Kennelly, Mairead M.
Kennelly, Mairead M.
Kennelly, Mairead M.
Now showing 1 - 5 of 5
- PublicationAntenatal Rubella Immunity in IrelandThe objective of the study was to identify those women attending for antenatal care who would have benefited from prepregnancy rubella vaccination. It was a population-based observational study of women who delivered a baby weighing ≥500 g in 2009 in the Republic of Ireland. The woman’s age, parity, nationality and rubella immunity status were analysed using data collected by the National Perinatal Reporting System. Of the 74,810 women delivered, the rubella status was known in 96.7% (n=72,333). Of these, 6.4%(n=4,665) women were not immune. Rubella seronegativity was 8.0%(n=2425) in primiparous women compared with 5.2%(n=2239) in multiparous women (p<0.001), 14.7%(n=10653) in women <25 years old compared with 5.0%(n=3083) in women ≥25 years old (p<0.001), and 11.4%(n=780) in women born outside the 27 European Union (EU27) countries compared with 5.9%(n=3886) in women born inside the EU27 countries (p<0.001). Based on our findings we recommend that to prevent Congenital Rubella Syndrome, the health services in Ireland should focus on women who are young, nulliparous and born outside the EU.
- PublicationThe impact of new guidelines on screening for gestational diabetes mellitusGestational diabetes mellitus (GDM) has important maternal and fetal implications. In 2010, the Health Service Executive published guidelines on GDM. We examined the impact of the new guidelines in a large maternity unit. In January 2011, the hospital replaced the 100g Oral Glucose Tolerance Test (OGTT) with the new 75g OGTT. We compared the first 6 months of 2011 with the first 6 months of 2010. The new guidelines were associated with a 22% increase in women screened from 1375 in 2010 to 1679 in 2011 (p<0.001). Of the women screened, the number diagnosed with GDM increased from 10.1% (n=139) to 13.2% (n=221) (p<0.001).The combination of increased screening and a more sensitive OGTT resulted in the number of women diagnosed with GDM increasing 59% from 139 to 221 (p=0.02).This large increase has important resource implications but, if clinical outcomes are improved, there should be a decrease in long-term costs.
- PublicationEarly pregnancy maternal cardiovascular profiling in the prediction of hypertensive disease in pregnancyPrediction of hypertensive disease in pregnancy re- mains challenging. Risk factor based screening util- izing history, physical characteristics, uterine artery Doppler and serum markers have been used with va- rying success. As hypertension in pregnancy appears to be associated with changes in the maternal vascu- lature, we have investigated the utility of maternal ar- terial elasticity measurement, prior to 20 weeks gesta- tion, in the prediction of hypertensive disease in preg- nancy. A HDI/Pulsewave CR2000 Research Cardio- vascular Profiling System was used to obtain radial artery pulse pressure waveforms from 623 Caucasian women at the time of their first antenatal visit. Out- come data were available in 610 cases and these com- prised the study group. The results showed that wo- men who subsequently developed gestational hypertension (n = 20) had higher baseline systolic, diastolic and pulse pressure values (though within the normal range) but similar arterial elasticity to those patients who did not develop hypertension. Women who later developed pre-eclampsia (n = 23) had, in addition, re- duced large artery elasticity and increased systemic vascular resistance compared with women who did not develop hypertension. The measurement of mater- nal radial artery elasticity in early pregnancy may pro- vide an additional refinement in screening for hyperten- sive disease, particularly pre-eclampsia, in pregnancy.
- PublicationReference ranges for fetal volumes in the late first trimester, obtained using 9-degree rotational stepsObjectives: In the course of another study, we calculated fetal volume centile values for each week of gestation from 11 to 14 weeks using nine-degree rotation steps.
- PublicationMaternal Obesity and Pre-Pregnancy Folic Acid SupplementationObjective: The purpose of this nested cohort study was to compare the rate of pre-pregnancy supplementation in obese women with that of women with a normal BMI. Methods: Pregnant women were enrolled at their convenience in a large university hospital. Weight and height were measured in the first trimester and BMI categorised. Results: Of the 288 women, 35.1% were in the normal, 29.5% in the overweight and 35.4% in the obese BMI categories. Only 45.1% (n = 46) of the obese women took pre-pregnancy folic acid compared with 60.4% (n = 61) of women with a normal BMI (p < 0.03). The lower incidence of folic acid supplementation in obese women was associated with an unplanned pregnancy in 36.3% of women compared with 22.8% in the normal BMI category (p < 0.04). Conclusions: Obese women should take folate supplements whether they are planning to conceive or not.
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