Please select the eligibility criteria that correspond to the clinical trial below.
Title: Efficacy of a Midwife-coordinated, Individualized, and Specialized Maternity Care Intervention (ChroPreg) in Addition to Standard Care in Pregnant Women With Chronic Disease: a Parallel Randomized Controlled Trial
Brief Summary: The number of pregnant women affected by chronic diseases such as epilepsy, hypertension and thyroid disease is rising, and in the Danish population 15 % of all pregnant women had a chronic disease in 2016. Chronic disease increase the risk of complications during pregnancy such as preterm birth and caesarian section, while children born of mothers with chronic disease have an increased risk of low birthweight, prematurity and birth effects. Moreover, pregnant women with chronic disease have an increased risk of post-natal depression and report higher rates of anxiety during pregnancy and have described dissatisfaction with the communication with care providers about issues such as breastfeeding, lack of coherence during the course of pregnancy and after delivery.

The purpose of this study is to examine the effect of an increased, interdisciplinary, coordinated and specialized maternity care multimodal intervention for pregnant women with chronic disease on the length of hospitalization (during pregnancy and after delivery). Secondarily, the purpose is to examine the effect of the intervention on psychological well-being and patient satisfaction.

The investigators hypothesis is that the delivery of an increased interdisciplinary, coordinated and specialized intervention targeted pregnant women with pre-existing chronic disease will be beneficial for this group of pregnant women's' length of hospitalization during pregnancy and after delivery due to improved maternity care and improved self-care. Also, the investigators hypothesize that the effect of the intervention will be improved psychological well-being and satisfaction with care during pregnancy and after delivery.


Options:
A: Inclusion Criteria:

1. First-time mothers
2. Be at least 17 years of age
3. Is residing in Singapore for the next 3 years
4. Understand English, or has a family member who is able to assist.

Exclusion Criteria:

1. Has existing medical conditions such as chronic illnesses
B: Inclusion Criteria

* All clinics in Nablus and Jericho governorate located in rural areas, that offer pregnancy- and postnatal-care in the whole study period.
* Only clinics that had the intervention continuously during the whole observations period (1st of January 2014 and continued till 31st of December 2015) will be included in the intervention group
* Only the clinics were there were no intervention at all during the whole period will be included in the control group.

Exclusion Criteria:

* Clinics located in urban areas (less than three km from Nablus or Jericho city centre).
* New Clinics that has not been open during the whole study period.
* Clinics were the intervention was only partially implemented
C: Inclusion Criteria:

* 18+ years of age
* Documented gestational age less than 13 weeks.
* Pregnancy documented as low risk (See high risk exclusion criteria below)
* Able to read and understand English
* Able to provide informed consent (i.e. no impairments or barriers)

Exclusion Criteria:

Clinical judgment that determines that the pregnancy is at high risk for complications.

Any of the following high risk factors would disqualify the mother for the study:

* Severe hypertension (\>160/110)
* Possible ectopic
* Congenital adrenal hypertension
* Prior PE/DVT/stroke
* Anticoagulation during prior pregnancy (e.g. antiphospholipid antibody syndrome)
* Prosthetic heart valve (non-bio)
* Pulmonary hypertension
* Mothers currently taking Immunosuppressants, Prednisone \> 10mg per day, antipsychotic (e.g. lithium, Haldol, Zyprexa), chemotherapy
* Recurrent pregnancy loss (\>2 losses)
* Current maternal malignancy
* Prior myocardial infarction/cardiomyopathy
* Bio-prosthetic heart valves
* Marfan syndrome
* Active liver disease (e.g. hepatitis)
* Congenital heart disease
* Coagulopathies including thrombophilias and bleeding disorders.
* Pre-existing diabetes
* Genetic disease/CF testing/anomalies in prior child
* Incompetent cervix (prior cerclage)
* Triplets or quads diagnosed by REI or ultrasound.
* Isoimmunization (Rh, Kell, etc.)
* History of transplant or currently on Dialysis
* Recurrent pregnancy loss (antiphospholipid antibody syndrome or collagen vascular disease)
* Chronic hypertension
* Prior 2nd or 3rd trimester loss
* HIV
* Inflammatory bowel disease
* Asthma and currently on steroid to control disease
D: Inclusion Criteria:

* Pregnant women 18 years and above of age.
* Pregnant women with one or more chronic diseases before pregnancy (e.g. epilepsy, hypertension, lung disease, thyroid disease, multiple sclerosis).
* high-risk pregnancy with planned antenatal care with obstetrician
* Pregnancy with a single fetus.
* Ability to give written informed consent.

Exclusion Criteria:

* Pregnant women below 18 years of age.
* Multiple pregnancies.
* Lack of ability to speak and understand Danish language.
* Substance abuse problems
* Women with diabetes mellitus before pregnancy and women with Heart disease ( these women already receive a special programme at the Deprtment of Obstetrics, Rigshospitalet)
* Chronic psychiatric disease (as only chronic disease)

Answer: D