Needs led research: ensuring relevant research in two PhD projects within maternity care.

Background: There has been a growing concern regarding research waste and the mismatch between conducted research and the research needs of knowledge users. The Needs Led Research (NLR) approach is proposed as an effective method to ensure that research address actual evidence gaps that are relevant to the users of the knowledge. By search and reviewing literature and involving knowledge users, NLR aims to identify, verify, and prioritize research needs.

How well can the fetal heart rate baseline be assessed by intrapartum intermittent auscultation? An interrater reliability and agreement study.

Background: We aimed to examine the inter-reliability and agreement among midwives when assessing the fetal heart rate (FHR) using the handheld Doppler. The primary aim was to measure the reliability and agreement of FHR baseline (baseline) as beats per minute (bpm). The secondary aims were to measure fluctuations from the baseline, defined as increases and decreases, and classifications (normal or abnormal) of FHR soundtracks.

Acute symptoms of depression and traumatic stress in men and women who terminate pregnancy after the detection of fetal anomaly: A prospective observational study.

Objective: To assess acute and long-term stress in men and women after the detection of fetal anomalies leading to pregnancy termination.

Design: Prospective observational study.

Setting: Tertiary referral centre for fetal medicine.

A history of depression and prenatal depression are associated with a lower likelihood of breastfeeding initiation and maintenance, and more breastfeeding problems.

Purpose: This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation (giving the baby any breastmilk during the first week of life) and breastfeeding maintenance (giving the baby breastmilk for at least 6 months), and a greater likelihood of reporting breastfeeding problems.

Methods: We analyzed data from the Norwegian Mother, Father, and Child cohort study (MoBa), N = 78,307. Mothers reported a lifetime history of depression during the second trimester of pregnancy, and current symptoms of depression during the third trimester using the Hopkins Symptoms Checklist short version (SCL-8).

Labor curves based on cervical dilatation over time and their accuracy and effectiveness: A systematic scoping review.

Objectives: This systematic scoping review was conducted to 1) identify and describe labor curves that illustrate cervical dilatation over time; 2) map any evidence for, as well as outcomes used to evaluate the accuracy and effectiveness of the curves; and 3) identify areas in research that require further investigation.

Methods: A three-step systematic literature search was conducted for publications up to May 2023. We searched the Medline, Maternity & Infant Care, Embase, Cochrane Library, Epistemonikos, CINAHL, Scopus, and African Index Medicus databases for studies describing labor curves, assessing their effectiveness in improving birth outcomes, or assessing their accuracy as screening or diagnostic tools.

Becoming Dad: Expectant Fathers' Attachment Style and Prenatal Representations of the Unborn Child.

How expectant fathers think and feel about the unborn child (prenatal representations), has shown associations with fathers' postnatal parenting behaviors, observed father-infant interactional quality and child cognitive development. There is limited knowledge about fathers' prenatal representations. The present study examined if fathers' partner-related attachment styles were related to their prenatal representations of the unborn child.

Anxiety and depression in expectant parents: ART versus spontaneous conception.

Study Question: Do expectant parents experience increased anxiety and depression during pregnancies conceived through ART compared to spontaneous conception?

Summary Answer: Among all expectant parents in the sample, those who conceived through ART reported overall lower levels of anxiety and depression in pregnancy compared to expectant parents who conceived spontaneously, while in the subsample of parents who conceived both through ART and spontaneous conception, expectant mothers experienced increased anxiety and depression in early pregnancy following ART compared to spontaneous conception.

What Is Known Already: Previous research on expectant parents' psychosocial adjustment in response to ART has found mixed results, with some studies suggesting ART is associated with increased anxiety and depression, and other studies suggesting improved mental health or no relationship. Mixed findings may relate to the use of cross-sectional designs that do not account for confounding differences between groups, or variability in the timing of assessment.

Reliability and agreement in intrapartum fetal heart rate monitoring interpretation: A systematic review.

Introduction: Fetal heart rate (FHR) monitoring is routine in intrapartum care worldwide and one of the most common obstetrical procedures. Intrapartum FHR monitoring helps assess fetal wellbeing and interpretation of the FHR help form decisions for clinical management and intervention. It relies on the observers' subjective assessments, with variation in interpretations leading to variations in intrapartum care.

Experiences of Norwegian co-parents during COVID-19 pandemic restrictions: A qualitative study.

Purpose: The COVID-19 pandemic restrictions have had a major impact on the organization of health services in Europe. Co-parents' experiences of not being allowed to fully participate during pregnancy, childbirth, and the postpartum period is poorly understood. We investigated how the non-birthing partner experienced becoming a parent during the pandemic.

Umbilical cord blood acid-base analysis at birth and long-term neurodevelopmental outcomes in children: a systematic review and meta-analysis.

Background: Umbilical cord blood acid-base sampling is routinely performed at many hospitals. Recent studies have questioned this practice and the association of acidosis with cerebral palsy.

Objective: To investigate the associations between the results of umbilical cord blood acid-base analysis at birth and long-term neurodevelopmental outcomes and mortality in children.

Long-Term Impact of Diagnosed Fetal Anomaly on Parental Traumatic Stress, Resilience, and Relationship Satisfaction.

Objective: Knowledge regarding the long-term psychological adjustment of parents to children with prenatal diagnosis of congenital malformation is scarce. The aim of this study is to examine traumatic stress trajectories, resilience, and relationship satisfaction among parents to children with prenatal diagnosis of a congenital malformation, and to compare this to a sample of non-affected parents.

