Professor Jenny Kurinczuk has been named an Honorary Fellow of the Royal College of Obstetricians and Gynaecologists at the RCOG's January 2019 Members' Admissions Ceremony. The honorary fellowship was awarded in recognition of her contribution to maternal and perinatal health.
Jenny is Professor of Perinatal Epidemiology and Director of the NPEU since 2011. Her research looks into causes, consequences and surgical treatments for congenital anomalies, and surveillance of near-miss maternal morbidity.
Congratulations to Jenny on this prestigious award!
New research has concluded that changes in the sociodemographic characteristics of women who become mothers in Great Britain (GB), and not improvement in breastfeeding practices, may be responsible for the increasing trend in breastfeeding initiation in GB since the 1980s. This is one of few studies globally to examine the relationship between increasing breastfeeding trends and sociodemographic changes in the population that may have resulted from decades of social and health policy reforms. The study used data from the 1985, 1990, 1995, 2000, 2005 and 2010 UK Infant Feeding Surveys, which included population-based samples of 7,000-12,000 women.
The findings showed that while the proportion of mothers who initiated breastfeeding increased from 64% in 1985 to 81% in 2010, there was also a considerable increase in the proportion of first-time mothers who were 30 or older, had higher education and higher-skilled occupations, were cohabiting with a partner, were of BME origin, and did not smoke in pregnancy. In each survey year, these same groups of mothers were significantly more likely to initiate breastfeeding than mothers who were younger, had lower education and lower-skilled occupations, were single, were of white ethnicity, and smoked during pregnancy. The findings suggest that more targeted interventions are necessary to support these latter groups of mothers with unmet needs. The study was conducted by Deon Simpson, and NPEU researchers Maria Quigley, Jenny Kurinczuk and Claire Carson, and can be read in full in PLoS ONE.
‘Doulas’ are trained or experienced lay women who provide social, emotional and practical support to other women during pregnancy and birth. In a qualitative interview study, NPEU researchers Jenny McLeish and Maggie Redshaw have explored the experiences of 19 volunteer doulas and 16 supported mothers at three community doula projects in England.
One paper from the study focuses on volunteer doulas at birth, examining the ways in which their continuous, empowering, woman-focused support sits alongside midwifery. A second paper considers the role of volunteer doulas working with disadvantaged mothers before and after birth. The study found that antenatal and postnatal support from doulas helped the mothers to succeed and flourish by reducing anxiety, unhappiness and stress; increasing self-esteem, self-efficacy, parenting confidence and skills; supporting them to make effective use of maternity services; and enabling them to build social ties in their community.
Studies Within A Trial (SWATs) are smaller studies carried out within a larger clinical trial. Large studies often offer the opportunity to investigate important issues around trial design, methodology and trial processes. Examples include whether sending a letter or telephoning potential participants as a method of follow-up improves recruitment to research, or if there is an optimum time and day to send invitation letter for trials.
Response rates to follow-ups are crucial to the success of a trial and therefore it is very important to maximise response rates in participants. The SIFT study, which aimed to recruit 2800 participants and follow them up at around 2 years, provided an excellent opportunity to monitor and assess response rates. The SIFT study team designed and implemented a SWAT which compared two types of incentive to participants in follow-up - an unconditional incentive (a £15 gift voucher enclosed with the follow-up questionnaire), versus the same value voucher sent to the participant on the return of the completed questionnaire. The SIFT SWAT has been registered with the MRC SWAT Repository Store, set up by Queen's University Belfast, in order to increase transparency in trials and share knowledge on trial methodology and design with other researchers.
Results of the SWAT are currently being written up, and will be submitted for publication very soon.
FROSTTIE has recently been granted REC and HRA approval. We are looking for more centres to join the trial as recruiting sites.
FROSTTIE (REC reference 18/SC/0580; IRAS 235355) is a multi-centred randomised trial for babies with breastfeeding difficulties who are thought to have tongue-tie and who are receiving breastfeeding support, and there is uncertainty about whether frenotomy would help continuation of breastfeeding.
The aim of the trial is to find out if skilled support for breastfeeding on its own, or together with a frenotomy helps mothers and their babies to breastfeed.
If you are able to provide or facilitate infant feeding support services, with a minimum breastfeeding support level of:
Initial face-to-face assessment of breastfeeding;
Advice on positioning and attachment;
At least one follow-up visit, together with drop-in clinic advice as required, but available on more than one day a week;*
A standard follow-up visit at 1-2 weeks after frenotomy;*
Your site may be able to take part in this study. *Please note follow-up visits do not necessarily have to take place at your trust for you to take part.
With no existing evidence to support the use of ursodeoxycholic acid (UDCA) to improve intrahepatic cholestasis of pregnancy (ICP), PITCHES, a Phase III clinical trial proposes to provide definitive evidence to discover if the use of UDCA improves pregnancy outcomes in women with this liver disorder.
For more information, please find the recently published study protocol for the PITCHES trial in the BioMedCentral Trials journal here.
There is considerable concern about the impact of the death of a baby on parents’ psychological and physical health and the way in which they are cared for at the time of the death and subsequently. The UK Department of Health funded Listening to Parents study focused on this aspect of maternity care.
This latest paper on women whose babies died soon after birth is one of a series of papers using data from Listening to Parents, a population-based study of parents whose baby died as a stillbirth or shortly after birth in 2012-131. Two previous papers focused on the experience of stillbirth for women living in deprived areas2 who have a higher incidence of stillbirth, and parent’s experience of the post-mortem process following stillbirth3.
Giving birth in a birth centre may be as safe for some obese women who have given birth before as it is for those with a lower Body Mass Index (BMI).
A new study, published in PLOS ONE and funded by the National Institute for Health Research (NIHR), has shown that, for women with a BMI between 35 and 40 who have given birth before and are otherwise healthy, planning birth in an alongside midwifery unit (AMU) can be just as safe as for women with a lower BMI.
Working with a network of midwives in AMUs across the UK, as part of the UK Midwifery Study System (UKMidSS), researchers at the NPEU, led by Dr Rachel Rowe, identified and collected information about all 1,122 severely obese pregnant women (with a BMI over 35kg/m2) who received labour care in AMUs, and 1,949 comparison women with a lower BMI who were looked after in the same units.
