OBJECTIVE: To assess the effectiveness of models of antenatal care designed to prevent and reduce @entity600 ( @entity600 ) in pregnant @entity1 . METHODS: We conducted a search of seven electronic databases and reference lists of retrieved studies to identify trials from inception up to July 2014 where pregnant @entity1 , regardless of risk factors for pregnancy complications, were randomly allocated to receive an alternative model of antenatal care or routine care. We pooled risks of @entity600 to determine the effect of alternative care models in all pregnant @entity1 . We also assessed secondary maternal and @entity1 outcomes, @entity1 's satisfaction and economic outcomes. RESULTS: 15 trials involving 22   437 @entity1 were included. Pregnant @entity1 in alternative care models were less likely to experience @entity600 (risk ratio 0.84, 95% CI 0.74 to 0.96). The subgroup of @entity1 randomised to midwife-led continuity models of antenatal care were less likely to experience @entity600 (0.78, 0.66 to 0.91) but there was no significant difference between this group and @entity1 allocated to specialised care (0.92, 0.76 to 1.12) (interaction test for subgroup differences p=0.20). Overall low-risk @entity1 in alternative care models were less likely to have @entity600 (0.74, 0.59 to 0.93), but this effect was not significantly different from that in mixed-risk populations (0.91, 0.79 to 1.05) (subgroup p=0.13). CONCLUSIONS: Alternative models of antenatal care for all pregnant @entity1 are effective in reducing @entity600 compared with routine care, but no firm conclusions could be drawn regarding the relative benefits of the two models. Future research should evaluate the impact of antenatal care models which include more recent interventions and predictive tests, and which also offer continuity of care by midwives throughout pregnancy. PROSPERO REGISTRATION NUMBER: CRD42014007116.

Models of antenatal care to reduce and prevent XXXX : a systematic review and meta-analysis.

@entity1 :: ('9606', 'Species') :: ['women', 'infant'] @entity600 :: ('MESH:D000014', 'Disease') :: ['preterm birth', 'PTB']
@entity600 :: (MESH:D000014,Disease) :: ['preterm birth']
