WHOは,定期的な産前ケアに関するランダム化比較試験を体系的にレビューした
G Carroli1, J Villar, G Piaggio
1Centro Rosarino de Estudios Perinatales, Pueyrredon 985, 2000, Rosario, Argentina. CREP@satlink.com
Lancet (London, England)
|May 30, 2001
まとめ
産前診察の数を減らすことは,母と乳児の健康上の結果について標準的なケアと同じくらい効果的です. この新しい産前ケアモデルは,母親の不満を招くかもしれないが,コストを削減する.
科学分野:
- 産婦人科と産婦人科を担当しています.
- 公衆衛生は公衆衛生である.
- 根拠に基づいた医学は,証拠に基づいた医療です.
背景:
- 標準的な産前ケアプログラムには,訪問頻度やタイミングに関する確固たる証拠がない.
- 様々な産前ケアモデルを評価するために,ランダム化試験のシステマティック・レビューが行われました.
研究 の 目的:
- 短縮された産前訪問スケジュールは,標準的なケアと同じくらい効果的かどうかを評価する.
- 標準的および削減された産前訪問モデル間の臨床結果,患者満足度,およびコストを比較するために.
主な方法:
- 57,000人以上の女性を対象とした7つのランダム化比較試験の体系的レビュー.
- 標準的な産前訪問プログラムと比較して,より少ない産前訪問を持つ新しいモデルを比較しました.
- 妊娠中絶前症,感染症,死亡率,出生体重,満足度,費用対効果など,分析されたアウトカム.
主要な成果:
- 妊娠前出血症,感染症,産後貧血,妊産婦死亡率,低出生体重における有意な臨床的差異は観察されなかった.
- 産前死亡率は,グループごとに類似していた.
- 訪問削減モデルでは,同等またはより低いコストがかかりましたが,特に先進国では,一定の不満が指摘されました.
結論:
- 減少した産前訪問モデルは,母親や赤ちゃんに対するリスクを増やすことなく,安全に実施できます.
- 新しいモデルでは,コスト削減の可能性が存在します.
- 母親の満足度は影響を受ける可能性があり,実施の際には慎重に検討する必要があります.
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