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The road to an integrated CenteringPregnancy. An effect evaluation.

Projectomschrijving

Bij CenteringPregnancy (CP) wordt in plaats van de één op één controles tijdens de zwangerschap de zorg aangeboden aan een groep van tien tot twaalf zwangeren met eenzelfde zwangerschapsduur. Tijdens een sessie worden de zwangerschapscontroles (zoals de bloeddruk, groei van de baby etc.) gecombineerd met voorlichting en gesprekken over wat vrouwen bezig houdt tijdens hun zwangerschap. In de regio Noordelijk Zuid-Holland is het effect van CP geëvalueerd in 13 verloskundige praktijken en 2 ziekenhuizen. Uit dit project blijkt dat er geen verschillen zijn in zwangerschapsuitkomsten tussen CP en individuele zorg. In CP kregen zwangeren wel meer verloskundige controles, waren vrouwen meer tevreden over de prenatale zorg en begonnen ze vaker met borstvoeding. Vrouwen in CP die voor het eerst zwanger waren vonden dat ze minder opvoedvaardigheden hadden. Ze hadden wel meer kennis over zwangerschap, rookten minder tijdens of na de zwangerschap en in vergelijking met vrouwen die niet voor CP kozen namen zij minder vaak pijnmedicatie tijdens de bevalling. Vrouwen in CP die zwanger waren van een volgend kind verwachtten meer pijn tijdens de bevalling maar, in vergelijking met vrouwen die niet voor CP kozen, voelden zij zich daarentegen beter voorbereid op de bevalling en bevielen vaker thuis. Ze aten daarnaast vaker fruit tijdens de zwangerschap en dronken minder vaak alcohol na de bevalling.

Producten

Titel: Group based prenatal care in a low-and high risk population in the Netherlands: a study protocol for a stepped wedge cluster randomized controlled trial
Auteur: van Zwicht, Birgit S., Crone, Matty R., van Lith, Jan M. M., Rijnders, Marlies E. B.
Magazine: BMC Pregnancy and Childbirth
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111184/
Titel: Pregnant women at increased risk of adverse perinatal outcomes: A combination of less healthy behaviors and adverse psychosocial and socio-economic circumstances
Auteur: Crone, M.R., Luurssen-Masurel, N., Bruinsma-van Zwicht, B.S., van Lith, J.M.M., Rijnders, M.E.B.
Magazine: Preventive Medicine
Link: https://pubmed.ncbi.nlm.nih.gov/31445113/

Verslagen


Samenvatting van de aanvraag

Perinatal and maternal morbidity/mortality is relatively high in the Netherlands, compared to other European countries. The perinatal outcomes are especially worse for pregnant women from lower socio-economic groups and from non-western origin. In the US a customized care model has been developed for these groups of women: CenteringPregnancy (CP). CP consists of consultations in group setting aimed at empowering the pregnant women by integrating three major components of care: health assessment, education, and support. Studies have shown positive effects of CP in the US: amongst others a decrease in the number of preterm births. CP is now being adapted to the Dutch primary health care and its feasibility is being studied. In the region Northern South-Holland in the Netherlands CP will be strengthened by a) involving chain partners from public health care, other primary care professionals and specialized health care, and b) the development of additional support for pregnant women with complex needs. In the present study this adapted CP is developed and its effects are evaluated. In collaboration with professionals from public health, primary health, and specialized health care, in the first half year of the project, a protocol is developed presenting the tasks and roles of the different chain partners during the group consultations of CP. In the next three years, we will use a wedged cluster randomized controlled trial to examine the effects of CP of infant outcomes, maternal outcomes, and care outcomes in 9 midwifery practices and 3 clinics. Instead of randomly allocating practices to the intervention or control condition, 9 midwifery practices are randomly allocated to the period in which they start with providing CenteringPregnancy. Data registered in the Dutch Perinatal Registration is used to monitor infant outcomes, and some of the maternal and care outcomes. Next, pregnant women will complete questionnaires three times during and one time after pregnancy. During the study the key professionals will monitor the process of prenatal care such as participation rate, uptake intervention, provided activities, and the costs of implementing group consultations. Professionals are also interviewed to assess their satisfaction with group consultations and with the integration of care. Pregnant women and their partners will be asked about their perceptions regarding the integration of care and their satisfaction with care. The project will be imbedded in our regional obstetric consortium group in which professionals and researchers in public health, primary, and specialized care are involved. The partners of our consortium are already collaborating in several networks: like the perinatal audits, obstetrics collaboration networks (verloskundig samenwerkingsVerband; VSV), and the Academic working place Public Health.

Onderwerpen

Kenmerken

Projectnummer:
209020006
Looptijd: 100%
Looptijd: 100 %
2012
2018
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
Dr. M.R. Crone
Verantwoordelijke organisatie:
Leiden University Medical Center