wow-inequalities/02-data/intermediate/wos_sample/b516e5f013bc24257efb76430a98f4af-fernandez-turienzo/info.yaml

abstract: 'Background

  Midwifery continuity of care is the only health system intervention

  shown to reduce preterm birth (PTB) and improve perinatal survival, but

  no trial evidence exists for women with identified risk factors for PTB.

  We aimed to assess feasibility, fidelity, and clinical outcomes of a

  model of midwifery continuity of care linked with a specialist obstetric

  clinic for women considered at increased risk for PTB.

  Methods and findings

  We conducted a hybrid implementation-effectiveness, randomised,

  controlled, unblinded, parallel-group pilot trial at an inner-city

  maternity service in London (UK), in which pregnant women identified at

  increased risk of PTB were randomly assigned (1:1) to either midwifery

  continuity of antenatal, intrapartum, and postnatal care (Pilot study Of

  midwifery Practice in Preterm birth Including women''s Experiences

  {[}POPPIE] group) or standard care group (maternity care by different

  midwives working in designated clinical areas). Pregnant women attending

  for antenatal care at less than 24 weeks'' gestation were eligible if

  they fulfilled one or more of the following criteria: previous cervical

  surgery, cerclage, premature rupture of membranes, PTB, or late

  miscarriage; previous short cervix or short cervix this pregnancy; or

  uterine abnormality and/or current smoker of tobacco. Feasibility

  outcomes included eligibility, recruitment and attrition rates, and

  fidelity of the model. The primary outcome was a composite of

  appropriate and timely interventions for the prevention and/or

  management of preterm labour and birth. We analysed by intention to

  treat. Between 9 May 2017 and 30 September 2018, 334 women were

  recruited; 169 women were allocated to the POPPIE group and 165 to the

  standard group. Mean maternal age was 31 years; 32\% of the women were

  from Black, Asian, and ethnic minority groups; 70\% were in employment;

  and 46\% had a university degree. Nearly 70\% of women lived in areas of

  social deprivation. More than a quarter of women had at least one

  pre-existing medical condition and multiple risk factors for PTB. More

  than 75\% of antenatal and postnatal visits were provided by a

  named/partner midwife, and a midwife from the POPPIE team was present at

  80\% of births. The incidence of the primary composite outcome showed no

  statistically significant difference between groups (POPPIE group 83.3\%

  versus standard group 84.7\%; risk ratio 0.98 {[}95\% confidence

  interval (CI) 0.90 to 1.08]; p = 0.742). Infants in the POPPIE group

  were significantly more likely to have skin-to-skin contact after birth,

  to have it for a longer time, and to breastfeed immediately after birth

  and at hospital discharge. There were no differences in other secondary

  outcomes. The number of serious adverse events was similar in both

  groups and unrelated to the intervention (POPPIE group 6 versus standard

  group 5). Limitations of this study included the limited power and the

  nonmasking of group allocation; however, study assignment was masked to

  the statistician and researchers who analysed the data.

  Conclusions

  In this study, we found that it is feasible to set up and achieve

  fidelity of a model of midwifery continuity of care linked with

  specialist obstetric care for women at increased risk of PTB in an

  inner-city maternity service in London (UK), but there is no impact on

  most outcomes for this population group.

  Larger appropriately powered trials are needed, including in other

  settings, to evaluate the impact of relational continuity and

  hypothesised mechanisms of effect based on increased trust and

  engagement, improved care coordination, and earlier referral on

  disadvantaged communities, including women with complex social factors

  and social vulnerability.'
affiliation: 'Turienzo, CF (Corresponding Author), Kings Coll London, Fac Life Sci
  \& Med, Dept Women \& Childrens Hlth, London, England.

  Fernandez Turienzo, Cristina; Silverio, Sergio A.; Singh, Claire; Seed, Paul T.;
  Tribe, Rachel M.; Shennan, Andrew H.; Sandall, Jane, Kings Coll London, Fac Life
  Sci \& Med, Dept Women \& Childrens Hlth, London, England.

  Bick, Debra, Univ Warwick, Warwick Med Sch, Warwick Clin Trials Unit, Coventry,
  W Midlands, England.

  Briley, Annette L., Flinders Univ S Australia, Caring Futures Inst, Adelaide, SA,
  Australia.

  Bollard, Mary, Lewisham \& Greenwich NHS Trust, Matern Serv, London, England.

  Coxon, Kirstie, Kingston Univ, Dept Midwifery, London, England.

  Coxon, Kirstie, St Georges Univ London, London, England.

  Cross, Pauline, London Borough Lewisham, Dept Publ Hlth, London, England.'
article-number: e1003350
author: Fernandez Turienzo, Cristina and Bick, Debra and Briley, Annette L. and Bollard,
  Mary and Coxon, Kirstie and Cross, Pauline and Silverio, Sergio A. and Singh, Claire
  and Seed, Paul T. and Tribe, Rachel M. and Shennan, Andrew H. and Sandall, Jane
  and Grp, POPPIE Pilot Collaborative
author-email: cristina.fernandez\_turienzo@kcl.ac.uk
author_list:
- family: Fernandez Turienzo
  given: Cristina
- family: Bick
  given: Debra
- family: Briley
  given: Annette L.
- family: Bollard
  given: Mary
- family: Coxon
  given: Kirstie
- family: Cross
  given: Pauline
- family: Silverio
  given: Sergio A.
- family: Singh
  given: Claire
- family: Seed
  given: Paul T.
- family: Tribe
  given: Rachel M.
- family: Shennan
  given: Andrew H.
- family: Sandall
  given: Jane
- family: Grp
  given: POPPIE Pilot Collaborative
da: '2023-09-28'
doi: 10.1371/journal.pmed.1003350
eissn: 1549-1676
files: []
issn: 1549-1277
journal: PLOS MEDICINE
language: English
month: OCT
number: '10'
number-of-cited-references: '30'
orcid-numbers: 'Fernandez Turienzo, Cristina/0000-0002-7393-6593

  Sandall, Jane/0000-0003-2000-743X

  Silverio, Sergio A./0000-0001-7177-3471

  Seed, Paul T/0000-0001-7904-7933

  Coxon, Kirstie/0000-0001-5480-597X

  Singh, Claire/0000-0003-1681-8467

  Tribe, Rachel/0000-0003-3675-9978

  Briley, Annette/0000-0002-4266-920X

  Bick, Debra/0000-0002-8557-7276

  Shennan, Andrew/0000-0001-5273-3132'
papis_id: 37f9a638bdc7ab1b9ad05a027ab33473
ref: Fernandezturienzo2020midwiferycontinuity
researcherid-numbers: 'Fernandez Turienzo, Cristina/IUM-1522-2023

  Sandall, Jane/D-4146-2009

  Coxon, KIRSTIE/HGQ-1180-2022

  Silverio, Sergio A./Y-7118-2019

  Seed, Paul T/C-4435-2008

  Bick, Debra/P-9575-2018

  '
times-cited: '22'
title: 'Midwifery continuity of care versus standard maternity care for women at increased
  risk of preterm birth: A hybrid implementation-effectiveness, randomised controlled
  pilot trial in the UK'
type: article
unique-id: WOS:000578286200003
usage-count-last-180-days: '0'
usage-count-since-2013: '12'
volume: '17'
web-of-science-categories: Medicine, General \& Internal
year: '2020'