Maternal and Child Health Commons^™

A Qualitative Analysis Of Women’S Postnatal Experiences Of Breastfeeding Supports During The Perinatal Period In Ireland, Niamh Lawlor, Lucia Prihodova, Deborah Byrne, Megan Etherton, Felicienne Rahill, Catie Wilson, Elizabeth O'Sullivan

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Ireland has among the lowest rates of breastfeeding worldwide. Despite policies to support breastfeeding, breastfeeding initiation and exclusivity remain low in Ireland. Greater knowledge about support received in the maternity unit may—in part—shed light on why this is so. Our aim was to analyse women’s experiences of the breastfeeding supports available in the early postnatal period in Ireland. We conducted an analysis of an open-ended question on a cross-sectional survey about breastfeeding support conducted in the Republic of Ireland in 2022. Participants were asked to provide comments about the breastfeeding support they received in the maternity unit or during your …

From Zero To Thrive: A Model Of Cross-System And Cross-Sector Relational Health To Promote Early Childhood Development Across The Child-Serving Ecosystem, Alison L. Miller, Sara F. Stein, Rebeccah Sokol, Rachel Varisco, Phoebe Trout, Megan M. Julian, Julie Ribaudo, Joshua B. Kay, Natasha V. Pilkauskas, Nicole Gardner-Neblett, Todd I. Herrenkohl, Kara Zivin, Maria Muzik, Katherine L. Rosenblum

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Early relational health between caregivers and children is foundational for child health and well-being. Children and caregivers are also embedded within multiple systems and sectors, or a “child-serving ecosystem”, that shapes child development. Although the COVID-19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the …

Cost-Effectiveness Of A Mobile Health-Supported Lifestyle Intervention For Pregnant Women With An Elevated Body Mass Index, Elizabeth O'Sullivan, Salwa Rokicki, Maria Kennelly, Kate Ainscough, Fionnuala M. Mcauliffe

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Objective To assess the cost-effectiveness of a mobile health-supported lifestyle intervention compared with usual care.

Methods We conducted a cost-effectiveness analysis from the perspective of the publicly-funded health care system. We estimated costs associated with the intervention and health care utilisation from first antenatal care appointment through delivery. We used bootstrap methods to quantify the uncertainty around cost‐effectiveness estimates. Health outcomes assessed in this analysis were gestational weight gain (GWG; kg), incidence of excessive GWG, quality-adjusted life years (QALYs), and incidence of large-for-gestational-age (LGA). Incremental cost-effectiveness ratios (ICERs) were calculated as cost per QALY gained, cost per kg of GWG …

Randomised Study Demonstrates Sustained Benefits Of A Pre-School Intervention Designed To Improve Nutrition And Physical Activity Practices, Diewerke De Zwarte, John Kearney, Clare A. Corish, Corina Glennon, Lorraine Maher, Charlotte Johnston Molloy

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Background: Health-promoting programmes must demonstrate sustained efficacy in order to make a true impact on public health. This study aimed to determine the effect of the Healthy Incentive for Pre-schools project on health-promoting practices in full-day-care pre-schools 18 months after a training intervention.

Methods: Thirty-seven pre-schools completed the initial study and were included in this follow-up study. The intervention consisted of one training session with either the pre-school 'manager-only' or 'manager and staff' using a specifically developed needs-based training resource pack comprised of written educational material and a validated health-promoting practice evaluation tool. Direct observation data of health-promoting practices were …

A Web-Based Dietary Intervention In Early Pregnancy And Neonatal Outcomes: A Randomized Controlled Trial, Rachel Ak Kennedy, C.M.E. Reynolds, S. Cawley, E. O'Malley, D.M. Mccartney, M.J. Turner

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Background Maternal nutrition is a determinant of pregnancy outcomes. Few studies have evaluated the potential of online nutrition resources to modify behaviour. This randomized controlled trial aimed to determine whether access to a customized evidence-based nutrition website in pregnancy improved neonatal outcomes.

Methods Women <18 weeks gestation were recruited at their convenience. The control group received standard care. In addition to standard care, the intervention group received access to an evidence-based nutrition website, customized to the preferences of pregnant women.

