James Matthew Harris1, Linda Franck2, Belinda Green3, Stephanie Wilson3, Susan Michie4. 1. Health Psychology Research Group, UCL Department of Clinical, Educational and Health Psychology, 1-19 Torrington Place, London WC1E 7HB, UK. Electronic address: james.m.harris@kcl.ac.uk. 2. Department of Family Health Care Nursing, University of California, San Francisco, USA. 3. Institute of Women׳s Health, UCLH, UK. 4. Department of Clinical, Educational and Health Psychology, UCL, UK.
Abstract
OBJECTIVE: to investigate the relationship between frequency of ultrasounds and birthplace preference. STUDY DESIGN: retrospective case-control study with the number of ultrasounds as the exposure and the pregnant woman's preference to give birth in a low-technology setting (midwifery-led unit or home) or a high-technology setting (obstetric unit) as the primary outcome. SAMPLE AND SETTING: low-risk primigravid women receiving antenatal care at a central London academic medical centre. MEASUREMENTS: antenatal ultrasound frequency; birthplace preference at the initial pregnancy appointment (T1) and at the commencement of labour (T2); demographic data including ethnicity, index of multiple deprivation, age, and body mass index. FINDINGS: 1100 cases were reviewed. Women received an average of 4.03 ultrasounds during their pregnancy (SD=1.96, range 2-14). The frequency of ultrasounds for women who had a low-technology T2 birthplace preference was significantly lower than for those who had a high-technology T2 birthplace preference (t=2.98, df=1098, p=0.003, r=0.1), and women who had a constant low-technology birthrate preference had significantly less ultrasounds than other women (F (3,644)=3.475, p=.02). However, within a logistic regression the frequency of ultrasound was not associated with T2 birthplace preference, after controlling for T1 birthplace preference. KEY CONCLUSIONS: the findings of this investigation suggest that a preference made early in pregnancy is a greater predictor of birthplace preference than exposure to antenatal ultrasounds. IMPLICATIONS FOR PRACTICE: further research is required to inform interventions that would encourage low-risk pregnant women to select a low-technology place of birth.
OBJECTIVE: to investigate the relationship between frequency of ultrasounds and birthplace preference. STUDY DESIGN: retrospective case-control study with the number of ultrasounds as the exposure and the pregnant woman's preference to give birth in a low-technology setting (midwifery-led unit or home) or a high-technology setting (obstetric unit) as the primary outcome. SAMPLE AND SETTING: low-risk primigravid women receiving antenatal care at a central London academic medical centre. MEASUREMENTS: antenatal ultrasound frequency; birthplace preference at the initial pregnancy appointment (T1) and at the commencement of labour (T2); demographic data including ethnicity, index of multiple deprivation, age, and body mass index. FINDINGS: 1100 cases were reviewed. Women received an average of 4.03 ultrasounds during their pregnancy (SD=1.96, range 2-14). The frequency of ultrasounds for women who had a low-technology T2 birthplace preference was significantly lower than for those who had a high-technology T2 birthplace preference (t=2.98, df=1098, p=0.003, r=0.1), and women who had a constant low-technology birthrate preference had significantly less ultrasounds than other women (F (3,644)=3.475, p=.02). However, within a logistic regression the frequency of ultrasound was not associated with T2 birthplace preference, after controlling for T1 birthplace preference. KEY CONCLUSIONS: the findings of this investigation suggest that a preference made early in pregnancy is a greater predictor of birthplace preference than exposure to antenatal ultrasounds. IMPLICATIONS FOR PRACTICE: further research is required to inform interventions that would encourage low-risk pregnant women to select a low-technology place of birth.
Authors: A B Witteveen; P De Cock; A C Huizink; A De Jonge; T Klomp; M Westerneng; C C Geerts Journal: BMC Pregnancy Childbirth Date: 2016-11-22 Impact factor: 3.007