Medicine and Health Sciences Commons^™

Complementary Medicines And Therapies In Clinical Guidelines On Pregnancy Care: A Systematic Review, Carolyn Ee, Kate Levett, Caroline Smith, Mike Armour, Hannah G. Dahlen, Prakshi Chopra, Paulette Maroun, Vibhuti S. Rao, Nicole Avard, Suzanne Grant, Hazel Keedle, Susanne Armour, Susan Arentz, Adele E. Cave, Kerry Sutcliffe, Kate Templeman

Medical Papers and Journal Articles

Background: There is a need for evidence-based guidance on complementary medicines and therapies (CMT) use during pregnancy due to high prevalence of use and lack of guidance on the balance of benefit and harms.

Aim: Evaluate the extent to which current clinical practice guidelines relevant to Australian healthcare professionals make clear and unambiguous recommendations about CMT use in pregnancy, and synthesise these recommendations.

Methods: The search included EMBASE, PubMed, the National Health and Medical Research Council’s Clinical Practice Guidelines Portal, and websites of Australian maternity hospitals and professional/notfor-profit organisations for published guidelines on pregnancy care. Data were synthesised narratively. Guidelines …

Antidepressant Exposure In Pregnancy And Child Sensorimotor And Visuospatial Development, Megan Galbally, Stuart J. Watson, Olav Spigset, Philip Boyce, Tim F. Oberlander, Andrew J. Lewis

Medical Papers and Journal Articles

Motor development underlies many aspects of education and learning. There has been uncertainty about the impact of exposure of antidepressant medication in pregnancy on child motor outcomes. This paper examines whether exposure to antidepressants in utero increases the risk of poorer motor development in two areas: sensorimotor and visuospatial processing. Data were obtained from 195 women and children across 3 groups: women with untreated depression in pregnancy, women treated with antidepressants and control women. Data were collected across pregnancy, postpartum and until 4 years for mother and child. Maternal depression was established at baseline with the Structured Clinical Interview for …

Is Intimate Partner Violence More Common In Pregnant Women With Severe Mental Illness? A Retrospective Study, Liana Suparare, Stuart J. Watson, Ray Binns, Jacqueline Frayne, Megan Galbally

Medical Papers and Journal Articles

Objective: To examine the risk of past and current experiences of intimate partner violence (IPV) in women with severe mental illness (SMI) in pregnancy.

Methods: We examined past and current experiences of IPV in women with SMI in pregnancy. The data of 304 women with SMI including schizophrenia and related psychotic disorders and Bipolar Disorder meeting International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) criteria were extracted from hospital records at King Edward Memorial Hospital, Western Australia. Comparisons were made between our study data and the Australian population data reported by the Australian Bureau …

Impact Of Lifestyle Factors On Group B Streptococcus Colonization During Pregnancy, Myra Joy Quilatan

Theses

Background: Group B Streptococcus (GBS) colonization in the genital tract of pregnant women is a known contributory factor for infection in the neonate, having an impact on morbidity and mortality especially if unrecognized and untreated prior to vaginal delivery. An understanding on how certain lifestyle factors contribute to the development of GBS colonization during pregnancy will assist in aiding a modification of behavior to promote prevention and improve general health.

Aim: The aim of this study was to investigate the effect of various lifestyle factors in isolation or combination on GBS colonization during pregnancy.

Methods: A cross-sectional survey research design …

A Randomized Trial Of Prenatal N-3 Fatty Acid Supplementation And Preterm Delivery, Maria Makrides, Karen Best, Lisa Yelland, Andrew Mcphee, Shao Zhou, Julie Quinlivan, Jodie Dodd, Elinor Atkinson, Huda Safa, Jacqueline Van Dam, Gustaaf Dekker, Monika Skubisz, Amanda Anderson, Beth Kean, Anneka Bowman, Carly Mccallum, Kara Cashman, Robert Gibson

Health Sciences Papers and Journal Articles

Background: Previous studies have suggested that maternal supplementation with n−3 long-chain polyunsaturated fatty acids may reduce the incidence of preterm delivery but may also prolong gestation beyond term; however, more data are needed regarding the role of n−3 long-chain polyunsaturated fatty acids in pregnancy.

