Antenatal Care Health Education Intervened by Social Networking on Mobile Phone Compared with Usual Care to Improve Maternal and Neonatal Outcomes: Randomized Controlled Trial

Background: Although there is a little evidence of social media, especially short message service or SMS, enhancing maternal-neonatal outcomes, clinical trials with social audio-video networking improving their maternal-neonatal outcomes have not been investigated yet. Objective: To determine whether antenatal-health education through audio-video social network about severe obstetric symptoms can provide earlier management and better maternal-neonatal outcomes. Materials and Methods: Using an open-label randomized controlled trial, the difference of the rate of preterm birth, neonatal respiratory distress syndrome (RDS), stillbirth, and perinatal mortality between the control group of routine antenatal health education and the intervention group with audio-video social networking about severe obstetric symptoms was analyzed. Between April 2015 and July 2018, the investigator randomly assigned 1,160 antenatal women in the control (n=558) and the intervention groups (n=602). Data from 832 participants (control n=400, intervention n=432) were available for analyses. Results: The intervention group had an inconclusively non-significant difference in the rate of preterm birth when compared with the control group (8.1% versus 11%), odds ratio (OR) 0.8 (95% confidence interval (CI) 0.5 to 1.2); p=0.260 with the statistical power of 0.26. However, the rate of neonatal RDS was significantly lower in the intervention group than in the control group with statistical significance (0.9% versus 3.8%), OR 0.3 (95% CI 0.1 to 0.9); p=0.028. There was a significant difference in labor pain duration before admission between the intervention and the control groups (121.7±95.3 versus 139.2±7.0 minutes), coefficient –17.7 (95% CI –31.4 to –4.0); p=0.011. Conclusion: Antenatal health education through audio-video social networking was found to significantly lower the rate of the neonatal RDS, which was the result of a significant shorter labor-pain time. The shorter labor-pain time plays a role in the early management of preterm birth and low birth weight. Keywords: Social networking, Mobile phone, Antenatal care, Health education, Maternal outcome, Neonatal outcome, Preterm birth