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Table 7 Systematic reviews on the impact of ANC on stillbirth and perinatal mortality

From: Reducing stillbirths: behavioural and nutritional interventions before and during pregnancy

Source Location and Type of Study Intervention Stillbirths/Perinatal Outcomes
Reviews and meta-analyses
Hodnett and Fredericks. 2003 [70] France, Australia, USA, South Africa, England, Argentina, Brazil, Cuba, and Mexico.
Meta-analysis (Cochrane). 11 randomised controlled trials (RCTs) (N = 9507 women) included.
Compared additional support during pregnancies at risk of low birth weight by either a professional (social worker, midwife, or nurse) or specially trained layperson, to routine care. Additional support included emotional support, information/advice, and physical help. PMR: RR = 1.15 (95% CI: 0.89–1.51) [NS]a
Gagnon and Sandall.
2007 [71]
Canada, USA.
Cochrane review. 1 RCT (N = 1280 women) included (N = 641 intervention group, N = 634 controls).
As part of a strategy to define predisposing, enabling, and reinforcing factors for deciding to attempt a vaginal birth after Caesarean (VBAC), the study compared pregnancy outcomes among an intervention group given individualised prenatal education and support by a trained research nurse and a resource person with personal experience of a VBAC to a group of controls given a pamphlet highlighting the benefits of a VBAC. PMR: RR = 0.50 (95% CI: 0.09–2.69) [NS]
[2/643 vs. 4/637 in intervention group vs. controls, respectively]
Villar et al. 2001 [65] Scotland, UK.
Meta-analysis (Cochrane). 2 RCTs (N = 2890 low-risk women) included.
To assess the effects of ANC programs for low-risk women, particularly whether care provided by a midwife/general practitioner was as effective as obstetrician/gynecologist-led shared care. PMR: Odds ratio (OR) = 0.59 (95% CI: 0.28–1.26) [NS]
Carroli and Villar 2001 [57] Multiple countries.
Meta-analysis (World Health Organization, WHO). 7 RCTs (N = 57,418 women) included (N = 30,799 in intervention groups, N = 26,619 in standard ANC groups). 5 RCTs reported perinatal mortality (N = 54,005 women).
To test the impact of a reduced number of ANC visits, with or without goal-oriented components, on perinatal mortality against standard ANC. PMR: OR = 1.06 (95% CI: 0.82–1.36) [NS]
  1. aNS = Non-significant