Methods: We performed a multicenter, double-blind, randomized trial in which women who were pregnant with single or multiple fetuses were assigned to receive either fish-oil capsules that contained 900 mg of n−3 long-chain polyunsaturated fatty acids (n−3 group) or vegetable-oil capsules that contained trace n−3 long-chain polyunsaturated fatty acids (control group) daily, beginning before 20 weeks …

The Impact Of Mandatory Iodine Fortification And Supplementation On Pregnant And Lactating Women In Australia, Stephen Hurley, Creswell J. Eastman, Gisselle Gallego

Medical Papers and Journal Articles

Background and Objectives: In Australia, two public health measures were introduced between 2009 and 2010 to reduce iodine deficiency. However there has been a shortage of information regarding their effectiveness and the ongoing prevalence of iodine deficiency in Australia. The primary aim of this study was to assess the extent to which these public health measures have reduced rates of iodine deficiency among pregnant and lactating women.

Methods and Study Design: A review was conducted to identify all studies published since January 2010 that quantitatively measured the iodine status of pregnant and/or lactating women in Australia.

Results: We found 25 …

Turning Conceptual Systems Maps Into Dynamic Simulation Models: An Australian Case Study For Diabetes In Pregnancy, Louise Freebairn, Jo-An Atkinson, Nathaniel D. Osgood, Paul M. Kelly, Geoff Mcdonnell, Lucie Rychetnik

Medical Papers and Journal Articles

Background: System science approaches are increasingly used to explore complex public health problems. Quantitative methods, such as participatory dynamic simulation modelling, can mobilise knowledge to inform health policy decisions. However, the analytic and practical steps required to turn collaboratively developed, qualitative system maps into rigorous and policy relevant quantified dynamic simulation models are not well described. This paper reports on the processes, interactions and decisions that occurred at the interface between modellers and end-user participants in an applied health sector case study focusing on diabetes in pregnancy.

Methods: An analysis was conducted using qualitative data from a participatory dynamic simulation …

Trans-Generational Stress Regulation: Mother-Infant Cortisol And Maternal Mental Health Across The Perinatal Period, Megan Galbally, Elisabeth F.C Van Rossum, Stuart J. Watson, Edo Ronald De Kloet, Andrew J. Lewis

Medical Papers and Journal Articles

Understanding maternal mental health and cortisol regulation across pregnancy and the relationship to the development of the offspring’s stress regulation is critical to a range of health outcomes. The aim of this study was to investigate infant and maternal cortisol in women with depression. Data were obtained from 241 pregnant women within the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a selected pregnancy cohort study. Depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) and repeat Edinburgh Postnatal Depression Scale (EPDS). Repeated measures of antidepressant use, stressful events, anxiety symptoms and maternal hair cortisol concentrations (HCC) and infant …

The Translation, Validity And Reliability Of The German Version Of The Fremantle Back Awareness Questionnaire, Katja Ehrenbrusthoff, Cormac G. Ryan, Christian Gruneberg, Benedict Wand, Denis J. Martin

Physiotherapy Papers and Journal Articles

Background: The Fremantle Back Awareness Questionnaire (FreBAQ) claims to assess disrupted self-perception of the back. The aim of this study was to develop a German version of the Fre-BAQ (FreBAQ-G) and assess its test-retest reliability, its known-groups validity and its convergent validity with another purported measure of back perception.

Methods: The FreBaQ-G was translated following international guidelines for the transcultural adaptation of questionnaires. Thirty-five patients with non-specific CLBP and 48 healthy participants were recruited. Assessor one administered the FreBAQ-G to each patient with CLBP on two separate days to quantify intra-observer reliability. Assessor two administered the FreBaQ-G to each patient …

Depression Across Pregnancy And The Postpartum, Antidepressant Use And The Association With Female Sexual Function, Megan Galbally, Stuart J. Watson, Michael Permezel, Andrew J. Lewis

Medical Papers and Journal Articles

Background: There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning.

