Do pregnant women contact their general practitioner? A register-based comparison of healthcare utilisation of pregnant and non-pregnant women in general practice

BACKGROUND: Midwives and obstetricians are the key providers of care during pregnancy and postpartum. Information about the consultations with a general practitioner (GP) during this period is generally lacking. The aim of this study is to compare consultation rates, diagnoses and GP management of pregnant women with those of non-pregnant women. METHODS: Data were retrieved from the Netherlands Information Network of General Practice (LINH), a nationally representative register. This register holds longitudinal data on consultations, prescriptions and the referrals of all patients listed at 84 practices in the Netherlands in 2007–2009, including 15,123 pregnant women and 102,564 non-pregnant women in the same age-range (15 to 45 years). We compared consultation rates (including all contacts with the practice), diagnoses (ICPC-1 coded), medication prescriptions (coded according to the Anatomical Therapeutic Chemical classification system), and rate and type of referrals from the start of the pregnancy until six weeks postpartum (336 days). RESULTS: Pregnant women contacted their GP on average 3.6 times, compared to 2.2 times for non-pregnant women. The most frequently recorded diagnoses for pregnant women were ‘pregnancy’ and ‘cystitis/urinary infection’, and ‘cystitis/urinary infection’ and ‘general disease not otherwise specified’ for non-pregnant women. The mean number of prescribed medications was lower in pregnant women (2.1 against 4.4). For pregnant women, the most frequent referral indication concerned obstetric care, for non-pregnant women this concerned physiotherapy. CONCLUSIONS: GP consultation rates in pregnancy and postpartum shows that GPs are important providers of care for pregnant women. Therefore, the involvement of GPs in collaborative care during pregnancy and postpartum should be reinforced

Pregnant women also visit the general practitioner

Deze studie beschrijft het gebruik van huisartsenzorg (contacten, gestelde diagnoses, geneesmiddelvoorschriften en verwijzingen) door zwangeren in vergelijking met niet-zwangeren. We gebruikten hiervoor longitudinale gegevens uit de NIVEL Zorgregistraties eerste lijn. Uit 84 huisartsenpraktijken in Nederland in de periode van 2007-2009 werden gegevens geanalyseerd van 15.123 zwangere en 102.564 niet-zwangere vrouwen van dezelfde leeftijd (15-45 jaar). Zwangeren hadden tijdens de zwangerschap gemiddeld 3,6 keer contact met de huisarts (consult, telefonisch, huisbezoek), niet-zwangeren in eenzelfde tijdsbestek 2,2 keer. Van de zwangeren had 35% geen contact met de huisarts. De meest frequent geregistreerde diagnoses bij zwangeren waren ‘zwangerschap’ en ‘urineweginfectie’, terwijl dit bij niet-zwangeren ‘urineweginfectie’ en ‘algemene ziekte, niet nader gespecificeerd’ waren. Het gemiddeld aantal geneesmiddelvoorschriften was lager voor zwangeren dan voor niet -zwangeren (respectievelijk 2.1 en 4.4). Huisartsen verwezen zwangeren het meest frequent naar verloskundige zorgverleners en niet-zwangeren naar de fysiotherapeut. De resultaten laten zien dat de huisarts een belangrijke zorgverlener is voor zwangeren. Daarom is het noodzakelijk dat de rol van huisartsen in de verloskundige zorgketen versterkt wordt

Arthritic disease activity: anti-MCV positive versus anti-MCV negative patients

Statistical comparisons were performed between anti-mutated citrullinated vimentin (anti-MCV)-positive and anti-MCV-negative patients at the indicated time points. Dotted lines represent anti-MCV-positive patients, and straight lines represents anti-MCV-negative patients. *< 0.05; **< 0.005. CRP, C-reactive protein; DAS28, Disease Activity Score based on 28 joints; ESR, erythrocyte sedimentation rate.<p><b>Copyright information:</b></p><p>Taken from "Antibodies to mutated citrullinated vimentin and disease activity score in early arthritis: a cohort study"</p><p>http://arthritis-research.com/content/10/1/R12</p><p>Arthritis Research & Therapy 2008;10(1):R12-R12.</p><p>Published online 28 Jan 2008</p><p>PMCID:PMC2374444.</p><p></p