Hybrid Maternity Care and Impact on Pregnancy Outcomes: A Systematic Review and Meta-Analysis

This study aimed to systematically evaluate the impact of hybrid antenatal care models (structured integration of in-person and remote visits) on adverse perinatal and maternal outcomes compared with traditional care. MEDLINE, CINAHL, Scopus, ClinicalTrials.gov, and the Cochrane Library were searched from inception to November 8, 2025. Studies comparing hybrid antenatal care with standard care were included. Primary outcome was stillbirth; secondary outcomes included small-for-gestational-age (SGA) at birth or fetal growth restriction (FGR), preterm birth (PTB) <37 weeks, cesarean delivery, preeclampsia with severe features, and neonatal intensive care unit (NICU) admission. Pooled odds ratios (ORs) were calculated using random-effects meta-analysis models with 95% CI and quantification of I2 statistics. Eight studies, encompassing 159.303 pregnancies, met the inclusion criteria. Of these, 60.987 (38.3%) received hybrid antenatal care, and 98.316 (61.7%) received traditional care. The incidence of stillbirth did not differ significantly between models (OR: 0.95; 95% CI: 0.76-1.19). Similarly, no differences were observed in SGA/FGR (OR: 0.99; 95% CI: 0.88-1.11), NICU admission (OR: 0.95; 95% CI: 0.86-1.05), PTB <37 weeks (OR: 1.01; 95% CI: 0.95-1.07), and preeclampsia with severe features (OR: 1.08; 95% CI: 0.94-1.23). A significant increase in cesarean delivery was observed among patients receiving hybrid care (OR: 1.08; 95% CI: 1.02-1.13). The latter achieves maternal and perinatal outcomes comparable to standard care models. Responsible implementation grounded in ethics, equity, and standardization might in the future reshape traditional maternity care.