Cargando…

Risk-guided maternity care to enhance maternal empowerment postpartum: A cluster randomized controlled trial

OBJECTIVE: To investigate whether a structured inquiry during pregnancy of medical factors and social factors associated with low socioeconomic status, and subsequent patient-centred maternity care could increase maternal empowerment. DESIGN: Cluster-randomised controlled trial. SETTING: This study...

Descripción completa

Detalles Bibliográficos
Autores principales: Lagendijk, Jacqueline, Sijpkens, Meertien K., Ernst-Smelt, Hiske E., Verbiest, Sarah B., Been, Jasper V., Steegers, Eric A. P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7679010/
https://www.ncbi.nlm.nih.gov/pubmed/33216791
http://dx.doi.org/10.1371/journal.pone.0242187
_version_ 1783612265507848192
author Lagendijk, Jacqueline
Sijpkens, Meertien K.
Ernst-Smelt, Hiske E.
Verbiest, Sarah B.
Been, Jasper V.
Steegers, Eric A. P.
author_facet Lagendijk, Jacqueline
Sijpkens, Meertien K.
Ernst-Smelt, Hiske E.
Verbiest, Sarah B.
Been, Jasper V.
Steegers, Eric A. P.
author_sort Lagendijk, Jacqueline
collection PubMed
description OBJECTIVE: To investigate whether a structured inquiry during pregnancy of medical factors and social factors associated with low socioeconomic status, and subsequent patient-centred maternity care could increase maternal empowerment. DESIGN: Cluster-randomised controlled trial. SETTING: This study was conducted among pregnant women in selected urban areas in the Netherlands. This study was part of the nationwide Healthy Pregnancy 4 All-2 programme. POPULATION: Pregnant women listed at one of the sixteen participating maternity care organisations between July 1, 2015, and Dec 31, 2016. METHODS: All practices were instructed to provide a systematic risk assessment during pregnancy. Practices were randomly allocated to continue usual care (seven practices), or to provide a patient-centred, risk-guided approach to addressing any risks (nine practices) identified via the risk assessment during pregnancy. MAIN OUTCOME MEASURES: Low postpartum maternal empowerment score. RESULTS: We recruited 1579 participants; 879 participants in the intervention arm, and 700 participants in the control arm. The prevalence of one or more risk factors during pregnancy was similar between the two arms: 40% and 39%, respectively. In our intention-to-treat analysis, the intervention resulted in a significant reduction in the odds of having a low empowerment score [i.e. the primary outcome; adjusted OR 0.69 ((95% CI 0.47; 0.99), P 0.046)]. CONCLUSIONS: Implementation of additional risk assessment addressing both medical and social factors and subsequent tailored preventive strategies into maternity care reduced the incidence of low maternal empowerment during the postpartum period. Introducing this approach in routine maternity care may help reduce early adversity during the postpartum period.
format Online
Article
Text
id pubmed-7679010
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-76790102020-12-02 Risk-guided maternity care to enhance maternal empowerment postpartum: A cluster randomized controlled trial Lagendijk, Jacqueline Sijpkens, Meertien K. Ernst-Smelt, Hiske E. Verbiest, Sarah B. Been, Jasper V. Steegers, Eric A. P. PLoS One Research Article OBJECTIVE: To investigate whether a structured inquiry during pregnancy of medical factors and social factors associated with low socioeconomic status, and subsequent patient-centred maternity care could increase maternal empowerment. DESIGN: Cluster-randomised controlled trial. SETTING: This study was conducted among pregnant women in selected urban areas in the Netherlands. This study was part of the nationwide Healthy Pregnancy 4 All-2 programme. POPULATION: Pregnant women listed at one of the sixteen participating maternity care organisations between July 1, 2015, and Dec 31, 2016. METHODS: All practices were instructed to provide a systematic risk assessment during pregnancy. Practices were randomly allocated to continue usual care (seven practices), or to provide a patient-centred, risk-guided approach to addressing any risks (nine practices) identified via the risk assessment during pregnancy. MAIN OUTCOME MEASURES: Low postpartum maternal empowerment score. RESULTS: We recruited 1579 participants; 879 participants in the intervention arm, and 700 participants in the control arm. The prevalence of one or more risk factors during pregnancy was similar between the two arms: 40% and 39%, respectively. In our intention-to-treat analysis, the intervention resulted in a significant reduction in the odds of having a low empowerment score [i.e. the primary outcome; adjusted OR 0.69 ((95% CI 0.47; 0.99), P 0.046)]. CONCLUSIONS: Implementation of additional risk assessment addressing both medical and social factors and subsequent tailored preventive strategies into maternity care reduced the incidence of low maternal empowerment during the postpartum period. Introducing this approach in routine maternity care may help reduce early adversity during the postpartum period. Public Library of Science 2020-11-20 /pmc/articles/PMC7679010/ /pubmed/33216791 http://dx.doi.org/10.1371/journal.pone.0242187 Text en © 2020 Lagendijk et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lagendijk, Jacqueline
Sijpkens, Meertien K.
Ernst-Smelt, Hiske E.
Verbiest, Sarah B.
Been, Jasper V.
Steegers, Eric A. P.
Risk-guided maternity care to enhance maternal empowerment postpartum: A cluster randomized controlled trial
title Risk-guided maternity care to enhance maternal empowerment postpartum: A cluster randomized controlled trial
title_full Risk-guided maternity care to enhance maternal empowerment postpartum: A cluster randomized controlled trial
title_fullStr Risk-guided maternity care to enhance maternal empowerment postpartum: A cluster randomized controlled trial
title_full_unstemmed Risk-guided maternity care to enhance maternal empowerment postpartum: A cluster randomized controlled trial
title_short Risk-guided maternity care to enhance maternal empowerment postpartum: A cluster randomized controlled trial
title_sort risk-guided maternity care to enhance maternal empowerment postpartum: a cluster randomized controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7679010/
https://www.ncbi.nlm.nih.gov/pubmed/33216791
http://dx.doi.org/10.1371/journal.pone.0242187
work_keys_str_mv AT lagendijkjacqueline riskguidedmaternitycaretoenhancematernalempowermentpostpartumaclusterrandomizedcontrolledtrial
AT sijpkensmeertienk riskguidedmaternitycaretoenhancematernalempowermentpostpartumaclusterrandomizedcontrolledtrial
AT ernstsmelthiskee riskguidedmaternitycaretoenhancematernalempowermentpostpartumaclusterrandomizedcontrolledtrial
AT verbiestsarahb riskguidedmaternitycaretoenhancematernalempowermentpostpartumaclusterrandomizedcontrolledtrial
AT beenjasperv riskguidedmaternitycaretoenhancematernalempowermentpostpartumaclusterrandomizedcontrolledtrial
AT steegersericap riskguidedmaternitycaretoenhancematernalempowermentpostpartumaclusterrandomizedcontrolledtrial