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. 2020 Mar 18;20(1):171.
doi: 10.1186/s12884-020-2822-5.

Systematic review of the measurement properties of indices of prenatal care utilization

Stewart Rowe  1 , Zahra Karkhaneh  1 , Isaiah MacDonald  1 , Thane Chambers  2 , Sana Amjad  3 , Alvaro Osornio-Vargas  4 , Radha Chari  1 , Manoj Kumar  4 , Maria B Ospina  5   6   7
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Systematic review of the measurement properties of indices of prenatal care utilization

Stewart Rowe et al. BMC Pregnancy Childbirth. .

Abstract

Background: An accurate assessment of the adequacy of prenatal care utilization is critical to inform the relationship between prenatal care and pregnancy outcomes. This systematic review critically appraises the evidence on measurement properties of prenatal care utilization indices and provides recommendations about which index is the most useful for this purpose.

Methods: MEDLINE, EMBASE, CINAHL, and Web of Science were systematically searched from database inception to October 2018 using keywords related to indices of prenatal care utilization. No language restrictions were imposed. Studies were included if they evaluated the reliability, validity, or responsiveness of at least one index of adequacy of prenatal care utilization. We used the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. We conducted an evidence synthesis using predefined criteria to appraise the measurement properties of the indices.

Results: From 2664 studies initially screened, 13 unique studies evaluated the measurement properties of at least one index of prenatal care utilization. Most of the indices of adequacy of prenatal care currently used in research and clinical practice have been evaluated for at least some form of reliability and/or validity. Evidence about the responsiveness to change of these indices is absent from these evaluations. The Adequacy Perinatal Care Utilization Index (APNCUI) and the Kessner Index are supported by moderate evidence regarding their reliability, predictive and concurrent validity.

Conclusion: The scientific literature has not comprehensively reported the measurement properties of commonly used indices of prenatal care utilization, and there is insufficient research to inform the choice of the best index. Lack of strong evidence about which index is the best to measure prenatal care utilization has important implications for tracking health care utilization and for formulating prenatal care recommendations.

Keywords: Pregnancy; Prenatal care; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA study flow for the review
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References

    1. Society of Obstetricians and Gynecologists of Canada . SOGC Clinical Practice Guidelines: Healthy beginnings: Guidelines for care during pregnancy and childbirth. Policy Statement No. 71. 1998.
    1. Andresen BS, Knudsen I, Jensen PKA, Rasmussen K, Gregersen N. Two novel nonradioactive polymerase chain reaction-based assays of dried blood spots, genomic DNA, or whole cells for fast, reliable detection of Z and S mutations in the alpha1-antitrypsin gene. Clin Chem. 1992;38(10):2100–2107. doi: 10.1093/clinchem/38.10.2100. - DOI - PubMed
    1. Omar MA, Schiffman RF. Satisfaction and adequacy of prenatal care utilization among rural low-income women. Outcomes Manag Nurs Pract. 2000;4(2):91–96. - PubMed
    1. Symon A, Pringle J, Downe S, Hundley V, Lee E, Lynn F, et al. Antenatal care trial interventions: a systematic scoping review and taxonomy development of care models. BMC Pregnancy Childbirth. 2017;17(1):8. doi: 10.1186/s12884-016-1186-3. - DOI - PMC - PubMed
    1. Dowswell T, Carroli G, Duley L, Gates S, Gulmezoglu AM, Khan-Neelofur D, et al. Alternative versus standard packages of antenatal care for low-risk pregnancy. Cochrane Database Syst Rev. 2015;7:CD000934. - PMC - PubMed

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