Medicine and Health Sciences Commons^™

Pain Assessment Tools For Use In Infants: A Meta-Review, Diana Arabiat, Evalotte Mörelius, Kreshnik Hoti, Jeffery Hughes

Research outputs 2022 to 2026

Background: Identifying pain in infants is challenging due to their inability to self-report pain, therefore the availability of valid and reliable means of assessing pain is critical. Objective: This meta-review sought to identify evidence that could guide the selection of appropriate tools in this vulnerable population. Methods: We searched Scopus, Medline, Embase, CINAHL, MIDRIS, EMCare and Google Scholar for eligible systematic reviews. Eligible reviews documented psychometric properties of available observational tools used to assess pain in infants. Results: A total of 516 reviews were identified of which 11 met our inclusion criteria. We identified 36 pain assessment tools (evaluated in …

Preliminary Efficacy, Feasibility And Safety Of Intra-Umbilical Oxytocin To Reduce The Time To Placental Delivery At Caesarean Section: An Exploratory Randomized Trial, Katrin Middleton, Fungai Mbengo, Thandisizwe R. Mavundla, George J. Hofmeyr

Research outputs 2022 to 2026

Background: Delayed placental separation either after vaginal birth or caesarean birth is an important cause of postpartum haemorrhage, among other causes such as uterine atony. Intra-umbilical oxytocin has been shown to reduce the time to placental delivery after vaginal birth. However, the efficacy of intra-umbilical oxytocin to reduce the time to placental delivery following caesarean section birth is not known. Objectives: To explore the preliminary efficacy, feasibility and safety of intra-umbilical oxytocin to reduce the time to placental delivery at caesarean section. Methods: A double-blind, placebo-controlled, exploratory randomized clinical trial was conducted at a tertiary hospital in the Eastern Cape …

Chromosomal Aberrations In Pediatric Patients With Moderate/Severe Developmental Delay/Intellectual Disability With Abundant Phenotypic Heterogeneities: A Single-Center Study, Dan Wu, Yi Wu, Yulong Lan, Shaocong Lan, Zhiwei Zhong, Duo Li, Zexin Zheng, Hongwu Wang, Lian Ma

Research outputs 2022 to 2026

Background: This study aimed to examine the clinical usefulness of chromosome microarray (CMA) for selective implementation in patients with unexplained moderate or severe developmental delay/intellectual disability (DD/ID) and/or combined with different dysphonic features in the Han Chinese population. Methods: We retrospectively analyzed data on 122 pediatric patients with unexplained isolated moderate/severe DD/ID with or without autism spectrum disorders, epilepsy, dystonia, and congenital abnormalities from a single-center neurorehabilitation clinic in southern China. Results: A total of 46 probands (37.7%) had abnormal CMA results among the 122 study patients. With the exclusion of aneuploidies, uniparental disomies, and multiple homozygotes, 37 patients harbored …

“I Believe…” - Graduating Midwifery Students’ Midwifery Philosophies And Intentions For Their Graduate Year: A Longitudinal Descriptive Study, Kate Dawson, Heather Wallace, Sara Bayes

Research outputs 2022 to 2026

Objective: Midwifery graduates may experience transition shock that makes them question their fit for their workplace and the profession and in extreme cases, may lead to them leaving. Understanding graduate midwives’ worldviews, job intentions and work experiences is important to inform retention strategies. Factors such as having a strong professional identity and experiencing strong job satisfaction are important for midwife retention. Conversely, stress, trauma and work-life imbalances are examples of factors that lead to attrition from midwifery. Transition shock experienced by some graduates can exacerbate these factors if not managed effectively. This study aimed to identify causes and impact of …

A Socioecological Description Of The Influencing Factors To Midwives’ Management Of Preeclampsia In A Ghanaian Tertiary Hospital, Isabella Garti, Michelle Gray, Angela Bromley, Benjamin Tan

