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Ashby EL, Donepudi S, Padilla HM. Understanding lactation policies and resources across a university system: survey and document review. BMC Pregnancy Childbirth 2024; 24:367. [PMID: 38750490 PMCID: PMC11094989 DOI: 10.1186/s12884-024-06541-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/24/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND In the U.S., employees often return to work within 8-12 weeks of giving birth, therefore, it is critical that workplaces provide support for employees combining breastfeeding and work. The Affordable Care Act requires any organization with more than 50 employees to provide a space other than a restroom to express breastmilk and a reasonable amount of time during the workday to do so. States and worksites differ in the implementation of ACA requirements and may or may not provide additional support for employees combining breastfeeding and work. The purpose of this study was to conduct an analysis of the policies and resources available at 26 institutions within a state university system to support breastfeeding when employees return to work after giving birth. METHODS Survey data was collected from Well-being Liaisons in the human resources departments at each institution. In addition, we conducted a document review of policies and online materials at each institution. We used univariate statistics to summarize survey results and an inductive and deductive thematic analysis to analyze institutional resources available on websites and in policies provided by the liaisons. RESULTS A total of 18 (65.3%) liaisons participated in the study and revealed an overall lack of familiarity with the policies in place and inconsistencies in the resources offered to breastfeeding employees across the university system. Only half of the participating liaisons reported a formal breastfeeding policy was in place on their campus. From the document review, six major themes were identified: placing the burden on employees, describing pregnancy or postpartum as a "disability," having a university-specific policy, inclusion of break times for breastfeeding, supervisor responsibility, and information on lactation policies. CONCLUSION The review of each institution's online resources confirmed the survey findings and highlighted the burden placed on employees to discover the available resources and advocate for their needs. This paper provides insight into how institutions support breastfeeding employees and provides implications on strategies to develop policies at universities to improve breastfeeding access for working parents.
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Cheung PS, McCaffrey T, Tighe SM, Mohamad MM. Healthcare practitioners' experiences and perspectives of music in perinatal care in Ireland: An exploratory survey. Midwifery 2024; 132:103987. [PMID: 38599130 DOI: 10.1016/j.midw.2024.103987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/11/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Evidence shows that music can promote the wellbeing of women and infants in the perinatal period. Ireland's National Maternity Strategy (2016-2026) suggests a holistic approach to woman's healthcare needs and music interventions are ideally placed as a non-pharmacological and cost-effective intervention to improve the quality of care offered to women and infants. This cross-sectional survey aimed to explore the healthcare practitioners' personal and professional experiences of using music therapeutically and its impact and barriers in practice. The survey also investigated practitioners' knowledge and attitudes towards the use of music as a therapeutic tool in perinatal care. METHODS A novel online survey was developed and distributed through healthcare practitioners' electronic mailing lists, social media, Perinatal Mental Health staff App, and posters at the regional maternity hospital during 26th June and 26th October 2020. Survey items included demographics, personal and professional use of music, and perspectives on music intervention in perinatal care. RESULTS Forty-six healthcare practitioners from across 11 professions were recruited and 42 were included in this study. 98 % of perinatal practitioners used music intentionally to support their wellbeing and 75 % referred to using music in their work. While 90 % found music beneficial in their practice, 15 % reported some negative effect. Around two-thirds of the respondents were familiar with the evidence on music and perinatal wellbeing and 95 % thought there was not enough guidance. 40 % considered music therapy an evidence-based practice and 81 % saw a role for music therapy in standard maternity service in Ireland. The qualitative feedback on how music was used personally and professionally, its' reported benefits, negative effects, and barriers are discussed. DISCUSSION This study offers insights into how healthcare practitioners viewed and applied music in perinatal practice. The findings indicate high interest and positive experiences in using music as a therapeutic tool in perinatal care which highlights the need for more evidence and guidance.
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Affiliation(s)
- Pui Sze Cheung
- Irish World Academy of Music and Dance, University of Limerick, Limerick V94DK18, Ireland; Health Research Institute, University of Limerick, Limerick, V94DK18, Ireland.
| | - Tríona McCaffrey
- Irish World Academy of Music and Dance, University of Limerick, Limerick V94DK18, Ireland; Health Research Institute, University of Limerick, Limerick, V94DK18, Ireland
| | - Sylvia Murphy Tighe
- Health Research Institute, University of Limerick, Limerick, V94DK18, Ireland; Department of Nursing and Midwifery, University of Limerick, Limerick V94DK18, Ireland
| | - Mas Mahady Mohamad
- Specialist Perinatal Mental Health Team, University Maternity Hospital Limerick, Limerick V94C566, Ireland; School of Medicine, University of Limerick, V94DK18, Ireland
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Utalo D, Israel E, Lenjebo TL, Aynalem A, Darebo TD. Determinants of respectful maternity care among women who gave childbirth in Southern Ethiopia. BMC Health Serv Res 2024; 24:451. [PMID: 38600494 PMCID: PMC11007911 DOI: 10.1186/s12913-024-10813-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 03/01/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Having a good provision of respectful maternity care (RMC) to a woman who gives childbirth is a crucial component of maternal health care to result in positive maternal and neonatal outcomes. Disrespect and lack of women-centered care in birth discourage a woman from seeking healthcare during childbirth contributing to poor healthcare-seeking behaviour and dissatisfaction with the maternity service. The current study aimed to assess key determinants of RMC during childbirth at selected public health facilities of the Gofa zone, Southern Ethiopia. METHODS A cross-sectional study design was conducted from March to April 2021 among 390 women who gave birth in eight randomly selected public health facilities of Gofa zone, Southern Ethiopia. The level of RMC was measured using structured exit interview items. A structured-interviewer-administered questionnaire was used to collect data and then entered into Epi-data version 4.6 and exported to SPSS version 25 for further analysis. Bivariate and multivariate logistic regression analyses were used to identify determinants of RMC among women. RESULTS A total of 390 women responded to the exit interview making a response rate of 100%. The mean (± SD) age of the 390 women was 27.9 (± 4.85) years. The overall prevalence of women who received RMC was 40.5%, 95% CI (36-45%). Two hundred and ninety-seven (76.2%; n = 297/390) women had antenatal care (ANC) attendance in the index pregnancy. A woman who had planned pregnancy (AOR = 1.72, CI: 1.04, 2.85), planned to deliver in a health facility (AOR = 1.68, CI: 1.00, 2.81), presence of familial support (AOR = 2.04, CI: 1.20, 3.48), and had information about service availability (AOR = 4.44, CI: 2.09, 9.42) were associated with RMC among women. CONCLUSION The provision of respectful maternity care in the study area was low when compared with local studies. Planned pregnancy, plan to deliver in a health facility, family support, and presence of information about service availability were factors associated with RMC among women. More attention should be given to training and supportive supervision of health care professionals on respectful maternity care and its standards to increase service uptake and make service more women-centred.
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Affiliation(s)
- Dawit Utalo
- Departement of Public Health, Consortium Project at Women Empowerment-Amref Health Africa, Wolaita Sodo, Ethiopia
| | - Eskinder Israel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Tsegaye Lolaso Lenjebo
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amdehiwot Aynalem
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Tadele Dana Darebo
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Wanni Arachchige Dona S, Angeles MR, Nguyen D, Cooper P, Sweet L, Peeters A. An assessment of ten popular pregnancy applications (Apps) available for women in Australia. Int J Med Inform 2024; 184:105354. [PMID: 38325121 DOI: 10.1016/j.ijmedinf.2024.105354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/14/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Given the growing popularity of health Apps, this study aimed to evaluate popular pregnancy Apps among Australian women. DESIGN Ten popular pregnancy mobile device Apps accessible within Australia were assessed using the Deakin Health E-technologies Assessment Lab (HEAL) framework, the Australian Privacy Principles (APP) and other context-specific criteria. RESULTS Most Apps were robust in use and user-friendly in terms of design. Based on the HEAL assessment, all the Apps scored between 70 and 89 out of 120. Only two of the ten Apps were locally hosted and operated. Only one App could search local health services using Victorian postcodes. All ten Apps were aligned with various privacy policy guidelines, but only one was reported to be fully aligned with the APP as it is locally hosted and operated. None of the Apps had accessibility features such as for visual or hearing difficulties. Only one App could be assessed as able to interface with the electronic medical record system in Australia due to a lack of publicly available information on this capability. CONCLUSIONS Due to privacy concerns, pregnancy Apps accessible in Australia should be used with caution unless care is taken to select an App that fully complies with local requirements or international equivalents. All Apps were subjectively rated as moderate in quality, and more attention to accessibility and privacy features by App developers is recommended, along with the focus on integration with Australian digital health services.
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Affiliation(s)
| | - Mary Rose Angeles
- Deakin University, Institute for Health Transformation, Deakin Health Economics, Geelong, Victoria, Australia
| | - Dieu Nguyen
- Deakin University, Institute for Health Transformation, Deakin Health Economics, Geelong, Victoria, Australia
| | - Paul Cooper
- Deakin University, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Linda Sweet
- Deakin University, Institute for Health Transformation, Centre for Quality and Patient Safety Research, Western Health Partnership, School of Nursing and Midwifery, Geelong, Victoria, Australia
| | - Anna Peeters
- Deakin University, Institute for Health Transformation, Geelong, Victoria, Australia
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Chiumento A, Fovargue S, Redhead C, Draper H, Frith L. Delivering compassionate NHS healthcare: A qualitative study exploring the ethical implications of resetting NHS maternity and paediatric services following the acute phase of the COVID-19 pandemic. Soc Sci Med 2024; 344:116503. [PMID: 38324977 DOI: 10.1016/j.socscimed.2023.116503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 02/09/2024]
Abstract
A distinction can be drawn between healthcare, where compassion is evident, and the functional delivery of health services. Measures to curb the spread of COVID-19, such as personal protective equipment, telehealth, and visiting restrictions created barriers to service delivery and put pressure on healthcare. Through 37 qualitative interviews with NHS senior managers (n = 11), health professionals (n = 26), and 5 focus group discussions with members of the public (n = 26), we explored experiences of the everyday ethical tensions created as services were being re-established following the acute phase of the COVID-19 pandemic in England. Our analysis enriches an understanding of compassionate care as outlined in NHS operational documents - covering the emotional, moral, and relational components of healthcare beyond the functionalities of treatment. From this analysis, we consider the normative standards underpinning NHS healthcare, concluding that, wherever possible, offering compassionate healthcare to patients and their families should be facilitated, and health professionals should themselves be compassionately supported in the workplace. Our findings foreground the need to consider the consequences of the short-term adoption of a functional treatment approach, including strategies that support health professionals and inform the public, to avoid the long-term damage caused by the fracturing of compassionate healthcare.
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Affiliation(s)
- Anna Chiumento
- School of Social and Political Sciences, University of Edinburgh, United Kingdom.
| | - Sara Fovargue
- School of Law, University of Sheffield, United Kingdom
| | - Caroline Redhead
- Centre for Social Ethics and Policy, Department of Law, The University of Manchester, United Kingdom
| | - Heather Draper
- Warwick Medical School, The University of Warwick, United Kingdom
| | - Lucy Frith
- Centre for Social Ethics and Policy, Department of Law, The University of Manchester, United Kingdom
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Ayers S, Horsch A, Garthus-Niegel S, Nieuwenhuijze M, Bogaerts A, Hartmann K, Karlsdottir SI, Oosterman M, Tecirli G, Turner JD, Lalor J. Traumatic birth and childbirth-related post-traumatic stress disorder: International expert consensus recommendations for practice, policy, and research. Women Birth 2024; 37:362-367. [PMID: 38071102 DOI: 10.1016/j.wombi.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Research suggests 1 in 3 births are experienced as psychologically traumatic and about 4% of women and 1% of their partners develop post-traumatic stress disorder (PTSD) as a result. AIM To provide expert consensus recommendations for practice, policy, and research and theory. METHOD Two consultations (n = 65 and n = 43) with an international group of expert researchers and clinicians from 33 countries involved in COST Action CA18211; three meetings with CA18211 group leaders and stakeholders; followed by review and feedback from people with lived experience and CA18211 members (n = 238). FINDINGS Recommendations for practice include that care for women and birth partners must be given in ways that minimise negative birth experiences. This includes respecting women's rights before, during, and after childbirth; and preventing maltreatment and obstetric violence. Principles of trauma-informed care need to be integrated across maternity settings. Recommendations for policy include that national and international guidelines are needed to increase awareness of perinatal mental health problems, including traumatic birth and childbirth-related PTSD, and outline evidence-based, practical strategies for detection, prevention, and treatment. Recommendations for research and theory include that birth needs to be understood through a neuro-biopsychosocial framework. Longitudinal studies with representative and global samples are warranted; and research on prevention, intervention and cost to society is essential. CONCLUSION Implementation of these recommendations could potentially reduce traumatic births and childbirth-related PTSD worldwide and improve outcomes for women and families. Recommendations should ideally be incorporated into a comprehensive, holistic approach to mental health support for all involved in the childbirth process.
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Affiliation(s)
- Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, EC1V 0HB, UK.
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland; Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Susan Garthus-Niegel
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Maastricht, the Netherlands; CAPHRI, Maastricht University, 6229 ER Maastricht, the Netherlands
| | - Annick Bogaerts
- REALIFE research group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | | | | | - Mirjam Oosterman
- Faculty of Behavioral and Movement Sciences, Department of Clinical Child & Family Studies, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, the Netherlands
| | - Gulcan Tecirli
- Health Technology Assessment Department, Republic of Turkiye Ministry of Health, Bilkent, Çankaya, Ankara, Turkiye
| | - Jonathan D Turner
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Joan Lalor
- School of Nursing and Midwifery, Trinity College Dublin, Ireland
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Kalra H, Tran T, Romero L, Sagar R, Fisher J. National policies and programs for perinatal mental health in India: A systematic review. Asian J Psychiatr 2024; 91:103836. [PMID: 37988929 DOI: 10.1016/j.ajp.2023.103836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND India is the most populous country in the world with millions of births annually. Perinatal mental disorders (PMDs) are prevalent worldwide including in India. This study was undertaken to evaluate how mental health is addressed in national maternity and mental health policies and programs in India. METHODS We conducted a systematic review of the national policies and programs in India related to maternity care and mental health. The identified policies and programs were analysed using health policy triangle framework. RESULTS Our search yielded 11 relevant documents and no peer reviewed publications. No specific national policy or program on maternal mental health could be identified. Universal access to health and mental health including for women and children was clearly articulated in both national mental health and maternity policies, which emphasised that access to mental health care and treatment is a fundamental right. There were few details about how the programs and policies were developed and no accounts of consultations with community members or service providers in their formation. CONCLUSION National maternity and mental health policies and programs in India appear not to consider perinatal mental health. There are promising state-based initiatives, but, given the disease burden of PMDs in India, the absence of a national policy leads to unrecognized and unmet needs of women in the states without these measures. These inequalities can be effectively minimized by well implemented national policies for perinatal mental health, accompanied by evidence-based locally tailored programs and interventions across the country.