Methods: A prospective longitudinal cohort study was conducted at a tertiary perinatal referral center.

The impact of diagnosed fetal anomaly, diagnostic severity and prognostic ambiguity on parental depression and traumatic stress: a prospective longitudinal cohort study.

Introduction: The detection of a fetal anomaly during routine obstetric ultrasound is a potentially traumatic experience. The aim of this study is to examine longitudinally the impact of diagnosis of fetal anomaly on symptoms of depression and traumatic stress among mothers and fathers, and to examine how variations in psychological adjustment relate to diagnostic severity and prognostic ambiguity.

Material And Methods: In this prospective observational study conducted at a tertiary perinatal referral center, 81 mothers and 69 fathers with ultrasound findings of fetal anomaly completed the Edinburgh Postnatal Depression Scale (EPDS) and Impact of Events Scale (IES) at four time points in pregnancy (T1-T4) and 6 weeks after birth (T5).

Practice, skills and experience with the Pinard stethoscope for intrapartum Foetal monitoring: Focus group interviews with Norwegian midwives.

Objective: In most high-income countries, the cardiotocography and handheld Doppler device have replaced the Pinard stethoscope for intrapartum foetal monitoring. As a result, the skills required to use the Pinard are rapidly disappearing from midwifery. The aim of this study was thus to illuminate the knowledge before it is lost, by exploring the practice, skills and experience of Norwegian midwives familiar with the Pinard for intrapartum foetal monitoring.

Changes in maternal cortisol, cortisol binding globulin and cortisone levels following diagnosis of fetal anomaly.

The diagnosis of fetal anomaly can be a major stressor to the expectant mother. Current understanding of the relationship between psychological stress and cortisol in pregnancy is limited. This study examined: (1) differences in the ratio of serum cortisol to cortisol binding globulin (SC/CBG) and cortisone levels among women with and without a diagnosis of fetal anomaly, (2) the association between self-reported stress and cortisol from mid to late pregnancy, and (3) the agreement between two different techniques for analyzing cortisol: liquid chromatography-tandem mass spectrometry (LC-MS/MS) and radioimmunoassay (RIA).

Recommendations for intrapartum fetal monitoring are not followed in low-risk women: A study from two Norwegian birth units.

Objective: International and national intrapartum fetal monitoring guidelines recommend intermittent auscultation in low-risk women, and admission cardiotocography and continuous cardiotocography in high-risk women. The present study aimed to investigate fetal monitoring practices for low- and high-risk women in two hospitals in Norway, and if practice were according to national and international guidelines.

Study Design: To this cross sectional study, data on methods of fetal monitoring and women's risk status were collected from the patient journals of 998 women with intended vaginal birth in 2017 and 2018.

Paternal Psychological Stress After Detection of Fetal Anomaly During Pregnancy. A Prospective Longitudinal Observational Study.

Background And Aims: Knowledge of carrying a fetus with a prenatal diagnosed anomaly may cause acute psychological stress to the parents. Most studies focus on maternal stress, yet fathers are often present at the ultrasound examinations and birth, and therefore may be affected, similarly, to the expectant mother. However, to date no existing studies have examined how detection of a fetal anomaly emotionally affects the expectant fathers throughout the pregnancy.

Intermittent auscultation fetal monitoring during labour: A systematic scoping review to identify methods, effects, and accuracy.

Background: Intermittent auscultation (IA) is the technique of listening to and counting the fetal heart rate (FHR) for short periods during active labour and continuous cardiotocography (CTC) implies FHR monitoring for longer periods. Although the evidence suggests that IA is the best way to monitor healthy women at low risk of complications, there is no scientific evidence for the ideal device, timing, frequency and duration for IA. We aimed to give an overview of the field, identify and describe methods and practices for performing IA, map the evidence and accuracy for different methods of IA, and identify research gaps.

National survey of routines for intrapartum fetal monitoring in Norway.

Introduction: This study describes clinical routines for intrapartum fetal monitoring in Norway and compliance with national clinical recommendations.

Material And Methods: A national survey of all (n = 48) birth units in Norway, using a self-reporting questionnaire about fetal monitoring methods and devices available in the birth units, admission cardiotocography (CTG) use, intrapartum fetal monitoring methods for women with and without risk factors, the availability of fetal scalp blood sampling facilities, and umbilical cord blood sampling routines.

Results: All birth units responded.

Maternal psychological responses during pregnancy after ultrasonographic detection of structural fetal anomalies: A prospective longitudinal observational study.

In this longitudinal prospective observational study performed at a tertiary perinatal referral centre, we aimed to assess maternal distress in pregnancy in women with ultrasound findings of fetal anomaly and compare this with distress in pregnant women with normal ultrasound findings. Pregnant women with a structural fetal anomaly (n = 48) and normal ultrasound (n = 105) were included. We administered self-report questionnaires (General Health Questionnaire-28, Impact of Event Scale-22 [IES], and Edinburgh Postnatal Depression Scale) a few days following ultrasound detection of a fetal anomaly or a normal ultrasound (T1), 3 weeks post-ultrasound (T2), and at 30 (T3) and 36 weeks gestation (T4).

Maternal psychological distress and placental circulation in pregnancies after a previous offspring with congenital malformation.

Introduction: Antenatal maternal psychological distress may be associated with reduced placental circulation, which could lead to lower birthweight. Studies investigating this in humans show mixed results, which may be partially due to type, strength and timing of distress. In addition, the arterial vascular resistance measures often used as outcome measures do not detect smaller changes in placental volume blood flow.