Comparison 1. Reduced number of antenatal care visits/goal‐oriented versus standard antenatal care visits.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mean number of antenatal visits	3	5359	Mean Difference (IV, Random, 95% CI)	‐2.65 [‐3.18, ‐2.12]
2 Five or fewer antenatal visits	1		Risk Ratio (Fixed, 95% CI)	1.12 [1.01, 1.25]
3 Maternal death (cluster‐randomised trials)	3		Risk Ratio (Fixed, 95% CI)	1.13 [0.50, 2.57]
4 Hypertensive disorders of pregnancy (various definitions)	6		Risk Ratio (Random, 95% CI)	0.95 [0.80, 1.12]
4.1 Individual randomisation	3		Risk Ratio (Random, 95% CI)	0.95 [0.71, 1.26]
4.2 Cluster randomisation	3		Risk Ratio (Random, 95% CI)	0.94 [0.73, 1.22]
5 Hypertensive disorders (breakdown by pre‐eclampsia and hypertension)	6		Risk Ratio (Random, 95% CI)	0.95 [0.80, 1.12]
5.1 Pre‐eclampsia (various definitions)	3		Risk Ratio (Random, 95% CI)	1.07 [0.85, 1.34]
5.2 Hypertension/ pre‐eclampsia (not clear/various definitions)	2		Risk Ratio (Random, 95% CI)	0.93 [0.44, 1.97]
5.3 Hospital referral for hypertension	1		Risk Ratio (Random, 95% CI)	0.92 [0.78, 1.09]
6 Perinatal death with ICC 0.0003	5		Risk Ratio (Fixed, 95% CI)	1.14 [1.00, 1.31]
6.1 Individual randomisation	2		Risk Ratio (Fixed, 95% CI)	0.90 [0.45, 1.80]
6.2 Cluster randomisation	3		Risk Ratio (Fixed, 95% CI)	1.15 [1.01, 1.32]
7 Perinatal death with ICC truncated to zero	5		Risk Ratio (Fixed, 95% CI)	1.15 [1.02, 1.30]
7.1 Individual randomisation	2		Risk Ratio (Fixed, 95% CI)	0.90 [0.45, 1.80]
7.2 Cluster randomisation	3		Risk Ratio (Fixed, 95% CI)	1.16 [1.02, 1.31]
8 Preterm birth	7		Risk Ratio (Fixed, 95% CI)	1.02 [0.94, 1.11]
8.1 Individual randomisation	4		Risk Ratio (Fixed, 95% CI)	1.24 [1.01, 1.52]
8.2 Cluster randomisation	3		Risk Ratio (Fixed, 95% CI)	0.99 [0.91, 1.08]
9 Small‐for‐gestational age	4		Risk Ratio (Fixed, 95% CI)	0.99 [0.91, 1.09]
9.1 Individual randomisation	2		Risk Ratio (Fixed, 95% CI)	0.97 [0.84, 1.11]
9.2 Cluster randomisation	2		Risk Ratio (Fixed, 95% CI)	1.01 [0.90, 1.14]
10 Antepartum haemorrhage	6		Risk Ratio (Fixed, 95% CI)	1.13 [0.92, 1.40]
10.1 Individual randomisation	3		Risk Ratio (Fixed, 95% CI)	1.01 [0.77, 1.33]
10.2 Cluster randomisation	3		Risk Ratio (Fixed, 95% CI)	1.33 [0.96, 1.85]
11 Postpartum haemorrhage	4		Risk Ratio (Fixed, 95% CI)	0.99 [0.81, 1.21]
11.1 Individual randomisation	2		Risk Ratio (Fixed, 95% CI)	1.00 [0.81, 1.22]
11.2 Cluster randomisation	2		Risk Ratio (Fixed, 95% CI)	0.95 [0.37, 2.45]
12 Caesarean section	4		Risk Ratio (Fixed, 95% CI)	0.99 [0.91, 1.08]
12.1 Individual randomisation	3		Risk Ratio (Fixed, 95% CI)	0.98 [0.86, 1.12]
12.2 Cluster randomisation	1		Risk Ratio (Fixed, 95% CI)	1.00 [0.89, 1.11]
13 Induction of labour	3		Risk Ratio (Random, 95% CI)	0.97 [0.86, 1.09]
13.1 Individual randomisation	2		Risk Ratio (Random, 95% CI)	0.97 [0.83, 1.14]
13.2 Cluster randomisation	1		Risk Ratio (Random, 95% CI)	0.92 [0.52, 1.62]
14 Severe postnatal anaemia	1		Risk Ratio (Fixed, 95% CI)	0.88 [0.75, 1.03]
14.1 Cluster randomisation	1		Risk Ratio (Fixed, 95% CI)	0.88 [0.75, 1.03]
15 Treated urinary tract infections	1		Risk Ratio (Fixed, 95% CI)	0.80 [0.64, 1.00]
15.1 Cluster randomisation	1		Risk Ratio (Fixed, 95% CI)	0.80 [0.64, 1.00]
