Improving Pregnancy Outcomes through Maternity Care Coordination: A Systematic Review

Womens Health Issues. 2016 Jan-Feb;26(1):87-99. doi: 10.1016/j.whi.2015.10.003. Epub 2015 Nov 12.

Abstract

Background: Care during pregnancy is multifaceted and often goes beyond traditional prenatal care from an obstetrical care provider. Coordinating care between multiple providers can be challenging, but is beneficial for providers and patients. Care coordination is associated with decreased costs, greater patient satisfaction, and a reduction in medical errors. To our knowledge, no previous review has examined maternity care coordination (MCC) programs and their association with pregnancy outcomes.

Methods: Using a search algorithm comprised of relevant MCC terminology, studies were identified through a systematic search of PubMed, Scopus, ClinicalTrials.gov, and Google Scholar. Studies meeting eligibility criteria (e.g., defining the care coordination components and examining at least one quantitative outcome) were fully abstracted and quality rated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist.

Main findings: Thirty-three observational studies of MCC were included in this review. Quality scores ranged from 27% to 100%. Most studies included strategies with a team approach to decision making and/or individual case management. Social service referrals to outside organizations were also common. Twenty-seven studies reported infant birth weight as a main outcome; 12 found a significant improvement in birth weights among care coordination participants.

Conclusions: Roughly one-third of the included studies reported improved birth weights among care coordination participants. However, it remains unknown what effect care coordination strategies have on patient and provider satisfaction in the prenatal care setting, two aspects of maternity care that may advance the quality and utilization of prenatal health services.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Continuity of Patient Care*
  • Delivery of Health Care, Integrated / organization & administration*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Maternal Health Services / organization & administration*
  • Medical Record Linkage
  • Pregnancy
  • Pregnancy Outcome*
  • Prenatal Care / statistics & numerical data*
  • Quality Improvement
  • United States