Does an early postnatal check-up improve maternal health: Results from a randomised trial in Australian general practice

被引:56
作者
Gunn, J
Lumley, J
Chondros, J
Young, D
机构
[1] Univ Melbourne, Dept Gen Practice & Publ Hlth, Carlton, Vic 3053, Australia
[2] LaTrobe Univ, Ctr Study Mothers & Childrens Hlth, Bundoora, Vic, Australia
来源
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY | 1998年 / 105卷 / 09期
关键词
D O I
10.1111/j.1471-0528.1998.tb10263.x
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objectives To investigate whether a visit to a general practitioner one week after discharge results in less depression, increased breastfeeding rates, improved patient wellbeing, fewer physical problems and greater satisfaction with general practice care than the traditional six week postnatal check-up. Design A randomised controlled trial. Setting Rural and metropolitan Victoria, Australia. Population Women giving birth at one rural and one metropolitan hospital between February and December 1995 inclusive. Methods All women received a letter and appointment date to see a general practitioner for a check-up: the intervention group for one week after hospital discharge, the control group for six weeks after birth. A mail-out survey was conducted at three and six months after birth, including Edinburgh Postnatal Depression Scale and Short Form 36. Results 1017/1407 (72.3%) women giving birth at participating hospitals were eligible for the trial: 683 (67.2%) gave informed consent. The average response rate to postal follow up at three and six months was 67.5%. No significant differences were found between the groups in: Edinburgh Postnatal Depression and Short Form 36 scores; number of problems; breastfeeding rates; or satisfaction with general practitioner care. Women in the intervention group were less likely to attend for their check-up (76.4% vs 88.4%; P = 0.001), more likely to discuss labour and birth at their check-up (OR=1.77, 95% CI 1.17-2.68), less likely to have a vaginal examination (OR = 0.51; 95% CI 0.34-0.77) or pap smear (OR = 0.34; 95% CI = 0.22-0.52) at their check; more likely to report difficulties with low milk supply (OR = 1.72; 95% CI = 1.12-2.66) and adjusting to the demands of a new baby (OR = 1.76; 95% CI 1.13-2.74), more likely to talk to a general practitioner about their baby (68.2% vs 58.0%; P=0.02) and less likely to consult a hospital doctor about their baby (7.3% vs 14.0%, P = 0.02). Conclusions To make clinically important improvements in maternal health more is required than early postnatal review.
引用
收藏
页码:991 / 997
页数:7
相关论文
共 17 条
[1]  
ASTBURY J, 1994, AUST J PUBLIC HEALTH, V18, P176
[2]   ATTENDANCE, CONTENT AND RELEVANCE OF THE 6 WEEK POSTNATAL EXAMINATION [J].
BICK, DE ;
MACARTHUR, C .
MIDWIFERY, 1995, 11 (02) :69-73
[3]  
BOWERS J, 1985, PRACTITIONER, V229, P1113
[4]  
BROWNE FJ, 1937, ANTENATAL POSTNATAL, P511
[5]  
BULPITT CJ, 1983, RANDOMISED CONTROLLE, P52
[6]  
COX JL, 1987, BRIT J PSYCHIAT, V150, P782, DOI 10.1007/978-94-007-1694-0_2
[7]   THE SF-36 HEALTH SURVEY QUESTIONNAIRE - AN OUTCOME MEASURE SUITABLE FOR ROUTINE USE WITHIN THE NHS [J].
GARRATT, AM ;
RUTA, DA ;
ABDALLA, MI ;
BUCKINGHAM, JK ;
RUSSELL, IT .
BMJ-BRITISH MEDICAL JOURNAL, 1993, 306 (6890) :1440-1444
[8]  
Glazener CM, 1993, CONT REV OBSTET GYNA, V5, P130
[9]   POSTNATAL MATERNAL MORBIDITY - EXTENT, CAUSES, PREVENTION AND TREATMENT [J].
GLAZENER, CMA ;
ABDALLA, M ;
STROUD, P ;
NAJI, S ;
TEMPLETON, A ;
RUSSELL, IT .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1995, 102 (04) :282-287
[10]   Visits to medical practitioners in the first 6 months of life [J].
Gunn, J ;
Lumley, J ;
Young, D .
JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 1996, 32 (02) :162-166