Publications by authors named "Eastwood Ka"
Background: The number of women entering pregnancy with overweight or obesity is increasing. This can increase the risk for excessive gestational weight gain (GWG) which is associated with health complications for mother and baby. There are limited evidence-based interventions within antenatal care settings to encourage healthy eating and physical activity behaviours and support women with managing GWG.
View Article and Find Full Text PDFIntroduction: Congenital heart disease (CHD) is the most common congenital anomaly, representing a significant global disease burden. Limitations exist in our understanding of aetiology, diagnostic methodology and screening, with metabolomics offering promise in addressing these.
Objective: To evaluate maternal metabolomics and lipidomics in prediction and risk factor identification for childhood CHD.
Background: Preconception health has the potential to improve parental, pregnancy and infant outcomes. This scoping review aims to (1) provide an overview of the strategies, policies, guidelines, frameworks, and recommendations available in the UK and Ireland that address preconception health and care, identifying common approaches and health-influencing factors that are targeted; and (2) conduct an audit to explore the awareness and use of resources found in the scoping review amongst healthcare professionals, to validate and contextualise findings relevant to Northern Ireland.
Methods: Grey literature resources were identified through Google Advanced Search, NICE, OpenAire, ProQuest and relevant public health and government websites.
Background: There is a high prevalence of autoimmune conditions in women specially in the reproductive years; thus, the association with adverse pregnancy outcomes has been widely studied. However, few autoimmune conditions/adverse outcomes have been studied more than others, and this umbrella review aims to consolidate existing knowledge in this area with the aim to provide new knowledge and also identify gaps in this research area.
Methods: Medline, Embase, and Cochrane databases were searched from inception to December 2023.
Background: The prevalence of autoimmune conditions is two-fold higher in women than in men, especially during the reproductive years. Autoimmune conditions have been associated with a greater risk of adverse pregnancy outcomes, and some conditions have been studied more than others with inconsistent findings. The objective of this umbrella review was to identify, appraise, synthesise, and consolidate findings from published systematic reviews of autoimmune conditions and adverse pregnancy outcomes.
View Article and Find Full Text PDFDetection and evaluation of signals associated with exposure to individual and combination of medications in pregnancy: a signal detection study protocol.
BMJ Open
October 2023
Article Synopsis
- The study addresses the issue of polypharmacy in pregnant women, highlighting the need for more research on the safety of their complex medication plans, particularly focusing on adverse and protective effects of various medications during pregnancy.
- It employs real-world data from the UK to conduct a pharmacovigilance study assessing medication safety in women during the preconception period and the first trimester.
- A multidisciplinary expert team will analyze and reach consensus on the signals of associations between medication exposure and pregnancy outcomes to filter out misleading data for further evaluation.
Article Synopsis
- Multimorbidity (presence of multiple health conditions) is prevalent among pregnant women, with 16.8% experiencing it and 3.6% having complex multimorbidity (four or more conditions) in a study of over 27,000 pregnancies.
- The prevalence of multimorbidity increases with maternal age, ranging from 10.2% in younger women (15-19) to 21.4% in those aged 40-44.
- Pregnant women with multimorbidity have higher rates of preterm birth (PTB), at 11.6%, compared to 6.7% in those without, and 15.6% in those with complex multimorbidity.*
Article Synopsis
- This study developed a core outcome set for future research on pregnant women with multimorbidity to tackle issues of inconsistent outcome reporting across studies.
- The development process involved a systematic literature search, focus groups, and Delphi surveys engaging diverse stakeholders, including affected women and healthcare professionals.
- The final core outcome set identified 11 key outcomes, including maternal death, severe morbidity, and baby survival rates, which should be consistently measured in related research.
Article Synopsis
- A qualitative study was conducted to identify important outcomes for pregnant women with multiple long-term health conditions by involving women, their partners, and healthcare professionals in focus groups.
- The study found 63 outcomes related to maternal health, child health, and healthcare utilization, with new outcomes discovered that haven't been previously emphasized in the literature.
- Participants highlighted the importance of care processes, particularly the need for effective information sharing during transitions in healthcare, showing a consensus on the significance of various outcomes across different stakeholders.
Background: Pre-eclampsia may be associated with the development of endometrial cancer; however, previous findings have been conflicting.
Objectives: To investigate if pre-eclampsia is associated with an increased risk of endometrial cancer.
Method: Two independent reviewers screened titles and abstracts of studies identified in MEDLINE, Embase, and Web of Science databases from inception until March 2022.
Introduction: Preconception care can significantly improve maternal and infant outcomes, and thus optimise intergenerational health. The aims of this scoping review are to (1) provide an up-to-date summary of preconception health and care strategies, policies, guidelines, frameworks and recommendations across the UK and Ireland and (2) explore preconception health and care services and interventions in Northern Ireland as a case study.
Methods And Analysis: This scoping review of grey literature will be conducted as per the Scoping Review Methods Manual by the Joanna Briggs Institute and the Arksey-O'Malley framework for scoping studies, and reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
Maternal and child outcomes for pregnant women with pre-existing multiple long-term conditions: protocol for an observational study in the UK.
BMJ Open
February 2023
Article Synopsis
- * Researchers will analyze data from UK health records spanning from 2000 to 2019, examining various health outcomes during different stages: antenatal, peripartum, postnatal, and long-term mental health.
