Incentivos para el aumento del uso de la atención prenatal por parte de las pacientes para mejorar los resultados maternos y neonatales
Información
- DOI:
- https://doi.org/10.1002/14651858.CD009916.pub2Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 15 diciembre 2015see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Embarazo y parto
- Copyright:
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- Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Sara R Till assisted in conceiving the review, designing the review, writing the protocol. She provided a clinical and policy perspective. She reviewed studies, extracted data, and wrote the review.
David Everetts provided general advice on the protocol, its preparation, and contributed to the writing of the review.
David M Haas assisted in designing the review, reviewed studies and extracted data, contributed to the writing of the review, and is guarantor for the review. He provided a clinical and methodological perspective, as well as providing general advice on the protocol.
Declarations of interest
Sara R Till: none known.
David Everetts: none known.
David M Haas: none known.
Acknowledgements
As part of the pre‐publication editorial process, this review has been commented on by three peers (an editor and two referees who are external to the editorial team), a member of the Pregnancy and Childbirth Group's international panel of consumers and the Group's Statistical Adviser.
This project was supported by the National Institute for Health Research, via Cochrane Infrastructure funding to Cochrane Pregnancy and Childbirth. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health.
Version history
| Published | Title | Stage | Authors | Version |
| 2015 Dec 15 | Incentives for increasing prenatal care use by women in order to improve maternal and neonatal outcomes | Review | Sara R Till, David Everetts, David M Haas | |
| 2012 Jun 13 | Incentives for increasing prenatal care use by women in order to improve maternal and neonatal outcomes | Protocol | David M Haas, Sara R Till, David Everetts | |
Differences between protocol and review
'Return for postpartum care' was added as a secondary outcome after publication of our protocol (Haas 2012). Given that postpartum care is widely regarded to be an essential component of perinatal care, the authors felt that return for postpartum care was consistent with the spirit of the frequency and adequacy of prenatal care outcome measures and should be included as a separate secondary outcome.
Some outcomes have been rephrased.
Primary outcome
'Perinatal deaths (fetal, neonatal, later deaths)' has been edited to 'Perinatal deaths (fetal, neonatal, infant deaths)'.
Secondary outcomes
'Adequacy of prenatal care (APNCU index or as reported by trialists)' has been edited to 'Adequacy of prenatal care.
'Frequencey of prenatal care (number of episodes per woman)' has been edited to 'Frequency of prenatal care'.
'Initiation of prenatal care (gestational age)' has been edited to 'Initiation of prenatal care'.
We have updated our methods in line with the current standard methods for Cochrane Pregnancy and Childbirth.
Subgroup analysis ‐ 'return for postpartum' care was examined with subgroup analysis given the substantial heterogeneity in meta‐analysis ‐ this was not prespecified in our published protocol.
We have rephrased one of our planned subgroup analyses ‐ 'monetary incentives versus goods/services incentives' was changed to 'cash versus non‐cash incentives',
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Adult; Female; Humans; Infant, Newborn; Pregnancy;
PICO
Study flow diagram.
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Comparison 1 Pregnant women who received incentives versus those who did not receive incentives, Outcome 1 Adequacy of prenatal care.
Comparison 1 Pregnant women who received incentives versus those who did not receive incentives, Outcome 2 Frequency of prenatal care.
Comparison 1 Pregnant women who received incentives versus those who did not receive incentives, Outcome 3 Initiation of prenatal care.
Comparison 1 Pregnant women who received incentives versus those who did not receive incentives, Outcome 4 Return for postpartum care.
Comparison 1 Pregnant women who received incentives versus those who did not receive incentives, Outcome 5 Cesarean delivery rate.
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Adequacy of prenatal care Show forest plot | 1 | 892 | Mean Difference (IV, Fixed, 95% CI) | 5.84 [1.88, 9.80] |
| 2 Frequency of prenatal care Show forest plot | 1 | 606 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.18 [1.01, 1.38] |
| 3 Initiation of prenatal care Show forest plot | 1 | 104 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.04 [0.78, 1.38] |
| 4 Return for postpartum care Show forest plot | 2 | 833 | Risk Ratio (M‐H, Random, 95% CI) | 0.75 [0.21, 2.64] |
| 4.1 Cash incentives | 1 | 593 | Risk Ratio (M‐H, Random, 95% CI) | 0.43 [0.30, 0.62] |
| 4.2 Non‐cash incentives | 1 | 240 | Risk Ratio (M‐H, Random, 95% CI) | 1.26 [1.09, 1.47] |
| 5 Cesarean delivery rate Show forest plot | 1 | 979 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.97 [1.18, 3.30] |