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Affiliation(s)
- Harish Kalra
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Notre Dame Australia.
| | - Thach Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lorena Romero
- The Ian Potter Library, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Barnsley H, McFall S, White R, Suleman S, Pichon B, Patel M. Emergence and control of an outbreak of PVL-positive MRSA in a UK-based maternity setting. J Hosp Infect 2023:S0195-6701(23)00411-5. [PMID: 38145811 DOI: 10.1016/j.jhin.2023.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 12/27/2023]
Abstract
This paper aims to describe the investigation and control of an outbreak of USA300 ST8 Panton-Valentine leucocidin (PVL)-positive meticillin-resistant Staphylococcus aureus (MRSA), confirmed by whole genome sequencing (WGS), within a maternity and neonatal setting in the UK. The identification of two linked PVL-MRSA cases led to an outbreak investigation. A lookback exercise conducted using the infection control surveillance database, typing of saved MRSA isolates, enhanced patient screening, and staff screening were used to identify further cases. Environmental screening was also performed. Genetic relatedness between isolates was assessed by WGS. During the outbreak, 18 cases were identified between 11th July 2021 and 22nd December 2022: 10 cases were infections and eight cases were colonizations. A healthcare worker (HCW) tested positive for colonization with the same strain, and environmental swabbing identified contaminated information technology equipment in the hospital. The outbreak was brought to an end by exclusion of the colonized HCW from work, and infection prevention and control measures. Since the end of the outbreak, cases of PVL-MRSA with similar molecular profiles have been found in the community. It is likely that the HCW played a role in the transmission of PVL-MRSA. Their exclusion from work and decolonization were key to preventing further cases. WGS was valuable in identifying and linking cases. The identification of community cases of PVL-MRSA with similar molecular profiles confirms transmission of the organism outside of healthcare settings.
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Affiliation(s)
| | - S McFall
- Faculty of Public Health, London, UK
| | - R White
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - S Suleman
- Field Service, UK Health Security Agency, Colindale, London, UK
| | - B Pichon
- Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, UK Health Security Agency, Colindale, London, UK
| | - M Patel
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
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Romanzini LP, Ishikura IA, Pires GN, Tufik S, Andersen ML. The Impact of Maternity and Working Demands in Women's Sleep Pattern. Sleep Med Clin 2023; 18:481-487. [PMID: 38501520 DOI: 10.1016/j.jsmc.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
This literature review seeks to understand how motherhood and profession affect women's sleep. After the birth of a child, there is an increase in dissatisfaction with the quantity and quality of sleep. Awakenings and sleep disturbances are more frequent and can lead to increased fatigue and stress to reconcile household activities and work demands. These changes in sleep can lead to physical and/or psychological health problems. Sleep hygiene and social support become fundamental for the performance of the maternal tasks, reducing risks and increasing prevention of future problems, both for women and children.
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Affiliation(s)
- Lisie P Romanzini
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil
| | - Isabela A Ishikura
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil.
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Wang J, Bourke AFG. Parentage exclusion of close relatives in haplodiploid species. Theor Popul Biol 2023; 154:40-50. [PMID: 37640113 DOI: 10.1016/j.tpb.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
Parentage exclusion probability is usually calculated to evaluate the informativeness of a set of markers for, and the statistical power of, a parentage analysis. Equations for parentage exclusion probability have been derived in various scenarios such as paternity exclusion when maternity is known or unknown or when candidate males are unrelated or loosely related (being from the same subpopulation) to the father. All previous work assumes a diploid species. Although marker-based parentage analyses have been conducted in haploidiploid species (such as ants, bees and wasps) for diploid offspring at the individual level or haploid offspring at the class level, rigorously derived formulations of parentage exclusion probability for haploid offspring at the individual level are lacking, which prevents the precise evaluation of the informativeness for and the statistical power of a parentage analysis. In this study we derive equations for the exclusion probability of maternity of a haploid male when multiple mother candidates (workers or queens) are unrelated or fullsibs to the mother. The usefulness of the equations is exemplified by numerical examples, and the results are discussed in the context of the study of worker reproductivity in eusocial haplodiploid species. The results are especially valuable for an optimal experimental design in determining sampling intensities (e.g. number of markers and number of individuals) to achieve satisfactory statistical power of a parentage analysis in investigating workers' reproductivity in eusocial haplodiploid species.
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Affiliation(s)
- Jinliang Wang
- Institute of Zoology, Zoological Society of London, London NW1 4RY, United Kingdom.
| | - Andrew F G Bourke
- School of Biological Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, United Kingdom
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Anderson EC, Blair PS, Finn A, Ingram J, Amirthalingam G, Cabral C. Maternal vaccination provision in NHS maternity trusts across England. Vaccine 2023; 41:7359-7368. [PMID: 37951792 DOI: 10.1016/j.vaccine.2023.10.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Vaccinations for seasonal influenza and pertussis have been recommended for pregnant women in England since 2010 and 2012, respectively. Uptake rates are suboptimal with large regional variations. To improve uptake, from 2016 onwards maternity trusts were commissioned to offer pertussis (and other) vaccinations in addition to these being available in primary care. Since 2021, Covid-19 vaccination has also been recommended for pregnant women. Overall maternal vaccination rates are routinely available, but not the relative provision by maternity trusts. We aimed to describe the national picture of maternity trust provision of maternal vaccinations, including how the maternity trust vaccination programme has progressed. METHODS Cross-sectional survey plus comparisons with 2017-18 figures for maternity trust provision of pertussis vaccination, and with UKHSA data for total pertussis vaccination. RESULTS Twelve NHS commissioners participated (from 13/06/22 to 31/03/23) providing data for 120 (of a total 124) maternity trusts across England. All 120 (100%) trusts were commissioned to deliver influenza, and 107 (89%) to deliver pertussis vaccinations, though not all actually administered the vaccines; 29% offered Covid-19 vaccinations. For 2021-22 we found a mean of 25% (range 0-81.3%) women were vaccinated for pertussis (a large increase compared with previous estimates for 2017-18); and 11% (range 0-74.2%) for influenza, via their maternity trust. Commissioners reported a negative impact of the pandemic on routine vaccination provision. There was indication of efficiency by vaccinating women attending for other appointments. There are diverse mechanisms for reporting pertussis and influenza vaccinations administered at maternity trusts back to primary care, which may be inefficient for maternity staff workload and accuracy of data transfer (especially for pertussis). CONCLUSION A high proportion of maternity trusts provide both pertussis and influenza vaccinations, despite a negative impact of the pandemic. Reasons for large between-trust variation in vaccination rates should be explored to improve uptake and equity.
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Affiliation(s)
- Emma C Anderson
- Centre for Academic Child Health, Bristol Medical School: Population Sciences, University of Bristol, Canynge Hall, Third Floor, 39 Whatley Road, Bristol BS8 2PS, United Kingdom; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom.
| | - Peter S Blair
- Centre for Academic Child Health, Bristol Medical School: Population Sciences, University of Bristol, Canynge Hall, Third Floor, 39 Whatley Road, Bristol BS8 2PS, United Kingdom.
| | - Adam Finn
- Centre for Academic Child Health, Bristol Medical School: Population Sciences, University of Bristol, Canynge Hall, Third Floor, 39 Whatley Road, Bristol BS8 2PS, United Kingdom.
| | - Jenny Ingram
- Centre for Academic Child Health, Bristol Medical School: Population Sciences, University of Bristol, Canynge Hall, Third Floor, 39 Whatley Road, Bristol BS8 2PS, United Kingdom.
| | - Gayatri Amirthalingam
- UK Health Security Agency, Nobel House, 17 Smith Square, London SW1P 3JR, United Kingdom.
| | - Christie Cabral
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom.
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Branjerdporn G, Gillespie K, Martin E, Kissane V, De Young A, Ewais T, Goldsmith K, Wilson S, Adhikary S, McGahan G, Schulz C, Beckmann M. Effectiveness and cost-effectiveness of an electronic mindfulness-based intervention to improve maternal mental health in the peripartum: study protocol for a randomised controlled trial. Trials 2023; 24:747. [PMID: 37996896 PMCID: PMC10666349 DOI: 10.1186/s13063-023-07746-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Perinatal women are highly vulnerable to developing mental health issues and particularly susceptible to a recurrence of psychiatric illness. Poor mental health during the perinatal period can have long-term impacts on the physical and psychiatric health of both mother and child. A potentially useful strategy to improve women's mental health is through a mobile application teaching mindfulness, an evidence-based technique helping individuals focus on the present moment. METHODS A mixed method, prospective randomised controlled trial. The study group comprise women aged 18 years and over, who are attending the public and private maternity clinics at Mater Mothers' Hospital. A sample of 360 prenatal women will be randomised into the intervention group (with the use of the mindfulness app) or usual care. Participants will remain in the study for 11 months and will be assessed at four timepoints for changes in postnatal depression, mother-infant bonding, and quality of life. A cost-effectiveness evaluation will also be conducted using quality-adjusted life year (QALY) calculations. A random selection of intervention participants will be invited to attend focus groups to give feedback on the mindfulness app. DISCUSSION Previous studies have found mindfulness interventions can reduce stress, anxiety, depression, and sleep disturbances in a prenatal population. The risks of the intervention are low, but could be of significant benefit for women who are unable to attend face-to-face appointments due to geographical, financial, or time barriers; during endemic or pandemic scenarios; or due to health or mobility issues. TRIAL REGISTRATION This study was approved by the Mater Misericordiae Human Research Ethics Committee (83,589). Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622001581752 ( https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385107&isReview=true ). Registered on 22 Dec. 2022.
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Affiliation(s)
- Grace Branjerdporn
- Mater Health, Annerley Road Campus, South Brisbane, QLD, 4101, Australia.
- Mater Research Institute - University of Queensland, Whitty Building (Ground Floor), Annerley Road, Mater Hill, South Brisbane, QLD, 4101, Australia.
| | - Kerri Gillespie
- Mater Research Institute - University of Queensland, Whitty Building (Ground Floor), Annerley Road, Mater Hill, South Brisbane, QLD, 4101, Australia
| | - Elizabeth Martin
- Mater Research Institute - University of Queensland, Whitty Building (Ground Floor), Annerley Road, Mater Hill, South Brisbane, QLD, 4101, Australia
- Wesley Research Institute, 451 Coronation Drive, Auchenflower, Qld, 4066, Australia
| | - Vivianne Kissane
- Peach Tree Perinatal Wellness Inc, 293 Ellison Rd, Geebung, QLD, 4034, Australia
| | - Alex De Young
- Queensland Centre for Perinatal and Infant Mental Health, Children's Health Queensland - Queensland Health, Nundah, QLD, 4012, Australia
| | - Tatjana Ewais
- Mater Health, Annerley Road Campus, South Brisbane, QLD, 4101, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Parklands Drive, Southport, QLD, 4222, Australia
- Faculty of Medicine, University of Queensland, 288 Herston Rd, Herston, Qld, 4006, Australia
| | - Kathleen Goldsmith
- Mater Health, Annerley Road Campus, South Brisbane, QLD, 4101, Australia
| | - Susan Wilson
- Children's Health Queensland, Queensland Health, 501 Stanley St, South Brisbane, QLD, 4101, Australia
| | - Sam Adhikary
- Mater Health, Annerley Road Campus, South Brisbane, QLD, 4101, Australia
- Mater Research Institute - University of Queensland, Whitty Building (Ground Floor), Annerley Road, Mater Hill, South Brisbane, QLD, 4101, Australia
| | - Greg McGahan
- Mater Health, Annerley Road Campus, South Brisbane, QLD, 4101, Australia
- Mater Research Institute - University of Queensland, Whitty Building (Ground Floor), Annerley Road, Mater Hill, South Brisbane, QLD, 4101, Australia
| | - Constanze Schulz
- Mater Health, Annerley Road Campus, South Brisbane, QLD, 4101, Australia
| | - Michael Beckmann
- Mater Health, Annerley Road Campus, South Brisbane, QLD, 4101, Australia
- Mater Research Institute - University of Queensland, Whitty Building (Ground Floor), Annerley Road, Mater Hill, South Brisbane, QLD, 4101, Australia
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Cheung PS, McCaffrey T, Tighe SM, Mohamad MM. Music as a health resource in pregnancy: A cross-sectional survey study of women and partners in Ireland. Midwifery 2023; 126:103811. [PMID: 37708586 DOI: 10.1016/j.midw.2023.103811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/18/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Wellbeing in pregnancy can have long term effects for women, infants, and families. Research has shown that music can promote maternal health, infant development, and parent-infant bonding. This study aimed to explore women's and their partners' experiences of using music during pregnancy while also considering their perspectives on the potential role of music in maternity care. METHODS A cross-sectional online survey was conducted from June to October 2020 in Ireland. 265 respondents including 254 women and 11 partners who were pregnant or had given birth in the past 12 months participated. Descriptive statistics and content analysis were used to analyse the results. RESULTS Findings indicated that, during pregnancy, 75% of respondents sang to their unborn baby, 47% created playlists for childbirth, 46% intentionally used music to support their wellbeing, over one-third were not aware of supporting evidence on music for perinatal wellbeing, 88% thought there was not enough guidance, and 70% supported the idea of establishing music therapy in maternity care. Qualitative analysis revealed three themes: 'Positive impacts of music', 'Facilitators and barriers to the use of music during pregnancy', and 'Future visions on implementing music in maternity care'. CONCLUSION This study is the first to explore the experience and perspectives of women and partners in Ireland on using music during pregnancy. The findings highlight the need for more music-based resources and education on this topic and suggests an openness amongst women and partners towards the implementation of music therapy in maternity care to promote perinatal health and wellbeing.
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Affiliation(s)
- Pui Sze Cheung
- Irish World Academy of Music and Dance, University of Limerick, Limerick V94DK18, Ireland.
| | - Triona McCaffrey
- Irish World Academy of Music and Dance, University of Limerick, Limerick V94DK18, Ireland. https://twitter.com/MccaffreyTriona
| | - Sylvia Murphy Tighe
- Department of Nursing and Midwifery, University of Limerick, Limerick V94DK18, Ireland. https://twitter.com/sylviamurphyt
| | - Mas Mahady Mohamad
- Specialist Perinatal Mental Health Team, University Maternity Hospital Limerick, Limerick, V94 C566, Ireland, School of Medicine, University of Limerick, V94DK18, Ireland. https://twitter.com/MahadyMas
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14
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Battershell M, Vu H, Callander EJ, Slavin V, Carrandi A, Teede H, Bull C. Development, women-centricity and psychometric properties of maternity patient-reported outcome measures (PROMs): A systematic review. Women Birth 2023; 36:e563-e573. [PMID: 37316400 DOI: 10.1016/j.wombi.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Measuring maternity care outcomes based on what women value is critical to promoting woman-centred maternity care. Patient-reported outcome measures (PROMs) are instruments that enable service users to assess healthcare service and system performance. AIM To identify and critically appraise the risk of bias, woman-centricity (content validity) and psychometric properties of maternity PROMs published in the scientific literature. METHODS MEDLINE, CINAHL Plus, PsycINFO and Embase were systematically searched for relevant records between 01/01/2010 and 07/10/2021. Included articles underwent risk of bias, content validity and psychometric properties assessments in line with COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. PROM results were summarised according to language subgroups and an overall recommendation for use was determined. FINDINGS Forty-four studies reported on the development and psychometric evaluation of 9 maternity PROMs, grouped into 32 language subgroups. Risk of bias assessments for the PROM development and content validity showed inadequate or doubtful methodological quality. Internal consistency reliability, hypothesis testing (for construct validity), structural validity and test-retest reliability varied markedly in sufficiency and evidence quality. No PROMs received a level 'A' recommendation, required for real-world use. CONCLUSION Maternity PROMs identified in this systematic review had poor quality evidence for their measurement properties and lacked sufficient content validity, indicating a lack of woman-centricity in instrument development. Future research should prioritise women's voices in deciding what is relevant, comprehensive and comprehensible to measure, as this will impact overall validity and reliability and facilitate real-world use.
