Improving Understanding of Macrosomia with a Graphics-Based Educational Tool: A Randomized Controlled Trial (MATE).

Abstract

Objective: We aimed to determine if a graphics-based education tool (GBET) leads to improved macrosomia knowledge on risk factors/complications (RF/C) and management options (MO) for macrosomia among pregnant individuals compared to routine care.

Study design: We conducted a randomized control trial (NCTO6281301). Inclusion criteria were individuals at 18-55 years, with singleton pregnancy delivering at > 36 weeks. After consent, participants were randomized to either routine care or GBET. To assess knowledge of macrosomia, a questionnaire consisting of 17 questions relating to the RF/C (11 questions) and MO (6 questions) of suspected macrosomic fetuses was administered to participants one time either directly after consent (if routine care) or directly following review of GBET. The primary outcome was the overall score on the questionnaire. Secondary outcomes were summary scores on the RF/C and MO. Descriptive statistics were used for baseline characteristics and outcomes. Chi-squared test or Fisher's exact test was used to compare categorical variables and Student's t-test for continuous variables.

Results: From January to July 2023, 232 eligible individuals were approached and 196 (84%) agreed to participate; of them, 98 received the GBET, while 98 received routine care. Baseline demographics were similar. The majority (42%) of respondents were non-Hispanic Black, 60% were employed, 56% had some level of college education, and 30% lived below the poverty line. There were 41% nulliparous, 67% with a BMI > 30 kg/m2 and 16% with diabetes. The primary outcome was significantly higher in those who received the GBET (70% versus 64%, p <0.001). The RF/C scores were also higher in the GBET group (72% versus 63%, p = 0.001); however, the MO scores were similar between groups (65% versus 68%, p=0.084).

Conclusion: In our population, a graphics-based education tool improved participant knowledge on the risk factors / complications for macrosomia, but not their management options.