Group antenatal care versus standard antenatal care and effect on mean gestational age at birth in Rwanda: protocol for a cluster randomized controlled trial

Gates Open Research

article

Sabine Furere Musange¹  Elizabeth Butrick²  Tiffany Lundeen²  Nicole Santos²  Hana Azman Firdaus²  Alejandra Benitez²  David Nzeyimana¹  Nathalie Kayiramirwa Murindahabi¹  Lauriane Nyiraneza⁴  Felix Sayinzoga⁴  Vedaste Ndahindwa¹  Fidele Ngabo⁴  Jeanine Condo⁵  Dylis Walker² 

[1] School of Public Health, College of Medicine and Health Sciences, University of Rwanda;Institute for Global Health Sciences, University of California San Francisco;University of California;Maternal, Child and Community Health Division - Institute of HIV/AIDs, Disease Prevention and Control, Rwanda Biomedical Center;Rwanda Biomedica Center;Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco

关键词: Antenatal care;    Postnatal care;    Group care;    Group based antenatal care;    Group prenatal care;    Centering Pregnancy;    Sub-Saharan Africa;    Pregnancy;    Preterm birth;    Gestational age;   

DOI  :  10.12688/gatesopenres.13053.1

学科分类：电子与电气工程

来源: American Journal Of Pharmtech Research

【 摘 要 】

Background: Group antenatal care has demonstrated promise as a service delivery model that may result in improved outcomes compared to standard antenatal care in socio-demographic populations at disparately high risk for poor perinatal outcomes. Intrigued by results from the United States showing lower preterm birth rates among high-risk women who participate in group antenatal care, partners working together as the Preterm Birth Initiative - Rwanda designed a trial to assess the impact of group antenatal care on gestational age at birth. Methods: This study is a pair-matched cluster randomized controlled trial with four arms. Pairs randomized to group or standard care were further matched with other pairs into quadruples, within which one pair was assigned to implement basic obstetric ultrasound at the health center and early pregnancy testing at the community. At facilities randomized to group care, this will follow the opt-out model of service delivery and individual visits will always be available for those who need or prefer them. The primary outcome of interest is mean gestational age at birth among women who presented for antenatal care before 24 completed weeks of pregnancy and attended more than one antenatal care visit. Secondary outcomes of interest include attendance at antenatal and postnatal care, preterm birth rates, satisfaction of mothers and providers, and feasibility. A convenience sample of women will be recruited to participate in a longitudinal survey in which they will report such indicators as self-reported health-related behaviors and depressive symptoms. Providers will be surveyed about satisfaction and stress. Discussion: This is the largest cluster randomized controlled trial of group antenatal and postnatal care ever conducted, and the first in a low- or middle-income country to examine the effect of this model on gestational age at birth. Trial registration: This study is registered on ClinicalTrials.gov as NCT03154177 May 16, 2017.

【 授权许可】

CC BY