TY - JOUR
AU - A. C. M. Hermans
AU - J. Spaan
AU - M. A. A. Hermus
AU - A. M. Hietkamp
AU - J. Visser
AU - A. Franx
AU - J. van der Kooy
A1 - 
AB - INTRODUCTION: This study focusses on the implementation of an integrated care pathway for women with SGA in their obstetric history that pursues value-based healthcare. This study aims to 1) Determine whether the integrated care pathway led to a reduction in the number of antenatal secondary care consultations, as an indicator of care efficacy, and 2) compare clinical outcomes for women with a history of SGA before and after implementation of the integrated care pathway. METHODS: Retrospective cohort study including data from pregnant women with a history of SGA within integrated maternity care organisation Annature, 2017-2020. Intervention was an integrated care pathway (2018). Pre- and post-intervention periods were compared assessing prenatal secondary care consultations, place and mode of delivery, and perinatal outcomes. RESULTS: The implementation of the care pathway for pregnant women with a history of SGA led to a reduction in mean number of prenatal secondary care consultations per pregnancy from 11 in 2017-5 in 2020, and fewer inductions of labour (78 (34.2%) vs 127 (26.8%), p = 0.045). Additionally, the number of births in primary care increased (35 (15.4%) vs 136 (28.8%), p < 0.001) with no significant adverse impact on neonatal outcomes in the post-intervention period compared to the pre-intervention period. CONCLUSION: The implementation of the care pathway for pregnant women with a history of SGA resulted in a reduction in prenatal secondary care consultations and fewer inductions of labour. Additionally, the number of births in primary care increased, with no significant adverse impact on neonatal outcomes in the post-intervention period compared to the pre-intervention period.
AD - Department of Obstetrics and Gynaecology, Erasmus Medical University Centre, Rotterdam, The Netherlands.; Department of Obstetrics and Gynaecology, Amphia Hospital, Breda, The Netherlands.; Midwifery Practice Oosterhout, Oosterhout, The Netherlands.
AN - 41604407
BT - PLoS One
C5 - Healthcare Disparities; Education & Workforce
CP - 1
DO - 10.1371/journal.pone.0341071
DP - NLM
ET - 20260128
IS - 1
JF - PLoS One
LA - eng
N2 - INTRODUCTION: This study focusses on the implementation of an integrated care pathway for women with SGA in their obstetric history that pursues value-based healthcare. This study aims to 1) Determine whether the integrated care pathway led to a reduction in the number of antenatal secondary care consultations, as an indicator of care efficacy, and 2) compare clinical outcomes for women with a history of SGA before and after implementation of the integrated care pathway. METHODS: Retrospective cohort study including data from pregnant women with a history of SGA within integrated maternity care organisation Annature, 2017-2020. Intervention was an integrated care pathway (2018). Pre- and post-intervention periods were compared assessing prenatal secondary care consultations, place and mode of delivery, and perinatal outcomes. RESULTS: The implementation of the care pathway for pregnant women with a history of SGA led to a reduction in mean number of prenatal secondary care consultations per pregnancy from 11 in 2017-5 in 2020, and fewer inductions of labour (78 (34.2%) vs 127 (26.8%), p = 0.045). Additionally, the number of births in primary care increased (35 (15.4%) vs 136 (28.8%), p < 0.001) with no significant adverse impact on neonatal outcomes in the post-intervention period compared to the pre-intervention period. CONCLUSION: The implementation of the care pathway for pregnant women with a history of SGA resulted in a reduction in prenatal secondary care consultations and fewer inductions of labour. Additionally, the number of births in primary care increased, with no significant adverse impact on neonatal outcomes in the post-intervention period compared to the pre-intervention period.
PY - 2026
SN - 1932-6203
SP - e0341071
ST - Introducing an integrated maternity care pathway for women with a history of small-for-gestational-age: Evaluation of its effect on care process and clinical outcomes
T1 - Introducing an integrated maternity care pathway for women with a history of small-for-gestational-age: Evaluation of its effect on care process and clinical outcomes
T2 - PLoS One
TI - Introducing an integrated maternity care pathway for women with a history of small-for-gestational-age: Evaluation of its effect on care process and clinical outcomes
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.1371/journal.pone.0341071
VL - 21
VO - 1932-6203
Y1 - 2026
ER -