My Baby’s Movements: a stepped wedge cluster randomised controlled trial to raise maternal awareness of fetal movements during pregnancy study protocol

K. Warrilow (1,2), M. Weller (1), G. Gardener (1,3), S. Henry (1), D. Ellwood (1,4), P. Middleton (1,5), A. Wojcieszek (1), C. East (1,6), F. Boyle (7), V. Flenady (1)

(1) Centre of Research Excellence in Stillbirth, Mater Research Institute, (2) The University of Queensland, Australia, (3) Mater health, (4) School of Medicine, Griffith University, Australia, (5) SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia, (6) School of Nursing and Midwifery, Monash University and Monash Women’s Maternity Services, Clayton, Victoria, Australia, (7) Institute for Social Science Research, The University of Queensland, Brisbane, Australia

1) Background: Late gestation stillbirth has been linked to both sub-optimal maternal perception, and untimely reporting of decreased fetal movements (DFM) and remains a topic of interest in preventing stillbirth. The My Baby’s Movements (MBM) trial aims to reduce stillbirth rates through offering a mobile phone application (app) to women in the third trimester for the purpose of improving knowledge and awareness of fetal movements (FM) and to encourage timely reporting of concerns.

2) Methods: The MBM trial is a stepped-wedge, cluster-randomised trial conducted across 26 maternity hospitals in Australia and New Zealand from 3 years from August 2016 to May 2019. Women attending for maternity care at each of these hospitals were invited to download the app. Data were obtained from a survey embedded within the MBM app which was provided once the woman had birthed.

3) Results: Of the 18,273 women who downloaded the MBM app by April 2019, 23% (4,156) have birthed and completed the MBM app survey. Nearly half of these women (46%; n=1922) reported having concerns about FM in the third trimester and 64% of them (n=1224) said they used the MBM app when they felt concerned. Almost one-third (n=1234, 29.7%) of the MBM app survey completer’s reported seeking care at their maternity hospital for FM concerns. Of these women, 533 (43.2%) reported doing so based upon prompting from the app and 440 (35.6%) reported using the app to inform discussion with their health care provider.

4) Conclusions: For a sizeable number of women, the MBM app appears to be a useful tool for promoting awareness, health care seeking, and interactions with health care providers around FM concerns.

Ethics statement: Primary ethical approval was obtained from Mater Misericordiae Ltd Human Research Ethics Committee (EC00332) (MML HREC) in 2015. Further jurisdictional ethics approval was obtained from seven participating HRECs across Australia and New Zealand. Governance clearance was obtained for each of the 26 facilities involved in the trial.

International Stillbirth Alliance, Annual Conference on Perinatal Mortality and Bereavement Care, Madrid, Spain. October 5-6th, 2019.

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