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Affiliation(s)
- M Battershell
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - H Vu
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - E J Callander
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - V Slavin
- Women-Newborn-Childrens Services, Gold Coast Health, QLD, Australia; School of Nursing and Midwifery, Griffith University, Meadowbrook, QLD, Australia
| | - A Carrandi
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - H Teede
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Endocrinology and Diabetes Units, Monash Health, VIC, Australia
| | - C Bull
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia.
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Chuang MT, Liang YL, Chen TS, Tsai HF, Wu PY, Chen PF, Chang CH, Kang L, Su MT, Tien YT, Hsu KF, Ko WC, Shen MR, Tsai PY. Setting up a specialized maternity unit in a tertiary hospital: An oasis for pregnant women with COVID-19 during the pandemic. Taiwan J Obstet Gynecol 2023; 62:823-829. [PMID: 38008500 DOI: 10.1016/j.tjog.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 11/28/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic has had an enormous impact on society and the medical environment in Taiwan in 2022. As pregnant women with COVID-19 are at higher risk for multiple complications, Taiwan needs a COVID-19 specialized maternity unit to improve the quality of maternal and neonatal care. MATERIALS AND METHODS We share our experience with specialized maternity unit for pregnant women with COVID-19 at the National Cheng Kung University Hospital, where we can have careful evaluation, safe birth, and comprehensive postpartum care. RESULTS Our COVID-19 specialized maternity unit enrolled 253 pregnant women with COVID-19, 90 (35.6%) pregnant women were admitted to the specialized maternity unit, and 71 (28.1%) pregnant women gave birth during hospitalization in two months. All pregnant women recovery well and real-time polymerase chain reaction tests on all infants were negative for COVID-19. CONCLUSION A specialized maternity unit can provide pregnant women with a safe birth environment, immediate maternity care, and high medical quality. It can also help health workers in non-specialized maternity units deal with COVID-19-related psychological stress. Therefore, setting up one specialized maternity unit in the city during the pandemic should be guardedly considered.
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Affiliation(s)
- Ming-Ta Chuang
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ling Liang
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ta-Sheng Chen
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsing-Fen Tsai
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Ying Wu
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Fan Chen
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chiung-Hsin Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Lin Kang
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mei-Tsz Su
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ting Tien
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Keng-Fu Hsu
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Ru Shen
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Yin Tsai
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Dupont C, Bocquet A, Brancato S, Chalumeau M, Darmaun D, de Luca A, Feillet F, Frelut ML, Guimber D, Lapillonne A, Linglart A, Peretti N, Roze JC, Siméoni U, Turck D, Chouraqui JP. Cow's milk-based infant formula supplements in breastfed infants and primary prevention of cow's milk allergy: A commentary of the Committee on Nutrition of the French Society of Pediatrics. Arch Pediatr 2023; 30:591-594. [PMID: 37709607 DOI: 10.1016/j.arcped.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/07/2023] [Indexed: 09/16/2023]
Abstract
The role of nutritional interventions for the primary prevention of cow's milk allergy (CMA) remains debated as well as the role of early introduction of allergenic foods, which is largely encouraged from the beginning of complementary feeding. Considering the introduction of cow's milk protein (CMP), current recommendations suggest avoidance of any cow's milk formula (CMF) supplements in breastfed infants in the maternity ward. By contrast, based on poor evidence, some authors support systematic supplements of CMP in breastfed children at risk of allergy from the first week of life. The Committee on Nutrition of the French Society of Pediatrics considers that such a proposal requires more clinical studies and mainly randomized and placebo-controlled clinical trials before becoming a recommendation.
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Affiliation(s)
- Christophe Dupont
- Paris Descartes University, Pediatric gastroenterology, Clinique Marcel Sembat, Ramsay Group, Boulogne Billancourt, France.
| | - Alain Bocquet
- French association of ambulatory paediatrics, France
| | - Sandra Brancato
- Institut de Recherche pour le Développement, Brignon, France
| | - Martin Chalumeau
- Paris Descartes University, APHP Necker-Enfants Malades hospital, Paris, France
| | | | - Arnaud de Luca
- Tours University and Inserm UMR 1069, 37000 Tours, France
| | | | | | - Dominique Guimber
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, University of Lille, INSERM U995, 59037 Lille, France
| | - Alexandre Lapillonne
- Paris Descartes University, APHP Necker-Enfants Malades hospital, Paris, France; CNRC, Baylor College of Medicine, Houston, TX, USA
| | - Agnès Linglart
- Paris-Sud, University, CHU de Bicêtre, 94270 Le Kremlin-Bicêtre, France
| | - Noel Peretti
- Pediatric Nutrition, University Pediatric Hospital of Lyon and INSERM U1060, CarMeN laboratory; Claude Bernard Lyon-1 University, F-69008 France
| | - Jean-Christophe Roze
- Neonatology and pediatric intensive care unit, Univesity hospital of Nantes and UMR 1280 INRA, Nantes University. France
| | - Umberto Siméoni
- Division of Pediatrics and DOHaD Lab, Woman, Mother and Child Department, Centre Hospitalier Universitaire Vaudois (CHUV), 21 rue du Bugnon, 1011 Lausanne, Switzerland
| | - Dominique Turck
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, University of Lille, INSERM U995, 59037 Lille, France
| | - Jean-Pierre Chouraqui
- Paediatric Division of Nutrition and Gastro-enterology, Pediatric Department, Grenoble-Alpes University Hospital (CHUGA), Grenoble, France
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Endehabtu BF, Angaw DA, Gonete TZ, Jisso M, Abera N, Alemayehu A, Fikre R, Abdissa B, Umer A, Kebede M, Mohammed H, Yazie B, Dessie K, Tamiso A, Sime H, Yesuf EA, Gurmu KK, Tilahun B. Availability of Maternal, Newborn care and Child Health Services at Primary Health Care Unit during COVID-19 Outbreak in Ethiopia. Ethiop J Health Sci 2023; 33:117-126. [PMID: 38352671 PMCID: PMC10859739 DOI: 10.4314/ejhs.v33i2.5s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/09/2023] [Indexed: 02/16/2024] Open
Abstract
Background The COVID-19 pandemic is putting a pressure on global health systems. The disruption of essential health services (EHS) has an impact on the health of mothers, neonate and children in developing countries. Therefore, the main aim of this study was assessing the availability of Maternal, Newborn care and Child health (MNCHS) services at primary health care unit during COVID-19 outbreak. Methods A cross-sectional survey was conducted in five regions of Ethiopia in 2021. Descriptive analyses were undertaken using STATA 16 software and the results presented using tables and different graphs. A continuity of EHS assessment tool adopted from WHO was used for data collection. Result During COVID -19 pandemic, 30 (69.8%) of woreda health offices, 52 (56.5%) of health centers (HCs), 7 (44.4%) of hospitals, and 165 (48%) of health posts (HPs) had a defined list of EHS. In comparison with other EHS, family planning is the least available service in all regions. At HPs level care for sick children and antenatal care (ANC) were available at 59.1 and 58.82% respectively. Except immunization services at SNNP, all other maternal, newborn, and child health EHS were not available to all HPs at full scale. Conclusion Immunization services were most available, while ANC and care for sick children were least available during COVID-19 at the HPs level. There was regional variation in MNCH EHS service availability at all levels.
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Affiliation(s)
- Berhanu Fikadie Endehabtu
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Ethiopia
- eHealthLab Ethiopia, University of Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Ethiopia
| | - Tajebew Zayede Gonete
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Ethiopia
| | - Meskerem Jisso
- Hawassa University, College of Medicine and Health Sciences, Ethiopia
| | - Netsanet Abera
- Hawassa University, College of Medicine and Health Sciences, Ethiopia
| | | | - Rekiku Fikre
- Hawassa University, College of Medicine and Health Sciences, Ethiopia
| | - Biru Abdissa
- Jimma University, Institute of Health, Jimma, Ethiopia
| | - Abdurezak Umer
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Mesfin Kebede
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Hussen Mohammed
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Bekele Yazie
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Kassahun Dessie
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Ethiopia
| | - Alemu Tamiso
- Hawassa University, College of Medicine and Health Sciences, Ethiopia
| | - Habtamu Sime
- Jimma University, Institute of Health, Jimma, Ethiopia
| | | | - Kassu Ketema Gurmu
- World Health Organization Country Office for Ethiopia, Universal Health Coverage/Life Course, Health System Strengthening Team, Ethiopia
| | - Binyam Tilahun
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Ethiopia
- eHealthLab Ethiopia, University of Gondar, Ethiopia
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Safont G, Garriga M, González-Rodríguez A, Amoretti S, Simón O, Solè E, Garcia-Rizo C, Arranz B, Vieta E, Bernardo M. Maternity in women with schizophrenia and schizoaffective disorder. Span J Psychiatry Ment Health 2023:S2950-2853(23)00011-X. [PMID: 38591833 DOI: 10.1016/j.sjpmh.2023.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/10/2024]
Abstract
PURPOSE Maternity rates in women with schizophrenia have tripled in the past decades, with a current percentage similar to the general population (50-60%). However, mothers with schizophrenia present higher rates of single marital status, and social dysfunction than the general population. In addition, the incidence of unplanned pregnancy, abortions, miscarriages and obstetric complications is higher. This study aimed to describe variables related to maternity in this population. METHODS One-hundred and ninety-two outpatient women diagnosed with schizophrenia and schizoaffective disorders were included (DSM-IV-TR criteria) in a two-site study. Psychosocial risk factors, demographic variables and clinical features were recorded in the same visit. Non-parametric tests were used in order to describe variables for likelihood offspring in psychotic women. RESULTS One-hundred and forty-seven (76.6%) women suffered from schizophrenia and 45 (23.4%) schizoaffective disorder. Psychotic mothers used to be married/having a partner and presented a later onset of the illness (over 36 years old) compared to non-mothers. In addition, mothers generally presented pregnancy before the onset of illness. Regarding obstetric complications, around the 80% of the sample presented at least one obstetric complication. Although desire or wish of pregnancy was reported in 66.3% of the mothers, rates of planned pregnancy were 25% and only the 47.9% were currently taking care of their children with their husband/partner. CONCLUSION Maternity rate is high in this population. This study highlights the need to promote reproductive health care for women with mental disorders and to consider their reproductive life plan. Later onset of disease and being married are potential predictors of maternity in our sample of women with a schizophrenia and schizoaffective disorders while only the half were caring their children at the moment of the evaluation.
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Affiliation(s)
- Gemma Safont
- Department of Psychiatry, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Marina Garriga
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | | | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), ISCIII, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | - Olga Simón
- Department of Psychiatry, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Eva Solè
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | - Belén Arranz
- Department of Mental Health, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
| | - Eduard Vieta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), ISCIII, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain.
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Lee SI, Hanley S, Vowles Z, Plachcinski R, Moss N, Singh M, Gale C, Fagbamigbe AF, Azcoaga-Lorenzo A, Subramanian A, Taylor B, Nelson-Piercy C, Damase-Michel C, Yau C, McCowan C, O'Reilly D, Santorelli G, Dolk H, Hope H, Phillips K, Abel KM, Eastwood KA, Kent L, Locock L, Loane M, Mhereeg M, Brocklehurst P, McCann S, Brophy S, Wambua S, Hemali Sudasinghe SPB, Thangaratinam S, Nirantharakumar K, Black M. The development of a core outcome set for studies of pregnant women with multimorbidity. BMC Med 2023; 21:314. [PMID: 37605204 PMCID: PMC10441728 DOI: 10.1186/s12916-023-03013-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/27/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Heterogeneity in reported outcomes can limit the synthesis of research evidence. A core outcome set informs what outcomes are important and should be measured as a minimum in all future studies. We report the development of a core outcome set applicable to observational and interventional studies of pregnant women with multimorbidity. METHODS We developed the core outcome set in four stages: (i) a systematic literature search, (ii) three focus groups with UK stakeholders, (iii) two rounds of Delphi surveys with international stakeholders and (iv) two international virtual consensus meetings. Stakeholders included women with multimorbidity and experience of pregnancy in the last 5 years, or are planning a pregnancy, their partners, health or social care professionals and researchers. Study adverts were shared through stakeholder charities and organisations. RESULTS Twenty-six studies were included in the systematic literature search (2017 to 2021) reporting 185 outcomes. Thematic analysis of the focus groups added a further 28 outcomes. Two hundred and nine stakeholders completed the first Delphi survey. One hundred and sixteen stakeholders completed the second Delphi survey where 45 outcomes reached Consensus In (≥70% of all participants rating an outcome as Critically Important). Thirteen stakeholders reviewed 15 Borderline outcomes in the first consensus meeting and included seven additional outcomes. Seventeen stakeholders reviewed these 52 outcomes in a second consensus meeting, the threshold was ≥80% of all participants voting for inclusion. The final core outcome set included 11 outcomes. The five maternal outcomes were as follows: maternal death, severe maternal morbidity, change in existing long-term conditions (physical and mental), quality and experience of care and development of new mental health conditions. The six child outcomes were as follows: survival of baby, gestational age at birth, neurodevelopmental conditions/impairment, quality of life, birth weight and separation of baby from mother for health care needs. CONCLUSIONS Multimorbidity in pregnancy is a new and complex clinical research area. Following a rigorous process, this complexity was meaningfully reduced to a core outcome set that balances the views of a diverse stakeholder group.
