Psychosocial outcomes from one cohort participating in the STan Australian Randomised controlled Trial (START)

Author:

Benton Madeleine1ORCID,Salter Amy2,Wilkinson Chris3,Simpson Bronni4,Turnbull Deborah1

Affiliation:

1. School of Psychology University of Adelaide Adelaide South Australia Australia

2. School of Public Health University of Adelaide Adelaide South Australia Australia

3. Maternal Fetal Medicine Women's and Children's Hospital Adelaide South Australia Australia

4. Women's and Children's Hospital Adelaide South Australia Australia

Abstract

AbstractBackgroundIn an Australian randomized controlled trial (RCT), two techniques for intrapartum fetal surveillance were compared: ST analysis (STan) as an adjunct to cardiotocography (CTG), compared with CTG alone. The aim was to determine whether CTG + STan could reduce emergency cesarean birth rates while maintaining or improving neonatal outcomes. Secondary aims were to compare clinical, economic, and psychosocial outcomes. The purpose of this paper was to present psychosocial outcomes from one cohort enrolled in the trial.MethodsThe study was conducted at one tertiary referral hospital. Participants who had taken part in the trial from the outset were invited to complete a questionnaire between March 2018 and January 2020, approximately 8 weeks after giving birth. Outcomes included depression, psychological distress, health‐related quality of life, and infant feeding practices. Analysis was by intention to treat.ResultsN = 207/527 participants completed the questionnaire (n = 113, STan; n = 94, CTG alone). Overall, no statistically significant or clinically meaningful differences were found in the two groups for symptoms of depression, psychological distress, quality of life, or infant feeding. A statistically significant difference was observed for the subscale of pain‐discomfort, where scores were higher on average in the CTG alone arm relative to that in the CTG + STan arm.ConclusionsAlthough STan as an adjunct to CTG constitutes a different clinical technology from CTG alone, both monitoring types appeared to produce similar results in terms of postnatal psychosocial outcomes for women. Findings from this study provide service users and staff with a comprehensive assessment of STan that can be used to make evidence‐informed decisions about monitoring options should STan become more widely available.

Funder

National Health and Medical Research Council

University of Adelaide

Publisher

Wiley

Reference26 articles.

1. Protocol for a randomised controlled trial of fetal scalp blood lactate measurement to reduce caesarean sections during labour: the Flamingo trial [ACTRN12611000172909]

2. Electronic Fetal Monitoring and Cesarean Birth: A Scoping Review

3. Prevention of birth asphyxia: responding appropriately to cardiotocograph (CTG) traces

4. Australian Institute of Health Welfare.National Core Maternity Indicators.2019.https://www.aihw.gov.au/reports/mothers‐babies/ncmi‐data‐visualisations

5. Pregnancy Outcome Unit.Pregnancy Outcome in South Australia 2017.2019https://www.sahealth.sa.gov.au/wps/wcm/connect/5a2705b2‐1034‐4c1b‐8420‐095d076a28bf/Pregnancy+Outcome+in+South+Australia+2017+V1+Feb.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE‐5a2705b2‐1034‐4c1b‐8420‐095d076a28bf‐n08dPLn

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