Literature DB >> 27938874

Rationale, study protocol and the cluster randomization process in a controlled trial including 40,000 women investigating the effects of mindfetalness.

Ingela Rådestad1, Anna Akselsson2, Susanne Georgsson3, Helena Lindgren4, Karin Pettersson5, Gunnar Steineck6.   

Abstract

BACKGROUND: Shortening pre-hospital delay may decrease stillbirth rates and rates of babies born with a compromised health. Stillbirth may be preceded by a decrease in fetal movements. Mindfetalness has been developed as a response to the shortcomings of kick-counting for the monitoring of fetal movements by the pregnant woman. We do not know if practicing Mindfetalness may diminish pre-hospital delay. Nor do we know if practicing Mindfetalness may increase or decrease the percentage of women seeking health care for unfounded, from a medical perspective, worry for her fetus' well-being.
METHODS: This article describes the rationale, study protocol and the randomization process for a planned study randomly allocating 40,000 pregnant women to receive, or not receive, proactive information about practicing Mindfetalness. The unit of randomization is 63 antenatal clinics in the Stockholm area. Midwives in the antenatal clinics randomized to Mindfetalness will verbally inform about practicing Mindfetalness, hand out brochures (printed in seven languages) and inform about a website giving information about Mindfetalness. Routine care will continue in the control clinics. All information for the analyses, including the main endpoint of an Apgar score below 7 (e.g., 0-6 with stillbirth giving a score of 0), measured five minutes after birth, will be retrieved from population-based registers.
RESULTS: We have randomized 33 antenatal clinics to Mindfetalness and 30 to routine care. In two clinics a pilot study has been performed. One of the clinics randomly allocated to inform about Mindfetalness will not do so (but will be included in the intention-to-treat analysis). In October 2016 we started to recruit women for the main study.
CONCLUSION: The work up to now follows the outlined time schedule. We expect to present the first results concerning the effects of Mindfetalness during 2018.
Copyright © 2016 Elsevier B.V. All rights reserved.

Entities:  

Keywords:  Fetal movements; Mindfetalness; Prehospital delay; Stillbirth

Mesh:

Year:  2016        PMID: 27938874     DOI: 10.1016/j.srhc.2016.10.004

Source DB:  PubMed          Journal:  Sex Reprod Healthc        ISSN: 1877-5756


  4 in total

1.  Can promoting awareness of fetal movements and focusing interventions reduce fetal mortality? A stepped-wedge cluster randomised trial (AFFIRM).

Authors:  Alexander E P Heazell; Christopher J Weir; Sarah J E Stock; Catherine J Calderwood; Sarah Cunningham Burley; J Frederik Froen; Michael Geary; Alyson Hunter; Fionnuala M McAuliffe; Edile Murdoch; Aryelly Rodriguez; Mary Ross-Davie; Janet Scott; Sonia Whyte; Jane E Norman
Journal:  BMJ Open       Date:  2017-08-11       Impact factor: 2.692

2.  Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a stepped wedge, cluster-randomised trial.

Authors:  Jane E Norman; Alexander E P Heazell; Aryelly Rodriguez; Christopher J Weir; Sarah J E Stock; Catherine J Calderwood; Sarah Cunningham Burley; J Frederik Frøen; Michael Geary; Fionnuala Breathnach; Alyson Hunter; Fionnuala M McAuliffe; Mary F Higgins; Edile Murdoch; Mary Ross-Davie; Janet Scott; Sonia Whyte
Journal:  Lancet       Date:  2018-09-27       Impact factor: 79.321

3.  Pregnancy outcomes among women born in Somalia and Sweden giving birth in the Stockholm area - a population-based study.

Authors:  Anna Akselsson; Helena Lindgren; Susanne Georgsson; Karin Pettersson; Viktor Skokic; Ingela Rådestad
Journal:  Glob Health Action       Date:  2020-12-31       Impact factor: 2.640

4.  A decrease in cesarean sections and labor inductions among Swedish women by awareness of fetal movements with the Mindfetalness method.

Authors:  Anna Akselsson; Helena Lindgren; Viktor Skokic; Ingela Rådestad
Journal:  BMC Pregnancy Childbirth       Date:  2020-10-01       Impact factor: 3.007

  4 in total

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