My Baby's Movements: a stepped-wedge cluster-randomised controlled trial of a fetal movement awareness intervention to reduce stillbirths.
Awareness
best practice
decreased fetal movements
maternity care
mobile phone application
stillbirth
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
accepted:
20
08
2021
pubmed:
24
9
2021
medline:
22
1
2022
entrez:
23
9
2021
Statut:
ppublish
Résumé
The My Baby's Movements (MBM) trial aimed to evaluate the impact on stillbirth rates of a multifaceted awareness package (the MBM intervention). Stepped-wedge cluster-randomised controlled trial. Twenty-seven maternity hospitals in Australia and New Zealand. Women with a singleton pregnancy without major fetal anomaly at ≥28 weeks of gestation from August 2016 to May 2019. The MBM intervention was implemented at randomly assigned time points, with the sequential introduction of eight groups of between three and five hospitals at 4-monthly intervals. Using generalised linear mixed models, the stillbirth rate was compared in the control and the intervention periods, adjusting for calendar time, study population characteristics and hospital effects. Stillbirth at ≥28 weeks of gestation. There were 304 850 births with 290 105 births meeting the inclusion criteria: 150 053 in the control and 140 052 in the intervention periods. The stillbirth rate was lower (although not statistically significantly so) during the intervention compared with the control period (2.2/1000 versus 2.4/1000 births; aOR 1.18, 95% CI 0.93-1.50; P = 0.18). The decrease in stillbirth rate was greater across calendar time: 2.7/1000 in the first versus 2.0/1000 in the last 18 months. No increase in secondary outcomes, including obstetric intervention or adverse neonatal outcome, was evident. The MBM intervention did not reduce stillbirths beyond the downward trend over time. As a result of low uptake, the role of the intervention remains unclear, although the downward trend across time suggests some benefit in lowering the stillbirth rate. In this study setting, an awareness of the importance of fetal movements may have reached pregnant women and clinicians prior to the implementation of the intervention. The My Baby's Movements intervention to raise awareness of decreased fetal movement did not significantly reduce stillbirth rates.
Identifiants
pubmed: 34555257
doi: 10.1111/1471-0528.16944
doi:
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
29-41Subventions
Organisme : Stillbirth Foundation
Organisme : Betty McGrath Fellowship through the Mater Research Institute
Organisme : National Health and Medical Research Council (NHMRC) Project Grant Application
ID : APP1067363
Organisme : Mater Foundation
Organisme : NHMRC Stillbirth Centre of Research Excellence
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 John Wiley & Sons Ltd.
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