Randomised controlled field trial of two antenatal care packages in rural south India.

A randomized community intervention trial was undertaken in 12 subcenters in Karur health unit district Tamil Nadu to compare the efficacy of two antenatal care packages. A newly recommended high-risk strategy package and a uniform package recommended by the Tamil Nadu Government were each implemented in 4 randomly selected subcenters by the study team and the latter was also delivered by routine health services in the 4 remaining subcenters. Analyses were based on 294 pregnant women on the high-risk package (HR) 242 on the Tamil Nadu Government (TNG) package and 335 women in the control series. The HR package reduced the differences between the high-risk women and the others in mean hemoglobin and the percentages with preventable neonatal morbidity and low birth weight and consequently the overall outcome was better in the HR series than in the TNG series. Finally the results with the TNG package were better when it was implemented by the study team than by the routine health services in terms of preventable maternal morbidity and preventable perinatal morbidity but there was no impact on birth weight. (authors)