86704
document
A randomised controlled trial comparing two schedules of antenatal visits : the antenatal care project . OBJECTIVE To compare the clinical and psychological effectiveness of the traditional British antenatal visit schedule ( traditional care ) with a reduced schedule of visits ( new style care ) for low risk women , together with maternal and professional satisfaction with care . DESIGN Randomised controlled trial . SETTING Places in south east London providing antenatal care for women receiving shared care and planning to deliver in one of three hospitals or at home . SUBJECT 2794 women at low risk fulfilling the trial 's inclusion criteria between June 1993 and July 1994 . MAIN OUTCOME MEASURES Measures of fetal and maternal morbidity , health service use , psychosocial outcomes , and maternal and professional satisfaction . RESULTS Pregnant women allocated to new style care had fewer day admissions ( 0.8 v 1.0 ; P=0.002 ) and ultrasound scans ( 1.6 v 1.7 ; P=0.003 ) and were less often suspected of carrying fetuses that were small for gestational age ( odds ratio 0.73 ; 95 % confidence interval 0.54 to 0.99 ) . They also had some poorer psychosocial outcomes ; for example , they were more worried about fetal wellbeing antenatally and coping with the baby postnatally , and they had more negative attitudes to their babies , both in pregnancy and postnatally . These women were also more dissatisfied with the number of visits they received ( odds ratio 2.50 ; 2.00 to 3.11 ) . CONCLUSIONS Patterns of antenatal care involving fewer routine visits for women at low risk may lead to reduced psychosocial effectiveness and dissatisfaction with frequency of visits . The number of antenatal day admissions and ultrasound scans performed may also be reduced . For the variables reported , the visit schedules studied are similar in their clinical effectiveness . Uncertainty remains as to the clinical effectiveness of reduced visit schedules for rare pregnancy problems .
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Intervention_Other
schedules of antenatal visits
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Intervention_Psychological
antenatal care
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Intervention_Educational
traditional British antenatal visit schedule
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Intervention_Control
( traditional care )
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Intervention_Psychological
reduced schedule of visits ( new style care )
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Intervention_Psychological
antenatal care
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Intervention_Other
new style care
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Intervention_Psychological
antenatal care
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Intervention_Other
visits
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Intervention_Other
reduced visit schedules
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Outcome_Mortality
Measures of fetal and maternal morbidity
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Outcome_Other
health service use
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Outcome_Mental
psychosocial outcomes
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Outcome_Other
maternal and professional satisfaction
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Outcome_Other
day admissions
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Outcome_Other
ultrasound scans
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Outcome_Physical
suspected of carrying fetuses that were small for gestational age
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Outcome_Mental
poorer psychosocial outcomes
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Outcome_Physical
fetal wellbeing antenatally
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Outcome_Physical
coping with the baby postnatally
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Outcome_Mental
attitudes
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Outcome_Other
dissatisfied with the number of visits
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Outcome_Mental
psychosocial effectiveness
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Outcome_Other
dissatisfaction
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Outcome_Other
antenatal day admissions
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Outcome_Other
ultrasound scans performed
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Participant_Sex
women
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Participant_Sex
women
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Participant_Sample-size
2794
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Participant_Sex
women
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Participant_Condition
Pregnant
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Participant_Sex
women