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CompletedNCT02865759MindfetalUpdated Jul 21, 2020

Mindfetalness to Improve Pregnancy Outcome

An interventional study of Mindfetalness in Pregnancy Outcomes, sponsored by Sophiahemmet University. Completed at 1 site in Sweden. Open to female participants. Per ClinicalTrials.gov, last updated 2020-07-21.

Sponsored by Sophiahemmet University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
39,000
Allocation
Randomized
Sex
Female
01

Study summary

To improve pregnancy outcome, 39 000 pregnant women will be randomized to receive information about Mindfetalness or to routine care. The level of randomization will be the antenatal clinics in the Stockholm area.

Read the detailed description

The investigators have randomized 33 antenatal clinics in Stockholm to the intervention (receiving information about Mindfetalness) and 30 to routine care. The randomization was performed in blocks according to varying yearly volumes of pregnant women and socio-economic residential area. Three small clinics, with a total of 85 women listed in 2015, were not randomized. Another four clinics, receiving referrals of women with need for specialized care, were not randomized either. The recruitment is restricted to the 63 randomized clinics. In a pilot study in one antenatal clinic, the intervention has been tested among 102 women. A run-in period will start at high-volume antenatal clinics 1 September 2016, one month before the investigators start to register the women that will be observed for pregnancy outcome. All information, including that of possible effect-modifying and possible confounding factors, will be fetched from population-based registers and linked by the personal identify number unique for each resident in Sweden. The Swedish Medical Birth Register, Obstetrix, the Swedish Educational Register, the Prescribed Drug Register and the National Patient Register provide the information. By this design, and the analyses according to the intention-to treat principle, attrition and differential misclassification of outcome becomes negligible. Non-differential misclassification of the predictor (Mindfetalness or no Mindfetalness) will be substantial, diluting the effect estimates. This dilution may be compensated by the large size of the trial. Since the unit of randomization is the antenatal clinics residual confounding is an issue. The investigators will have, however, information on important possible confounding factors, including educational level, age, parity, body mass index, country of birth, diabetes mellitus before the pregnancy, certain other pre-pregnancy diseases, previous stillbirth, gestational diabetes mellitus and preeclampsia.

An article describing the study protocol has been published. A pilot study testing complicance of mindfetalness has been published. Data concerning outcome (all recruited women are followed from gestational week 32+0 until delivery) will be exported from the pregnancy register during October 2018.

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Conditions studied

  • Pregnancy Outcomes
03

In context

Lead sponsor

Sophiahemmet University is the lead sponsor of 9 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Pregnant woman with a fetus being at least 25 weeks old (gestational age)
  • Having a Swedish personal identity number

Exclusion criteria

Exclusion Criteria:

  • None
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Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
39,000 participants (actual)

Study arms

  • Experimental
    Mindfetalness

    The pregnant woman will be informed about the possibility of practicing Mindfetalness verbally, in a brochure and at a website. The practice is described as spending 15 minutes every day from gestational week 28 to get to know the fetal movement pattern. The fetus must be awake when she practice Mindfetalness and the woman is suggested to lay on her left side when she observe the fetal movements. In the brochure as well at the website the woman can write down something about the nature, frequency or strength of the fetal movements. If the woman experiences decreased frequency of fetal movements or weaker movements she is instructed to seek health-care without unnecessary delay.

    Behavioral: Mindfetalness

  • No intervention
    Routine Care

    No activities will take place in the antenatal clinics randomized to routine care.

Interventions

  • BehavioralMindfetalness

    The pregnant woman is motivated to practice Mindfetalness verbally, by a brochure and at a website.

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What researchers measure

Primary outcomes

  1. An Apgar Score below 7

    We will use the score assessed in routine care and reported to the Pregnancy Register.

    Time frame: Five minutes after birth

  2. Caesarian section

    We will use the information in the Pregnancy Register. The responsible health-care professionals clasify the mode of delivery and report it to the register. The register is population-based and covers by and large every birth in the region at the time.

    Time frame: At delivery

  3. Induction of Labor

    We will use the information in the Pregnancy Register. The responsible health-care professionals clasify the mode of delivery and report it to the register. The register is population-based and covers by and large every birth in the region at the time.

