Child and maternal benefits and risks of caseload midwifery – a systematic review and meta-analysis
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Le résumé fourni par la source
BACKGROUND: It has been reported that caseload midwifery, which implies continuity of midwifery care during pregnancy, childbirth, and the postnatal period, improves the outcomes for the mother and child. The aim of this study was to review benefits and risks of caseload midwifery, compared with standard care comparable to the Swedish setting where the same midwife usually provides antenatal care and the checkup postnatally, but does not assist during birth and the first week postpartum. METHODS: Medline, Embase, Cinahl, and the Cochrane Library were searched (Nov 4th, 2021) for randomized controlled trials (RCTs). Retrieved articles were assessed and pooled risk ratios calculated when possible, using random-effects meta-analyses. Certainty of evidence was assessed according to GRADE. RESULTS: In all, 7,594 patients in eight RCTs were included, whereof five RCTs without major risk of bias, including 5,583 patients, formed the basis for the conclusions. There was moderate certainty of evidence for little or no difference regarding the risk of Apgar ≤ 7 at 5 min, instrumental birth, and preterm birth. There was low certainty of evidence for little or no difference regarding the risk of perinatal mortality, neonatal intensive care, perineal tear, bleeding, and acute caesarean section. Caseload midwifery may reduce the overall risk of caesarean section. Regarding breastfeeding after hospital discharge, maternal mortality, maternal morbidity, health-related quality of life, postpartum depression, health care experience/satisfaction and confidence, available studies did not allow conclusions (very low certainty of evidence). For severe child morbidity and Apgar ≤ 4 at 5 min, there was no literature available. CONCLUSIONS: When caseload midwifery was compared with models of care that resembles the Swedish one, little or no difference was found for several critical and important child and maternal outcomes with low-moderate certainty of evidence, but the risk of caesarean section may be reduced. For several outcomes, including critical and important ones, studies were lacking, or the certainty of evidence was very low. RCTs in relevant settings are therefore required.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Child and maternal benefits and risks of caseload midwifery – a systematic review and meta-analysis
- Date Crossref
- 15/09/2023
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Sahlgrenska University Hospital Department of Obstetrics and Gynecology pays non établi dans la noticeÉtablissement de santé
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Lund University Department of Clinical Sciences Malmö pays non établi dans la noticeUniversité ou école supérieure
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Skåne University Hospital Department Research and education pays non établi dans la noticeÉtablissement de santé
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Region Västra Götaland pays non établi dans la noticeOrganisme public
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University of Gothenburg Department of Pharmacology pays non établi dans la noticeUniversité ou école supérieure
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Regional Healthcare pays non établi dans la noticeInstitution
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Midwifery Clinic in Primary Care pays non établi dans la noticeÉtablissement de santé
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Medical faculty Department of Health Science pays non établi dans la noticeUniversité ou école supérieure
Department of Obstetrics and Gynecology — Sahlgrenska University Hospital, Department of Clinical Sciences Malmö — Lund University et Department Research and education — Skåne University Hospital, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.