Now showing 1 - 5 of 5
  • Publication
    A national audit of smoking cessation services in Irish maternity units
    There is international consensus that smoking cessation in the first half of pregnancy improves foetal outcomes. We surveyed all 19 maternity units nationally about their antenatal smoking cessation practices. All units recorded details on maternal smoking at the first antenatal visit. Only one unit validated the self-reported smoking status of pregnant women using a carbon monoxide breath test. Twelve units (63%) recorded timing of smoking cessation. In all units women who reported smoking were given verbal cessation advice. This was supported by written advice in 12 units (63%), but only six units (32%) had all midwives trained to provide this advice. Only five units (26%) reported routinely revisiting smoking status later in pregnancy. Although smoking is an important modifiable risk factor for adverse pregnancy outcomes, smoking cessation services are inadequate in the Irish maternity services and there are variations in practices between hospitals.
  • Publication
    Pilot evaluation of an online weight management programme
    This intervention examined the efficacy of a six-week online weight loss programme. Students and staff of a third level institution (n=183) were recruited to the programme which provided individualised dietary advice for weight loss. Eighty-five participants (mean age 29.7 years, mean BMI 28.9kg/m2, 33% male) met the minimum inclusion criterion of logging on to the study website at least twice. All participants who completed the full six-week programme lost weight (n=31), with significant reductions in mean weight (2.8kg), BMI (0.9kg/m2) and waist circumference (4.1cm) observed between the start and end of the programme (all P<0.001). Among "completers", males lost more weight than females (4.2kg vs. 1.9kg, P=0.004). One in four completers lost >5% of their bodyweight, with reductions in biscuit and alcohol consumption being most predictive of weight loss. These findings suggest that individualised online dietary advice is effective in achieving short-term weight loss, especially in males.
  • Publication
    Provision of Information about Infant Feeding Postpartum Through Digital Media
    Abstract Women seek information about infant feeding from multiple sources, which may conflict. Increasingly women use digital media for pregnancy information. This study examined women's use of digital media for information on infant feeding. In addition to clinical and socio-demographic data, detailed data concerning women's infant feeding practices and their use of digital media for infant feeding information were collected. We surveyed 295 women who attended nine months postpartum as part of a longitudinal study on maternal weight trajectories. Digital media was used by 130 women (44.1%) to access information on infant feeding, which is higher than hitherto reported. Women who did not use digital media were more likely to be multigravidous (p = 0.03), to be socially disadvantaged (p = 0.01), and were less likely to breastfeed (p = 0.01). However, on multivariable analysis, only women economically disadvantaged were less likely to use digital media [OR 0.25, p < 0.02]. The types of digital media used varied, and an overwhelming majority were non-subscription resources. Less than 5% of women used professional evidence-based digital media sources. The use of digital media was not associated with the timing of weaning. Information on infant feeding should be evidence-based and provided digitally to women across all socioeconomic gradients as part of an e-health national policy.                           
  • Publication
    Comparison at the first prenatal visit of the maternal dietary intakes of smokers with non-smokers in a large maternity hospital: a cross-sectional study
    Objectives: Using detailed dietary and supplement questionnaires in early pregnancy, we compared the dietary intakes of micronutrients and macronutrients at the first prenatal visit of women who reported continuing to smoke during pregnancy with the intakes of women who were non-smokers. Design: Cross-sectional study conducted between June 2014 and March 2016. Setting: Stand-alone tertiary maternity hospital in an urban setting with approximately 8000 deliveries per year. Participants: Women were recruited at their convenience after sonographic confirmation of an ongoing singleton pregnancy (n=502). Detailed dietary and supplement information was available for 398 women. Women <18 years and those who did not speak English fluently were excluded. Primary and secondary outcome measures: The differences in dietary micronutrients and macronutrients and maternal folate levels between women who continued to smoke in pregnancy compared with non-smokers. Results: Of the 502 women, the mean age was 30.5 (SD 5.6) years, 42.5% were nulliparas, 19.2% were obese and 398 (79.3%) completed the questionnaire satisfactorily. In the 50 (12.6%) current smokers, the micronutrients magnesium, iron, carotene and copper were lower (all p<0.005) whereas sodium and chloride were higher compared with the 348 (87.4%) non-smokers. Smokers reported lower intakes of dietary total folate (p=0.006) compared with non-smokers (i.e., dietary folate equivalents; intake from natural and fortified dietary sources) (p=0.005). Smokers also reported lower intakes of fibre than non-smokers (13.1 g (IQR 7.7) vs 16.3 g (IQR 8.5), p<0.001). The dietary intakes of former smokers compared favourably with non-smokers. Conclusions: We found that women who continue to smoke during pregnancy have serious dietary inadequacies which could potentially aggravate fetal growth restriction associated with direct toxicity from cigarettes. This provides a further reason to promote smoking cessation interventions in pregnancy, and highlights the need for dietary and supplementation interventions in women who continue to smoke.
      219Scopus© Citations 3
  • Publication
    Duration of periconceptional folic acid supplementation in women booking for antenatal care
    OBJECTIVE: To provide accurate estimates of the commencement time, duration and dosage of folic acid (FA) supplementation taken by Irish women in the periconceptional period. The study also aimed to establish the factors associated with optimal FA supplementation practices.DESIGN: Cross-sectional observational study. Women's clinical and sociodemographic details were computerised. Maternal weight and height were measured before calculating BMI. Detailed FA supplementation questionnaires were completed under the supervision of a trained researcher.SETTING: A large university maternity hospital, Republic of Ireland, January 2014-April 2016.SUBJECTS: Women (n 856) recruited at their convenience in the first trimester.RESULTS: While almost all of the women (97 %) were taking FA at enrolment, only one in four women took FA for at least 12 weeks preconceptionally (n 208). Among the 44 % of women who were supplementing with FA preconceptionally, 44 % (162/370) reported taking FA for less than the 12 weeks required to achieve optimal red-blood-cell folate levels for prevention of neural tube defects. On multivariate analysis, only planned pregnancy and nulliparity were associated with taking FA for at least 12 weeks preconceptionally. Among women who only took FA postconceptionally, almost two-thirds commenced it after day 28 of their pregnancy when the neural tube had already closed.CONCLUSIONS: As the timing of FA was suboptimal both before and after conception, we recommend that current national FA guidelines need to be reviewed.                          
      341Scopus© Citations 10