Efficacy of innovative models of maternity care for young women and their infants: A systematic review and meta-analysis
In brief
Midwife-led care reduces preterm birth by about 38% in adolescents
Combining two trials and ten observational studies of 6,227 young mothers, innovative models that include a midwife lowered the risk of preterm birth to 0.62 of usual care-about a 38% drop. The result is promising but may be affected by confounding in non-randomized studies, so larger randomized trials are needed.
- Journal
- Women and birth : journal of the Australian College of Midwives (Q1)
- Published
- 25 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Jyai Allen, Jenny Gamble, Sarah Hay, Caitlyn Atkinson, Lukman Thalib
- PMID
- 42641446
- DOI
- 10.1016/j.wombi.2026.102394
Why clinicians should know about it
- Picked for Obstetrics and Gynecology (top studies of the week, 30 August 2026): Systematic review/meta‑analysis of innovative maternity care models
Abstract
PROBLEM: Pregnant adolescents are a vulnerable group who face barriers to accessible, acceptable, and comprehensive maternity care, contributing to poorer perinatal outcomes. BACKGROUND: There is a gap in the evidence on maternity models of care for young women. Three relevant quantitative reviews were published (2012, 2018, 2023). Two reviews examined antenatal interventions for the population without conducting quantitative data synthesis. Two reviews included a mix of interventions to address social determinants of health which were not limited to the antenatal period. AIM: To determine the risk of preterm birth for young women aged ≤ 25 years in innovative models of care with a midwife, compared with routine care. METHOD: This review synthesises evidence from randomised controlled and observational studies that met inclusion criteria. Searches were conducted across four databases from inception to November 2025. Meta-analysis was conducted where sufficient data were available; otherwise, narrative synthesis was used. Researchers assessed methodological quality and risk of bias; publication bias; certainty of evidence; and heterogeneity. FINDINGS: From 2389 records, two randomised controlled trials and 10 observational studies involving 6227 participants were included. Overall, innovative models significantly lowered the risk of preterm birth (RR:0.62, 95% CI: 0.49-0.80; I2 =44.3%). DISCUSSION: Innovative models of care that include a midwife, designed to meet the specific needs of young women, may reduce preterm birth. This should be interpreted with caution due to potential confounding in non-randomised studies. CONCLUSION: Future research should prioritise adequately powered, randomised studies to definitively establish causal effects and inform clinical practice.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.