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- Essai clinique NCT03165838
Effectiveness of Shortened Time Interval to Postpartum Visit in Improving Postpartum Attendance
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Postpartum care is an essential component of women's reproductive health. During this time, the health care provider and the new mother review the previous pregnancy course, assess the mother's wellbeing, and establish treatment plans for any ongoing problems. Prospective guidance is given for both the mother and the baby in areas such as breastfeeding, nutrition, depression screening, and perineal/vulvar care. However, one of the most important goals of the postpartum visit is to discuss the new mother's desire for future pregnancies and the interval she wishes before another pregnancy. Inadequate reproductive health planning may result in unintended or rapid repeat of pregnancy (RROP), clinically defined as a second pregnancy within 24 months of the end of a previous pregnancy. A short inter-pregnancy interval is a risk factor for poor pregnancy outcomes including stillbirth, early neonatal death, extreme preterm births, and babies born small for gestational age. Compared to women who conceived 18-23 months after a previous birth, women conceiving less than five months after a previous birth had increased third trimester bleeding, uterine infection, premature rupture of membranes, and maternal death.Central to these outcomes is the rate of postpartum contraception use.
In fact, research shows an association between a postpartum visit and use of a reliable contraceptive method after pregnancy.
The optimal time for postpartum visit may be 3-4 weeks post-delivery rather than 6-8 weeks post-delivery with regard to visit attendance and proactive management of reproductive health, including contraception and time intervals between pregnancies. The timing of the postpartum visits are also linked to economic outcomes and healthcare utilization; postpartum care that results in decreased RROP and unintended pregnancies will likely decrease healthcare costs associated with the adverse consequences of inadequate reproductive health planning. Despite the obvious potential benefits of a decreased interval between delivery and the postpartum visit, to date, there have been no studies to systematically compare the impact of postpartum visit timing on visit attendance, contraception use and, subsequently, RROP.
This study is designed to investigate the effect of reduced time interval to postpartum visit on postpartum visit attendance rate, contraceptive use, and RROP. Additionally, the study will assess the impact of the two visit schedules on these outcomes by race, providing critical information about high risk populations. Finally, this research will assess the cost effectiveness of the shortened postpartum visit schedule relative to the standard of care. In order to account for potential bias in increased attendance rate due to intervention effect, compensation and other factors, this study will also compare the effectiveness of shortened time interval to postpartum visit on postpartum attendance rate and contraceptive use to a historic cohort.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- at least 18 years of age
- delivered vaginally a healthy, full-term (at least 37 weeks gestation) baby
- received prenatal care services at the VCUMCV OB clinic
- speak English
- provide informed consent for study participation.
Exclusion Criteria:
- cognitive impairment, psychiatric instability, or language barriers that limit their ability to provide informed consent
- surgically sterilized
- have complicated deliveries that require extended hospital stays
- need early follow-up to monitor their conditions
- any problems with infants such as preterm birth, admission to the Neonatal Intensive Care Unit (NICU), congenital malformations or respiratory problems that would require frequent clinic visits or prolonged hospital admissions for the infants.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Double
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Expérimental: Postpartum Visit 3-4 Weeks
Participants will have postpartum visit scheduled 3-4 weeks after birth
|
This visit will be the same as the standard of care postpartum visit, but it will be scheduled earlier.
|
Expérimental: Postpartum Visit 6-8 Weeks
Participants will have postpartum visit scheduled 6-8 weeks after birth
|
This standard of care postpartum visit will be scheduled for the standard time interval.
Autres noms:
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Postpartum Clinic Attendance
Délai: assessed at 12 weeks postpartum
|
To compare the effectiveness of 3-4 week and 6-8 week intervals to postpartum visit on improving the rate of postpartum visit attendance.
The investigators hypothesize that study participants with postpartum visits scheduled 3-4 weeks after delivery will be more likely to attend visits than study participants scheduled for visits 6-8 weeks after delivery.
|
assessed at 12 weeks postpartum
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Contraception Use
Délai: Assessed at 3, 6, 9, 12, & 18 month follow-ups
|
Compare the effectiveness of 3-4 week and 6-8 week intervals to postpartum visit on consistent contraceptive use
|
Assessed at 3, 6, 9, 12, & 18 month follow-ups
|
Rapid Repeat Pregnancy
Délai: Assessed at 3, 6, 9, 12, & 18 month follow-ups
|
Compare the effectiveness of 3-4 week and 6-8 week intervals to postpartum visit on repeat pregnancy
|
Assessed at 3, 6, 9, 12, & 18 month follow-ups
|
Cost effectiveness
Délai: 18 month postpartum
|
Compare overall cost of postpartum care
|
18 month postpartum
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Racial Differences
Délai: baseline, postpartum, 3, 6, 9, 12, & 18 month follow-ups
|
Compare the effectiveness of 3-4 week and 6-8 week intervals to postpartum visit on reducing racial differences in postpartum visit attendance rates and contraceptive use.
Specifically, the study team hypothesizes that the difference in postpartum visit attendance and consistent contraceptive use rates between AA and CA study participants will be lower among study participants with postpartum visits scheduled 3-4 weeks after delivery compared to study participants scheduled for visits 6-8 weeks after delivery.
|
baseline, postpartum, 3, 6, 9, 12, & 18 month follow-ups
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Saba W Masho, Virginia Commonwealth University
Publications et liens utiles
Publications générales
- Yonemoto N, Nagai S, Mori R. Schedules for home visits in the early postpartum period. Cochrane Database Syst Rev. 2021 Jul 21;7(7):CD009326. doi: 10.1002/14651858.CD009326.pub4.
- Masho SW, Ihongbe TO, Wan W, Graves WC, Karjane N, Dillon P, Bazzoli G, McGee E. Effectiveness of shortened time interval to postpartum visit in improving postpartum attendance: Design and rationale for a randomized controlled trial. Contemp Clin Trials. 2019 Jun;81:40-43. doi: 10.1016/j.cct.2019.04.012. Epub 2019 Apr 18.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Autres numéros d'identification d'étude
- HM20000032
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
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Essais cliniques sur Postpartum Visit 3-4 Weeks
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Jeffrey A. Cohen, MDJacobus PharmaceuticalRésiliéFaiblesse musculaireÉtats-Unis
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Pharma Holdings ASCTC Clinical Trial Consultants ABComplétéDécolonisation nasale de Staphylococcus aureusSuède
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Hospital Central Norte PEMEXRecrutementPerformance de la coloscopie | Tolérance de la coloscopieMexique
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Seoul National University HospitalInconnue
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Merz Pharmaceuticals GmbHComplétéCorrection des rides/plis du visage | Amélioration du volume du visageAllemagne
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Otto Bock Healthcare Products GmbHComplétéAmputation du membre inférieur au-dessus du genou (blessure)L'Autriche, Belgique
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University of AlbertaRetiréCancer de la tête et du cou | Opération | La nutrition | AvalerCanada
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Klinikum der Universität KölnInconnue
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The University of Tennessee, KnoxvilleRecrutementObésité | Régime alimentaireÉtats-Unis
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Istanbul University - Cerrahpasa (IUC)Actif, ne recrute pasEn bonne santé | Inactivité physiqueTurquie