- * Ethical approval has been secured, and findings are set to be published in peer-reviewed journals and presented at major conferences for wider dissemination.
Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019.
BMC Med
January 2023
Article Synopsis
- The study looks at how many pregnant women are taking multiple medications, which has become more common over the last 20 years.
- It gathered data from a big medical records database to see how often women used 2 or more medicines during pregnancy.
- The findings show that about 25% of women used multiple medications in their first trimester, and some risk factors for this include being overweight, from certain ethnic groups, or being a smoker.
Aetiological understanding and screening methods for congenital heart disease (CHD) are limited. Maternal metabolomic assessment offers the potential to identify risk factors and biomarkers. We performed a systematic review (PROSPERO CRD42022308452) investigating the association between fetal/childhood CHD and endogenous maternal metabolites.
View Article and Find Full Text PDFArticle Synopsis
- Pregnancy complications like pre-eclampsia and gestational diabetes usually get better after childbirth, but they can lead to long-term health risks for women, such as heart disease.
- This study will look at different reviews to see how pregnancy problems are connected to five types of long-term health issues, including autoimmune diseases, cancers, and mental health issues.
- The researchers will analyze lots of studies to understand these links better and share the results, helping to create predictions for women's future health risks.
Pre-eclampsia is a serious consideration for women with type 1 diabetes mellitus (T1DM) planning pregnancy. Risk stratification strategies, such as biomarkers measured in the first trimester of pregnancy, could help identify high-risk women. The literature on T1DM-specific pre-eclampsia biomarkers is expanding.
View Article and Find Full Text PDFRaising awareness of pre-conception care in community pharmacies: a feasibility study.
Pilot Feasibility Stud
February 2022
Background: There is growing evidence to support the introduction of pre-conception interventions to optimise the health of mothers and their future children. At present, there is poor awareness regarding the importance of pre-conception care (PCC) amongst healthcare professionals and couples planning a pregnancy. Community pharmacies are ideally placed to reach a range of prospective couples planning a pregnancy and could effectively provide information about PCC.
View Article and Find Full Text PDFBackground: Although maternal death is rare in the United Kingdom, 90% of these women had multiple health/social problems. This study aims to estimate the prevalence of pre-existing multimorbidity (two or more long-term physical or mental health conditions) in pregnant women in the United Kingdom (England, Northern Ireland, Wales and Scotland).
Study Design: Pregnant women aged 15-49 years with a conception date 1/1/2018 to 31/12/2018 were included in this population-based cross-sectional study, using routine healthcare datasets from primary care: Clinical Practice Research Datalink (CPRD, United Kingdom, n = 37,641) and Secure Anonymized Information Linkage databank (SAIL, Wales, n = 27,782), and secondary care: Scottish Morbidity Records with linked community prescribing data (SMR, Tayside and Fife, n = 6099).
Trends in maternal body mass index in Northern Ireland: a cross-sectional and longitudinal study.
Fam Med Community Health
December 2021
Objectives: Explore (1) associations between maternal body mass index (BMI), demographic and clinical characteristics, (2) longitudinal trends in BMI, (3) geographical distributions in prevalence of maternal overweight and obesity.
Design: Retrospective population-based study.
Setting: Linked, anonymised, routinely collected healthcare data and official statistics from Northern Ireland.
Article Synopsis
- The study focuses on developing a core outcome set (COS) for maternal and offspring health in pregnant women who have pre-existing multimorbidity, which may negatively impact health outcomes.
- It employs a four-stage design: a systematic literature search, focus groups for personal insights, a Delphi survey for prioritization, and a consensus meeting to finalize the outcomes.
- Ethical approval has been granted by the University of Birmingham, ensuring the study follows proper ethical guidelines and will effectively gather and disseminate relevant findings.
Diabetes in pregnancy is associated with adverse pregnancy outcomes including preterm birth. Although the mechanisms leading to these pregnancy complications are still poorly understood, aberrant angiogenesis and endothelial dysfunction play a key role. FKBPL and SIRT-1 are critical regulators of angiogenesis, however, their roles in pregnancies affected by diabetes have not been examined before in detail.
View Article and Find Full Text PDFContext: Preeclampsia is a leading cardiovascular complication in pregnancy lacking effective diagnostic and treatment strategies.
Objective: To investigate the diagnostic and therapeutic target potential of the angiogenesis proteins, FK506-binding protein like (FKBPL) and CD44.
Design And Intervention: FKBPL and CD44 plasma concentration or placental expression were determined in women pre- or postdiagnosis of preeclampsia.
Objective: To assess ability of first and second trimester Placental Vascularization Indices (PVIs) to predict pre-eclampsia (PE) in high-risk pregnancies.
Method: PVIs derived from 3-Dimensional power Doppler imaging were measured at 11+0-13 + 6 (n = 194) and 19+0-21 + 6 weeks (n = 195). Logistic regression (LR) models used PE as the outcome.
Article Synopsis
- The transcript covers a scientific conference focused on prenatal surgery for spina bifida, featuring insights from various medical professionals and patients involved in the topic.
- Experts include obstetricians, neurosurgeons, and neurologists, sharing their perspectives on the benefits and challenges of fetal surgery for this condition.
- The discussion includes current practices in prenatal surgery, along with recommendations for future research to improve outcomes for affected patients.