Home visits for pregnancy complications and management of antenatal care: an overview of three randomized controlled trials.
OBJECTIVE
To examine whether a policy of home visits reduces the amount of antenatal care provided by hospital maternity units.


METHODS
A meta-analysis of three randomized controlled trials.


METHODS
9 maternity units in France.


METHODS
1410 women with pregnancy complications.


METHODS
1 or 2 home visits a week by a midwife.


METHODS
Admission rate and length of stay in hospital.


RESULTS
The home-visiting system did not affect the hospital admission rate (typical odds ratio = 0.9; 95% CI = 0.7-1.2). In each trial, the length of hospital stay did not differ between the intervention and the control groups.


CONCLUSIONS
The home-visiting system did not greatly alter the practice of antenatal hospital admission in the maternity units studied. The results question the way the health services were used and suggest that a better integration of hospital and home services is needed to make a more rational use of health care resources.
Blondel
B
B
INSERM-U 149, Maternal and Child Health Epidemiological, Villejuif, France.
Breart
G
G
D005260:Female; D005602:France; D006760:Hospitalization; D006792:House Calls; D006801:Humans; D007902:Length of Stay; D015201:Meta-Analysis as Topic; D008880:Midwifery / Q000191:economics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011295:Prenatal Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic