The Department of Health has published Physical Activity for pregnant women. This infographic outline the duration, frequency and type of physical activity required to achieve general health benefits for different age ranges. It relates to the start active stay active report published by the UK’s four Chief Medical Officers for the NHS, local authorities and a range of other organisations designing services to promote physical activity
Using a computerised decision-support system to interpret the outputs of continuous electronic fetal monitoring during labour does not show any advantages over clinicians interpreting the outputs themselves. This is the first trial to assess decision support of this kind.
In this large NIHR-funded trial, rates of poor neonatal outcomes, caesarean sections and assisted deliveries were not affected by whether clinicians were alerted to potential problems by the decision-support system or by their own interpretation of the data. Developmental outcomes at two years of age were not affected either.
The system used in the trial only looked at fetal heart rate patterns, and didn’t use other data about the labour (which may affect how a clinician manages the labour). This suggests that maternity units should focus on other ways of improving recognition of problems and decision making when they are detected rather than investing in such decision-support systems at this time.
Induction of labour does not increase the risk of caesarean delivery in pregnant women with a larger than average baby.
This is based on a review of four trials of 1190 women with a suspected large baby who were allocated either to have labour induced from 38 weeks or to watchful waiting.
Induction did not increase the risk of most negative outcomes for the baby, such as bleeding in the brain, or mother, such as major tearing. However, these outcomes are rare, so a larger number of women would need to be studied to be confident in these findings. When mothers were not induced babies were larger and born about a week later than if they were induced. They did suffer from more fractures, which can be a complication of delivering a larger baby.
Current guidance recommends only offering induction at 41 or 42 weeks in otherwise healthy women who have a larger than average baby.
This analysis suggests that earlier induction is likely to be safe and may be an option for women to consider.
This is a report on NHS-funded maternity services in England for February 2017, using data submitted to the Maternity Services Data Set (MSDS). The MSDS has been developed to help achieve better outcomes of care for mothers, babies and children.
Of the births that had a recorded delivery method, 60 per cent were spontaneous vaginal births, 11 per cent had instrumental assistance, 12 per cent were elective caesarean sections and 15 per cent were emergency caesarean sections. The proportion of births by emergency caesarean was highest in the London Commissioning Region (17 per cent), and was 14 per cent for all other Commissioning Regions.
Among women that gave birth at 37 weeks gestation or later, 80 per cent had skin-to-skin contact with their baby within one hour of birth. The percentage of women that had skin-to-skin contact within one hour was highest in the London Commissioning Region (84 per cent) and lowest in the North of England Commissioning Region (76 per cent).
75 per cent of babies received maternal or donor breast milk as their first feed
The London Maternity Clinical Network, NHS England and the Stillbirth and Neonatal death charity (SANDS) has published Gathering feedback from families following the death of their baby: A resource to support professionals in maternity care. Many parents who have experienced bereavement want to offer feedback to ensure lessons are learned and good practice is shared. The Maternity Bereavement Experience Measure questionnaire and supporting resource is designed to seek feedback from bereaved parents where a baby or babies have died during pregnancy or shortly after birth. It should also enable commissioners and providers to collect and understand women’s insight from all communities, cultures and ethnic groups to help explore where local improvements may be needed
The objective of this study was to investigate whether advanced maternal age is associated with preterm birth, irrespective of parity.
The study concluded that advanced maternal age is associated with an increased risk of preterm birth, irrespective of parity, especially very preterm birth. Women aged 35 years and older, expecting their first, second, or third births, should be regarded as a risk group for very preterm birth.
Waldenström U, Cnattingius S, Vixner L, Norman M. Advanced maternal age increases the risk of very preterm birth, irrespective of parity: a population-based register study. BJOG 2017; 124:1235–1244.
Researchers aimed to predict the impact of advising pregnant women to use calcium supplements (1,000 mg/day) on the number of cases of pre-eclampsia prevented and related health care costs. By use of a decision-analytic model, we assessed the expected impact of advising calcium supplementation to either (1) all pregnant women, (2) women at high risk of developing pre-eclampsia, or (3) women with a low dietary calcium intake compared with current care.
The study concluded that advising pregnant women to use calcium supplements can be expected to cause substantial reductions in the incidence of pre-eclampsia as well as related health care costs. It appears most efficient to advise calcium supplementation to all pregnant women, not subgroups only.
Linda J. E. Meertens, Hubertina C. J. Scheepers, Jessica P. M. M. Willemse et al. Should women be advised to use calcium supplements during pregnancy? A decision analysis. Maternal & Child Nutrition 18 JUN 2017 DOI: 10.1111/mcn.12479