Research outputs 2022 to 2026

Introduction: In low-resource settings, midwives are the first contact for women with preeclampsia and lead the coordination of care. Unfavourable preeclampsia outcomes create a burden for women, families, and the health system. It is therefore important to understand the unique context of midwives’ practice and the complex factors that influence the delivery of maternal healthcare. Aim: This qualitative study explored the perspectives of key stakeholders in a tertiary hospital in Ghana regarding the facilitators and barriers influencing midwives’ provision of preeclampsia care using a socioecological model. Methods: Semi-structured interviews were conducted with 42 participants comprising senior managers (n = 7) …

Paramedic Training, Experience, And Confidence With Out-Of-Hospital Childbirth (Oohb) In Australia, Michella G. Hill, Belinda Flanagan, Brennen Mills, Sara Hansen, Luke Hopper

Research outputs 2022 to 2026

Background: Out-of-hospital births (OOHBs) are rare representing ∼0.05% of prehospital callouts. OOHBs are at increased risk of complications including life-threatening conditions such as postpartum haemorrhage and neonate resuscitation. This research investigated Australian paramedics perceptions of’ training, experience, and confidence with OOHBs. Methods: Semi-structured qualitative interviews were undertaken in late 2021 via online conference or face-to-face. Sessions were audio-recorded and transcribed. Data was analysed and coded into over-arching themes using thematic analysis. Results: Fourteen participants were interviewed from military, industrial, and jurisdictional ambulance services. Nine participants were female, and experience ranged from 1.5 to 20 years. Six Australian states were represented, …

Differences In Birth Weight Between Immigrants' And Natives' Children In Europe And Australia: A Lifecycle Comparative Observational Cohort Study, Sandra Florian, Mathieu Ichou, Lidia Panico, Stéphanie Pinel-Jacquemin, Tanja G. M. Vrijkotte, Margreet W. Harskamp-Van Ginkel, Rae-Chi Huang, Jennie Carson, Loreto Santa Marina Rodriguez, Mikel Subiza-Pérez, Martine Vrijheid, Sílvia Fernández-Barrés, Tiffany C. Yang, John Wright, Eva Corpeleijn, Marloes Cardol, Elena Isaevska, Chiara Moccia, Marjolein N. Kooijman, Ellis Voerman, Vincent Jaddoe, Marieke Welten, Elena Spada, Marisa Rebagliato, Andrea Beneito, Luca Ronfani, Marie-Aline Charles

Research outputs 2022 to 2026

Objective:

Research on adults has identified an immigrant health advantage, known as the 'immigrant health paradox', by which migrants exhibit better health outcomes than natives. Is this health advantage transferred from parents to children in the form of higher birth weight relative to children of natives?

Setting:

Western Europe and Australia.

Participants:

We use data from nine birth cohorts participating in the LifeCycle Project, including five studies with large samples of immigrants' children: Etude Longitudinale Française depuis l'Enfance - France (N=12 494), the Raine Study - Australia (N=2283), Born in Bradford - UK (N=4132), Amsterdam Born Children and their Development …

Effect Of Antenatal Milk Expression Education On Lactation Outcomes In Birthing People With Pre-Pregnancy Body Mass Index ≥ 25: Protocol For A Randomized, Controlled Trial, Jill R. Demirci, Melissa Glasser, Debra L. Bogen, Susan M. Sereika, Dianxu Ren, Kristin Ray, Lisa M. Bodnar, Therese A. O'Sullivan, Katherine Himes

Research outputs 2022 to 2026

Background: Birthing people with pre-pregnancy body mass indices (BMIs) ≥ 25 kg/m2, particularly those without prior breastfeeding experience, are at increased risk for suboptimal lactation outcomes. Antenatal milk expression (AME) may be one way to counteract the negative effects of early infant formula supplementation common in this population. Methods: This ongoing, randomized controlled trial in the United States evaluates the efficacy of a telelactation-delivered AME education intervention versus an attention control condition on lactation outcomes to 1 year postpartum among 280 nulliparous-to-primiparous, non-diabetic birthing people with pre-pregnancy BMI ≥ 25 kg/m2. The assigned study treatment is delivered via four weekly …

