Transcript Results of the MidU study

Collaboration in research – overview
of the MAMMI and OptiBIRTH studies
Cecily Begley
Trinity College Dublin
Why collaborate?
Because otherwise…..
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Benefits of collaboration
are enormous
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Two examples:
• Maternal health And Maternal
Morbidity in Ireland - The MAMMI
study
• The OptiBIRTH study – increasing
VBAC
• Future collaborative work
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Trinity College Dublin
The The MAMMI study
(Maternal health And Maternal
Morbidity in Ireland)
Trinity College Dublin
Professor Cecily Begley, Déirdre Daly Lecturer in
Midwifery/HRB Research Fellow,
Professor Mike Clarke, Queen’s University Belfast
Trinity College Dublin
• There are no publicly available
data on maternal health and health
problems following discharge
from the maternity hospitals in
Ireland
• Women’s attendances at health
services or readmissions to
hospitals are not linked to their
maternity records (i.e. there is no
connectivity between their
records)
The MAMMI Study
General
health
Intimate
partner
violence
Mental
health
2,600
primiparous
women
(A/N, 3, 6, 9 and
12 months
postpartum)
Sexual
health
Data collection
from women’s
records
Faecal
incontinence
Urinary
incontinence
Pelvic
girdle
pain
The MAMMI Study
General
health
Intimate
partner
violence
2,600
primiparous
women
Mental
health
(A/N, 3, 6, 9 and
12 months
postpartum)
Sexual
health
Data collection
from women’s
records
Faecal
incontinence
Urinary
incontinence
Pelvic
girdle
pain
The MAMMI Study
General
health
Intimate
partner
violence
Mental
health
2,600
primiparous
women
(A/N, 3, 6, 9 and
12 months
postpartum)
Sexual
health
Data collection
from women’s
records
Faecal
incontinence
Urinary
incontinence
Pelvic
girdle
pain
The MAMMI Study
General
health
Intimate
partner
violence
Mental
health
2,600
primiparous
women
(A/N, 3, 6, 9 and
12 months
postpartum)
Sexual
health
Data collection
from women’s
records
Faecal
incontinence
Urinary
incontinence
Pelvic
girdle
pain
The MAMMI Study
General
health
Intimate
partner
violence
Mental
health
2,600
primiparous
women
(A/N, 3, 6, 9 and
12 months
postpartum)
Sexual
health
Data collection
from women’s
records
Faecal
incontinence
Urinary
incontinence
Pelvic
girdle
pain
The MAMMI Study
General
health
Intimate
partner
violence
Sexual
health
Mental
health
2,600
primiparous
women
(A/N, 3, 6, 9 and
12 months
postpartum)
Data collection
from women’s
records
Faecal
incontinence
Urinary
incontinence
Pelvic
girdle
pain
The MAMMI Study
General
health
Intimate
partner
violence
Mental
health
2,600
primiparous
women
(A/N, 3, 6, 9 and
12 months
postpartum)
Sexual
health
Data collection
from women’s
records
Faecal
incontinence
Urinary
incontinence
Pelvic
girdle
pain
The MAMMI Study
Cross-cutting themes
Caesarean
section
2,600 primiparous
women
Nutrition
(A/N, 3, 6, 9 and 12
months postpartum)
Data collection
from women’s
records
Consent
Urinary incontinence
Trinity College Dublin
On
On way to
exercise toilet
At start of
pregnancy
n=723
At 3 months
postnatal
n=124
33.5% 16.8%
Urinary incontinence
Trinity College Dublin
On
On way to
exercise toilet
At start of
pregnancy
n=723
At 3 months
postnatal
n=124
33.5% 16.8%
Urinary incontinence
Trinity College Dublin
On
On way to
exercise toilet
At start of
pregnancy
n=723
33.5% 16.8%
At 3 months
postnatal
n=124
54.8% 39.8%
Trinity College Dublin
The Early The MAMMI study
(Maternal health And Maternal
Morbidity in Ireland)
The OptiBIRTH Study
Aim of OptiBIRTH
To increase VBAC rates from 25 to 53%
(approximately)…..
through enhanced women-centred care…
CS rates across EU
38%
29.5%
27.3%
23%
15%
17%
17%
Caesarean section
• CS, when performed for certain medical
indications such as placenta praevia or
transverse lie, for example, is a necessary
and sometimes life-saving operation
(Neilson 2003).
BUT
• CS is not without its risks.
• 9 deaths fewer per 100,000 women with
pVBAC compared to women with ERCS
Caesarean section
• So – CS is not an operation to be
undertaken lightly.
OptiBIRTH study
• A cluster randomised trial in Ireland,
Germany and Italy, with 15 clusters
(maternity units) of 120 women in each.
• To test an educational intervention for
women and clinicians.
Intervention
• Was developed through:
– Two systematic reviews of interventions to
increase VBAC, targeting clinicians and
women.
– Focus group and individual interviews involving
115 clinicians and 71 women, held in Ireland,
Italy, Germany (low VBAC rates), and Finland,
Sweden and the Netherlands (high VBAC
rates).
What is happening now
• Randomised trial (pilot) has started in
January/February 2014
• Outcomes will be measured in both groups
• Costs will be assessed in both groups
Future studies
• Must be collaborative.
• Need to have interdisciplinary teams of
clinicians, researchers and consumers.
Future studies
• Interdisciplinary….
• Clinicians have expert clinical knowledge and
know what research is needed, and how to
apply the findings.
• Researchers know how to collect data in a
valid and reliable fashion, and how to analyse
and interpret it.
• Women and their families know what they
want.
Future studies
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