Results Of the 250 women, there were no differences in characteristics between the two groups. Of the women, 91.0% reported they make a conscious effort currently to eat a healthy diet. However, only 19.6% met dietary requirements for calcium, 13.2% for iron, 2.7% for folate and 2.3% for iodine. The most popular website section was pregnancy …

The Relationship Between Maternal Plasma Homocysteine In Early Pregnancy And Birth Weight, Shona Cawley, Eimer O'Malley, Rachel Kennedy, Ciara Reynolds, Anne Molloy, Michael Turner

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Background: There is limited evidence that plasma homocysteine (Hcy) is increased in women with adverse pregnancy outcomes, such as low birth weight (LBW).

Objective: We examined the relationship between maternal Hcy at the first prenatal visit and birth weight.

Study design: In a prospective observational study, women were recruited during their first prenatal visit after sonographic confirmation of gestational age. Along with the standard tests, blood was also taken for the measurement of maternal serum and red blood cell (RBC) folate, vitamin B12, and Hcy. In addition to collecting standard clinical and sociodemographic details, a detailed questionnaire on vitamin supplementation …

Avoiding Maternal Vitamin D Deficiency May Lower Blood Glucose In Pregnancy, Méabh Walsh, Linnea Bärebring, Hanna Augustin

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Background Vitamin D status is hypothesised to play a role in gestational glucose control. No studies to date have examined vitamin D in relation to changes in blood glucose in pregnancy. Thus, the aim was to examine if vitamin D in early pregnancy and vitamin D trajectory associate with blood glucose trajectory over pregnancy in a Swedish cohort. We also investigated the relation between maternal vitamin D status and excessive fetal growth.

Methods In 2013–2014, pregnant women were recruited to the GraviD cohort study when registering at the antenatal clinics in south-west Sweden. In the present analysis, 1928 women were …

Development Of A Novel Periconceptual Nutrition Score (Pens) To Examine The Relationship Between Maternal Dietary Quality And Fetal Growth, Rachel Ak Kennedy, Michael J. Turner

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Background Maternal nutrition may influence intrauterine fetal development. To date, the relationship between contemporary European dietary guidelines and fetal growth has not been examined.

Aims To develop a novel Periconceptual Nutrition Score (PENS) to assess maternal dietary quality in early pregnancy and examine its relationship with fetal growth.

Study design Women were recruited conveniently at their first clinic visit and completed a supervised four day retrospective diet history. The PENS was developed using European Food Safety Authority recommended dietary intakes for pregnancy. The relationship between PENS and fetal growth was examined.

Subjects Women with a singleton pregnancy.

Outcome measures Birthweight, …

The Maternal Health Behaviours Of Non-Irish Nationals During Pregnancy And The Effect Of Time Living In Ireland, R. Palmer, R. Layte, John Kearney

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Objectives Maternal health behaviours (MHBs) can influence pregnancy outcomes. Despite efforts internationally to encourage positive MHBs, women often fail to comply with pregnancy guidelines. International studies show differences in MHBs between nationalities and an effect of time spent in the host country. There is limited Irish data in this area, with no previous research relating to the effect of time in Ireland.

Study design This study is a cross-sectional analysis of the Growing Up in Ireland infant cohort, a nationally representative longitudinal study. Methods Examination of the MHBs of non-Irish nationals during pregnancy and the effect of time in Ireland …

Infant Feeding Practices In China And Ireland - Ireland Chinese Mother, Qianling Zhou, Katherine Younger, John Kearney

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Introduction: Migration to another country may induce changes in infant feeding practices especially where such practices differ considerably between the two countries. This study was undertaken to compare the infant feeding practices between Chinese mothers who gave birth in Ireland (CMI) with immigrant Chinese mothers who gave birth in China (CMC), and to examine the factors that influence these practices. Methods: A cross-sectional self-administrated survey was conducted among a convenience sample of 322 Chinese mothers living in Ireland. Data were obtained from mailed questionnaires. Infant feeding practices between CMC and CMI were compared by Chi-square or independent sample t-test. Binary …

Optimization Of Folic Acid Supplementation In The Prevention Of Neural Tube Defects, Shona Cawley, Daniel Mccartney, Jayne V. Woodside, Mary Rose Sweeney, Robert Mcdonnell, Anne M. Molloy, Michael J. Turner

