Midwifery/pregnancy/Pregnancy complicated by chronic medical conditions

​We aim to investigate the effect of a midwife coordinated and specialized maternity care intervention among pregnant women with chronic medical conditions.

A research project by Midwife, PhD student Mie Gaarskjær de Wolff 


Study 1 is an RCT investigating the effect of a midwife-led intervention on length of hospital stay, patient reported outcomes and delivery outcomes. In studies 2 and 3 we investigate if women with CMC differ from women without CMC according to preconception health behaviors and psychological well- being during early pregnancy.

Background
The incidence of chronic medical conditions (CMC) among pregnant women is rising worldwide as well as in Denmark, and almost 20% of pregnant women seeking antenatal care at Rigshospitalet have one or more CMCs. This is a vulnerable group of pregnant women , as CMC increases the risk of adverse pregnancy outcomes and the pregnancy can worsen the symptoms of CMC. Pregnant women with CMC are more often worried and feel insecure and length of hospital stay is longer among this group. Further, the literature on lifestyle and psychological well-being among pregnant women with CMC is sparse.

Aims
In study 1 the effect of a midwife-coordinated, specialized intervention during pregnancy and postpartum for women with CMC is investigated in a randomized controlled study. In study 2 and 3 the Copenhagen pregnancy Cohort is used to study associations between CMC and pre pregnancy health behavior (i.e. folic acid, smoking, alcohol intake and exercise) (study 2) and level and content of pregnancy worry (study 3) 

Methods
Study 1 is an RCT including 262 pregnant women with CMC randomized 1:1 to intervention or control group. The recruitment was finalized January 20, 2020. The methods are described in detail in the study protocol (de Wolff et al., 2019). Study 2 and 3 are cross-sectional hospital-based studies with data from the Copenhagen pregnancy Cohort with data from 28.000 pregnancies from 2011-2019. 

de Wolff MG, Johansen M, Ersbøll AS, Rosthøj S, Brunsgaard A, Midtgaard J, et al. Efficacy of a midwife-coordinated, individualized, and specialized maternity care intervention (ChroPreg) in addition to standard care in pregnant women with chronic disease: protocol for a parallel randomized controlled trial. Trials 2019;20:291. https://doi.org/10.1186/s13063-019-3405-5.





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