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Fewer Visits May Suffice in Low-Risk Pregnancies

Adequate prenatal care is important in ensuring good pregnancy outcomes. But how much is adequate? This study addressed the question by randomizing 2764 low-risk pregnant women to 14 prenatal visits -- the current standard in the U.S. -- or 9 visits. All women presented to the Kaiser Permanente group in Colorado during their first trimester. Neither patients nor clinicians were blinded to the nature of the study, and added visits could be scheduled if risk factors were identified.

The group assigned to 14 visits averaged 12.9 visits, while the 9-visit group averaged 10.3. Although this was 2.6 visits fewer than the 14-visit group, the 9-visit group had no significant increases in the rates of preterm delivery, preeclampsia, C-section, or low-birth-weight infants. Nor did satisfaction differ between the groups, as determined by surveys at the six-week postpartum visit (completion rate, 51%).

Comment: In 1989, an expert panel organized by the Public Health Service recommended the reduced schedule of prenatal visits used in this study. The findings suggest that scheduling only 9 visits for low-risk pregnancies is safe and does not compromise patient satisfaction. However, these patients were mostly white and well-educated; generalizing to other populations may not be appropriate.

— SD Gharib

Published in Journal Watch Women's Health April 1, 1996

Citation(s):

McDuffie RS Jr et al. Effect of frequency of prenatal care visits on prenatal outcome among low-risk women: a randomized controlled trial. JAMA 1996 Mar 20 275 847-851.

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