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Affiliation(s)
- Siang Ing Lee
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Stephanie Hanley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Zoe Vowles
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - Ngawai Moss
- Patient and public representative, London, UK
| | - Megha Singh
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Adeniyi Francis Fagbamigbe
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Amaya Azcoaga-Lorenzo
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
- Hospital Rey Juan Carlos, Instituto de Investigación Sanitaria Fundación Jimenez Diaz, Madrid, Spain
| | | | - Beck Taylor
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Christine Damase-Michel
- Medical and Clinical Pharmacology, School of Medicine, Université Toulouse III, Toulouse, France
- Center for Epidemiology and Research in Population Health (CERPOP), INSERM, Toulouse, France
| | - Christopher Yau
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
- Health Data Research UK, London, UK
| | - Colin McCowan
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Dermot O'Reilly
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
| | | | - Helen Dolk
- Centre for Maternal, Fetal and Infant Research, Ulster University, Belfast, UK
| | - Holly Hope
- Centre for Women's Mental Health, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK
| | - Katherine Phillips
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kathryn M Abel
- Centre for Women's Mental Health, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Kelly-Ann Eastwood
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
- St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Lisa Kent
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
| | - Louise Locock
- Health Services Research Unit, Health Sciences Building, Foresterhill, University of Aberdeen, Aberdeen, UK
| | - Maria Loane
- The Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Mohamed Mhereeg
- Data Science, Medical School, Swansea University, Swansea, UK
| | - Peter Brocklehurst
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sharon McCann
- Health Services Research Unit, Health Sciences Building, Foresterhill, University of Aberdeen, Aberdeen, UK
| | - Sinead Brophy
- Data Science, Medical School, Swansea University, Swansea, UK
| | - Steven Wambua
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Mairead Black
- Aberdeen Centre for Women's Health Research, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
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20
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Li Z, Jia Y, Parshley I, Zhang Y, Wang J, Long Q. Current prevalence, changes, and determinants of breastfeeding practice in China: data from cross-sectional national household health services surveys in 2013 and 2018. Int Breastfeed J 2023; 18:40. [PMID: 37568207 PMCID: PMC10416475 DOI: 10.1186/s13006-023-00572-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 07/10/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The World Health Organization and the government of China have made many efforts to improve breastfeeding practices. The evidence of breastfeeding practices over the past decade in China is limited. The current study aimed to describe the current prevalence, variation trends, and determinants of breastfeeding practices in China using data from the National Household Health Service Surveys (NHHSS) in 2013 and 2018. METHODS Women who had at least one live birth in the five years from the 2013 NHHSS numbered 10,544, and 12,766 women from the 2018 NHHSS were included in the current study. The rates of breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months since birth, and continued breastfeeding accompanied by adequate complementary feeding for over two years were measured. Logistic regressions were performed to study the associations between breastfeeding practices and maternal-based, healthcare-based, and infant-based characteristics. RESULTS In the 2018 survey, the rates of practiced any breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months, and continued breastfeeding for over two years were 91.50%, 28.16%, 47.90%, and 4.78%, respectively, showing significant improvements compared to the 2013 survey period. Women who received high education, were from a household with high incomes, had more than one child, and had more antenatal and postnatal visits, were more likely to practice breastfeeding and initiate it within the first hour, but they were less likely to breastfeed the infants for two years. Births by caesarean section and low birthweight were associated with worse breastfeeding practices. CONCLUSIONS The rates of practicing breastfeeding and exclusive breastfeeding for six months or more in China improved over the past decades, suggesting improved awareness and knowledge of breastfeeding among women. However, individual and social factors may impact practices of early initiation and continued breastfeeding. Strengthening breastfeeding support from family, community, and health professionals (e.g., family member engagement, friendly work environment, and professional consultation, etc.) during the postpartum and infant period may improve women's confidence in breastfeeding practices.
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Affiliation(s)
- Zeyu Li
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Yufei Jia
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Iris Parshley
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Yaoguang Zhang
- Centre for Health Statistics and Information, National Health Commission, 38 Beilishi Road, Xicheng, Beijing, 100810, NO, China.
| | - Jia Wang
- Yuzhong District Center for Diseases Prevention and Control, 254 Heping Road, Yuzhong District, Chongqing, 400010, China.
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
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21
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Lee SI, Hanley S, Vowles Z, Plachcinski R, Azcoaga-Lorenzo A, Taylor B, Nelson-Piercy C, McCowan C, O'Reilly D, Hope H, Abel KM, Eastwood KA, Locock L, Singh M, Moss N, Brophy S, Nirantharakumar K, Thangaratinam S, Black M. Key outcomes for reporting in studies of pregnant women with multiple long-term conditions: a qualitative study. BMC Pregnancy Childbirth 2023; 23:551. [PMID: 37528358 PMCID: PMC10391909 DOI: 10.1186/s12884-023-05773-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 06/10/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Maternal multiple long-term conditions are associated with adverse outcomes for mother and child. We conducted a qualitative study to inform a core outcome set for studies of pregnant women with multiple long-term conditions. METHODS Women with two or more pre-existing long-term physical or mental health conditions, who had been pregnant in the last five years or planning a pregnancy, their partners and health care professionals were eligible. Recruitment was through social media, patients and health care professionals' organisations and personal contacts. Participants who contacted the study team were purposively sampled for maximum variation. Three virtual focus groups were conducted from December 2021 to March 2022 in the United Kingdom: (i) health care professionals (n = 8), (ii) women with multiple long-term conditions (n = 6), and (iii) women with multiple long-term conditions (n = 6) and partners (n = 2). There was representation from women with 20 different physical health conditions and four mental health conditions; health care professionals from obstetrics, obstetric/maternal medicine, midwifery, neonatology, perinatal psychiatry, and general practice. Participants were asked what outcomes should be reported in all studies of pregnant women with multiple long-term conditions. Inductive thematic analysis was conducted. Outcomes identified in the focus groups were mapped to those identified in a systematic literature search in the core outcome set development. RESULTS The focus groups identified 63 outcomes, including maternal (n = 43), children's (n = 16) and health care utilisation (n = 4) outcomes. Twenty-eight outcomes were new when mapped to the systematic literature search. Outcomes considered important were generally similar across stakeholder groups. Women emphasised outcomes related to care processes, such as information sharing when transitioning between health care teams and stages of pregnancy (continuity of care). Both women and partners wanted to be involved in care decisions and to feel informed of the risks to the pregnancy and baby. Health care professionals additionally prioritised non-clinical outcomes, including quality of life and financial implications for the women; and longer-term outcomes, such as children's developmental outcomes. CONCLUSIONS The findings will inform the design of a core outcome set. Participants' experiences provided useful insights of how maternity care for pregnant women with multiple long-term conditions can be improved.
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Affiliation(s)
- Siang Ing Lee
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Stephanie Hanley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Zoe Vowles
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - Amaya Azcoaga-Lorenzo
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Beck Taylor
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Colin McCowan
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Dermot O'Reilly
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
| | - Holly Hope
- Centre for Women's Mental Health, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK
| | - Kathryn M Abel
- Centre for Women's Mental Health, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Kelly-Ann Eastwood
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
- St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Louise Locock
- Health Services Research Unit, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Megha Singh
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Ngawai Moss
- Patient and public representative, London, UK
| | - Sinead Brophy
- Data Science, Medical School, Swansea University, Swansea, UK
| | | | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Mairead Black
- Aberdeen Centre for Women's Health Research, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
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22
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Jackson C, Brawner J, Ball M, Crossley K, Dickerson J, Dharni N, Rodriguez DG, Turner E, Sheard L, Smith H. Being pregnant and becoming a parent during the COVID-19 pandemic: a longitudinal qualitative study with women in the Born in Bradford COVID-19 research study. BMC Pregnancy Childbirth 2023; 23:494. [PMID: 37403018 PMCID: PMC10320984 DOI: 10.1186/s12884-023-05774-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 06/10/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Uncertainty around the risk of COVID-19 to pregnant women and their babies prompted precautionary restrictions on their health and care during the pandemic. Maternity services had to adapt to changing Government guidance. Coupled with the imposition of national lockdowns in England and restrictions on daily activities, women's experiences of pregnancy, childbirth and the postpartum period, and their access to services, changed rapidly. This study was designed to understand women's experiences of pregnancy, labour and childbirth and caring for a baby during this time. METHODS This was an inductive longitudinal qualitative study, using in-depth interviews by telephone with women in Bradford, UK, at three timepoints during their maternity journey (18 women at timepoint one, 13 at timepoint two and 14 at timepoint three). Key topics explored were physical and mental wellbeing, experience of healthcare services, relationships with partners and general impact of the pandemic. Data were analysed using the Framework approach. A longitudinal synthesis identified over-arching themes. RESULTS Three longitudinal themes captured what was important to women: (1) women feared being alone at critical points in their maternity journey, (2) the pandemic created new norms for maternity services and women's care, and (3) finding ways to navigate the COVID-19 pandemic in pregnancy and with a baby. CONCLUSIONS Modifications to maternity services impacted significantly on women's experiences. The findings have informed national and local decisions about how best to direct resources to reduce the impact of COVID-19 restrictions and the longer-term psychological impact on women during pregnancy and postnatally.
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Affiliation(s)
- Cath Jackson
- Valid Research Ltd, Sandown House, Sandbeck Way, Wetherby, LS22 7DN, UK.
| | | | - Matthew Ball
- Justice Studio, 10 Portfleet Place, De Beauvoir Road, London, N1 5SZ, UK
| | - Kirsty Crossley
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Josie Dickerson
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Nimarta Dharni
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Ella Turner
- Justice Studio, 10 Portfleet Place, De Beauvoir Road, London, N1 5SZ, UK
| | - Laura Sheard
- York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD, York, UK
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23
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Alvarez M, Hotton EJ, Harding S, Ives J, Crofts JF, Wade J. Women's and midwives' views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study. Pilot Feasibility Stud 2023; 9:98. [PMID: 37322539 DOI: 10.1186/s40814-023-01330-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/26/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Recruitment to intrapartum research is complex. Women are expected to understand unfamiliar terminology and assess potential harm versus benefit to their baby and themselves, often when an urgent intervention is required. Time pressures of intrapartum interventions are a major challenge for recruitment discussions taking place during labour, with research midwives expected to present, discuss and answer questions whilst maintaining equipoise. However, little is known about these interactions. An integrated qualitative study (IQS) was used to investigate information provision for women invited to participate in the Assist II feasibility study investigating the OdonAssist™-a novel device for use in assisted vaginal birth with an aim to generate a framework of good practice for information provision. METHODS Transcripts of in-depth interviews with women participants (n = 25), with recruiting midwives (n = 6) and recruitment discussions between midwives and women (n = 21), accepting or declining participation, were coded and interpreted using thematic analysis and content analysis to investigate what was helpful to women and what could be improved. RESULTS Recruiting women to intrapartum research is complicated by factors that impact on women's understanding and decision-making. Three key themes were derived from the data: (i) a woman-centred recruitment process, (ii) optimising the recruitment discussion and (iii) making a decision for two. CONCLUSION Despite evidence from the literature that women would like information provision and the research discussion to take place in the antenatal period, intrapartum studies still vary in the recruitment processes they offer women. Particularly concerning is that some women are given information for the first time whilst in labour, when they are known to feel particularly vulnerable, and contextual factors may influence decision-making; therefore, we propose a framework for good practice for information provision for research involving interventions initiated in the intrapartum period as a woman centred, and acceptable model of recruitment, which addresses the concerns of women and midwives and facilitates fair inclusion into intrapartum trials. TRIAL REGISTRATION ISRCTN. This qualitative research was undertaken as part of the ASSIST II Trial (trial registration number: ISRCTN38829082. Prospectively registered on 26/06/2019).
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Affiliation(s)
- Mary Alvarez
- Department of Women's and Children's Health, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK.
- Bristol Medical School, Bristol University, BS8 2PS, Bristol, UK.
| | - Emily J Hotton
- Department of Women's and Children's Health, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK
- Translational Health Sciences, Bristol University, Bristol, UK
| | - Sam Harding
- Department of Women's and Children's Health, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK
- Research and Innovation, Learning and Research Building, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK
| | - Jonathan Ives
- Bristol Medical School, Bristol University, BS8 2PS, Bristol, UK
- Centre for Ethics in Medicine, Bristol University, Bristol, UK
| | - Joanna F Crofts
- Department of Women's and Children's Health, Southmead Hospital, North Bristol NHS Trust, BS10 5NB, Bristol, UK
| | - Julia Wade
- Bristol Medical School, Bristol University, BS8 2PS, Bristol, UK
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24
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Khan AG, West H, Razzaque A, Kuhn R. The effects of spousal migration on perinatal healthcare utilization. BMC Pregnancy Childbirth 2023; 23:434. [PMID: 37308841 PMCID: PMC10258923 DOI: 10.1186/s12884-023-05590-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 04/10/2023] [Indexed: 06/14/2023] Open
Abstract
Over the last three decades, out-migration has become a stable source of income for more than 12 million Bangladeshis. Of those migrants, 90% are men. Due to patriarchal cultural norms in Bangladeshi society, the migration of a male spouse may have significant consequences for the social well-being and health of left-behind women. In this study, we examine the impact of external (out of country) and internal (rural to urban) spousal migration on the perinatal healthcare utilization of left-behind women. We used data from the 2012 Matlab Health and Socioeconomic Survey (MHSS2) to examine use of antenatal care, presence of a medically qualified attendant at birth, and delivery at a healthcare facility for live births that occurred between 2007 and 2014 for currently married women aged 15-45 (N = 1,458 births among 1,180 women). Adjusted regression models indicated that for births occurring to women with a migrant spouse, odds of receiving antenatal care were significantly higher (OR: 4.1 for births to women with a domestic urban migrant spouse and 4.6 for births to women with an international migrant spouse, p < 0.01). Spousal migration was not linked to having a medically qualified attendant at birth or delivery at a clinic or hospital. Results suggest that spousal migration may be beneficial for receiving health care during a pregnancy, but not for the type of attendant or place of delivery at birth.
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Affiliation(s)
- Angubeen Gul Khan
- Department of Community Health Sciences, University of California, Los Angeles, USA
| | - Heidi West
- Department of Health Policy and Management, University of California, Los Angeles, USA
| | - Abdur Razzaque
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (Icddr,B), Dhaka, Bangladesh
| | - Randall Kuhn
- Department of Community Health Sciences, University of California, Los Angeles, USA
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25
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Marsh A, Hundley VA, Luce A, Richens Y. The perfect birth: a content analysis of midwives' posts about birth on Instagram. BMC Pregnancy Childbirth 2023; 23:422. [PMID: 37286939 DOI: 10.1186/s12884-023-05706-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/15/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND There is limited research into how midwives use social media within their professional role. Small pilot studies have explored the introduction of social media into maternity practice and teaching but there is little evidence around how midwives use social media professionally. This is important as 89% of pregnant women turn to social media for advice during pregnancy, and how midwives use social media could be influencing women, their perception of birth and their decision making. METHODS AIM: To analyse how popular midwives portray birth on the social media platform Instagram. This is an observational mixed methods study using content analysis. Five 'popular' midwives from each country (UK, New Zealand, USA and Australia) were identified and their posts about birth collated from a one-year period (2020-21). Images/videos were then coded. Descriptive statistics enabled comparison of the posts by country. Categorisation was used to analyse and understand the content. RESULTS The study identified 917 posts from the 20 midwives' accounts, containing 1216 images/videos, with most coming from USA (n = 466), and UK (n = 239), Australia (n = 205) and New Zealand (n = 7) respectively. Images/videos were categorised into 'Birth Positivity', 'Humour', 'Education', 'Birth Story' and 'Advertisement'. Midwives' portrayals of birth represented a greater proportion of vaginal births, waterbirths and homebirths than known national birth statistics. The most popular midwives identified mainly had private businesses (n = 17). Both the midwives and women portrayed in images were primarily white, demonstrating a disproportionate representation. CONCLUSION There is a small midwifery presence on Instagram that is not representative of the broader profession, or the current picture of midwifery care. This paper is the first study to explore how midwives are using the popular social media platform Instagram to portray birth. It provides insight into how midwives post an un-medicalised, low risk representation of birth. Further research is recommended to explore midwives' motivation behind their posts, and how pregnant and postnatal women engage with social media.
