Efficacy of a 24-hour hybrid maternal care model for preventing high-risk pregnancy in local network

Background

Preventable maternal mortality remains a major public health concern and often driven by delays in reaching and receiving appropriate obstetric care. This study implemented a hybrid care integrating digital tools enabled 24-hour One Labor Room Network Model to strengthen coordination between a tertiary hospital and local hospitals network.

Methods

A quasi-experimental prospective study was conducted from Oct 2023–September 2025 across the tertiary Hospital (hub) and local hospitals network. The intervention integrated 24/7 specialist consultation via digital platforms, fast-track referral pathways, daily multidisciplinary case reviews, and high-risk pregnancy surveillance. Quantitative data were extracted from medical records and digital platforms. Qualitative data were collected through in-depth interviews with health professionals.

Results

All six local hospitals in the network participated. All pregnant women were systematically risk-screened with specialist consultation. The study detected 393 pregnancies with high risk of medical or obstetric complications, and all cases received appropriated co-management or referrals. Compared with the pre-intervention period, preterm rate decreased by 3.72%, while the successful natural births in local hospitals increased by approximately 30% and successful seamless referrals increased by 5.06 %. Postpartum home follow-up for high-risk women reached 100% coverage. The mean ‘work satisfaction’ scores among health professionals increased from 3.72 to 4.26 after joining this hybrid care model, with the highest gains in inter-hospital coordination (4.40) and referral efficiency (4.35).

Conclusions

The hybrid 24-hour One Labor Room Network Model reduced preventable maternal risks, strengthened referral systems, enhanced workforce capacity, and improved maternal health outcomes. The network-based, digitally hybrid care model shows promising feasibility and efficacy in preventing high-risk pregnancy and is scalable.

Key messages

• A hybrid 24-hour One Labor Room Network Model reduces preventable maternal deaths and improved maternal health by strengthening real-time referral and specialist support across the hospitals network.

• Networked obstetric care increased local hospitals capacity, reduced delays in care, and improved workforce confidence and coordination in maternal health services.