Methods: This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood …

Disrupted Body-Image And Pregnancy-Related Lumbopelvic Pain. A Preliminary Investigation, B Wand, R Elliott, A Sawyer, R Spence, D Beales, P O'Sullivan, A Smith, W Gibson

Physiotherapy Papers and Journal Articles

Background: Recent investigations have suggested that disrupted body-image may contribute to the lumbopelvic pain experience. The changes in body shape and size associated with pregnancy suggest that pregnancy-related lumbopelvic pain might be a problem in which alterations in body-image are particularly relevant.

Objectives: To investigate if self-reported body-image is related to lumbopelvic pain status in women during pregnancy and explore the factors that might contribute to changes in body-image in women experiencing pregnancy-related lumbopelvic pain.

Design: Cross-sectional cohort study.

Method: Forty-two women in the third trimester of pregnancy were recruited regardless of clinical status. Pain intensity and disability were measured …

Antenatal Influenza And Pertussis Vaccine Uptake Among Aboriginal Mothers In Western Australia, Kennia Lotter, Annette K. Regan, Tyra Thomas, Paul V. Effler, Donna B. Mak

Medical Papers and Journal Articles

Background: Antenatal influenza and pertussis vaccination prevent serious disease in mothers and infants. Aboriginal individuals are at increased risk of infection yet little is known about vaccine coverage among Aboriginal mothers.

Aims: To estimate the uptake of influenza and pertussis vaccination among pregnant Aboriginal women in Western Australia and identify barriers and enablers to vaccination.

Materials and methods: Four hundred Aboriginal women, aged ≥18 years, who gave birth to a live infant between April and October 2015, were randomly selected and invited to participate in telephone interviews. Of the 387 women who did not decline, 178 had a functioning phone …

Beneficial Effects On Pregnancy Outcomes Of Thyroid Hormone Replacement For Subclinical Hypothyroidism, N. Blumenthal, C. Eastman

Medical Papers and Journal Articles

Hypothyroidismand raised thyroid antibody levels have been associated with adverse obstetrical outcomes. Several studies have investigated causal associations, but results have been inconsistent and fewstudies have reported the effects of thyroxine replacement therapy on pregnancy outcomes in hypothyroid patients. Objective.The primary study objective was to determine the outcome of pregnancies in women diagnosed with overt and subclinical hypothyroidism (SCH) (serum TSH > 2.5mIU/L) and those with elevated circulating thyroid autoantibody levels in the first trimester of pregnancy and after the institution of appropriate thyroxine replacement therapy to maintain the serum TSH ≤ 2.5mIU/L. Study Design. This prospective observational study was undertaken …

Disturbed Body Perception, Reduced Sleep, And Kinesiophobia In Subjects With Pregnancy-Related Persistent Lumbopelvic Pain And Moderate Levels Of Disability: An Exploratory Study, Darren Beales, Alison Lutz, Judith Thompson, Benedict M. Wand, Peter O'Sullivan

Physiotherapy Papers and Journal Articles

Background: For a small but significant group, pregnancy-related lumbopelvic pain may become persistent. While multiple factors may contribute to disability in this group, previous studies have not investigated sleep impairments, body perception or mindfulness as potential factors associated with disability post-partum.

Objectives: To compare women experiencing no pain post-pregnancy with those experiencing pregnancy-related persistent lumbopelvic pain (either low- or high-level disability) across multiple biopsychosocial domains.

Design: Cross-sectional

Methods: Participants completed questionnaires for thorough profiling of factors thought to be important in pregnancy-related lumbopelvic pain. Specific measures were the Urinary Distress Inventory, Medical Outcomes Study Sleep Scale, Back Beliefs Questionnaire, Tampa …

Does Cardiotocography Have A Role In The Antenatal Management Of Pregnancy Complicated By Gestational Diabetes Mellitus?, T Jeffery, R Petersen, J Quinlivan

Medical Papers and Journal Articles

Background: Controversy surrounds the role of fetal cardiotocography (CTG) in the antenatal management of pregnancy complicated with gestational diabetes mellitus (GDM).

Aim: The aim was to investigate whether antenatal CTG aids the management in pregnancy complicated by GDM. Materials and Methods: A prospective audit of 1404 consecutive antenatal CTGs in women diagnosed with GDM. Outcomes for all CTGs were audited to determine if the CTGs altered pregnancy management.

