- Title
- Does midwifery continuity of care make a difference to women with perinatal mental health conditions: A cohort study, from Australia
- Creator
- Cummins, Allison; Baird, Kathleen; Melov, Sarah J.; Melhem, Lena; Hilsabeck, Carolyn; Hook, Monica; Elhindi, James; Pasupathy, Dharmintra
- Relation
- Women and Birth Vol. 36, Issue 2, p. e270-e275
- Publisher Link
- http://dx.doi.org/10.1016/j.wombi.2022.08.002
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2023
- Description
- BACKGROUND: Perinatal mental health (PMH) conditions are associated with an increased risk of adverse perinatal outcomes including preterm birth. Midwifery caseload group practice (continuity of care, MCP) improves perinatal outcomes including a 24 % reduction of preterm birth. The evidence is unclear whether MCP has the same effect for women with perinatal mental health conditions. AIM: To compare perinatal outcomes in women with a mental health history between MCP and standard models of maternity care. The primary outcome measured the rates of preterm birth. METHODS: A retrospective cohort study using routinely collected data of women with PMH conditions between 1st January 2018 - 31st January 2021 was conducted. We compared characteristics and outcomes between groups. Multivariate logistic regression models were performed adjusting for a-priori selected variables and factors that differ between models of care. RESULTS: The cohort included 3028 women with PMH, 352 (11.6 %) received MCP. The most common diagnosis was anxiety and depression (n = 723, 23.9 %). Women receiving MCP were younger (mean 30.9 vs 31.3, p = 0.03), Caucasian (37.8 vs 27.1, p < 0.001), socio-economically advantaged (31.0 % vs 20.2, p < 0.001); less likely to smoke (5.1 vs 11.9, p < 0.001) and with lower BMI (mean 24.3 vs 26.5, p < 0.001) than those in the standard care group. Women in MCP had lower odds of preterm birth (adjOR 0.46, 95 % CI 0.24-0.86), higher odds of vaginal birth (adjOR 2.55, 95 % CI 1.93-3.36), breastfeeding at discharge (adj OR 3.06, 95 % CI 2.10-4.55) with no difference in severe adverse neonatal outcome (adj OR 0.79, 95 % CI 0.57-1.09). CONCLUSIONS: This evidence supports MCP for women with PMH. Future RCTs on model of care for this group of women is needed to establish causation.
- Subject
- perinatal mental health; midwifery continuity of care; pre-term birth
- Identifier
- http://hdl.handle.net/1959.13/1487603
- Identifier
- uon:52193
- Identifier
- ISSN:1871-5192
- Rights
- x
- Language
- eng
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