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Affiliation(s)
- Anna Marsh
- Centre for Midwifery Maternal & Perinatal Health, Bournemouth University, Bournemouth Gateway Building, St Pauls Lane, Bournemouth, BH8 8GP, UK.
- Elizabeth Garrett Anderson Unit, University College London Hospitals NHS Foundation Trust, 25 Grafton Way, London, WC1E 6DB, UK.
| | - Vanora A Hundley
- Centre for Midwifery Maternal & Perinatal Health, Bournemouth University, Bournemouth Gateway Building, St Pauls Lane, Bournemouth, BH8 8GP, UK
| | - Ann Luce
- Department of Journalism and Communication, Bournemouth University, Weymouth House, Talbot Campus, Fern Barrow, Poole, BH12 5BB, UK
| | - Yana Richens
- Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, L8 7SS, UK
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26
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Kazemi A, Beigi M, Najafabadi HE. Environmental factors influencing women's childbirth experiences in labor-delivery-recovery-postpartum unit: a qualitative cross-sectional study. BMC Pregnancy Childbirth 2023; 23:169. [PMID: 36915051 PMCID: PMC10009833 DOI: 10.1186/s12884-023-05488-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/02/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Women's experiences of birth environment influence their mental health and that of their families. Identifying women's childbirth experiences in the labor-delivery-recovery-postpartum unit (LDRP) unit can help design a peaceful environment. Therefore, this study aimed to evaluate environmental factors influencing women's childbirth experiences in LDRP unit. METHODS This qualitative cross-sectional study was conducted on 20 women with a childbirth experience in the LDRP unit. A purposive sampling was performed and continued until data saturation. The data were collected through unstructured interviews and analyzed using inductive content analysis. RESULTS Data analysis led to the extraction of three categories: physical security, a meaning-oriented environment, and physical comfort. The physical security category was obtained from three sub-categories: privacy, bed ergonomics, and the possibility of medical interventions. The meaning-oriented environment category was extracted from four sub-categories: promising symbols of becoming a mother, a peaceful environment, and a spiritual environment, and the physical comfort category was extracted from three sub-categories: minimizing noise pollution, ambient lighting, and LDRP internal design. CONCLUSIONS These study results showed that women's experience of giving birth in LDRP was accompanied by perceiving physical security, a meaning-oriented environment, and physical comfort. Moreover, the results indicated that the childbirth experience in the LDRP unit might be influenced by physical and emotional environmental factors. Therefore, in order to design a peaceful environment, it is necessary to take into account these factors.
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Affiliation(s)
- Ashraf Kazemi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Marjan Beigi
- Reproductive Health Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Hezarjerib Av., Isfahan, Iran
| | - Hajar Enteshary Najafabadi
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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27
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Engeltjes B, van Herk N, Visser M, van Wijk A, Cronie D, Rosman A, Scheele F, Wouters E. Patients' experiences with an obstetric telephone triage system: A qualitative study. Patient Educ Couns 2023; 108:107610. [PMID: 36584556 DOI: 10.1016/j.pec.2022.107610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/01/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Telephone Triage Systems aim to provide a uniform and practical system for healthcare professionals in order to prioritize urgency of care. A disadvantage of telephone triage system could be that the conversations are experienced as less personal, as it uses a uniform procedure for every patient. Therefore, aside from the clinical relevance, patient expectations, experiences and satisfaction were studied. OBJECTIVE The purpose of this study is to explore patients' experiences with obstetric telephone triage. METHODS A descriptive, qualitative design to explore experiences after triage with Dutch Obstetric Telephone Triage System. Participants, recruited from two Dutch hospitals, were pregnant women who received triage by telephone. Semi-structured interviews were held. The following topics were discussed: expectations before triage, experiences with triage, waiting time, information and communication, approach of healthcare professional, and quality of treatment. Data were analyzed using open, axial and selective coding. RESULTS Overall, the participants experienced the telephone conversation as satisfactory. This was due to the perceived professionalism with high accessibility and perceived reassurance. The approach of the professional was experienced as friendly and empathetic. Participants suggested that triage services could be improved by looking specifically at information provision. Explaining in advance how the service works can be helpful to create more awareness and to align better with expectations. CONCLUSION Participants reported that they could tell their own story and most participants realized that the professional asked extra questions in order to quantify the seriousness of the complaints. The level of involvement in the next steps of their care episode experienced by respondents lead us to conclude that the professional intended patient-centered care. PRACTICE IMPLICATIONS Improving the provision of information during waiting times and about the accessibility of the service can increase the quality of obstetric triage care. Patient involvement is necessary to increase trust and to meet the needs of the patient.
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Affiliation(s)
- Bernice Engeltjes
- Athena institute for transdisciplinary research, Faculty of science, VU University, Amsterdam, the Netherlands; Department of Healthcare Studies, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.
| | - Nikki van Herk
- Department of Obstetrics and Gynecology, IJsselland Hospital, Capelle aan den IJssel, the Netherlands
| | - Maud Visser
- Department of Obstetrics and Gynecology, Diakonessenhuis Hospital, Utrecht, the Netherlands
| | - Astrid van Wijk
- Department of Healthcare Education, OLVG Teaching Hospital, Amsterdam, the Netherlands
| | - Doug Cronie
- Department of Healthcare Studies, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Ageeth Rosman
- Department of Healthcare Studies, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Fedde Scheele
- Athena institute for transdisciplinary research, Faculty of science, VU University, Amsterdam, the Netherlands; Department of Obstetrics and Gynecology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Eveline Wouters
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
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Tania AT, Natalia AR, Verónica VB, Pilar MS, Rubén GF, Cristina LP. Social support and mental health in maternity: Effects of the COVID-19 pandemic. Midwifery 2023; 118:103580. [PMID: 36584610 PMCID: PMC9789545 DOI: 10.1016/j.midw.2022.103580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Motherhood involves a process of adaptation and the perception of social support influences mental health, breastfeeding or newborn care among others. The COVID-19 pandemic has generated a distancing from family, friends and health professionals. METHODS Quantitative, descriptive, cross-sectional study. The present study aims to describe and analyze the social support and mental health of mothers during this period. METHODS The sample were 179 women with children older than 6 months. The questionnaires used were the DUKE-UNC-11 and GHQ-12. Data analysis was carried out with Spearman's Rho and Mann Whitney U test. RESULTS 75.8% of the sample perceived normal social support during the pandemic. Within the dimensions of social support, women reported perceiving satisfactory confidential support, while affective support was perceived as low. Correlational analysis reported a significant relationship between mental health, confidential support and affective support. Group comparison noted greater confidential support in primiparous. CONCLUSIONS The sample is sensitive to changes originated by COVID-19 constraints influencing perceived social support and mental health. Affective and confidential support as well as the involvement of health professionals and the environment are fundamental for mental health during the first year of maternity. RELEVANCE TO CLINICAL PRACTICE Mothers' mental health is sensitive and vulnerable to social changes, in this case, those that occurred as a consequence of the COVID-19 outbreak.
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Affiliation(s)
| | - Arias-Ramos Natalia
- SALBIS Research Group, Facultad de Ciencias de la Salud, Universidad de León, Campus de Ponferrada s/n, Leon, Spain.
| | - Valle-Barrio Verónica
- Campus de Ponferrada, Universidad de León. Gerencia Regional de Salud (SACyL), León, Spain.
| | - Marqués-Sánchez Pilar
- SALBIS Research Group, Facultad de Ciencias de la Salud, Universidad de León, Campus de Ponferrada s/n, Leon, Spain.
| | - García-Fernández Rubén
- SALBIS Research Group, Facultad de Ciencias de la Salud, Universidad de León, Campus de Ponferrada s/n, Leon, Spain.
| | - Liébana-Presa Cristina
- SALBIS Research Group, Facultad de Ciencias de la Salud, Universidad de León, Campus de Ponferrada s/n, Leon, Spain.
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Harrison S, Alderdice F, Quigley MA. Impact of sampling and data collection methods on maternity survey response: a randomised controlled trial of paper and push-to-web surveys and a concurrent social media survey. BMC Med Res Methodol 2023; 23:10. [PMID: 36635637 PMCID: PMC9835028 DOI: 10.1186/s12874-023-01833-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Novel survey methods are needed to tackle declining response rates. The 2020 National Maternity Survey included a randomised controlled trial (RCT) and social media survey to compare different combinations of sampling and data collection methods with respect to: response rate, respondent representativeness, prevalence estimates of maternity indicators and cost. METHODS A two-armed parallel RCT and concurrent social media survey were conducted. Women in the RCT were sampled from ONS birth registrations and randomised to either a paper or push-to-web survey. Women in the social media survey self-selected through online adverts. The primary outcome was response rate in the paper and push-to-web surveys. In all surveys, respondent representativeness was assessed by comparing distributions of sociodemographic characteristics in respondents with those of the target population. External validity of prevalence estimates of maternity indicators was assessed by comparing weighted survey estimates with estimates from national routine data. Cost was also compared across surveys. RESULTS The response rate was higher in the paper survey (n = 2,446) compared to the push-to-web survey (n = 2,165)(30.6% versus 27.1%, difference = 3.5%, 95%CI = 2.1-4.9, p < 0.0001). Compared to the target population, respondents in all surveys were less likely to be aged < 25 years, of Black or Minority ethnicity, born outside the UK, living in disadvantaged areas, living without a partner and primiparous. Women in the social media survey (n = 1,316) were less representative of the target population compared to women in the paper and push-to-web surveys. For some maternity indicators, weighted survey estimates were close to estimates from routine data, for other indicators there were discrepancies; no survey demonstrated consistently higher external validity than the other two surveys. Compared to the paper survey, the cost saving per respondent was £5.45 for the push-to-web survey and £22.42 for the social media survey. CONCLUSIONS Push-to-web surveys may cost less than paper surveys but do not necessarily result in higher response rates. Social media surveys cost significantly less than paper and push-to-web surveys, but sample size may be limited by eligibility criteria and recruitment window and respondents may be less representative of the target population. However, reduced representativeness does not necessarily introduce more bias in weighted survey estimates.
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Affiliation(s)
- Siân Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus Headington, Oxford, OX3 7LF UK
| | - Fiona Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus Headington, Oxford, OX3 7LF UK
| | - Maria A. Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus Headington, Oxford, OX3 7LF UK
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Doherty E, Wiggers J, Wolfenden L, Tully B, Lecathelinais C, Attia J, Elliott EJ, Dunlop A, Symonds I, Rissel C, Tsang TW, Kingsland M. Differential effectiveness of a practice change intervention to improve antenatal care addressing alcohol consumption during pregnancy: Exploratory subgroup analyses within a randomised stepped-wedge controlled trial. Midwifery 2023; 116:103528. [PMID: 36334528 DOI: 10.1016/j.midw.2022.103528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE A practice change intervention demonstrated improvements in the provision of antenatal care addressing alcohol consumption. The aim of this study was to explore whether the effectiveness of the intervention differed between subgroups of pregnant women and types and location of maternity services. DESIGN AND SETTING Post-hoc exploratory subgroup analyses of the outcomes from a randomised stepped-wedge controlled trial conducted with all public maternity services within three sectors of a local health district in Australia. MEASUREMENTS Two outcomes (receipt of alcohol assessment and complete care) measured at two visit types (initial and subsequent) were included in analyses. Logistic regression models explored interactions between pre-post differences and subgroups of women (age, Aboriginal origin, education level, disadvantage, gravidity and alcohol consumption in pregnancy) and services (geographic remoteness, service and provider type/s) that have been reported to be associated with variation in guideline implementation. FINDINGS Surveys from 5694 women were included in the analyses. For the initial visit, no significant differential intervention effects between subgroups of women or type/location of services were found for either outcome. For subsequent visits, the intervention effect differed significantly only between Aboriginal origin subgroups (Aboriginal OR: 1.95; 95% CI: 0.99-3.85; non-Aboriginal OR: 5.34; 95% CI: 4.17-6.83; p<0.01) and women's alcohol consumption in pregnancy subgroups (consumed alcohol OR: 1.28; 95% CI: 0.59-2.78; not consumed alcohol OR: 5.22; 95% CI: 4.11-6.65; p<0.001) for assessment of alcohol consumption. KEY CONCLUSIONS These exploratory results suggest that the intervention may have had similar effects between different subgroups of women and types and location of services, with the exception of women who were non-Aboriginal and women who had not consumed alcohol, for whom the intervention was potentially more effective. IMPLICATIONS FOR PRACTICE The practice change intervention could be implemented with different maternity service and provider types to effectively support improvements in antenatal care addressing alcohol consumption. These exploratory results provide further data for hypothesis generation regarding targeted areas for the testing of additional strategies that enable Aboriginal women to benefit equally from the intervention, and to ensure those women most in need of care, those consuming alcohol during pregnancy, have their care needs met.