Results: In women requiring combination therapy (diet and medication), 43 CTGs were required to change management of a pregnancy. In women managed by diet alone with a secondary pregnancy complication, 161 CTGs …

Early Life Events And Motor Development: A Longitudinal Study, Tegan Grace

Theses

Longitudinal studies are important to fully understand the processes of neurological development during gestation and how risk factors present during this time impact motor development outcomes, yet few to date have focused on this critical time period.

The purpose of this study was to identify modifiable risk factors influencing motor development during the prenatal period. Of particular interest was finding out whether these risk factors differed between the sexes.

Participants (N=2900) were from the Western Australian Pregnancy Cohort (Raine) Study. The Raine Study began in May 1989 and women were recruited between 16-20 weeks gestation (m = 18 weeks) from …

Can We Identify Women Who Initiate And Then Prematurely Cease Breastfeeding? An Australian Multicentre Cohort Study, Julie Quinlivan, Sonia Kua, Robert A. Gibson, Andrew Mcphee, Maria M. Makrides

Medical Papers and Journal Articles

Background: Health authorities recommend 6 months of fully breastfeeding and continuation of breastfeeding for at least a year. Many women initiate breastfeeding in hospital but discontinue before the six-month period, and therefore do not optimise the public health benefits. The aim of this study was to determine whether these women could be identified at hospital discharge, to enable targeted interventions.

Methods: A secondary analysis of women who intended to breastfeed and were enrolled in a large randomized trial was undertaken. Women were enrolled in the antenatal period and antenatal, delivery and six month postnatal questionnaires were completed. Univariate and multivariate …

Surveillance Of Antenatal Influenza Vaccination: Validity Of Current Systems And Recommendations For Improvement, Annette Regan, Donna Mak, Hannah C. Moore, Lauren Tracey, Richard Saker, Catherine Jones, Paul Effler

Medical Papers and Journal Articles

Abstract

Background: Although influenza vaccination is recommended during pregnancy as standard of care, limited surveillance data are available for monitoring uptake. Our aim was to evaluate the validity of existing surveillance in Western Australia for measuring antenatal influenza immunisations.

Methods: The self-reported vaccination status of 563 women who delivered between April and October 2013 was compared against three passive data collection sources: a state-wide antenatal influenza vaccination database maintained by the Department of Health, a public maternity hospital database, and a private health service database. Sensitivity, specificity, and positive and negative predictive values were calculated for each system using self-report …

A Prospective Cohort Study Comparing The Reactogenicity Of Trivalent Influenza Vaccine In Pregnant And Non-Pregnant Women, A Regan, L Tracey, C Blyth, D Mak, P Richmond, G Shellam, C Talbot, P Effler

Medical Papers and Journal Articles

Background: Influenza vaccination during pregnancy can prevent serious illness in expectant mothers and provide protection to newborns; however, historically uptake has been limited due to a number of factors, including safety concerns. Symptomatic complaints are common during pregnancy and may be mistakenly associated with reactions to trivalent influenza vaccine (TIV). To investigate this, we compared post-vaccination events self-reported by pregnant women to events reported by non-pregnant women receiving TIV.

Methods: A prospective cohort of 1,086 pregnant women and 314 non-pregnant female healthcare workers (HCWs) who received TIV between March-May 2014 were followed-up seven days post-vaccination to assess local and systemic …

The Challenge To Deliver Cost Effective Care For Patients With Gestational Diabetes Mellitus, Julie Quinlivan

Health Sciences Papers and Journal Articles

The global rise in obesity and gestational weight gain, along with recent trials demonstrating improved pregnancy and neonatal outcomes associated with the treatment of mild hyperglycaemia, have resulted in a clinical challenge to deliver cost effective healthcare to manage the epidemic of Gestational Diabetes Mellitus (GDM). Whilst clinicians now have clear criteria by which to diagnose GDM, and the glycaemic targets to achieve, less clear are the pathways to achieve these outcomes in a cost effective manner. The value of using allied health providers such as dieticians compared to less trained patient educators, the effectiveness of individualised versus group dietician …