Evidence map›Paper›PMID 38176865›Full record

ArticleBMJ open2024

Implementation of integrated maternity care in the southwestern region of the Netherlands: evaluation of its effect on preterm birth, low birthweight infants and number of secondary care consultations.

Anne Hermans, Julia Spaan, Marieke Hermus, Jantien Visser, Annature Research Collaboration, Arie Franx, Jacoba van der Kooy

Abstract read
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Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Anne HermansGynaecology and Obstetrics, Erasmus MC, Rotterdam, the Netherlands a.c.m.hermans@erasmusmc.nl.ORCID 0000-0001-6976-1201
Julia SpaanGynaecology and Obstetrics, Amphia Hospital, Breda, Netherlands.
Marieke HermusMidwifery Practice, Oosterhout, Breda, the Netherlands.
Jantien VisserGynaecology and Obstetrics, Amphia Hospital, Breda, Netherlands.
Annature Research Collaboration
Arie FranxGynaecology and Obstetrics, Erasmus MC, Rotterdam, the Netherlands.
Jacoba van der KooyGynaecology and Obstetrics, Erasmus MC, Rotterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo determine whether integrated maternity care is associated with reduced preterm births (PTB) and fewer small-for-gestational-age infants (SGA), and whether its implementation leads to a reduction of secondary care consultations.

designRetrospective study.

settingIntegrated maternity care organisation in the southwestern region of the Netherlands.

participantsAll singleton pregnancies (≥24 weeks) within integrated maternity care organisation Annature between 2015 and 2020.

interventionImplementation of a shared maternity record in primary and secondary care.

methodsData of 20 818 women were derived from patient records and from the Netherlands Perinatal Registry. Intervention was the introduction of integrated maternity care in January 2018. Through multivariate logistic regression and segmented regression analysis we assessed the combined prevalence of SGA and PTB (SGA-PTB) before (2015-2017), and after the intervention (2018-2020). Regional rates were contrasted with nationwide rates (n=782 176).

main outcome measuresSGA-PTB prevalence and mean number of secondary care consultations per pregnancy.

resultsSGA-PTB prevalence declined from 618/3443 (17.9%) in 2015 to 560/3501 (16.0%) in 2017 to 507/3459 (14.7%) in 2020 (p<0.005). Mean number of secondary care consultations declined from six per pregnancy in 2015 to three in 2020. Logistic regression demonstrated a significant decline in odds of SGA-PTB (OR 0.83 (95% CI 0.77 to 0.89)) between 2015-2017 and 2018-2020 adjusted for changes in sociodemographic characteristics over time. A statistically significant average monthly 7.3% (p=0.05) reduction in SGA-PTB prevalence and 12.4% (p<0.005) mean monthly reduction in secondary care consultations were demonstrated for 2015-2017. Immediately after the intervention, mean monthly prevalence of SGA-PTB dropped non-significantly to 14.7%. Between 2018 and 2020 a significant 15.2% (p<0.005) reduction in secondary care consultations was shown.

conclusionOur results suggest that implementation of integrated maternity care was associated with reduced PTBs and/or low birth weight, and fewer secondary care consultations. These encouraging findings were observed in a less favourable sociodemographic profile and should be confirmed in other regions with sufficiently large populations, and the possibility to test individual components of integrated maternity care.

Indexed as

Maternal Health ServicesPremature BirthBirth WeightFemaleHumansInfantInfant, Low Birth WeightInfant, NewbornInfant, Small for Gestational AgeNetherlandsParturitionPregnancyRetrospective StudiesSecondary Health CareMaternal medicineOBSTETRICSPERINATOLOGY

Identifiers

PMID38176865
PMCPMC10773402

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.