Effects of a Personal Health Record in Maternity Care: A Stepped-Wedge Trial

Groenen CJM et al. recently assessed the usefulness of a personal health record (PHR) in routine maternity care to improve the active participation of pregnant women in their maternal health and multidisciplinary collaboration between maternal care professionals. 

They studied the effects of this intervention on the percentage of uncomplicated births, women's perspectives on quality of care, and the collaboration between health care professionals. They conducted a stepped-wedge cluster randomized controlled trial with four clusters and 13 maternity health centers (community-based midwife practices and hospitals) in one collaborative area, involving 7350 pregnant women and 220 health care professionals. 

They found that uncomplicated births comprised 51.8% of total births in the control group and 55.0% in the intervention group. Further, they found that the differences in the stepped-wedge study were due to time and not the intervention. Women's perspectives on quality of care and collaboration between health care professionals showed no relevant differences between the control and intervention groups. The introduction of the PHR had no significant effect on the chosen measures of quality of maternal care. 

Thus the researchers concluded that the innovative intervention MyPregn@ncy contained no significant effect on the percentage of uncomplicated births, which was the primary outcome of this study. 

They reviewed that though the raw data suggested a positive effect, it became insignificant after correction for time. This positive pattern was primarily due to the rising trend in uncomplicated birth rates in the total eligible population during the study period. This local trend, less visible in the national database, was probably due to slight changes toward an improved collaborative culture among the local professionals participating in the study. Considering this, the investigators declared that person-centered collaboration rewards, regardless of the intervention itself.

Groenen CJM, Kremer JAM, IntHout J, Meinders MJ, van Duijnhoven NTL, Vandenbussche FPHA. Effects of a Personal Health Record in Maternity Care: A Stepped-Wedge Trial. Int J Environ Res Public Health. 2021 Sep 30;18(19):10343. doi: 10.3390/ijerph181910343. PMID: 34639642; PMCID: PMC8508495.