Evaluation of a blended care programme for caregivers and working pregnant women to prevent adverse pregnancy outcomes: an intervention study

Abstract

ObjectiveWork-related activities can be a risk factor for pregnancy complications such as preterm birth. This study evaluates the effectiveness of a blended care programme, Pregnancy and Work, that provides pregnant workers and their obstetrical caregivers with advice on work adjustment.MethodsWomen less than 20 weeks of gestation, in paid employment or self-employed, in the care of four participating hospitals and their referring midwifery practices in the Netherlands received either the blended care programme (n=119), consisting of a training for professionals and a mobile health application, or care as usual (n=122) in a controlled intervention study with a follow-up in intervention and control populations. All participants completed three questionnaires concerning health and working conditions at 16, 24 and 32 weeks of pregnancy. Primary outcome was the percentage of women who received advice from their obstetrical caregiver about work adjustment. Secondary outcomes were work status, realised work adjustment and working conditions. Groups were compared using univariate and multivariate regression analyses.ResultsA total of 188 (78%) completed all three questionnaires. In the blended care group, women received more advice from obstetrical caregivers to adjust their work than in the control group, 41 (39%) vs 21 (18%) (adjusted relative risk (aRR) 2.2, 95% CI 1.4 to 3.4), but less from their employer 8 (8%) vs 31 (28%) (aRR 0.29, 95% CI 0.14 to 0.61). There were no significant differences in realised work adjustments. At 24 weeks, 30% of the pregnant women in both groups continued to work in hazardous workplaces.ConclusionAmong working pregnant women, the blended care intervention increases advice on work adjustment given by midwives and obstetricians, but does not lead to more work adjustments.

Work as a social risk factor in pregnancy: A systematic review of screening practices related to working conditions and family leave among pregnant adults

“…Eight articles met all inclusion criteria and focused specifically on pregnant populations (Figure 1). [18][19][20][21][22][23][24][25] Seven of the included studies were quantitative descriptive studies, and one was a nonrandomized controlled trial. Table 1 summarizes the included articles.…”

“…32 In the case of employmentrelated risk, these could include offering prenatal care outside normal work hours to facilitate attendance among people working full time or discussing strategies for avoiding or mitigating specific occupational risks (adjustment); for patients in need of workplace accommodations during pregnancy, providing information about workplace rights, writing doctors' notes to support work accommodation or leave requests, and/or referring patients to legal aid (assistance); and working to promote paid family leave policies at the local, state, or national levels (alignment and advocacy). Our review uncovered very few tools with sufficient detail to inform adjustment activities, 18,19 and just one that approaches assistance. 19 This highlights a need for more detailed study of screening practices and other activities to align employment-related support with prenatal care.…”

“…Our review uncovered very few tools with sufficient detail to inform adjustment activities, 18,19 and just one that approaches assistance. 19 This highlights a need for more detailed study of screening practices and other activities to align employment-related support with prenatal care.…”

Screening Tools for Employment in Clinical Healthcare Delivery Systems: A Content Analysis

“…In contrast, most items that assess Employment Exposure were highly contextualized (Level 3). • Ganguli et al tool [32] • Health Leads [33,34] • iScreen [37] • Patient Reported Outcome Quality of Life Tool (PROQoL) [40,41] • Reves et al tool [48] • Semple-hess et al tool [50] • Sokol et al tool [51] • The Online Advocate [53] • THRIVE [54] • WE CARE [58-63] • Tong et al tool [55] • Fleeger et al tool [30] • Flinders University Social Health History Screening Tool FUST [31] • PRAPARE [42][43][44][45][46] • Razani et al tool [47] Level • OHRA [39] • Schwartz et al tool [49] • Van Beukering et al tool [57] • Zachek et al tool [66]…”

Development and validation of an e-health module – PregEx to support antenatal exercise and education

“…Monique van Beukering et al2021 stated that a blended care intervention, which consists of a training session for obstetrical caregivers and the personalized advice provided by a specifically developed mHealth application, increases the percentage of advice on work adjustments given by midwives and obstetricians to pregnant workers [14]. Gabriela Frid et al 2021 conducted a systematic search, evaluation, and analysis of features on mobile health apps for Pregnant Women.…”