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, Julie Midtgaard, Marianne Johansen, Ane L. Rom, Susanne Rosthøj, Ann Tabor and Hanne K. Hegaard
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Mie G. de Wolff: Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
Julie Midtgaard: Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
Marianne Johansen: Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
Ane L. Rom: Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, 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

IJERPH, 2021, vol. 18, issue 15, 1-16

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: maternity care; midwife-led intervention; satisfaction; randomized controlled trial; antenatal care; chronic medical conditions; integrated care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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