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Article

Association between Adherence with Recommended Antenatal Care in Low-Risk, Uncomplicated Pregnancy, and Maternal and Neonatal Adverse Outcomes: Evidence from Italy

by 1,2, 1,2,*, 3, 1,2, 4, 5, 1,6 and 7 on behalf of the Monitoring and Assessing Diagnostic-Therapeutic Paths (MAP) Working Group of the Italian Heath Ministry
1
National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
2
Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
3
Department of Obstetrics and Gynecology, ASST Vimercate, Vittorio Emanuele III Hospital, University of Milano-Bicocca, Monza-Brianza, 20126 Milan, Italy
4
Welfare Department, Epidemiologic Observatory, Lombardy Region, 20121 Milan, Italy
5
Department of Health Planning, Italian Health Ministry, 5–00144 Rome, Italy
6
Center of Epidemiology and Biostatistics, Polytechnic University of Marche, 60121 Ancona, Italy
7
Woman and Child Health Department, Azienda Ospedaliera della Provincia di Lecco, 23900 Lecco, Italy
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2021, 18(1), 173; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010173
Received: 17 November 2020 / Revised: 23 December 2020 / Accepted: 24 December 2020 / Published: 29 December 2020
(This article belongs to the Special Issue Real-World Evidence in Clinical Epidemiology and Public Health)
Antenatal care (ANC) aims of monitoring wellbeing of mother and foetus during pregnancy. We validate a set of indicators aimed of measuring the quality of ANC of women on low-risk, uncomplicated pregnancy through their relationship with maternal and neonatal outcomes. We conducted a population-based cohort study including 122,563 deliveries that occurred between 2015 and 2017 in the Lombardy Region, Italy. Promptness and appropriateness of number and timing of gynaecological visits, ultrasounds and laboratory tests were evaluated. We assessed several maternal and neonatal outcomes. Log-binomial regression models were used to estimate prevalence ratio (PR), and corresponding 95% confidence interval (95% CI), for the exposure→outcome association. Compared with women who adhered with recommendations, those who were no adherent had a significant higher prevalence of maternal intensive care units admission (PR: 3.1, 95%CI: 1.2–7.9; and 2.7, 1.1–7.0 respectively for promptness of gynaecological visits, and appropriateness of ultrasound examinations), low Apgar score (1.6, 1.1–1.2; 1.9, 1.3–2.7; and 2.1, 1.5–2.8 respectively for appropriateness and promptness of gynaecological visits, and appropriateness of ultrasound examinations), and low birth weight (1.8, 1.5–2.3 for appropriateness of laboratory test examinations). Benefits for mothers and newborn are expected from improving adherence to guidelines-driven recommendations regarding antenatal care even for low-risk, uncomplicated pregnancies. View Full-Text
Keywords: antenatal care; maternal outcomes; neonatal outcomes; periodic examinations; pregnancy; recommendations antenatal care; maternal outcomes; neonatal outcomes; periodic examinations; pregnancy; recommendations
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MDPI and ACS Style

Corrao, G.; Cantarutti, A.; Locatelli, A.; Porcu, G.; Merlino, L.; Carbone, S.; Carle, F.; Zanini, R., on behalf of the Monitoring and Assessing Diagnostic-Therapeutic Paths (MAP) Working Group of the Italian Heath Ministry. Association between Adherence with Recommended Antenatal Care in Low-Risk, Uncomplicated Pregnancy, and Maternal and Neonatal Adverse Outcomes: Evidence from Italy. Int. J. Environ. Res. Public Health 2021, 18, 173. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010173

AMA Style

Corrao G, Cantarutti A, Locatelli A, Porcu G, Merlino L, Carbone S, Carle F, Zanini R on behalf of the Monitoring and Assessing Diagnostic-Therapeutic Paths (MAP) Working Group of the Italian Heath Ministry. Association between Adherence with Recommended Antenatal Care in Low-Risk, Uncomplicated Pregnancy, and Maternal and Neonatal Adverse Outcomes: Evidence from Italy. International Journal of Environmental Research and Public Health. 2021; 18(1):173. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010173

Chicago/Turabian Style

Corrao, Giovanni, Anna Cantarutti, Anna Locatelli, Gloria Porcu, Luca Merlino, Simona Carbone, Flavia Carle, and Rinaldo Zanini on behalf of the Monitoring and Assessing Diagnostic-Therapeutic Paths (MAP) Working Group of the Italian Heath Ministry. 2021. "Association between Adherence with Recommended Antenatal Care in Low-Risk, Uncomplicated Pregnancy, and Maternal and Neonatal Adverse Outcomes: Evidence from Italy" International Journal of Environmental Research and Public Health 18, no. 1: 173. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010173

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