    Time frame: At delivery.

Secondary outcomes

  1. Visit to health care due to worry about decrease in fetal movements

    We will use events registered in the Pregnancy Register.

    Time frame: Pregnancy from week 28

Other outcomes

  1. An Apgar Score below 4

    We will use the score assessed in routine care and reported to the Pregnancy Register.

    Time frame: Five minutes after birth

  2. An Apgar Score below 10

    We will use the score assessed in routine care and reported to the Pregnancy Register.

    Time frame: Five minutes after birth

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Study locations

1 site
  • Stockholm region
    Stockholm, Sweden
08

References and documents

Publications

  • Malm MC, Radestad I, Rubertsson C, Hildingsson I, Lindgren H. Women's experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy--a crossover trial. BMC Pregnancy Childbirth. 2014 Oct 7;14:349. doi: 10.1186/1471-2393-14-349. PubMed 25288075 ↗
  • Radestad I. Strengthening mindfetalness. Sex Reprod Healthc. 2012 Jun;3(2):59-60. doi: 10.1016/j.srhc.2012.01.002. Epub 2012 Jan 27. PubMed 22578751 ↗
  • Radestad I, Akselsson A, Georgsson S, Lindgren H, Pettersson K, Steineck G. Rationale, study protocol and the cluster randomization process in a controlled trial including 40,000 women investigating the effects of mindfetalness. Sex Reprod Healthc. 2016 Dec;10:56-61. doi: 10.1016/j.srhc.2016.10.004. Epub 2016 Oct 26. PubMed 27938874 ↗
  • Akselsson A, Georgsson S, Lindgren H, Pettersson K, Radestad I. Women's attitudes, experiences and compliance concerning the use of Mindfetalness- a method for systematic observation of fetal movements in late pregnancy. BMC Pregnancy Childbirth. 2017 Oct 16;17(1):359. doi: 10.1186/s12884-017-1548-5. PubMed 29037234 ↗
  • Akselsson A, Lindgren H, Georgsson S, Pettersson K, Steineck G, Skokic V, Radestad I. Mindfetalness to increase women's awareness of fetal movements and pregnancy outcomes: a cluster-randomised controlled trial including 39 865 women. BJOG. 2020 Jun;127(7):829-837. doi: 10.1111/1471-0528.16104. Epub 2020 Feb 8. PubMed 31971325 ↗
  • Lindgren H, Radestad I, Pettersson K, Skokic V, Akselsson A. Epidural use among women with spontaneous onset of labour - an observational study using data from a cluster-randomised controlled trial. Midwifery. 2021 Dec;103:103156. doi: 10.1016/j.midw.2021.103156. Epub 2021 Sep 30. PubMed 34634721 ↗
  • Radestad I, Pettersson K, Lindgren H, Skokic V, Akselsson A. Country of birth, educational level and other predictors of seeking care due to decreased fetal movements: an observational study in Sweden using data from a cluster-randomised controlled trial. BMJ Open. 2021 Jun 25;11(6):e050621. doi: 10.1136/bmjopen-2021-050621. PubMed 34172554 ↗
  • Akselsson A, Lindgren H, Skokic V, Radestad I. A decrease in cesarean sections and labor inductions among Swedish women by awareness of fetal movements with the Mindfetalness method. BMC Pregnancy Childbirth. 2020 Oct 1;20(1):577. doi: 10.1186/s12884-020-03268-1. PubMed 32998708 ↗

Study documents

  • Statistical analysis plan · Sep 24, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 21, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02865759
Lead sponsor
Sophiahemmet University
Collaborators
Karolinska Institutet, Göteborg University
Responsible party
Ingela Radestad (Principal Investigator, Sophiahemmet University) — Principal investigator
First posted
Aug 12, 2016
Start date
Nov 1, 2016
Primary completion
Jun 30, 2018
Completion
Jun 30, 2018
Last update
Jul 21, 2020

Study contacts

Ingela Rådestad, PhD
principal investigator · Sophiahemmet University

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jul 2020. You cannot join it, but the record below documents what was studied.

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