Résumé :
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[BDSP. Notice produite par INIST-CNRS coJR0xJ3. Diffusion soumise à autorisation]. Objective. We compared outcomes, safety, and resource utilization in a collaborative management birth center model of perinatal care versus traditional physician-based care. Methods. We studied 2957 low-risk, low-income women : 1808 receiving collaborative care and 1149 receiving traditional care. Results. Major antepartum (adjusted risk difference [RD]=-0.5% ; 95% confidence interval [CI]=-2.5,1.5), intrapartum (adjusted RD=0.8% ; 95% CI=-2.4,4.0), and neonatal (adjusted RD=-1.8% ; 95% CI=-3.8,0.1) complications were similar, as were neonatal intensive care unit admissions (adjusted RD=-1.3% ; 95% CI=-3.8,1.1). Collaborative care had a greater number of normal spontaneous vaginal deliveries (adjusted RD=14.9% ; 95% CI=11.5,18.3) and less use of epidural anesthesia (adjusted RD=-35.7% ; 95% CI=-39.5, - 31.8). Conclusions. For low-risk women, both scenarios result in safe outcomes for mothers and babies. However, fewer operative deliveries and medical resources were used in collaborative care.
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