Living in an Isolated Area, Pregnancy
Conditions
Keywords
Pregnancy, Home visitation, Isolated geographic area
Brief summary
Pregnant women who live in rural area have fewer prenatal consultations. It has been demonstrated that maternal and neonatal morbidity and mortality increase if time travel to a maternity ward is longer than 30 min. Home visitation in isolated area may improve prenatal follow-up as it gives full access to women to health care professionals as well as biological and ultrasound exams without travelling. Our aim is to assess the impact of home visitation on prenatal follow-up as compared to prenatal follow-up in maternity ward and in primary care. Isolated areas will be randomized, for women living in areas included in the intervention group, home visitations will be planned for prenatal follow-up. Ultrasound screening as well as blood exams will be performed during home visitations. For women living in control areas, they will be free to choose prenatal follow-up modalities.
Interventions
OTHERHome visitation
Home visitation for pregnancy follow-up
Sponsors
University Hospital, Clermont-Ferrand
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
12 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* At the first antenatal consultation, confirming the pregnancy. * Pregnant women who live in an area of geographic vulnerability covered by a perinatal network * The women must be informed about the study, understand, read, and speak French, and must be able to consent to participate in medical research
Exclusion criteria
* Pregnant women who live outside an area of geographic vulnerability covered by a perinatal network * Women who give birth in a maternity ward outside Auvergne * Women from another region giving birth in a maternity ward in Auvergne
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| adequate pregnancy follow-up according to the French recommendations | 9 months | number of consultations, In all, 8 consultations should take place in a pregnancy that goes to term |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adherence to antenatal care consultations of women | 9 months | Adherence to the applicable French regulations concerning the term and number of consultations that must be performed until delivery |
| Adherence to antenatal care complementary exams of women by the mobile antenatal care clinic | 9 months | The performance of all of the recommended ultrasounds at the recommended dates and all of the mandatory or recommended laboratory tests for antenatal care |
| adverse neonatal outcome | 9 months | prematurity, in utero death, small or large for gestational age, transfer in intensive unit |
| adverse maternal outcome | 10 months | gestational hypertension, preeclampsia, gestational diabetes, post-partum hemmorage, maternal death, transfer in intensive unit |
| economic analyse of the intervention | 24 months | cost of equipment, human resources, balanced to income inherent to the project in accordance with the standards of cost budget accounting by insurance perspective. |
Countries
France
Outcome results
None listed