Measuring Success: Program Fidelity Of Queensland's Child Health Home Visiting Services. A Document Analysis, Nicole Latham, Jeanine Young, Josephine Wilson, Michelle Gray

Research outputs 2022 to 2026

Background: The Family CA.R.E. (Community-based Assistance Resourcing and Education) program was introduced in Queensland two decades ago. It aimed to redress health inequalities for infants from families experiencing specific social stressors. The program has been locally adapted over time and has not been evaluated against the original program. This study assessed the extent to which selected hospital and health services in Queensland, Australia have modified the original Family C.A.R.E. program. Methods: Altheide's model was used to facilitate a critical document analysis of policies and guidelines for adapted Family C.A.R.E. home visiting programs in use by hospital and health services (target …

Maternal Educational Attainment In Pregnancy And Epigenome-Wide Dna Methylation Changes In The Offspring From Birth Until Adolescence, Priyanka Choudhary, Giulietta S. Monasso, Ville Karhunen, Justiina Ronkainen, Giulia Mancano, Caitlin G. Howe, Zhongzheng Niu, Xuehuo Zeng, Weihua Guan, John Dou, Jason I. Feinberg, Charles Mordaunt, Giancarlo Pesce, Nour Baïz, Rossella Alfano, Dries S. Martens, Congrong Wang, Elena Isaevska, Elina Keikkala, Sanna Mustaniemi, Chris H. L. Thio, Eliza Fraszczyk, Elmar W. Tobi, Anne P. Starling, Marta Cosin-Tomas, Jose Urquiza, Stefan Röder, Thanh T. Hoang, Christian Page, Dereje D. Jima, John S. House, Rachel L. Maguire, Raffael Ott, Xenia Pawlow, Lea Sirignano, Lea Zillich, Anni Malmberg, Sebastian Rauschert, Phillip Melton, Tong Gong, Robert Karlsson, Ruby Fore, Wei Perng, Zachary M. Laubach, Darina Czamara, Gemma Sharp, Carrie V. Breton, Enrique Schisterman, Edwina Yeung, Sunni L. Mumford, M. Daniele Fallin, Janine M. Lasalle, Rebecca J. Schmidt, Kelly M. Bakulski, Isabella Annesi-Maesano, Barbara Heude, Tim S. Nawrot, Michelle Plusquin, Akram Ghantous, Zdenko Herceg, Lorenza Nisticò, Marina Vafeiadi, Manolis Kogevinas, Marja Vääräsmäki, Eero Kajantie, Harold Snieder, Eva Corpeleijn, Regine P. M. Steegers-Theunissen, Ivana V. Yang, Dana Dabelea, Serena Fossati, Ana C. Zenclussen, Gunda Herberth, Maria Magnus, Siri E. Håberg, Stephanie J. London, Monica C. Munthe-Kaas, Susan K. Murphy, Cathrine Hoyo, Anette-G Ziegler, Sandra Hummel, Stephanie H. Witt, Fabian Streit, Josef Frank, Katri Räikkönen, Jari Lahti, Rae-Chi Huang, Catarina Almqvist, Marie-France Hivert, Vincent W. V. Jaddoe, Marjo-Riitta Järvelin, Marko Kantomaa, Janine F. Felix, Sylvain Sebert

Research outputs 2022 to 2026

Maternal educational attainment (MEA) shapes offspring health through multiple potential pathways. Differential DNA methylation may provide a mechanistic understanding of these long-term associations. We aimed to quantify the associations of MEA with offspring DNA methylation levels at birth, in childhood and in adolescence. Using 37 studies from high-income countries, we performed meta-analysis of epigenome-wide association studies (EWAS) to quantify the associations of completed years of MEA at the time of pregnancy with offspring DNA methylation levels at birth (n = 9 881), in childhood (n = 2 017), and adolescence (n = 2 740), adjusting for relevant covariates. MEA was …

