Premium
Mindfetalness to increase women’s awareness of fetal movements and pregnancy outcomes: a cluster‐randomised controlled trial including 39 865 women
Author(s) -
Akselsson A,
Lindgren H,
Georgsson S,
Pettersson K,
Steineck G,
Skokic V,
Rådestad I
Publication year - 2020
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.16104
Subject(s) - medicine , apgar score , obstetrics , relative risk , pregnancy , gestational age , population , gestation , caesarean section , randomized controlled trial , fetus , confidence interval , genetics , environmental health , biology
Objective To examine whether a method for raising women's awareness of fetal movements, Mindfetalness, can affect pregnancy outcomes. Design Cluster‐randomised controlled trial. Setting Sixty‐seven maternity clinics in Stockholm, Sweden. Population Women with singleton pregnancy with birth from 32 weeks’ gestation. Methods Women registered at a clinic randomised to Mindfetalness were assigned to receive a leaflet about Mindfetalness ( n = 19 639) in comparison with routine care ( n = 20 226). Data were collected from a population‐based register. Main outcome measures Apgar score <7 at 5 minutes after birth, visit to healthcare due to decrease in fetal movements. Other outcomes: Apgar score <4 at 5 minutes after birth, small‐for‐gestational‐age and mode of delivery. Results No difference (1.1 versus 1.1%, relative risk [RR] 1.0; 95% CI 0.8–1.2) was found between the Mindfetalness group and the Routine care group for a 5‐minute Apgar score <7. Women in the Mindfetalness group contacted healthcare more often due to decreased fetal movements (6.6 versus 3.8%, RR 1.72; 95% CI 1.57–1.87). Mindfetalness was associated with a reduction of babies born small‐for‐gestational‐age (RR 0.95, 95% CI 0.90–1.00), babies born after gestational week 41 +6 (RR 0.91, 95% CI 0.83–0.98) and caesarean sections (19.0 versus 20.0%, RR 0.95; 95% CI 0.91–0.99). Conclusions Mindfetalness did not reduce the number of babies born with an Apgar score <7. However, Mindfetalness was associated with the health benefits of decreased incidence of caesarean section and fewer children born small‐for‐gestational‐age. Tweetable abstract Introducing Mindfetalness in maternity care decreased caesarean sections but had no effect on the occurrence of Apgar scores <7.