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Affiliation(s)
- Emma Doherty
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales 2287, Australia; School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305, Australia.
| | - John Wiggers
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales 2287, Australia; School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305, Australia
| | - Luke Wolfenden
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales 2287, Australia; School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305, Australia
| | - Belinda Tully
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales 2287, Australia
| | - Christophe Lecathelinais
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales 2287, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, The University of Sydney, New South Wales 2006, Australia; Sydney Children's Hospital Network, Kids' Research Institute, Westmead, New South Wales 2145, Australia
| | - Adrian Dunlop
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305, Australia; Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales 2302, Australia
| | - Ian Symonds
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Chris Rissel
- College of Medicine and Public Health, Flinders University, Casuarina, Northern Territory 0909, Australia
| | - Tracey W Tsang
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, The University of Sydney, New South Wales 2006, Australia; Sydney Children's Hospital Network, Kids' Research Institute, Westmead, New South Wales 2145, Australia
| | - Melanie Kingsland
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales 2287, Australia; School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305, Australia
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Ducros M, Tourneux P, Fontaine C. Early discharge from maternity ward in response to the COVID-19 pandemic: Impact on emergency attendance. Arch Pediatr 2023; 30:25-30. [PMID: 36481161 PMCID: PMC9682060 DOI: 10.1016/j.arcped.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND In response to the coronavirus disease 2019 (COVID-19) epidemic, our maternity department had to rapidly implement a protocol for early postpartum discharge. We evaluated the benefits and risks of early postpartum discharge. METHODS We performed an observational, single-center case-control study over a 3 month-period during the COVID-19 outbreak (from June 1 to August 31, 2020), following implementation of the early discharge policy. Newborns were classified into an early discharge group (within 48-72 h of a vaginal delivery and within 72-96 h of a cesarean delivery) or a standard discharge group (more than 72 h after a vaginal delivery and more than 96 h after a cesarean delivery). The primary outcome measure was inappropriate pediatric emergency department visits within 28 days of delivery. RESULTS A total of 546 newborns were included. A total of 22 (8.9%) of the 246 newborns in the early discharge group attended the pediatric emergency department vs. 30 (10.0%) of the 300 newborns in the standard discharge group (p = 0.65). Nine visits (40.9%) were considered inappropriate in the early discharge group vs. 13 (43.3%) in the standard discharge group (p = 0.83). Likewise, the intergroup difference in the hospital readmission rate was not statistically significant. DISCUSSION The implementation of early discharge and early follow-up did not result in a significantly greater need (vs. standard discharge) for inappropriate emergency visit or hospital readmission during the first 28 days postpartum, regardless of the parity and breastfeeding status.
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Affiliation(s)
- M. Ducros
- Neonatal Intensive Care Unit, Amiens University Medical Center, Amiens, France
| | - P. Tourneux
- Neonatal Intensive Care Unit, Amiens University Medical Center, Amiens, France,PériTox UMR_I 01, UFR de médecine, Université de Picardie Jules Verne, Amiens, France
| | - C. Fontaine
- Neonatal Intensive Care Unit, Amiens University Medical Center, Amiens, France,Corresponding author at: Neonatal Intensive Care Unit, Amiens University Hospital, 1 rue du Professeur Christian Cabrol, F-80054 Amiens cedex 1, France
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Hards A, Cameron A, Sullivan E, Kornelsen J. Actualizing community-academic partnerships in research: a case study on rural perinatal peer support. Res Involv Engagem 2022; 8:73. [PMID: 36529798 PMCID: PMC9760182 DOI: 10.1186/s40900-022-00407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Within the field of patient and public involvement in health service research, there is a growing movement towards not only involving patients in research but engaging them as co-producers of knowledge. We explore such a co-productive research relationship in a case study on rural perinatal mental health, with the aim of collaboratively developing knowledge based on both the relevant lived experience of a community partner, and the systemic knowledge of academic researchers. METHODS Data was gathered through a community forum and subsequent interviews with social service program administrators from rural British Columbia, Canada. Interviews were analyzed separately by the community partner and academic researchers using principles of thematic analysis. Both the community partner and academic researchers were involved from project genesis to data collection, analysis, interpretation, and manuscript writing. RESULTS Common themes identified by the academic and community researchers included needs for peer support, barriers to peer support, and gaps in mental health care. Divergently, the academic researcher focused on systems-level challenges while the community partner emphasized the impact of power dynamics within health systems. Researchers generated five methodological values propositions from the process of co-production, including (a) mutual respect for all viewpoints, (b) a rejection of assumed hierarchy, (c) commitments to truth speaking, (d) attention to process, and (e) equivalence of contribution. CONCLUSIONS Co-production highlights the value of lived experience in health research, sets it in conversation with scientific inquiry, and moves away from hierarchies of assumed knowledge often embedded in traditional health care research. Incorporating both academic researcher and community partner writing into our paper reflects a commitment to maintaining the integrity and authenticity of lived experience, an affirmation of its equal validity as a source of knowledge, and a rejection of qualifying patient voices. The exploration of this co-production research relationship lays groundwork for future research teams considering collaborative methodology. We suggest co-productive research as a means of addressing the epistemic injustice that arises in health care research from the privileging of certain forms of knowledge, and the exclusion of others, namely that derived from patient experience.
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Affiliation(s)
| | - Audrey Cameron
- Centre for Rural Health Research, Department of Family Practice, University of British Columbia, 3rd Floor David Strangway Building, 5950 University Boulevard, Vancouver, BC, V6T1Z3, Canada
| | - Eva Sullivan
- Centre for Rural Health Research, Department of Family Practice, University of British Columbia, 3rd Floor David Strangway Building, 5950 University Boulevard, Vancouver, BC, V6T1Z3, Canada
| | - Jude Kornelsen
- Centre for Rural Health Research, Department of Family Practice, University of British Columbia, 3rd Floor David Strangway Building, 5950 University Boulevard, Vancouver, BC, V6T1Z3, Canada.
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Sharma S, Rodrigues PR, Zaher S, Davies LC, Ghazal P. Immune-metabolic adaptations in pregnancy: A potential stepping-stone to sepsis. EBioMedicine 2022; 86:104337. [PMID: 36470829 PMCID: PMC9782817 DOI: 10.1016/j.ebiom.2022.104337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/30/2022] [Accepted: 10/17/2022] [Indexed: 12/04/2022] Open
Abstract
Physiological shifts during pregnancy predispose women to a higher risk of developing sepsis resulting from a maladapted host-response to infection. Insightful studies have delineated subtle point-changes to the immune system during pregnancy. Here, we present an overlay of these point-changes, asking what changes and when, at a physiological, cellular, and molecular systems-level in the context of sepsis. We identify distinct immune phases in pregnancy delineated by placental hormone-driven changes in homeostasis setpoints of the immune and metabolic systems that subtly mirrors changes observed in sepsis. We propose that pregnancy immune-metabolic setpoint changes impact feedback thresholds that increase risk for a maladapted host-response to infection and thus act as a stepping-stone to sepsis. Defining maternal immune-metabolic setpoint changes is not only vital for tailoring the right diagnostic tools for early management of maternal sepsis but will facilitate an unravelling of the pathophysiological pathways that predispose an individual to sepsis.
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Affiliation(s)
- Simran Sharma
- Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK,Department of Obstetrics & Gynaecology, University Hospital of Wales, Cardiff, CF14 4XW, UK,Corresponding author. Department of Obstetrics & Gynaecology, University Hospital of Wales, Cardiff, CF14 4XW, UK.
| | - Patricia R.S. Rodrigues
- Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK
| | - Summia Zaher
- Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK,Department of Obstetrics & Gynaecology, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Luke C. Davies
- Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK,Biomedical Sciences Unit, Swansea University Medical School, Singleton Park, Swansea, SA2 8PP, UK
| | - Peter Ghazal
- Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK,Corresponding author. Systems Immunity Research Institute, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK.
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McHugh S, Sheard L, O'Hara J, Lawton R. The feasibility and acceptability of implementing video reflexive ethnography (VRE) as an improvement tool in acute maternity services. BMC Health Serv Res 2022; 22:1308. [PMID: 36324173 PMCID: PMC9629879 DOI: 10.1186/s12913-022-08713-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/20/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Video-reflexive ethnography (VRE) has been argued to be an alternative approach to collaborative learning in healthcare teams, more able to capture the complexities of the healthcare environment than simulation. This study aims to explore the feasibility and acceptability of employing VRE as an improvement tool in acute maternity services. METHOD Focused ethnography and semi-structured interviews (n = 17) explored the feasibility of employing VRE from the perspective of the researcher-facilitator, and that of the healthcare staff participants. Reflexive thematic analysis was used to generate key themes. RESULTS We identified four themes related to feasibility of employing VRE as an improvement approach: laying the groundwork; challenges of capturing in-situ video footage; effective facilitation of reflexive feedback; and, power to change. Of note was the central role of the facilitator in building and maintaining staff trust in the process, particularly in being able to guide collaborative, non-punitive discussion during reflexive feedback sessions. Interestingly, when considering implementation of change, structural hierarchies were evident with more senior staff better able to develop and effect ideas. Two themes related to acceptability of VRE among healthcare staff were identified: staff response to the role of VRE in improvement; and the power of a different perspective. Staff were overwhelmingly positive about their experience of VRE, particularly appreciating the time, space and autonomy it afforded them to navigate and articulate ideas for change and improvement. CONCLUSION VRE is both feasible and acceptable as an improvement tool with acute, multi-disciplinary maternity staff teams. It is an important healthcare improvement tool that could prompt the development and maintenance of team resilience factors in the face of increasing stress and burn-out of healthcare staff in maternity services.
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Affiliation(s)
- Siobhan McHugh
- School of Healthcare, University of Leeds, Baines Wing, Leeds, LS2 9JT, UK. .,School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.
| | - Laura Sheard
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Jane O'Hara
- School of Healthcare, University of Leeds, Baines Wing, Leeds, LS2 9JT, UK
| | - Rebecca Lawton
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
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Vasilevski V, Ryan D, Crowe G, Askern A, McCormick M, Segond S, Sweet L. Evaluating the implementation of the Birmingham Symptom-specific Obstetric Triage System (BSOTS) in Australia. Women Birth 2022; 36:290-298. [PMID: 36127283 DOI: 10.1016/j.wombi.2022.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obstetric triage is usually undertaken by a midwife and involves conducting a physical assessment to identify a woman's presenting problem. The Birmingham Symptom-specific Obstetric Triage System (BSOTS) was developed in the United Kingdom (UK) to overcome challenges associated with triaging women by standardising the maternity triage process. The Australian study site is the first hospital outside the UK to implement this approach. AIM To evaluate the implementation of the BSOTS in an Australian tertiary maternity service. METHODS A multi-method approach including pre-implementation BSOTS education evaluations (n = 26), post-implementation clinical data audit (n = 660), and staff focus groups (n = 9) was undertaken. Participants included midwives who worked in the Maternity Assessment Centre. Data of women who had attended the service during BSOTS implementation was analysed in the audit component. FINDINGS Staff valued the BSOTS standardised approach to maternity triage, particularly for midwives new to the role. The retrospective audit showed that time to triage and time to care outcomes for women improved from pre-implementation audits and were mostly adhering to auditable standards. Lack of knowledge amongst staff (especially medical staff) regarding the BSOTS was considered a barrier to the effective flow of care of women through the centre. DISCUSSION The BSOTS is a useful approach for prioritising women's care. Ensuring that all staff are aware of the system and its benefits is likely to enhance implementation and improve triage outcomes. CONCLUSION The BSOTS is an innovative midwife led practice change that is applicable to the Australian context, and benefits women, midwives, and the maternity service.
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Affiliation(s)
- Vidanka Vasilevski
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia.
| | | | | | | | | | | | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
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Ewesesan R, Chartier MJ, Nickel NC, Wall-Wieler E, Urquia ML. Psychosocial and behavioral health indicators among immigrant and non-immigrant recent mothers. BMC Pregnancy Childbirth 2022; 22:612. [PMID: 36008777 PMCID: PMC9413808 DOI: 10.1186/s12884-022-04937-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perinatal risk factors can vary by immigration status. We examined psychosocial and behavioral perinatal health indicators according to immigration status and immigrant characteristics. METHODS We conducted a population-based cross-sectional study of 33,754 immigrant and 172,342 non-immigrant childbearing women residents in Manitoba, Canada, aged 15-55 years, who had a live birth and available data from the universal newborn screen completed within 2 weeks postpartum, between January 2000 and December 2017. Immigration characteristics were from the Canadian federal government immigration database. Logistic regressions models were used to obtain Odds Ratios (OR) with 95% confidence intervals (CI) for the associations between immigration characteristics and perinatal health indicators, such as social isolation, relationship distress, partner violence, depression, alcohol, smoking, substance use, and late initiation of prenatal care. RESULTS More immigrant women reported being socially isolated (12.3%) than non-immigrants (3.0%) (Adjusted Odds Ratio (aOR): 6.95, 95% CI: 6.57 to 7.36) but exhibited lower odds of depression, relationship distress, partner violence, smoking, alcohol, substance use, and late initiation of prenatal care. In analyses restricted to immigrants, recent immigrants (< 5 years) had higher odds of being socially isolated (aOR: 9.04, 95% CI: 7.48 to 10.94) and late initiation of prenatal care (aOR: 1.50, 95% CI: 1.07 to 2.12) compared to long-term immigrants (10 years or more) but lower odds of relationship distress, depression, alcohol, smoking and substance use. Refugee status was positively associated with relationship distress, depression, and late initiation of prenatal care. Secondary immigrants, whose last country of permanent residence differed from their country of birth, had lower odds of social isolation, relationship distress, and smoking than primary migrants. There were also differences by maternal region of birth. CONCLUSION Immigrant childbearing women had a higher prevalence of social isolation but a lower prevalence of other psychosocial and behavioral perinatal health indicators than non-immigrants. Health care providers may consider the observed heterogeneity in risk to tailor care approaches for immigrant subgroups at higher risk, such as refugees, recent immigrants, and those from certain world regions.
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Affiliation(s)
- Roheema Ewesesan
- Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Mariette J Chartier
- Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Nathan C Nickel
- Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Elizabeth Wall-Wieler
- Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Marcelo L Urquia
- Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. .,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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Dietz P, Legat L, Sattler MC, van Poppel MNM. Triple careers of athletes: exploring the challenges of planning a pregnancy among female elite athletes using semi-structured interviews. BMC Pregnancy Childbirth 2022; 22:643. [PMID: 35971097 PMCID: PMC9377111 DOI: 10.1186/s12884-022-04967-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background The challenging factors that elite athletes perceive for combining their sportive career with planning a pregnancy and motherhood need to be identified in order to develop supportive measures. Therefore, this phenomenological qualitative study aimed to explore challenges associated with planning a pregnancy among female, non-pregnant elite athletes. Methods Semi-structured skype-interviews were performed among female elite athletes (athletes competing on national or international level) aged 28 years or older. Using Mayring’s qualitative content analysis approach, anchor examples served to identify potential challenges of planning a pregnancy which were categorized independently by two researchers. Results Interviews of 16 elite athletes (mean age 30.7 years) entered analysis. Eleven challenges of planning a pregnancy were identified, categorized into organizational / environmental, financial, personal, and physical factors. Conclusions With regard to financial challenges, we propose mandatory maternity leave and continuation of the contracts and salary. Furthermore, mentoring programs may help to provide support and advice to new generations of female elite athletes and help to reduce concerns regarding the wish of becoming pregnant during a sportive career. In order to reduce physical concerns regarding pregnancy and exercise, we see a need for scientific studies investigating the association of sport discipline specific characteristics on sportive performance and the mother´s, fetus’ and child´s health. Finally, the results of the current study may be used in future quantitative studies to test specific hypotheses.
