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Randomized Controlled Trial
. 2021 Jul 25;18(15):7875.
doi: 10.3390/ijerph18157875.

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

Mie G de Wolff  1   2   3 , Julie Midtgaard  3   4 , Marianne Johansen  1   5 , Ane L Rom  1   2   6 , Susanne Rosthøj  7 , Ann Tabor  8 , Hanne K Hegaard  1   2   3
Affiliations
Randomized Controlled Trial

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

Mie G de Wolff et al. Int J Environ Res Public Health. .

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.

Keywords: antenatal care; chronic medical conditions; integrated care; maternity care; midwife-led intervention; randomized controlled trial; satisfaction.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Main components of the ChroPreg intervention.
Figure 2
Figure 2
Flowchart of the study population.
See this image and copyright information in PMC

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