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

Monique van Beukering, Adeline Velu, Lydia Henrike Nicole Schonewille, Ruben Duijnhoven, Ben Willem Mol, Teus Brand, Monique Frings-Dresen, Marjolein Kok

Research output: Contribution to journalArticlepeer-review

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OBJECTIVE: Work-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.

METHODS: Women 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.

RESULTS: A 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.

CONCLUSION: Among 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.

Original languageEnglish
Pages (from-to)809-817
Number of pages17
JournalOccupational and Environmental Medicine
Issue number11
Early online date19 Apr 2021
Publication statusPublished - 1 Nov 2021

Bibliographical note

Acknowledgements We thank all the participating hospitals and their referring
midwifery practices from the Regional Perinatal Network North-West Netherlands
for all their efforts. We also thank Dr Robert de Leeuw (Department of Obstetrics and Gynaecology, Amsterdam UMC) for his support in the development of the P&W app
Funding This pilot study received funding from ZonMw, the Netherlands
Organisation for Health Research and Development, and is part of the Pregnancy
and Birth Program.


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