Table 8 Impact of maternity waiting homes on stillbirths and perinatal mortality

Guruvare et al. 2007 [109]

India. Six satellite maternity homes attached to the tertiary care hospital.

Descriptive intervention study.

To assess the perinatal mortality rate among pregnant women taken care of at the hospital, along with the attached satellite maternity homes. This rate was compared with the national average.

PMR: 21/1000 vs. 70/1000 live births in the study group vs. the national average. (63% of perinatal deaths were stillbirths).

Observational studies

Chandramohan et al. 1995 [106]

Zimbabwe. Rural hospital-based.

Cohort study. N = 4488 high risk pregnant women (N = 1573 in the intervention group, N = 2915 in the controls) during the period 1989–1991.

Information on antenatal risk factors, use of ANC, access to the hospital and stage of labour on arrival was collected for each woman.

Compared the effect of staying in a maternity waiting home from 36 wks to delivery (intervention) vs. going straight from home to hospital at the time of delivery (controls).

SBR: 19.2/1000 vs. 10.8/1000 in the control and intervention groups, respectively.

PMR: RR = 1.7 (95% CI: 1.1–2.6); P < 0.05.

[32.2 vs. 19.1/1000 in the control vs. intervention groups, respectively].

PMR: adj. RR = 1.5 (95% CI: 0.95–2.5); P = 0.07 in the control vs. intervention group.

However, when the analysis was restricted to women with antenatal risk factors there was a significant 50% reduction in the risk of perinatal death for the women in the intervention vs. controls (adj. RR = 1.9; 95% CI: 1.1–3.4; P < 0.05).

Poovan et al. 1990 [108]

Ethiopia. Hospital based.

Prospective cohort study. N = 777 pregnant women at high risk of complications or those living in remote areas (N = 142 intervention group, N = 635 controls).

Compared the impact of either coming via a maternity waiting home (intervention) vs. coming directly to the hospital (controls).

SBR: 28.2/1000 (4/142) vs. 253.5/1000 (161/635) births in intervention and control groups, respectively. Statistical significance data not given.

MMR: 0/1000 vs. 21.2/1000 live births in intervention and control groups, respectively. Statistical significance data not given.

Tumwine 1996 [107]

Zimbabwe. Rural district.

Prospective cohort study. N = 1,053 pregnant women (N = 280 intervention group, N = 773 controls).

Compared the impact on pregnancy outcomes of women using a maternity waiting shelter (exposed group) vs. those coming directly to the hospital i.e. non-waiting mothers (unexposed).

PMR: 25.0/1000 vs. 29.8/1000 in intervention and control groups, respectively; P > 0.05 [NS].

van Lonkhuijzen et al. 2003 [105]

Zambia. Rural setting.

Prospective cohort study. N = 510 pregnant women (N = 218 exposed group, N = 292 non-exposed).

Compared the impact on risk status and pregnancy outcome in women staying at maternity waiting homes (exposed) with those women who gave birth in hospital after direct admission (unexposed).

PMR/MMR/Birth weight: No significant differences between the two groups.

Spontaneous vaginal vertex delivery: 86% vs. 95% in the exposed and non-exposed groups, respectively.