{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:18:35Z","timestamp":1784287115330,"version":"3.55.0"},"reference-count":34,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["10100022020013"],"award-info":[{"award-number":["10100022020013"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,10,3]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether integrated maternity care is associated with reduced preterm births (PTB) and fewer small-for-gestational-age infants (SGA), and whether its implementation leads to a reduction of secondary care consultations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Integrated maternity care organisation in the southwestern region of the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All singleton pregnancies (\u226524 weeks) within integrated maternity care organisation Annature between 2015 and 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Implementation of a shared maternity record in primary and secondary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data of 20\u2009818\u2009women were derived from patient records and from the Netherlands Perinatal Registry. Intervention was the introduction of integrated maternity care in January 2018. Through multivariate logistic regression and segmented regression analysis we assessed the combined prevalence of SGA and PTB (SGA-PTB) before (2015\u20132017), and after the intervention (2018\u20132020). Regional rates were contrasted with nationwide rates (n=782\u2009176).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>SGA-PTB prevalence and mean number of secondary care consultations per pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>SGA-PTB prevalence declined from 618\/3443 (17.9%) in 2015 to 560\/3501 (16.0%) in 2017 to 507\/3459 (14.7%) in 2020 (p&lt;0.005). Mean number of secondary care consultations declined from six per pregnancy in 2015 to three in 2020. Logistic regression demonstrated a significant decline in odds of SGA-PTB (OR 0.83 (95% CI 0.77 to 0.89)) between 2015\u20132017 and 2018\u20132020 adjusted for changes in sociodemographic characteristics over time. A statistically significant average monthly 7.3% (p=0.05) reduction in SGA-PTB prevalence and 12.4% (p&lt;0.005) mean monthly reduction in secondary care consultations were demonstrated for 2015\u20132017. Immediately after the intervention, mean monthly prevalence of SGA-PTB dropped non-significantly to 14.7%. Between 2018 and 2020\u2009a significant 15.2% (p&lt;0.005) reduction in secondary care consultations was shown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results suggest that implementation of integrated maternity care was associated with reduced PTBs and\/or low birth weight, and fewer secondary care consultations. These encouraging findings were observed in a less favourable sociodemographic profile and should be confirmed in other regions with sufficiently large populations, and the possibility to test individual components of integrated maternity care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-069556","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:32:49Z","timestamp":1704846769000},"page":"e069556","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Implementation of integrated maternity care in the southwestern region of the Netherlands: evaluation of its effect on preterm birth, low birthweight infants and number of secondary care consultations"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6976-1201","authenticated-orcid":false,"given":"Anne","family":"Hermans","sequence":"first","affiliation":[{"name":"Gynaecology and Obstetrics, Erasmus MC, Rotterdam, the Netherlands"},{"name":"Gynaecology and Obstetrics, Amphia Hospital, Breda, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Spaan","sequence":"additional","affiliation":[{"name":"Gynaecology and Obstetrics, Amphia Hospital, Breda, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke","family":"Hermus","sequence":"additional","affiliation":[{"name":"Midwifery Practice, Oosterhout, Breda, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jantien","family":"Visser","sequence":"additional","affiliation":[{"name":"Gynaecology and Obstetrics, Amphia Hospital, Breda, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Annature Research Collaboration","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie","family":"Franx","sequence":"additional","affiliation":[{"name":"Gynaecology and Obstetrics, Erasmus MC, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacoba van der","family":"Kooy","sequence":"additional","affiliation":[{"name":"Gynaecology and Obstetrics, Erasmus MC, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"2025121602303173000_14.1.e069556.1","article-title":"Decrease in foetal and neonatal mortality in the Netherlands; comparison with other Euro-Peristat countries in 2004, 2010 and 2015","volume":"163","author":"Broeders","year":"2019","journal-title":"Ned Tijdschr Geneeskd"},{"key":"2025121602303173000_14.1.e069556.2","unstructured":"Perined | Home [Internet], Available: https:\/\/www.perined.nl\/"},{"key":"2025121602303173000_14.1.e069556.3","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1111\/1471-0528.15857","article-title":"Perinatal health monitoring through a European lens: eight lessons from the Euro-Peristat report on 2015 births","volume":"126","author":"Zeitlin","year":"2019","journal-title":"BJOG"},{"key":"2025121602303173000_14.1.e069556.4","unstructured":"European perinatal health report. 2018. 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