Public Health England has produced Best start in life: return on investment tool. This tool aims to help local commissioners provide cost-effective interventions for children aged up to 5 years old and pregnant women. It pulls together evidence on the effectiveness and associated costs for a number of interventions aimed at providing children with the best start in life. It is accompanied by a report providing details on how the tool was constructed.
Eating disorders affect approximately 7.5% of pregnant women and can impact on maternal and infant outcomes. Researchers at King’s College London have translated research on eating disorders during pregnancy and motherhood into practical training resources to help healthcare professionals provide the best care for pregnant women and mothers. This animation aims to raise awareness of eating disorders amongst all health professionals working with women in the perinatal period.
For more information and to see the animation visit the Institute of Health Visiting here
No blood test can accurately tell if a pregnant or recently pregnant woman has a blood clot. All pregnant women with a suspected clot should continue to have imaging investigations as per current UK guidelines.
This NIHR-funded study recruited 328 pregnant or postpartum women with a suspected blood clot in the lung (pulmonary embolism) or leg (deep vein thrombosis). They had a blood test to measure the levels of 13 biomarkers, such as the D-dimer, to see if they could rule a blood clot in or out. It was hoped that this could reduce the number of women who would need confirmation from a scan, and so decrease their exposure to radiation.
None of the tests were accurate enough. The range of levels for each biomarker overlapped between women with and without a clot.
Hunt BJ, Parmar K, Horspool K, et al. The DiPEP (Diagnosis of PE in Pregnancy) biomarker study: An observational cohort study augmented with additional cases to determine the diagnostic utility of biomarkers for suspected venous thromboembolism during pregnancy and puerperium. Br J Haematol. 2018;180(5):694-704.
Do you work with women with learning disabilities? Can you help PHE with their online survey? Publishing easy guides is one way PHE aims to reduce inequalities, by allowing everybody to get the information they need to make informed decisions about screening.
With support from PHE Screening, NHS England is beginning an evaluation of how information on antenatal and newborn screening is provided to women with learning disabilities in London. They would like feedback on the ‘Screening tests for you and your baby: easy guides’ from anyone involved in the antenatal and newborn screening pathway. Please complete the short survey which closes on 1 March 2018.
More information and the survey link is available here
The Royal College of Obstetricians and Gynaecologists has published a new patient information leaflet Group B Streptococcus (GBS) in pregnancy and newborn babies. This leaflet provides advice for women who are pregnant or planning to become pregnant about Group B Streptococcus infection in newborn babies.
Cytomegalovirus (CMV), a member of the human herpesvirus family, is the most common viral cause of congenital infection, affecting 0.2–2.2% of all live births. It is responsible for significant morbidity, especially in infants who are symptomatic in the neonatal period. It is the leading non-genetic cause of sensorineural hearing loss and a major cause of neurological disability. Around 10–15% of neonates with congenital CMV will be symptomatic at birth, with a similar percentage developing problems later in childhood.
This Scientific Impact Paper summarises the issues around screening, diagnosis and treatment of CMV in pregnancy, utilising the best available evidence and highlighting recent advances.
Khalil A, Heath P, Jones C, Soe A, Ville YGon behalf of the Royal College of Obstetricians and Gynaecologists. Congenital Cytomegalovirus Infection: Update on Treatment. Scientific Impact Paper No. 56. BJOG2017; DOI: 10.1111/1471-0528.14836.
Giving low dose aspirin to high-risk women reduced their risk of pre-eclampsia before 37 weeks of pregnancy. Preterm pre-eclampsia developed in 1.6% of women given 150mg aspirin daily compared with 4.3% who took a placebo.
Pre-eclampsia is a condition which can harm mother and baby. In the mother, it causes high blood pressure and protein in the urine, which can show in pregnancy after 20 weeks. Women with risk factors, such as previous pre-eclampsia, diabetes or high blood pressure, are often prescribed 75mg aspirin from 12 weeks onwards. This study aimed to test double this dose (still classified as a `low dose’) after using a new risk assessment with additional clinical tests to better identify those at high risk of the condition. Aspirin did not affect other pregnancy outcomes and didn’t increase the risk of adverse effects.
This research adds to current knowledge about the range of doses that is effective and refines the definition and detection of women at high risk. The research did not compare 75mg with 150mg doses.