Reducing antenatal appointments for pregnant woman is not as safe as has been thought, researchers warn today.
A new study says that women who are offered four rather than eight antenatal visits during pregnancy face a significantly increased risk of suffering a still-birth.
A few years ago a major World Health Organisation study concluded that just four visits was safe.
This led to some countries cutting the number of visits to four – but a review by the Cochrane group in 2010 warned this might be dangerous for women.
For the latest study, researchers in South Africa took a fresh look at the original study – and concluded it was wrong to say it showed four visits was adequate.
Reporting in the journal Reproductive Health, the researchers concluded that low-risk women faced a 50% increased risk of losing their baby while high risk women faced an 82% increased risk.
Professor Justus Hofmeyr, from University of the Witwatersrand, South Africa, said: "After a century of blind faith, this paper provides probably the first direct evidence from a randomised trial that routine antenatal visits for healthy pregnant women do make a difference."
He added: "An increased number of routine visits may detect asymptomatic conditions such as pre-eclampsia, foetal growth restriction or reduced foetal movements earlier, allowing more timely intervention.
"The importance of the content and quality of routine antenatal care should not be lost to policymakers when decisions about numbers of visits with the available resources are being made."
Dr Joshua Vogel, of WHO, said the findings suggested the quality of ante-natal visits was also important.
He said: "This increased risk of foetal death is linked to a reduced number of antenatal visits, but this may be due to differences in settings, content and quality of care.
"The timing and quality of visits is also important – reduced numbers of visits may miss important windows when foetuses are still at risk."
Antenatal care packages with reduced visits and perinatal mortality: a secondary analysis of the WHO Antenatal Care Trial Reproductive Health 12 April 2013, 10:19 doi:10.1186/1742-4755-10-19
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