Randomised Controlled Trial Of Two Antenatal Care Models

Objective:To compare a five-visit antenatal care (ANC) model with specified goals with the standard model on pregnancy outcome.Method:170pregnant women lining antenatal examination in the second clinical medical school of shanxi medical university were randomly allocated to provide either the new model (88pregnant women) or the standard model currently in use (82pregnant women). Women enrolled in clinic offering the new model were classified on the basis of history of obstetric and clinical conditions. Those who did not require further specific assessment or treatment were offered the basic component of the new model and nutrition guidance during pregnancy, and those deemed at higher risk received the usual care for their conditions; however, all were included in the new-model group for the analyses, which were by intention to treat.Result:5cases were lost to follow-up and165cases were followed to hospital after childbirth.1. There was no difference in median maternal age, parity, family income and gestational age at booking between women in the standard model and those in the new model.Inspection fees in the two groups was statistically significant differences.2. Women attending clinics assigned the new model had a median of five visits compared with ten within the standard model.78.8%of women had fewer than six visits in the new model compared with8.8%in the standard model.3.5%of women had fewer than five visits in the new model compared with7.5%in the standard model. Two groups was statistically significant differences.(;x2值=0.608, P=0.,436)3. More women in the new model than in the standard model were referred to higher levels of antepartum care.There were no difference in intrapartum or postpartum transfers.4. The cesarean section rate of the observation group and control group were respectively29.4%and33.8%. Two groups was statistically significant differences. There were negligible differences between groups for adverse pregnancy outcomes.5. Women in both groups were, in general, satisfied with the care received, although some women assigned the new model expressed concern about the timing of visits. Women in observation groups were, in general, satisfied with the communication with the doctor and the acquisition of knowledge during pregnancy.Conclusions:A focused five-visit schedule seems not not to affect maternal and perinatal outcomes but was more effective as expressed by reduced production cost and better use of institutional health care.