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BMC Public Health
Published in: BMC Public Health 1/2006

Open Access 01-12-2006 | Research article

Aiming to increase birth weight: a randomised trial of pre-pregnancy information, advice and counselling in inner-urban Melbourne

Authors: Judith Lumley, Lisa Donohue

Published in: BMC Public Health | Issue 1/2006

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Abstract

Background

In the 1980s there was substantial interest in early pregnancy and pre-pregnancy interventions to increase birth weight and reduce preterm birth. We developed an inter-pregnancy intervention, implemented in a randomised controlled trial, to be provided by midwives at home soon after women's first birth.

Methods

MCH nurses invited women to take part during their home visit to new mothers. Women's contact details, with their permission, were passed to the study midwife. She had a randomisation schedule to which women's names were added before she met the women or their partners. All women recruited had a home visit from the study midwife with a discussion of their first pregnancy, labour and birth and the postpartum experience. Women in the intervention arm received in addition a pre-pregnancy intervention with discussion of social, health or lifestyle problems, preparation and timing for pregnancy, family history, rubella immunisation, referrals for health problems, and a reminder card. The primary outcome was defined as a birth weight difference in the second birth of 100 g (one-sided) in favour of the intervention. Additional data collected were gestational age, perinatal deaths and birth defects. Analyses used EPI-INFO and STATA.

Results

Intervention and comparison groups were comparable on socioeconomic factors, prior reproductive history and first birth outcomes. Infant birth weight in the second birth was lower (-97.4 g,)) among infants in the intervention arm. There were no significant differences between intervention and comparison arms in the proportion of women having a preterm birth, an infant with low birthweight, or an infant with a birth weight <10th percentile. There were more adverse outcomes in the intervention arm: ten births <32 weeks), compared with one in standard care, and more infants with a birth weight <2000 g, 16 compared with two in standard care