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Background We examined the relationship between timing and duration of folic acid (FA) supplementation in achieving red blood cell (RBC) folate levels in early pregnancy which are optimal (>906 nmol/l) for the prevention of neural tube defects (NTDs). Methods Clinical, FA supplementation and dietary folate details were computerized at the first antenatal visit. Maternal blood samples were analysed for RBC and serum folate. Results Of the 502 women, 98.2% (n = 493) reported taking FA. There was a positive correlation between duration of supplementation and both RBC folate (r = 0.43, P < 0.001) and serum folate (rho = 0.29, P < 0.001). The optimal RBC folate level was achieved in 80.4% (n = 46) of women who started FA 400 μg 4–8 weeks before their LMP compared with only 53.6% (n = 153) in women who started 4–8 weeks after their LMP (P < 0.001). Conclusions This study provides, for the first …

Preferences Of Women For Web-Based Nutritional Information In Pregnancy, Rachel Ak Kennedy, Laura Mullaney, C.M.E. Reynolds, S. Cawley, Daniel Mccartney, M.J. Turner

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Objectives During pregnancy, women are increasingly turning to web-based resources for information. This study examined the use of web-based nutritional information by women during pregnancy and explored their preferences. Study design Cross-sectional observational study. Methods Women were enrolled at their convenience from a large maternity hospital. Clinical and sociodemographic details were collected and women's use of web-based resources was assessed using a detailed questionnaire. Results Of the 101 women, 41.6% were nulliparous and the mean age was 33.1 years (19–47 years). All women had internet access and only 3% did not own a smartphone. Women derived pregnancy-related nutritional information from …

Views Of Fathers In Ireland On The Experience And Challenges Of Having A Breast-Feeding Partner, Annemarie Bennett, Daniel Mccartney, John Kearney

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Objective this study investigated the relationship between fathers and breast feeding in Ireland.

Design and method a cross-sectional semi-quantitative questionnaire with closed-ended and open-ended questions was posted to 1398 men with an Irish partner who had given birth 4–7 months previously. Fathers who specified that their partner breast fed their last or only child were questioned about their: influence on the breast feeding decision; ability to assist with breast feeding challenges; preferred type of information on breast feeding; perceived advantages and disadvantages to breast feeding; and views on breastfeeding in public. Data from closed-ended questions on breast feeding were presented …

Breast-Feeding And Postpartum Maternal Weight Trajectories, Laura Mullaney, Amy O'Higgins, Shona Cawley, Rachel Kennedy, Daniel Mccartney, Michael J. Turner

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We examined whether breast-feeding, and in particular exclusive breast-feeding, was associated with maternal weight and body composition changes at 4 months postpartum independently of other maternal variables.

The Positive Role Of Breastfeeding On Infant Health During The First 6 Weeks: Findings From A Prospective Observational Study Based On Maternal Reports, Roslyn Tarrant, Margaret Sheridan-Pereira, Katherine Younger, John Kearney

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This study aimed to report on adverse infant and maternal clinical outcomes, and investigate the relationship between infant feedingpractice and such adverse clinical outcomes in infants during the first 6 weeks postpartum. From an eligible sample of 450 motherterminfant pairs recruited from the Coombe Women and Infants University Hospital in Dublin, 27.1% of infants (n=122) werematernally reported to have had an illness during the first 6 weeks that necessitated the provision of prescribed medication ± generalpractitioner/paediatrician attendance ± hospitalisation. Of these, 90 infants had ≥1 episode of infection ± viral ± gastro-intestinalrelatedcondition. After adjustment, ‘any’ breastfeeding to 6 weeks was …

Rescuing Baby Doe, Mary Crossley

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The twenty-fifth anniversary of the Baby Doe Rules offers a valuable opportunity to reflect on how much has changed during the past two-and-one-half decades and how much has stayed the same, at least in situations when parents and physicians face the birth of an infant who comes into the world with its life in peril.

The most salient changes are the medical advances in the treatment of premature infants and the changes in social attitudes towards and legal protections for people with disabilities. The threshold at which a prematurely delivered infant is considered viable has advanced steadily earlier into pregnancy, …