Dowswell Therese, Middleton Philippa, Weeks Andrew
Cochrane Pregnancy and Childbirth Group, School of Reproductive and Developmental Medicine, Division of Perinatal and Reproductive Medicine, The University of Liverpool, First Floor, Liverpool Women's NHS Foundation Trust, Liverpool, UK, L8 7SS.
Cochrane Database Syst Rev. 2009 Oct 7;2009(4):CD001803. doi: 10.1002/14651858.CD001803.pub2.
Antenatal day care units have been widely used as an alternative to inpatient care for women with pregnancy complications including mild and moderate hypertension, and preterm prelabour rupture of the membranes.
The objective of this review is to compare day care units with routine care or hospital admission for women with pregnancy complications in terms of maternal and perinatal outcomes, length of hospital stay, acceptability, and costs to women and health services providers.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (February 2009).
Randomised controlled trials comparing day care with inpatient or routine care for women with complicated pregnancy.
Two review authors independently carried out data extraction and assessed studies for risk of bias.
Three trials with a total of 504 women were included. For most outcomes it was not possible to pool results from trials in meta-analyses as outcomes were measured in different ways.Compared with women in the ward/routine care group, women attending day care units were less likely to be admitted to hospital overnight (risk ratio 0.46, 95% confidence interval 0.34 to 0.62). The average length of antenatal admission was shorter for women attending for day care, although outpatient attendances were increased for this group. There was evidence from one study that women attending for day care were significantly less likely to undergo induction of labour, but mode of birth was similar for women in both groups. For other outcomes there were no significant differences between groups.The evidence regarding the costs of different types of care was mixed; while the length of antenatal hospital stays were reduced, this did not necessarily translate into reduced health service costs.While most women tended to be satisfied with whatever care they received, women preferred day care compared with hospital admission.
AUTHORS' CONCLUSIONS: Small studies suggest that there are no major differences in clinical outcomes for mothers or babies between antenatal day units or hospital admission, but women may prefer day care.
产前日间护理单元已被广泛用作患有包括轻度和中度高血压以及胎膜早破在内的妊娠并发症的女性住院护理的替代方案。
本综述的目的是比较日间护理单元与常规护理或住院治疗对患有妊娠并发症的女性在孕产妇和围产期结局、住院时间、可接受性以及对女性和医疗服务提供者的成本方面的差异。
我们检索了Cochrane妊娠与分娩组试验注册库（2009年2月）。
比较日间护理与患有复杂妊娠的女性的住院或常规护理的随机对照试验。
两位综述作者独立进行数据提取并评估研究的偏倚风险。
纳入了三项试验，共504名女性。对于大多数结局，由于结局的测量方式不同，无法在荟萃分析中汇总试验结果。与病房/常规护理组的女性相比，参加日间护理单元的女性夜间住院的可能性较小（风险比0.46，95%置信区间0.34至0.62）。参加日间护理的女性产前住院的平均时间较短，尽管该组的门诊就诊次数增加。有一项研究表明，参加日间护理的女性引产的可能性明显较小，但两组女性的分娩方式相似。对于其他结局，两组之间没有显著差异。关于不同类型护理成本的证据不一；虽然产前住院时间缩短了，但这不一定转化为医疗服务成本的降低。虽然大多数女性往往对她们接受的任何护理都感到满意，但与住院相比，女性更喜欢日间护理。
小型研究表明，产前日间护理单元或住院治疗对母亲或婴儿的临床结局没有重大差异，但女性可能更喜欢日间护理。
