Reduced antenatal visits add risk

Tags: pregnancy

Fetal death risk is heightened between 32-36 weeks for women with a reduced antenatal care package.

Re-analysis of the World Health Organisation's Antenatal Care Trial (WHOACT) showed that there was an increased risk of fetal death for women who had lower numbers of antenatal visits during pregnancy.

An original analysis of the WHOACT had concluded that reducing antenatal visits of low risk women from eight to four was not detrimental to their or their babies' health and could cut costs.

However, an international group of researchers decided to re-analyse the data in light of the 2010 Cochrane review, which suggested that reduced antenatal visits were in fact detrimental to health.

Once the data was adjusted for maternal risk, such as smoking, age, and education, the group found the increase risk of fetal death was highest between 32 and 36 weeks.

Specifically, for high risk women the risk of fetal death at 36 weeks or less was 80% higher while for low risk women it increased by 50%.

"This increased risk of fetal death is linked to a reduced number of antenatal visits, but this may be due to differences in settings, content and quality of care," said Dr Joshua Vogel from the World Health Organization.

"The timing and quality of visits is also important - reduced numbers of visits may miss important windows when fetuses are still at risk."

The research - published in BioMed Central's open access journal Reproductive Health  - suggests that routine antenatal visits for healthy pregnant women do make a difference.
Copyright Press Association 2013


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