Conclusion

As the primary outcome was envisaged to be either improved birth weight or no effect, the study was not designed to identify the alternative outcome with confidence. Despite widespread support for pre-pregnancy interventions to improve maternal and perinatal health, this first randomised controlled trial of a multi-component intervention provided at home, did not have a beneficial outcome.
Appendix
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Literature
1.
Wynn M, Wynn A: Prevention of handicap and the health of women. 1979, London: Routledge & Kegan Paul, 43-63.
2.
Lumley J, Astbury J: Advice for pregnancy. Effective care in pregnancy and childbirth. Edited by: Chalmers I, Enkin M, Keirse M. 1982, Oxford, Oxford University Press, 236-254.
3.
Kohner N, Health Education Council: Pregnancy book. A guide to becoming pregnant, being pregnant and caring for your newborn baby. 1984, London: Health Education Council
4.
US Academy of Sciences, Committee to Study the Prevention of Low Birth Weight, Division of Health Promotion and Disease Prevention, Institute of Medicine. Preventing low birthweight. 1985, Washington, DC, National Academy Press, 1-3. 15–18
5.
6.
Chamberlain G, Lumley J, (eds): Pre-pregnancy care. A manual for practice. 1986, John Wiley & Sons, Chichester
7.
Goldenberg RL, Culhane JF: Prepregnancy health status and the risk of preterm delivery. Arch Pediatr Adolesc Med. 2005, 159: 89-90. 10.1001/archpedi.159.1.89.CrossRefPubMed
8.
Department of Human Services, Victoria: Maternal and Child Health Program, Annual Report 1995–6. 1997, Melbourne, Department of Human Services
9.
Alderson M: An introduction to epidemiology. 1976, London and Basingstoke, The Macmillan Press, 113, 180-
10.
Gates S, Brocklehurst P: How should randomised trials including multiple pregnancies be analysed?. BJOG. 2004, 111: 213-9. 10.1111/j.1471-0528.2004.00059.x.CrossRefPubMed
11.
Kramer MS, Platt RW, Wen SW, Joseph KS, Allen A, Abrahamowicz M, Blondel B, Bréart G: A new and improved population-based Canadian reference for birthweight for gestational age. Pediatrics. 2001, 108: e35-10.1542/peds.108.2.e35.CrossRefPubMed
12.
Dean AG, Dean JA, Burton AH, Docker RC: Epi Info version 5: a word processing, database and statistics program for epidemiology on microcomputers. USD, Incorporated, Stone Mountain, Georgia. 1990
13.
Stata Corporation STATA 8.0 Statistics/Data Analysis, 2003. Stata Corporation: college Station, Texas
14.
Congalton AA: Status and prestige in Australia. 1969, Melbourne: Cheshire
15.
Perinatal Data Collection Unit, Victoria: Births In Victoria 1983–92. 1994, Melbourne: The Consultative Council on Obstetric and Paediatric Mortality and Morbidity, Victoria, Table 5.2
16.
Perinatal Data Collection Unit, Victoria: Congenital malformations in Victoria, 1983–94. 1996, The Consultative Council on Obstetric and Paediatric Mortality and Morbidity, Victoria, 11-
17.
Oakley A, Rajan L, Grant A: Social support and pregnancy outcome. Br J Obstet Gynaecol. 1990, 97: 155-162.CrossRefPubMed
18.
Spencer B, Thomas H, Morris J: A randomized controlled trial of the provision of a social support service during pregnancy: the South Manchester Family Worker Project. Br J Obstet Gynaecol. 1989, 96: 281-8.CrossRefPubMed
19.
20.
Bryce R, Stanley FJ, Garner JB: Randomized controlled trial of antenatal social support to prevent preterm birth. Br J Obstet Gynaecol. 1991, 98: 1001-8.CrossRefPubMed
21.
Rush D, Stein Z, Susser M: A randomized controlled trial of prenatal nutritional supplementation in New York City. Pediatrics. 1980, 65 (4): 683-97.PubMed
22.
Kafatos AG, Tsitoura S, Pantelakis SN, Doxiadis SA: Maternal and infant health education in a rural Greek community. Hygie. 1991, 10 (1): 32-7.PubMed
23.
Kafatos AG, Vlackonikolis JG, Cadrington CA: Nutrition during pregnancy: the effect of an educational intervention program in Greece. Am J Clin Nutr. 1989, 50: 970-9.PubMed
24.
Osrin D, Viadya A, Shrestha Y, et al: Effects of antenatal multiple micronutrient supplementation on birthweight and gestational age duration in Nepal: double-blind randomised controlled trial. Lancet. 2005, 365 (9463): 916-7. 10.1016/S0140-6736(05)71084-9.CrossRef
25.
Dole N, Savitz DA, Hertz-Picciotto I, Siega-Riz AM, McMahon MJ, Buekens P: Maternal stress and preterm birth. Am J Epidemiol. 2003, 157 (1): 14-24. 10.1093/aje/kwf176.CrossRefPubMed
26.
Ruiz RJ, Fullerton J, Dudley DJ: The interrelationship of maternal stress, endocrine factors, and inflammation on gestational length. Obstet Gynecol Surv. 2003, 58 (6): 415-28. 10.1097/00006254-200306000-00025.PubMed
27.
Wald N: Possible prevention of neural tube defects by vitamin supplementation. Appendix III. Prevention of spina bifida and other neural tube defects. Edited by: Dobbing J. 1983, London: Academic Press, 231-239.
28.
Czeizel AE, Dudás I: Prevention of first occurrence of neural tube defects by periconceptional vitamin supplementation. New Engl J med. 1992, 327: 1832-35.CrossRefPubMed
29.
Kirke PN, Daly LE, Elwood JH, for the Irish Vitamin Study Group: A randomised trial of low dose folic acid tp prevent neural tube defects. Arch Dis Child. 1992, 67: 1442-6.CrossRefPubMedPubMedCentral
30.
MRC Vitamin Study Group: Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet. 1991, 338: 131-7. 10.1016/0140-6736(91)90133-A.CrossRef
31.
Laurence KM, James N, Miller MH, Tennnant BG, Campbell H: Double-blind randomised controlled trial of folate treatment before conception to prevent recurrences of neural tube defects. Br Med J. 1981, 282: 1509-11.CrossRef
32.
Little RE, Sing CF: Father's drinking and infant birth weight: report of an association. Teratology. 1987, 36: 59-65. 10.1002/tera.1420360109.CrossRefPubMed
33.
Little RE, Asker RL, Sampson PD, Renwick JH: Fetal growth and moderate drinking in early pregnancy. Am J Epidemiol. 1986, 123: 270-8.PubMed
34.
Lumley J, Newman NM, Curran JT: Cigarette smoking, alcohol consumption and fetal outcome in Tasmania 1981–2. Aust NZ J Obstet Gynaecol. 1985, 25: 33-40.CrossRef
35.
Passaro KT, Little RE, Savitz DA, Noss J: Effect of paternal alcohol consumption before conception on infant birth weight. ALSPAC Study Team. Teratology. 1998, 57: 294-301. 10.1002/(SICI)1096-9926(199806)57:6<294::AID-TERA2>3.0.CO;2-X.CrossRefPubMed
36.
Passaro KT, Little RE, Savitz D, Noss J: Effect of maternal drinking before conception and in early pregnancy on infant birthweight. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Epidemiology. 1996, 7: 377-83. 10.1097/00001648-199607000-00007.CrossRefPubMed
37.
Jackson M, Berman N, Huber M, Snetselaar L, Granek I, Boe K, Milas C, Spivak J, Chlebowski RT: Research staff turnover and participant adherence in the Women's Health Initiative. Controlled Clinical Trials. 2003, 24: 422-35. 10.1016/S0197-2456(03)00027-8.CrossRefPubMed
38.
Donohue L: Tracing lost research participants. Aust J Adv Nursing. 1995, 12: 6-10.
39.
Korenbrot CC, Steinberg A, Bender C, Newberry S: Preconception care: a systematic review. Maternal and Child Health J. 2002, 6 (2): 75-88. 10.1023/A:1015460106832.CrossRef
40.
Jack BW, Culpepper L, Babcock J, Kogan MD, Weissmiller D: Addressing preconception risks identified at the time of a negative pregnancy test: a randomised trial. J Fam Pract. 1998, 47 (1): 33-8.PubMed
41.
Andrews WW, Goldenberg RL, Hauth JC, Cliver SP, Copper R, Connor M: Inter-conceptional antibiotics to prevent spontaneous preterm birth: a randomized clinical trial. Am J Obstet Gynecol. 2006, 194: 617-23. 10.1016/j.ajog.2005.11.049.CrossRefPubMed
42.
Johnson K, Posner SF, Biermann J, Cordero JF, Atrash HK, Parker CS, Boulet S, Curtis MG, CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care: Recommendations to Improve Preconception Health and Health Care – United States. MMWR. 55 (RR06): 1-23. April 21, 2006
Metadata
Title
Aiming to increase birth weight: a randomised trial of pre-pregnancy information, advice and counselling in inner-urban Melbourne
Authors
Judith Lumley
Lisa Donohue
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2006
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-6-299

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