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Implementation of integrated maternity care in the southwestern region of the Netherlands: evaluation of its effect on preterm birth, low birthweight infants and number of secondary care consultations

Por: Hermans · A. · Spaan · J. · Hermus · M. · Visser · J. · Annature Research Collaboration · Franx · A. · Kooy · J. v. d.
Objectives

To determine whether integrated maternity care is associated with reduced preterm births (PTB) and fewer small-for-gestational-age infants (SGA), and whether its implementation leads to a reduction of secondary care consultations.

Design

Retrospective study.

Setting

Integrated maternity care organisation in the southwestern region of the Netherlands.

Participants

All singleton pregnancies (≥24 weeks) within integrated maternity care organisation Annature between 2015 and 2020.

Intervention

Implementation of a shared maternity record in primary and secondary care.

Methods

Data of 20 818 women were derived from patient records and from the Netherlands Perinatal Registry. Intervention was the introduction of integrated maternity care in January 2018. Through multivariate logistic regression and segmented regression analysis we assessed the combined prevalence of SGA and PTB (SGA-PTB) before (2015–2017), and after the intervention (2018–2020). Regional rates were contrasted with nationwide rates (n=782 176).

Main outcome measures

SGA-PTB prevalence and mean number of secondary care consultations per pregnancy.

Results

SGA-PTB prevalence declined from 618/3443 (17.9%) in 2015 to 560/3501 (16.0%) in 2017 to 507/3459 (14.7%) in 2020 (p

Conclusion

Our results suggest that implementation of integrated maternity care was associated with reduced PTBs and/or low birth weight, and fewer secondary care consultations. These encouraging findings were observed in a less favourable sociodemographic profile and should be confirmed in other regions with sufficiently large populations, and the possibility to test individual components of integrated maternity care.

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