Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany.
Department of Gynecology and Obstetrics, University Women's Clinic Leipzig, Leipzig, Germany.
JMIR Mhealth Uhealth. 2019 Jan 7;7(1):e11458. doi: 10.2196/11458.
Pregnancy can be distressing, particularly if expectant mothers are worried about the well-being of their fetus. Consequently, the desire for reassurance and frequent fetal monitoring is often pronounced. Smart wearable devices and telemedicine are promising tools that could assist women in self-monitoring their pregnancy at home, hence disburdening emergency departments (EDs). They present the possibility to clarify the need for urgent care remotely and offer tighter pregnancy monitoring. However, patients' acceptance of such new technologies for fetal monitoring has not yet been explored extensively.
This survey aimed to elucidate the attitudes of women toward self-monitoring of their pregnancy using noninvasive electronic devices. The technical details of the proposed devices were not specified.
A cross-sectional multicenter study was conducted at the departments of obstetrics of the University Hospitals of Heidelberg and Leipzig, Germany. All patients seen in the obstetrics clinic who were above 18 years were offered participation. We designed a survey questionnaire including validated instruments covering population characteristics, issues in current and past pregnancies, as well as attitudes toward self-monitoring of pregnancy with smart devices.
A total of 509 pregnant women with no previous experience in telemedicine participated. Only a small minority of 5.9% (29/493) regarded self-monitoring with wearable devices as an alternative to consulting their physicians. Along these lines, only 7.7% (38/496) strongly believed they would visit the ED less often if such devices were readily available. However, if the procedure were combined with a Web-based telemetric physician consult, 13.5% (66/487) would be highly motivated to use the devices. Furthermore, significantly more women regarded it as an alternative prior to seeing a doctor when they perceived a decline in fetal movements (P<.001). Interestingly, women with university degrees had a higher propensity to engage in pregnancy self-monitoring compared with women without one (37% vs 23%; P=.001). Of the participants, 77.9% (381/489) would like smart wearable devices to measure fetal heart sounds, and 62.6% (306/489) wished to use the devices on their own. Feedback from a doctor or midwife was also very important in their choice of such devices (61.8%, 301/487 wished feedback). The intended frequency of use differed vastly among women, ranging from 13.8% (65/471) who would like to use such a device several times per day to 31.6% (149/471) who favored once per week at most.
Our results point to a skeptical attitude toward pregnancy self-monitoring among pregnant women. Nevertheless, many women are open to using devices for pregnancy monitoring in parallel to consulting their physician. The intention to use such devices several times daily or weekly, expressed by more than half of the participants, highlights the potential of such technologies.
怀孕可能会让人感到不安，尤其是当孕妇担心胎儿的健康时。因此，她们通常会强烈渴望得到安慰和频繁的胎儿监测。智能可穿戴设备和远程医疗是很有前途的工具，可以帮助女性在家中进行自我妊娠监测，从而减轻急诊部门（ED）的负担。它们提供了远程明确紧急护理需求的可能性，并提供了更紧密的妊娠监测。然而，患者对这些用于胎儿监测的新技术的接受程度尚未得到广泛探索。
本研究旨在阐明女性对使用非侵入性电子设备自我监测妊娠的态度。研究未具体说明拟议设备的技术细节。
这是一项在德国海德堡和莱比锡大学附属医院妇产科进行的横断面多中心研究。向妇产科诊所中所有 18 岁以上的患者提供参与机会。我们设计了一份调查问卷调查，其中包括涵盖人口特征、当前和过去妊娠问题以及对使用智能设备自我监测妊娠的态度的经过验证的工具。
共有 509 名没有远程医疗经验的孕妇参与了研究。只有极少数（5.9%（29/493））的人认为使用可穿戴设备进行自我监测是咨询医生的替代方法。同样，只有 7.7%（38/496）的人强烈认为如果这些设备易于获得，他们去急诊的次数会减少。然而，如果该程序与基于网络的远程医生咨询相结合，那么 13.5%（66/487）的人将非常有动力使用这些设备。此外，当女性感知到胎儿运动减少时，更多的女性认为这是在看医生之前的一种替代方法（P<.001）。有趣的是，与没有大学学历的女性相比，具有大学学历的女性更倾向于进行妊娠自我监测（37%比 23%；P=.001）。在参与者中，77.9%（381/489）希望智能可穿戴设备测量胎儿的心跳声，62.6%（306/489）希望自行使用该设备。医生或助产士的反馈在她们选择此类设备时也非常重要（61.8%，301/487 希望得到反馈）。女性使用此类设备的频率差异很大，范围从 13.8%（65/471）希望每天使用几次到 31.6%（149/471）最多每周使用一次。
我们的研究结果表明，孕妇对妊娠自我监测持怀疑态度。然而，许多女性愿意在咨询医生的同时使用设备进行妊娠监测。超过一半的参与者表达了每天或每周多次使用此类设备的意图，这突出了这些技术的潜力。