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Affiliation(s)
- Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre, University of Mainz, Mainz, Germany.
| | - Larissa Legat
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre, University of Mainz, Mainz, Germany
| | - Matteo C Sattler
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
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Due C, Walsh M, Aldam I, Winter A, Cooper S, Sheriff J, Ziersch A. Perinatal care for women with refugee backgrounds from African countries: a qualitative study of intersections with psychological wellbeing. BMC Pregnancy Childbirth 2022; 22:628. [PMID: 35941567 PMCID: PMC9358632 DOI: 10.1186/s12884-022-04957-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Experiences with healthcare services, including perinatal healthcare services, contribute to psychological wellbeing for refugees post-resettlement. To address the paucity of literature examining the relationship between perinatal healthcare and psychological wellbeing in women with refugee backgrounds from African countries this study aimed to: (1) understand the relationship between psychological wellbeing and perinatal care amongst this population, and; (2) identify areas for improved perinatal healthcare services to ensure positive wellbeing outcomes in this population. Methods A total of 39 participants were included in the study. Nineteen women from seven African countries participated in interviews – seven both prior to and after having their babies, two only while pregnant and ten only after their baby had been born. In addition, interviews were conducted with 20 service providers. Interviews were thematically analysed. Results Four key themes were identified, covering continuity of care, cultural safety of care, agency in decision making, and ongoing impacts of perinatal care experiences. Conclusions The results highlighted the need for changes to perinatal healthcare provision at the systems level, including implementing a continuity of care model, and ensuring women’s access to individualised, trauma-informed perinatal services which attend to the cultural and psychosocial resettlement needs of this population. These findings informed recommendations for improving perinatal healthcare services and better psychological outcomes – and in turn broader health outcomes – for African-background refugee mothers.
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Affiliation(s)
- Clemence Due
- The School of Psychology, The University of Adelaide, Adelaide, SA, Australia. .,College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
| | - Moira Walsh
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Isadora Aldam
- The School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Amelia Winter
- The School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Susan Cooper
- Flinders Medical Centre, Adelaide, SA, Australia
| | - Josephine Sheriff
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Anna Ziersch
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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Barrett NM, Burrows L, Atatoa-Carr P, Smith LT, Masters-Awatere B. Holistic antenatal education class interventions: a systematic review of the prioritisation and involvement of Indigenous Peoples' of Aotearoa New Zealand, Australia, Canada and the United States over a 10-year period 2008 to 2018. Arch Public Health 2022; 80:169. [PMID: 35836247 PMCID: PMC9281049 DOI: 10.1186/s13690-022-00927-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research into the effectiveness of antenatal education classes is crucial for Indigenous Peoples from Aotearoa New Zealand, Australia, Canada and the United States who experience poorer maternal and infant health outcomes compared to non-Indigenous populations. Our systematic review questions were intended to determine the extent of Indigenous Peoples prioritisation and involvement in antenatal education classes, and to understand the experience of Indigenous Peoples from these countries in antenatal education classes. METHODS Using a standardised protocol, we systematically searched five electronic databases for primary research papers on antenatal education classes within the four countries noted and identified 17 papers that met the criteria. We undertook a qualitative meta-synthesis using a socio-critical lens. RESULTS Systematic review of the academic literature demonstrates that Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States are not prioritised in antenatal education classes with only two of 17 studies identifying Indigenous participants. Within these two studies, Indigenous Peoples were underrepresented. As a result of poor engagement and low participation numbers of Indigenous Peoples in these antenatal education classes, it was not possible to understand the experiences of Indigenous Peoples. CONCLUSION Given that Indigenous Peoples were absent from the majority of studies examined in this review, it is clear little consideration is afforded to the antenatal health needs and aspirations of Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States. To address the stark antenatal health inequities of Indigenous Peoples, targeted Indigenous interventions that consider culture, language, and wider aspects of holistic health must be privileged. TRIAL REGISTRATION PROSPERO Registration ID: CRD4202017658.
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Affiliation(s)
- Nikki M Barrett
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.
| | - Lisette Burrows
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | - Polly Atatoa-Carr
- National Institute of Demographic and Economic Analysis, University of Waikato, Hamilton, New Zealand
| | - Linda T Smith
- Te Whare Wānanga o Awanuiārangi, Whakatane, New Zealand
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Akerstrom M, Carlsson Y, Sengpiel V, Veje M, Elfvin A, Jonsdottir IH, Degl'Innocenti A, Ahlstrom L, Wijk H, Linden K. Working conditions for hospital-based maternity and neonatal health care workers during extraordinary situations - A pre-/post COVID-19 pandemic analysis and lessons learned. Sex Reprod Healthc 2022; 33:100755. [PMID: 35853385 PMCID: PMC9273518 DOI: 10.1016/j.srhc.2022.100755] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022]
Abstract
Objective The aim of this study was to investigate how the changed work routines during the COVID-19 pandemic has been affecting the working environment for hospital-based maternity and neonatal health care workers, and to identify preventive measures to be used in future situations when health care organizations are under pressure. Methods All maternity and neonatal health care workers in a Swedish university hospital were surveyed during October 2019 and September 2020. The data was analyzed by document analysis of implemented changes in working routines, a quantitative analysis of the overall effects on the working conditions, and a qualitative analysis of open-ended responses. Results A total of 660 maternity and neonatal health care workers completed the pre-COVID-19 survey (74% response rate) and 382 the COVID-19 survey (35% response rate). Lack of personal protective equipment, worry about becoming infected, uncertainty whether implemented changes were enough, and challenges in communicating updated routines had negative effects on maternity and neonatal health care workers’ working conditions. Team spirit and feeling valued by peers had a positive effect. Conclusions Results suggest that negative effects on maternity and neonatal health care workers’ health can partly be prevented in future critical situations by creating a work climate that acknowledges the employees’ worry about being infected, securing adequate pre-conditions for managers, creating a strong psychosocial safety climate and systematically improving the working conditions for the maternity and neonatal health care workers, as well as maintaining the positive perceived effects of increased team spirit and feeling valued by peers.
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Affiliation(s)
- Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Ylva Carlsson
- Region Västra Götaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Verena Sengpiel
- Region Västra Götaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Malin Veje
- Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Elfvin
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Department of Paediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Alessio Degl'Innocenti
- Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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Shikuku DN, Nyaoke I, Maina O, Eyinda M, Gichuru S, Nyaga L, Iman F, Tallam E, Wako I, Bashir I, Allott H, Ameh C. The determinants of staff retention after Emergency Obstetrics and Newborn Care training in Kenya: a cross-sectional study. BMC Health Serv Res 2022; 22:872. [PMID: 35794569 PMCID: PMC9261014 DOI: 10.1186/s12913-022-08253-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/27/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction Kenya’s maternal mortality ratio is relatively high at 342/100,000 live births. Confidential enquiry into maternal deaths showed that 90% of the maternal deaths received substandard care with health workforce related factors identified in 75% of 2015/2016 maternal deaths. Competent Skilled Health Personnel (SHP) providing emergency obstetric and newborn care (EmONC) in an enabling environment reduces the risk of adverse maternal and newborn outcomes. The study objective was to identify factors that determine the retention of SHP 1 – 5 years after EmONC training in Kenya. Methods A cross-sectional review of EmONC SHP in five counties (Kilifi, Taita Taveta, Garissa, Vihiga and Uasin Gishu) was conducted between January–February 2020. Data was extracted from a training database. Verification of current health facilities where trained SHP were deployed and reasons for non-retention were collected. Descriptive data analysis, transfer rate by county and logistic regression for SHP retention determinants was performed. Results A total of 927 SHP were trained from 2014–2019. Most SHP trained were nurse/midwives (677, 73%) followed by clinical officers (151, 16%) and doctors (99, 11%). Half (500, 54%) of trained SHP were retained in the same facility. Average trained staff transfer rate was 43%, with Uasin Gishu lowest at 24% and Garissa highest at 50%. Considering a subset of trained staff from level 4/5 facilities with distinct hospital departments, only a third (36%) of them are still working in relevant maternity/newborn/gynaecology departments. There was a statistically significant difference in transfer rate by gender in Garissa, Vihiga and the combined 5 counties (p < 0.05). Interval from training in years (1 year, AOR = 4.2 (2.1–8.4); cadre (nurse/midwives, AOR = 2.5 (1.4–4.5); and county (Uasin Gishu AOR = 9.5 (4.6- 19.5), Kilifi AOR = 4.0 (2.1–7.7) and Taita Taveta AOR = 1.9 (1.1–3.5), p < 0.05, were significant determinants of staff retention in the maternity departments. Conclusion Retention of EmONC trained SHP in the relevant maternity departments was low at 36 percent. SHP were more likely to be retained by 1-year after training compared to the subsequent years and this varied from county to county. County policies and guidelines on SHP deployment, transfers and retention should be strengthened to optimise the benefits of EmONC training.
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Affiliation(s)
- Duncan N Shikuku
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya.
| | - Irene Nyaoke
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | - Onesmus Maina
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | - Martin Eyinda
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | - Sylvia Gichuru
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | - Lucy Nyaga
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | | | | | - Ibrahim Wako
- Clinical Officers Council of Kenya, Nairobi, Kenya
| | - Issak Bashir
- Department of Family Health, Ministry of Health, Nairobi, Kenya
| | - Helen Allott
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Charles Ameh
- Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
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Joensuu JM, Saarijärvi H, Rouhe H, Gissler M, Ulander VM, Heinonen S, Torkki P, Mikkola TS. Maternal childbirth experience and induction of labour in each mode of delivery: a retrospective seven-year cohort study of 95,051 parturients in Finland. BMC Pregnancy Childbirth 2022; 22:508. [PMID: 35739476 PMCID: PMC9229460 DOI: 10.1186/s12884-022-04830-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Childbirth experience has been shown to depend on the mode of delivery. However, it is unclear how labour induction influences the childbirth experience in different modes of delivery. Thus, we assessed the childbirth experience among mothers with spontaneous and induced labours. Design A retrospective cohort study. Setting Childbirths in four delivery hospitals in Helsinki and Uusimaa District, Finland, in 2012-2018. Sample 95051 childbirths excluding elective caesarean sections. Methods Obstetric data combined to maternal childbirth experience measured by Visual Analogue Scale (VAS) was analysed with univariate linear modelling and group comparisons. The primiparas and multiparas were analysed separately throughout the study due to the different levels of VAS. Main outcome measures Maternal childbirth experience measured by VAS. Results The negative effect of labour induction on the childbirth experience was discovered in each mode of delivery. Operative deliveries were perceived more negatively when they were preceded by labour induction. The rate of poor childbirth experience (VAS≤5) was higher for mothers with labour induction (ORs varying from 1.43 to 1.77) except in emergency caesarean sections. The negative effect of labour induction was smaller than the effect of mode of delivery, while successful vaginal delivery with induction (meanPRIMI=8.00 [95% CI 7.96–8.04], meanMULTI=8.50 [8.47–8.53]) was perceived more positive than operational deliveries with spontaneous labour (meansPRIMI≤7.66 [7.61–7.70], meansMULTI≤7.96 [7.89–8.03]). However, labour induction more than doubled the risk of caesarean section for both primiparas and multiparas. Conclusions Labour induction generates more negative experiences for both primiparas and multiparas. The negative effect of labour induction is detected for all modes of delivery, being worst among labour induction resulting in operative delivery. The parturients facing cumulative obstetric interventions require special support and counselling during and after delivery. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04830-9.
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Affiliation(s)
- Johanna M Joensuu
- Helsinki University Hospital, Obstetrics and Gynecology, Haartmaninkatu 2 PL 140, Helsinki, 00029, Finland. .,Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Hannu Saarijärvi
- Tampere University, Faculty of Management and Business, Tampere, Finland
| | - Hanna Rouhe
- University of Helsinki and Helsinki University Hospital, Obstetrics and Gynecology, Helsinki, Finland
| | - Mika Gissler
- Finnish Institute for Health and Welfare, Information Services Department, Helsinki, Finland.,Karolinska Institute, Department of Molecular Medicine and Surgery, Stockholm, Sweden.,Academic Primary Health Care Centre, Stockholm, Region Stockholm, Sweden
| | - Veli-Matti Ulander
- University of Helsinki and Helsinki University Hospital, Obstetrics and Gynecology, Helsinki, Finland
| | - Seppo Heinonen
- University of Helsinki and Helsinki University Hospital, Obstetrics and Gynecology, Helsinki, Finland
| | - Paulus Torkki
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tomi S Mikkola
- University of Helsinki and Helsinki University Hospital, Obstetrics and Gynecology, Helsinki, Finland.,Folkhälsan Research Center, Biomedicum, Helsinki, Finland
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Hanley SJ, Jones AB, Baxter E, Sharkey D, Gray J, Walker KF. Implementation of Public Health England Infection Prevention and Control Guidance in Maternity Units in response to the COVID-19 pandemic. J Hosp Infect 2022:S0195-6701(22)00135-9. [PMID: 35588996 DOI: 10.1016/j.jhin.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/20/2022]
Abstract
Background This study aimed to explore the successes and barriers to the implementation of Public Health England (PHE) infection prevention and control guidance in English maternity units during the COVID-19 pandemic. Methods Qualitative semi-structured interviews with obstetricians, midwives and neonatologists who worked in a maternity unit in England, UK, between March 2020 and July 2021. A thematic analysis was performed. Results Successes to the implementation of PHE guidance were related to existing infrastructure, training satisfaction, and organisational culture where subthemes considered the importance of a multidisciplinary approach, COVID-19 dedicated roles and hospital-wide communication. Barriers to implementation related to the applicability of the guidance with subthemes highlighting contradictions between updates, specialties and hospitals, undesirable timings and frequency of guidance updates, reductions in staff compliance and delayed implementation. Finally, the layout of some units made it difficult to implement various aspects of the guidance (e.g., social distancing), and many detailed issues related to information technology compatibility, a lack of availability and accessibility to appropriate personal protective equipment (PPE), and variations in testing arrangements between units. Conclusions This research provides information on the experiences of healthcare professionals working on maternity units during the COVID-19 pandemic. Findings illustrate the importance of effective hospital-wide communication and the need for consistent, easily understood guidance. These results will be used to inform the content of an expert panel consensus meeting.
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Vendittelli F. [How to prepare for the V2020 certification visit by the French Health Authority in a maternity ward?]. Gynecol Obstet Fertil Senol 2022; 50:409-414. [PMID: 35124275 DOI: 10.1016/j.gofs.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
Although certification in France is at the health establishment level, maternity wards are directly and indirectly concerned by the certification of their establishment. The purpose of this article is to help perinatal caregivers in maternity wards to prepare, as well as possible, for the certification visit of their establishment. The 7 stages of preparation for the visit are explained with concrete examples from the Haute Autorité de santé (HAS) certification guide. With good organization, the certification visit can go stress-free and professionals will be ready to meet HAS experts.
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Affiliation(s)
- F Vendittelli
- CNRS, Clermont Auvergne INP, institut Pascal, CHU, université Clermont-Auvergne, 63000 Clermont-Ferrand, France; Audipog, université Claude-Bernard Lyon 1-Laennec, Lyon, France.