Fetal Growth Trajectories And Measures Of Insulin Resistance In Young Adults, Ashish Yadav, Lawrence J. Beilin, Rae-Chi Huang, John P. Newnham, Scott W. White, Trevor A. Mori

Research outputs 2022 to 2026

Context: Events during gestation greatly influence the risk of cardiometabolic diseases including diabetes in offspring during later life. Objective: This study aimed to investigate relationships between serial ultrasound-derived fetal growth trajectories and markers of insulin resistance in young adults in the Raine Study, an Australian pregnancy cohort. Methods: Linear mixed modeling examined the relationship between fetal growth trajectory groups, constructed using serial ultrasound-based abdominal circumference (AC), femur length (FL), and head circumference (HC) from 1333 mother-fetal pairs, and offspring Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), as a marker of diabetes risk, at 20 (n = 414), 22 (n = …

Altered Dietary Behaviour During Pregnancy Impacts Systemic Metabolic Phenotypes, Charlotte E. Rowley, Samantha Lodge, Siobhon Egan, Catherine Itsiopoulos, Claus T. Christophersen, Desiree Silva, Elizabeth Kicic-Starcevich, Therese A. O’Sullivan, Julien Wist, Jeremy Nicholson, Gary Frost, Elaine Holmes, Nina D’Vaz

Research outputs 2022 to 2026

Rationale: Evidence suggests consumption of a Mediterranean diet (MD) can positively impact both maternal and offspring health, potentially mediated by a beneficial effect on inflammatory pathways. We aimed to apply metabolic profiling of serum and urine samples to assess differences between women who were stratified into high and low alignment to a MD throughout pregnancy and investigate the relationship of the diet to inflammatory markers. Methods: From the ORIGINS cohort, 51 pregnant women were stratified for persistent high and low alignment to a MD, based on validated MD questionnaires. 1H Nuclear Magnetic Resonance (NMR) spectroscopy was used to investigate the …

Gestational Age At Birth And Body Size From Infancy Through Adolescence: An Individual Participant Data Meta-Analysis On 253,810 Singletons In 16 Birth Cohort Studies, Johan L. Vinther, Tim Cadman, Demetris Avraam, Claus T. Ekstrøm, Thorkild I. A. Sørensen, Ahmed Elhakeem, Ana C. Santos, Angela Pinot De Moira, Barbara Heude, Carmen Iñiguez, Costanza Pizzi, Elinor Simons, Ellis Voerman, Eva Corpeleijn, Faryal Zariouh, Gilian Santorelli, Hazel M. Inskip, Henrique Barros, Jennie Carson, Jennifer R. Harris, Johanna L. Nader, Justiina Ronkainen, Katrine Strandberg-Larsen, Loreto Santa-Marina, Lucinda Calas, Luise Cederkvist, Maja Popovic, Marie-Aline Charles, Marieke Welten, Martine Vrijheid, Meghan Azad, Padmaja Subbarao, Paul Burton, Puishkumar J. Mandhane, Rae Chi Huang, Rebecca C. Wilson, Sido Haakma, Sílvia Fernández-Barrés, Stuart Turvey, Susana Santos, Suzanne C. Tough, Sylvain Sebert, Theo J. Moraes, Theodosia Salika, Vincent W. V. Jaddoe, Deborah A. Lawlor, Anne-Marie Nybo Andersen

Research outputs 2022 to 2026

Background:

Preterm birth is the leading cause of perinatal morbidity and mortality and is associated with adverse developmental and long-term health outcomes, including several cardiometabolic risk factors and outcomes. However, evidence about the association of preterm birth with later body size derives mainly from studies using birth weight as a proxy of prematurity rather than an actual length of gestation. We investigated the association of gestational age (GA) at birth with body size from infancy through adolescence.

Methods and Findings:

We conducted a two-stage individual participant data (IPD) meta-analysis using data from 253,810 mother-child dyads from 16 general population-based cohort …