Whitworth, Melissa, Quenby, Siobahn, Cockerill, Ruth O. and Dowswell, Therese. (2011) Specialised antenatal clinics for women with a pregnancy at high risk of preterm birth (excluding multiple pregnancy) to improve maternal and infant outcomes. Cochrane Database of Systematic Reviews, Vol.9 . Article No.CD006760. ISSN 1469-493X

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Abstract

Background: Amongst the risk factors for preterm birth, previous preterm delivery is a strong predictor. Specialised clinics for women with a history of spontaneous preterm delivery have been advocated as a way of improving outcomes for women and their infants. Objectives: To assess using the best available evidence, the value of specialised antenatal clinics for women with a pregnancy at high risk of preterm delivery when compared with 'standard' antenatal clinics. Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2011). Selection criteria: All published, unpublished, and ongoing randomised controlled trials (including cluster-randomised trials) examining specialised compared with standard antenatal clinic care for women with a singleton pregnancy considered at high risk of preterm labour. Data collection and analysis: Two review authors independently assessed trial quality and extracted data. Main results: We included three trials with 3400 women, all carried out in the USA. All focused on specialised clinics for women at high risk of preterm birth. Gestational age at delivery, preterm delivery, or both were primary outcomes in all studies. The interventions in the three trials differed. Overall there was very little data on our prespecified outcomes. For most outcomes a single study provided data, hence there was not the statistical power to detect any possible differences between groups. There was no clear evidence that specialised antenatal clinics reduce the number of preterm births. Authors' conclusions: Specialised antenatal clinics are now an accepted part of care in many settings, and carrying out further randomised trials may not be possible. Any future research in this area should include psychological outcomes and should focus on which aspects of service provision are preferred by women. Such research could underpin further service development in this area.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General) R Medicine > RG Gynecology and obstetrics
Divisions:	Faculty of Medicine > Warwick Medical School > Clinical Sciences Research Institute (CSRI) Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Maternal health services, Prenatal care, Premature labor, Systematic reviews (Medical research)
Journal or Publication Title:	Cochrane Database of Systematic Reviews
Publisher:	John Wiley & Sons Ltd.
ISSN:	1469-493X
Date:	2011
Volume:	Vol.9
Page Range:	Article No.CD006760
Identification Number:	10.1002/14651858.CD006760.pub2
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	University of Liverpool, National Institute for Health Research (Great Britain) (NIHR)
URI:	http://wrap.warwick.ac.uk/id/eprint/38747

Data sourced from Thomson Reuters' Web of Knowledge

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