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Cited by 212Maternal and Neonatal HealthcareTelemedicine and Telehealth ImplementationMobile Health and mHealth Applications

The DOI matches its Crossref record; 19 of the 20 references it cites were found in a registry or an index.

Randomized comparison of a reduced-visit prenatal care model enhanced with remote monitoring

Butler Tobah, Yvonne S., LeBlanc, Annie, Branda, Megan E., Inselman, Jonathan W., Morris, Megan A., Ridgeway, Jennifer L., Finnie, Dawn M., Theiler, Regan, Torbenson, Vanessa E., Brodrick, Ellen M., Meylor de Mooij, Marnie, Gostout, Bobbie, Famuyide, Abimbola·2019·American Journal of Obstetrics and Gynecology
DOI 10.1016/j.ajog.2019.06.034
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Abstract

Background Standard prenatal care, consisting of 12-14 visits per pregnancy, is expensive and resource intensive, with limited evidence supporting the structure, rhythm, or components of care. Some studies suggest a reduced-frequency prenatal care model is as safe as the standard model of care for low-risk pregnant women, but evidence is limited. We developed and evaluated an innovative, technology-enhanced, reduced prenatal visit model (OB Nest).Objective To evaluate the acceptability and effectiveness of OB Nest, a reduced-frequency prenatal care model enhanced with remote home monitoring devices and nursing support.Study design A single-center randomized controlled trial, composed of pregnant women, aged 18-36 years, recruited from an outpatient obstetric tertiary academic center in the Midwest United States. OB Nest care consisted of 8 onsite appointments with an obstetric provider; 6 virtual visits consisting of phone or online communication with an assigned nurse, supplemented with fetal Doppler and sphygmomanometer home monitoring devices; and access to an online community of pregnant women. Usual care consisted of 12 prescheduled prenatal clinic appointments with obstetric providers. Acceptability of OB Nest was measured by validated surveys of patient satisfaction with care at 36 weeks; perception of stress at 14, 24, and 36 weeks; and perceived quality of care at 36 weeks of gestation. Effectiveness was analyzed by comparing adherence to the American College of Obstetricians and Gynecologists recommended routine prenatal and ancillary services, maternal and fetal safety outcomes, and healthcare utilization.Results Three hundred pregnant women at <13 weeks of gestation were recruited and randomized to OB Nest or usual care (150 in each arm) using a minimization algorithm. Demographic characteristics were similar between groups. Compared to usual care, patients in OB Nest had higher satisfaction on a 100-point validated modified Littlefield and Adams Satisfaction scale (OB Nest = 93.9% vs usual care = 78.9%, P < .01). Pregnancy-related stress, measured, on a 0-2 point PreNatal Maternal Stress validated scale, with higher scores indicating higher levels of stress, was lower among OB Nest participants at 14 weeks (OB Nest = 0.32 vs usual care = 0.41, P < .01) and at 36 weeks of gestation (OB Nest = 0.34 vs usual care = 0.40, P < .03). There was no statistical difference in perceived quality of care. Adherence to the provision of American College of Obstetricians and Gynecologists prenatal services was similar in both arms. Maternal and fetal clinical outcomes were similar between groups. Total reported nursing time was higher in OB Nest (OB Nest = 171.2 minutes vs usual care = 108.2 minutes, 95% confidence interval, 48.7-77.4).Conclusion OB Nest is an innovative, acceptable, and effective reduced-frequency prenatal care model. Compared to routine prenatal care, OB Nest resulted in higher patient satisfaction and lower prenatal stress, while reducing the number of appointments with clinicians and maintaining care standards for pregnant women. This program is a step toward evidence-driven prenatal care that improves patient satisfaction.

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Crossref · 10.1016/j.ajog.2019.06.034

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Metadata

Authors
Butler Tobah, Y. S., LeBlanc, A., Branda, M. E., Inselman, J. W., Morris, M. A., Ridgeway, J. L., Finnie, D. M., Theiler, R., Torbenson, V. E., Brodrick, E. M., Meylor de Mooij, M., Gostout, B., & Famuyide, A.
Affiliations
Mayo Clinic (US)
ORCID
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2019-12
Volume
221
Issue
6
Pages
638.e1-638.e8
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/j.ajog.2019.06.034
OpenAlex
W2952303999
Cited by
212
References
20
Citations by year
2026: 18 · 2025: 14 · 2024: 32 · 2023: 45 · 2022: 41 · 2021: 40 · 2020: 22
FWCI
35.16
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Mayo Clinic (NCT02082275)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
remote fetal monitoring, patient satisfaction, pregnancy-related stress, perceived quality of care, health care utilization, low-risk pregnancy, maternal and fetal safety
MeSH terms
Adult, Blood Pressure Determination, Delivery of Health Care, Female, Heart Rate, Fetal, Humans, Obstetric Nursing, Obstetrics, Patient Acceptance of Health Care, Pregnancy, Prenatal Care, Quality of Health Care, Self Care, Stress, Psychological, Patient Satisfaction, Telemedicine, Ultrasonography, Doppler, Sphygmomanometers

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