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Hanrahan V, Biesty L, Lawrie L, Duncan E, Gillies K. Theory-guided interviews identified behavioral barriers and enablers to healthcare professionals recruiting participants to maternity trials. J Clin Epidemiol 2022; 145:81-91. [PMID: 35081447 DOI: 10.1016/j.jclinepi.2022.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/24/2021] [Accepted: 01/18/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To conduct a behavioral investigation, using the Theoretical Domains Framework (TDF), to identify barriers and enablers to maternity healthcare professionals (HCP) inviting all eligible women to participate in a maternity care trial. STUDY DESIGN AND SETTING We invited HCP recruiters from maternity care trials in high priority research areas including, diabetes, preeclampsia and breastfeeding, from across Ireland and the UK, to take part in a semi-structured interview. Data collection was informed by the TDF, followed by inductive thematic analysis and deductive mapping to the TDF. RESULTS Twenty-two recruiters including midwives, nurses, allied health professionals and doctors were interviewed online or by telephone phone. Thematic analysis generated four global themes; Availability and accessibility of resources, Navigating the recruitment pathway, Prioritising clinical responsibilities over research responsibilities and The influence of colleagues and peers. Themes were mapped to the TDF, identifying 13 domains relevant to the behaviour. CONCLUSION This paper identifies the factors enabling or inhibiting maternity HCP recruiters to invite all eligible women to participate in a maternity care trial. The findings provide guidance for researchers designing trials for this population and the essential first step in developing a recruiter-focused behaviour change intervention to support recruitment to trials in maternity care.
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Affiliation(s)
- Vivienne Hanrahan
- School of Nursing and Midwifery, National University of Ireland, Galway, Áras Moyola, Upper Newcastle, Galway, Ireland; Health Research Board - Trial Methodology Research Network, Áras Moyola, NUI Galway, University Road, Galway, Ireland.
| | - Linda Biesty
- School of Nursing and Midwifery, National University of Ireland, Galway, Áras Moyola, Upper Newcastle, Galway, Ireland
| | - Louisa Lawrie
- Health Services Research Unit, Health Sciences Building, Foresterhill, Aberdeen, UK
| | - Eilidh Duncan
- Health Services Research Unit, Health Sciences Building, Foresterhill, Aberdeen, UK
| | - Katie Gillies
- Health Services Research Unit, Health Sciences Building, Foresterhill, Aberdeen, UK
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Park S, Hur HK, Chung C. Learning effects of virtual versus high-fidelity simulations in nursing students: a crossover comparison. BMC Nurs 2022; 21:100. [PMID: 35473614 PMCID: PMC9042657 DOI: 10.1186/s12912-022-00878-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Simulation is an alternative or complementary method for students who cannot obtain sufficient direct care experience, as they allow students to experience various clinical situations. Mixed learning is becoming increasingly common as a way to provide students with opportunities to experience real-life clinical scenarios. This study compared the learning effects of a virtual simulation and a high-fidelity simulation in a different order of presentation, with a focus on training for premature rupture of membranes in the field maternity nursing. Through this comparison, this study aimed to obtain evidence to support decision-making regarding the most effective way to utilize mixed simulation strategies. Methods A quasi-experimental, crossover-design study was performed with two randomly allocated groups of 26 junior nursing students each. The virtual simulation used the vSim® for nursing, and the high-fidelity simulation used a scenario developed by the research team. The learning effects were measured in terms of the problem-solving process, clinical reasoning, reflective thinking, satisfaction with the practicum, and self-confidence. The data collected with a structured questionnaire were analyzed using the Mann–Whitney test. Results The virtual simulation-first, high-fidelity simulation-second order led to significantly higher scores for reflective thinking (z = 3.53, p < .001) and self-confidence (z = 2.47, p = .013) than the other order. Conclusions The initial application of virtual simulation seemed to improve students’ thought processes, and then high-fidelity simulation seemed to allow them to perform actual practice better. Further trials of mixed learning methods are necessary to maximize learning effects in nursing education. Trial registration KCT0005767 at 2021–01-12 registered.
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Affiliation(s)
- SoMi Park
- Department of Nursing, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju, Gangwon-do, Korea
| | - Hea Kung Hur
- Department of Nursing, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju, Gangwon-do, Korea
| | - ChaeWeon Chung
- College of Nursing, Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Korea.
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Hassan SM. Religious practices of Muslim women in the UK during maternity: evidence-based professional practice recommendations. BMC Pregnancy Childbirth 2022; 22:335. [PMID: 35440069 PMCID: PMC9020041 DOI: 10.1186/s12884-022-04664-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 04/07/2022] [Indexed: 12/02/2022] Open
Abstract
Background Muslim women commonly observe certain religious practices during their maternity journey and research in this area suggests that more could be done from a service provision perspective to support Muslim women in the UK through this significant life event. Aim This study identifies Muslim women’s religious practices during maternity, needs and challenges of religious practice while engaging with maternity services, and support needs from healthcare professionals. Method Qualitative mixed method study; that includes eight longitudinal interviews with first-time pregnant Muslim women, five focus groups with 23 Muslim mothers experiencing childbirth in last three years in UK, and 12 one-to-one interviews with Health care Professionals (HCPs) with previous experience working with Minority Ethnic groups. Participants recruited from local Muslim community groups and Maternity Care Provider, North West Coast, England. Data analysed using thematic analysis. Result Qualitative findings indicate common religious practices that Muslim women exercise at different stages of their maternity journey. These practices can be divided into two categories of common religious practices for Muslim women that 1) require only healthcare professionals’ awareness of these practices and 2) require awareness and active involvement of healthcare professionals. Findings highlight key recommendations for healthcare professionals when addressing Muslim women’s religious needs in the UK. Discussion/Conclusion This study provides evidence-based recommendations for professional practice to assist healthcare professionals in developing understanding and addressing Muslim women’s religious practice needs in the UK. Further research is required to explore the impact of these recommendations for professional practice.
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Affiliation(s)
- Shaima M Hassan
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, L69 3GL, UK. .,NIHR Applied Research Collaboration NWC, Liverpool, England.
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Gold S, Clarfield L, Johnstone J, Diambomba Y, Shah PS, Whittle W, Abbasi N, Arzola C, Ashraf R, Biringer A, Chitayat D, Czikk M, Forte M, Franklin T, Jacobson M, Keunen J, Kingdom J, Lapinsky S, MacKenzie J, Maxwell C, Preisman M, Ryan G, Selk A, Sermer M, Silversides C, Snelgrove J, Watts N, Young B, De Castro C, D'Souza R. Adapting obstetric and neonatal services during the COVID-19 pandemic: a scoping review. BMC Pregnancy Childbirth 2022; 22:119. [PMID: 35148698 PMCID: PMC8840792 DOI: 10.1186/s12884-022-04409-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 01/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background The provision of care to pregnant persons and neonates must continue through pandemics. To maintain quality of care, while minimizing physical contact during the Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV2) pandemic, hospitals and international organizations issued recommendations on maternity and neonatal care delivery and restructuring of clinical and academic services. Early in the pandemic, recommendations relied on expert opinion, and offered a one-size-fits-all set of guidelines. Our aim was to examine these recommendations and provide the rationale and context to guide clinicians, administrators, educators, and researchers, on how to adapt maternity and neonatal services during the pandemic, regardless of jurisdiction. Method Our initial database search used Medical subject headings and free-text search terms related to coronavirus infections, pregnancy and neonatology, and summarized relevant recommendations from international society guidelines. Subsequent targeted searches to December 30, 2020, included relevant publications in general medical and obstetric journals, and updated society recommendations. Results We identified 846 titles and abstracts, of which 105 English-language publications fulfilled eligibility criteria and were included in our study. A multidisciplinary team representing clinicians from various disciplines, academics, administrators and training program directors critically appraised the literature to collate recommendations by multiple jurisdictions, including a quaternary care Canadian hospital, to provide context and rationale for viable options. Interpretation There are different schools of thought regarding effective practices in obstetric and neonatal services. Our critical review presents the rationale to effectively modify services, based on the phase of the pandemic, the prevalence of infection in the population, and resource availability. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04409-4.
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Affiliation(s)
- Shira Gold
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | | | - Jennie Johnstone
- Department of Laboratory Medicine and Pathobiology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Yenge Diambomba
- Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada
| | - Prakesh S Shah
- Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada
| | - Wendy Whittle
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Nimrah Abbasi
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Cristian Arzola
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rizwana Ashraf
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Anne Biringer
- Department of Family Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - David Chitayat
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Marie Czikk
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Milena Forte
- Department of Family Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Tracy Franklin
- Department of Family and Community Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michelle Jacobson
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Johannes Keunen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - John Kingdom
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | | | - Joanne MacKenzie
- Department of Nursing, Mount Sinai Hospital, Toronto, ON, Canada
| | - Cynthia Maxwell
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Mary Preisman
- Department of Psychiatry, Mount Sinai Hospital, Toronto, ON, Canada
| | - Greg Ryan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Amanda Selk
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Mathew Sermer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Candice Silversides
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - John Snelgrove
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Nancy Watts
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada
| | - Beverly Young
- Department of Psychiatry, Mount Sinai Hospital, Toronto, ON, Canada
| | | | - Rohan D'Souza
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, 700 University Avenue, Room 3-908, Toronto, ON, M5G 1X5, Canada.
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Lee SI, Azcoaga-Lorenzo A, Agrawal U, Kennedy JI, Fagbamigbe AF, Hope H, Subramanian A, Anand A, Taylor B, Nelson-Piercy C, Damase-Michel C, Yau C, Crowe F, Santorelli G, Eastwood KA, Vowles Z, Loane M, Moss N, Brocklehurst P, Plachcinski R, Thangaratinam S, Black M, O'Reilly D, Abel KM, Brophy S, Nirantharakumar K, McCowan C. Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a population-based cross-sectional study. BMC Pregnancy Childbirth 2022; 22:120. [PMID: 35148719 PMCID: PMC8840793 DOI: 10.1186/s12884-022-04442-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/24/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Although maternal death is rare in the United Kingdom, 90% of these women had multiple health/social problems. This study aims to estimate the prevalence of pre-existing multimorbidity (two or more long-term physical or mental health conditions) in pregnant women in the United Kingdom (England, Northern Ireland, Wales and Scotland). STUDY DESIGN Pregnant women aged 15-49 years with a conception date 1/1/2018 to 31/12/2018 were included in this population-based cross-sectional study, using routine healthcare datasets from primary care: Clinical Practice Research Datalink (CPRD, United Kingdom, n = 37,641) and Secure Anonymized Information Linkage databank (SAIL, Wales, n = 27,782), and secondary care: Scottish Morbidity Records with linked community prescribing data (SMR, Tayside and Fife, n = 6099). Pre-existing multimorbidity preconception was defined from 79 long-term health conditions prioritised through a workshop with patient representatives and clinicians. RESULTS The prevalence of multimorbidity was 44.2% (95% CI 43.7-44.7%), 46.2% (45.6-46.8%) and 19.8% (18.8-20.8%) in CPRD, SAIL and SMR respectively. When limited to health conditions that were active in the year before pregnancy, the prevalence of multimorbidity was still high (24.2% [23.8-24.6%], 23.5% [23.0-24.0%] and 17.0% [16.0 to 17.9%] in the respective datasets). Mental health conditions were highly prevalent and involved 70% of multimorbidity CPRD: multimorbidity with ≥one mental health condition/s 31.3% [30.8-31.8%]). After adjusting for age, ethnicity, gravidity, index of multiple deprivation, body mass index and smoking, logistic regression showed that pregnant women with multimorbidity were more likely to be older (CPRD England, adjusted OR 1.81 [95% CI 1.04-3.17] 45-49 years vs 15-19 years), multigravid (1.68 [1.50-1.89] gravidity ≥ five vs one), have raised body mass index (1.59 [1.44-1.76], body mass index 30+ vs body mass index 18.5-24.9) and smoked preconception (1.61 [1.46-1.77) vs non-smoker). CONCLUSION Multimorbidity is prevalent in pregnant women in the United Kingdom, they are more likely to be older, multigravid, have raised body mass index and smoked preconception. Secondary care and community prescribing dataset may only capture the severe spectrum of health conditions. Research is needed urgently to quantify the consequences of maternal multimorbidity for both mothers and children.
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Affiliation(s)
- Siang Ing Lee
- Institute of Applied Health Research, IOEM Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Amaya Azcoaga-Lorenzo
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Utkarsh Agrawal
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | | | - Adeniyi Francis Fagbamigbe
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Holly Hope
- Centre for Women's Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK
| | - Anuradhaa Subramanian
- Institute of Applied Health Research, IOEM Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Astha Anand
- Institute of Applied Health Research, IOEM Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Beck Taylor
- Institute of Applied Health Research, IOEM Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | | | - Christine Damase-Michel
- Medical and Clinical Pharmacology, School of Medicine, Université Toulouse III, Toulouse, France
- INSERM, Centre for Epidemiology and Research in Population Health (CERPOP), CIC 1436, Toulouse, France
| | - Christopher Yau
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
- Health Data Research, London, UK
| | - Francesca Crowe
- Institute of Applied Health Research, IOEM Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | | | - Kelly-Ann Eastwood
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
- St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Zoe Vowles
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Maria Loane
- The Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Ngawai Moss
- Patient and Public Representative, London, UK
| | - Peter Brocklehurst
- Institute of Applied Health Research, IOEM Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | | | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Mairead Black
- Aberdeen Centre for Women's Health Research, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Dermot O'Reilly
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
| | - Kathryn M Abel
- Centre for Women's Mental Health, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine & Health, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sinead Brophy
- Data Science, Medical School, Swansea University, Swansea, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, IOEM Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Colin McCowan
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
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50
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Kokab F, Jones E, Goodwin L, Taylor B, Kenyon S. Community midwives views of postnatal care in the UK; A descriptive qualitative study. Midwifery 2021; 104:103183. [PMID: 34808526 DOI: 10.1016/j.midw.2021.103183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/23/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore views and experiences of community midwives delivering postnatal care. DESIGN A descriptive qualitative study design undertaking focus groups with community midwives and community midwifery team leaders. SETTING All focus groups were carried out in community midwifery care settings, across four hospitals in two NHS organisations, April to June 2018 in the West Midlands, UK. PARTICIPANTS 47 midwives: 34 community midwives and 13 community midwifery team leaders took part in 7 focus groups. FINDINGS Inductive framework analysis of data led to the development of themes and sub-themes relating to factors influencing discharge from hospital, strategies to address increases in discharge and the broader challenges to providing care. Conditions on the postnatal ward and women's experiences of care in the hospital were factors influencing timing of discharge from hospital that resulted in community midwives managing women and babies with more complex needs. In order to manage increased workloads, there was growing but varied use of flexible approaches to providing care such as telephone consultations, postnatal clinics, and maternity support workers. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE In a context of short postnatal hospital stays, community midwives appear to be responding to women's needs and service pressures in the postnatal period. Wider implementation of specific strategies to organise and deliver support to women and babies may further improve care and outcomes.
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Affiliation(s)
- Farina Kokab
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK.
| | - Eleanor Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK.
| | - Laura Goodwin
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK.
| | - Beck Taylor
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK.
| | - Sara Kenyon
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK.
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