NewPreBP: Project Newborn -Preparation for Birth and Parenthood
The Danish regions aim to implement antenatal education in small groups for all expectant parents. The effects of general antenatal education for childbirth or parenthood, or both, remain largely unknown. Also it is unknown if antenatal education in small groups is superior to antenatal lectures which is currently standard care.
The aim of the trial is to evaluate if antenatal birth and parent preparation in small groups can increase parenting resources thereby easing birth and creating a smoother and less stressful transition to parenthood among the participants, compared to those allocated to standard care. This in turn is hypothesized to improve health and thriving among newborn families and affect their use of healthcare services. A thorough process evaluation will be conducted highlighting enabling factors and barriers to the implementation. Finally cost-effectiveness analysis will be conducted.
Individually randomised trial sited at Hvidovre Hospital, a large birth clinic in the Copenhagen Capital Region of Denmark.
Participants: 2350 pregnant women ≥ 18 years old, recruited before 20+0 weeks gestation, due to give birth at Hvidovre Hospital. Being legally able and willing to provide signed consent, having a singleton pregnancy, and being fluent in Danish.
Women are randomised to receive:
- A research-based birth and parenting program. The intervention consists of 4 sessions in small groups that last for 2,5 hours per session at 25, 33 and 35 weeks of gestation, and a post-natal session 5 weeks after expected due date.
- Standard care (control group). The pregnant woman and her partner are offered two antenatal lectures in an auditorium.
The allocation of participants to the intervention will be 1:1 to the intervention and the control group.
Data will be collected via questionnaires at baseline, 37 weeks gestation, 9 weeks post-partum, 6 months post-partum and 1 year post-partum, via the hospital obstetric database, and via the national registers. Analyses will be intention to treat. Subgroup analysis will be conducted in relation to personal and demographic characteristics. Process evaluation will be conducted using questionnaires and qualitative interviews. The incremental societal cost of the intervention will be computed and compared to the measured outcomes in a cost-effectiveness analysis.
Outcomes: Stress, parenting alliance, depressive symptoms, use of health care services, self-efficacy, divorce.
Other: Birth and parent preparation
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Prevention
|Official Title:||NewPreBP: Project Newborn -Preparation for Birth and Parenthood. A Large Interdisciplinary Randomised Trial on the Effect of Birth and Parent Preparation|
- Epidural use [ Time Frame: during labour ] [ Designated as safety issue: No ]Epidural use during will be measured using data from the hospital obstetric database
- Perceived stress [ Time Frame: baseline, 37 weeks gestation, 9 weeks post-partum, 6 months post-partum, 1 year post-partum ] [ Designated as safety issue: No ]The perceived stress scale (PSS) will be used to measure global levels of perceived stress. The PSS takes into account the individual's ability to cope. The scale was developed on the basis of appraisal theory and was designed to tap the degree to which respondents found their lives unpredictable, uncontrollable, and overloading.
- Parenting stress [ Time Frame: 9 weeks post-partum, 6 months post-partum, 1 year post-partum ] [ Designated as safety issue: No ]Parenting stress will be measured using the Swedish Parenthood Stress Questionnaire (SPSQ) translated into Danish. The scale takes into account the individual's ability to cope and assesses parental stress with a sum score and subscale scores of incompetence, role restriction, social isolation, spouse relationship and health problems
- stress frequency [ Time Frame: baseline, 9 weeks post-partum, 6 months post-partum, 1 year post-partum ] [ Designated as safety issue: No ]single item question
- stress intensity [ Time Frame: baseline, 9 weeks post-partum, 6 months post-partum, 1 year post-partum ] [ Designated as safety issue: No ]single item question
- Parenting alliance [ Time Frame: 9 weeks post-partum, 6 months post-partum, 1 year post-partum ] [ Designated as safety issue: No ]Parenting alliance will be measured by the Parenting Alliance Measure
|Study Start Date:||November 2012|
|Estimated Study Completion Date:||March 2015|
|Estimated Primary Completion Date:||March 2014 (Final data collection date for primary outcome measure)|
Experimental: Birth and parent preparation
The following subjects will be covered in the sessions:
Session 1 (25 weeks gestation):
Session 2 (33 weeks gestation):
Session 3 (35 weeks gestation):
Session 4 (5 weeks post-partum):
Other: Birth and parent preparation
4 sessions of birth and parent preparation in small groups of 6-8 couples. 3 sessions during pregnancy, 1 session following birth.
No Intervention: control group
The control group are offered two lectures in an auditorium during pregnancy - one on breastfeeding and one on labour. This is standard care.
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|Contact: Vibeke Koushede, PhD||+45 6550 firstname.lastname@example.org|
|Hvidovre, Denmark, 2650|
|Contact: Marianne Skovby, midwife +45 3862 3433 email@example.com|
|Study Director:||Pernille Due, MD||University of Southern Denmark|
|Principal Investigator:||Vibeke Koushede, PhD||University of Southern Denmark|
|Study Chair:||Christian Gluud, MD||Copenhagen Trial Unit|
|Study Chair:||Morten Grønbæk, MD||University of Southern Denmark|