDaily, 12 April 2013. <www.sciencedaily.com/releases/2013/04/130412084539.htm>.
BioMed Central Limited. (2013, April 12). Are four prenatal visits enough?. ScienceDaily. Retrieved September 1, 2014 from www.sciencedaily.com/releases/2013/04/130412084539.htm
BioMed Central Limited. "Are four prenatal visits enough?." ScienceDaily. www.sciencedaily.com/releases/2013/04/130412084539.htm (accessed September 1, 2014).

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