Disaster in pregnancy: midwifery continuity positively impacts infant neurodevelopment, QF2011 study

BMC Pregnancy Childbirth. 2018 Jul 27;18(1):309. doi: 10.1186/s12884-018-1944-5.


Background: Research shows that continuity of midwifery carer in pregnancy improves maternal and neonatal outcomes. This study examines whether midwifery group practice (MGP) care during pregnancy affects infant neurodevelopment at 6-months of age compared to women receiving standard hospital maternity care (SC) in the context of a natural disaster.

Methods: This prospective cohort study included 115 women who were affected by a sudden-onset flood during pregnancy. They received one of two models of maternity care: MGP or SC. The women's flood-related objective stress, subjective reactions, and cognitive appraisal of the disaster were assessed at recruitment into the study. At 6-months postpartum they completed the Ages and Stages Questionnaire (ASQ-3) on their infants' communication, fine and gross motor, problem solving, and personal-social skills.

Results: Greater maternal objective and subjective stress predicted worse infant outcomes. Even when controlling for maternal stress from the flood, infants of mothers who were in the MGP model of maternity care performed better than infants of mothers in SC on two of the five ASQ-3 domains (fine motor and problem solving) at 6-months of age. Furthermore, infants in the SC model were more likely to be identified as at risk for delayed development on these domains than infants in the MGP model of care.

Conclusions: Continuity of midwifery care has positive effects on infant neurodevelopment when mothers experience disaster-related stress in pregnancy, with significantly better outcomes on two developmental domains at 6 months compared to infants whose mothers received standard hospital care.

Keywords: Infant development; Midwifery group practice; Prenatal maternal stress.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Child Development*
  • Continuity of Patient Care
  • Female
  • Floods*
  • Hospitals, Maternity
  • Humans
  • Infant
  • Midwifery / methods*
  • Models, Organizational
  • Natural Disasters*
  • Neurodevelopmental Disorders* / etiology
  • Neurodevelopmental Disorders* / prevention & control
  • Patient Care Management / methods
  • Pregnancy
  • Pregnant Women / psychology*
  • Prenatal Exposure Delayed Effects* / etiology
  • Prenatal Exposure Delayed Effects* / prevention & control
  • Stress, Psychological / etiology
  • Stress, Psychological / therapy*