16 Low birthweight (> 2500 g)	6		Risk Ratio (Fixed, 95% CI)	1.04 [0.97, 1.11]
16.1 Individual randomisation	3		Risk Ratio (Fixed, 95% CI)	1.00 [0.81, 1.24]
16.2 Cluster randomisation	3		Risk Ratio (Fixed, 95% CI)	1.04 [0.97, 1.12]
17 Neonatal intensive care unit admission	5		Risk Ratio (Fixed, 95% CI)	0.89 [0.79, 1.02]
17.1 Individual randomisation	3		Risk Ratio (Fixed, 95% CI)	1.06 [0.80, 1.41]
17.2 Cluster randomisation	2		Risk Ratio (Fixed, 95% CI)	0.86 [0.74, 0.99]
18 Patient satisfaction with; (mean) score range 1 to 6	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
18.1 Amount of visit time	1	331	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.27, 0.27]
18.2 Quality of prenatal care	2	2198	Mean Difference (IV, Fixed, 95% CI)	‐0.20 [‐0.28, ‐0.11]
18.3 Get questions answered	1	331	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.26, 0.26]
18.4 Attitude of care giver (friendliness and courtesy)	1	331	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.14, 0.34]
19 Perception of care (rated as satisfied)	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
19.1 Quality of prenatal care	1	1189	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.98, 1.01]
19.2 Quality of pregnancy education	1	1189	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.95, 1.02]
19.3 Would choose same schedule in future (answered yes)	1	1862	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [1.05, 1.20]
20 Process outcome; prenatal diagnostic testing	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
20.1 Alpha‐feto protein	2	2729	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.98, 1.03]
20.2 Obstetric ultrasound at 15 to 24 weeks	1	2328	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.86, 1.00]
20.3 Haematocrit	1	2328	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [1.00, 1.01]
20.4 Diabetic screening	2	2729	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.99, 1.01]
21 Process outcome; use of other medical services	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
21.1 Visit to a non‐obstetric clinic	1	2328	Risk Ratio (M‐H, Fixed, 95% CI)	0.94 [0.86, 1.03]
21.2 Emergency visit	1	2328	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.91, 1.25]
21.3 Telephone calls	1	2328	Risk Ratio (M‐H, Fixed, 95% CI)	1.03 [0.98, 1.08]
21.4 "Outpatient" antepartum admission	1	2328	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.97, 1.21]
21.5 Inpatient antepartum admission	1	2328	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.78, 1.68]
22 Process outcome; mean (SD)	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
22.1 Obstetric ultrasound	2	3064	Mean Difference (IV, Fixed, 95% CI)	‐0.12 [‐0.19, ‐0.05]
22.2 Emergency room visits	1	81	Mean Difference (IV, Fixed, 95% CI)	0.06 [‐0.04, 0.16]
22.3 Telephone calls	1	81	Mean Difference (IV, Fixed, 95% CI)	0.04 [‐0.32, 0.40]
22.4 In‐patient admissions	1	2624	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.04, 0.04]
22.5 Number of nights in the hospital	1	2609	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.06, 0.26]
22.6 Prenatal visits, non attendance	2	482	Mean Difference (IV, Fixed, 95% CI)	‐0.07 [‐0.19, 0.05]