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Effects of a Midwife-Coordinated Maternity Care Intervention (ChroPreg) vs. Standard Care in Pregnant Women with Chronic Medical Conditions: Results from a Randomized Controlled Trial

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  • Mie G. de Wolff

    (Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
    The Research Unit for Women’s and Children’s Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
    Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark)

  • Julie Midtgaard

    (Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
    Mental Health Centre Glostrup, University of Copenhagen, 2600 Glostrup, Denmark)

  • Marianne Johansen

    (Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
    Unit for Pregnancy and Heart Disease, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark)

  • Ane L. Rom

    (Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
    The Research Unit for Women’s and Children’s Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
    Research Unit of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark)

  • Susanne Rosthøj

    (Section of Biostatistics, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark)

  • Ann Tabor

    (Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark)

  • Hanne K. Hegaard

    (Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
    The Research Unit for Women’s and Children’s Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
    Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark)

Abstract

The proportion of childbearing women with pre-existing chronic medical conditions (CMC) is rising. In a randomized controlled trial, we aimed to evaluate the effects of a midwife-coordinated maternity care intervention (ChroPreg) in pregnant women with CMC. The intervention consisted of three main components: (1) Midwife-coordinated and individualized care, (2) Additional ante-and postpartum consultations, and (3) Specialized known midwives. The primary outcome was the total length of hospital stay (LOS). Secondary outcomes were patient-reported outcomes measuring psychological well-being and satisfaction with maternity care, health utilization, and maternal and infant outcomes. A total of 362 women were randomized to the ChroPreg intervention ( n = 131) or Standard Care ( n = 131). No differences in LOS were found between groups (median 3.0 days, ChroPreg group 0.1% lower LOS, 95% CI −7.8 to 7%, p = 0.97). Women in the ChroPreg group reported being more satisfied with maternity care measured by the Pregnancy and Childbirth Questionnaire (PCQ) compared with the Standard Care group (mean PCQ 104.5 vs. 98.2, mean difference 6.3, 95% CI 3.0–10.0, p < 0.0001). In conclusion, the ChroPreg intervention did not reduce LOS. However, women in the ChroPreg group were more satisfied with maternity care.

Suggested Citation

  • Mie G. de Wolff & Julie Midtgaard & Marianne Johansen & Ane L. Rom & Susanne Rosthøj & Ann Tabor & Hanne K. Hegaard, 2021. "Effects of a Midwife-Coordinated Maternity Care Intervention (ChroPreg) vs. Standard Care in Pregnant Women with Chronic Medical Conditions: Results from a Randomized Controlled Trial," IJERPH, MDPI, vol. 18(15), pages 1-16, July.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:15:p:7875-:d:601037
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    References listed on IDEAS

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    1. Oona M R Campbell & Luca Cegolon & David Macleod & Lenka Benova, 2016. "Length of Stay After Childbirth in 92 Countries and Associated Factors in 30 Low- and Middle-Income Countries: Compilation of Reported Data and a Cross-sectional Analysis from Nationally Representativ," PLOS Medicine, Public Library of Science, vol. 13(3), pages 1-24, March.
    2. Kenneth F Schulz & Douglas G Altman & David Moher & for the CONSORT Group, 2010. "CONSORT 2010 Statement: Updated Guidelines for Reporting Parallel Group Randomised Trials," PLOS Medicine, Public Library of Science, vol. 7(3), pages 1-7, March.
    3. Virginia Schmied & Annie Mills & Sue Kruske & Lynn Kemp & Cathrine Fowler & Caroline Homer, 2010. "The nature and impact of collaboration and integrated service delivery for pregnant women, children and families," Journal of Clinical Nursing, John Wiley & Sons, vol. 19(23‐24), pages 3516-3526, December.
    4. Roslyn E. Donnellan-Fernandez & Debra K. Creedy & Emily J. Callander, 2018. "Cost-effectiveness of continuity of midwifery care for women with complex pregnancy: a structured review of the literature," Health Economics Review, Springer, vol. 8(1), pages 1-16, December.
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