Publications by authors named "Jennifer Kurinczuk"

Background: Breast milk has significant benefits for preterm babies, but 'very preterm' babies are unable to feed directly from the breast at birth. Their mothers have to initiate and sustain lactation through expressing milk for tube feeding until their babies are developmentally ready to feed orally. There are wide disparities between neonatal units in England in rates of breast milk feeding at discharge.

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Objective: To investigate whether induction/augmentation of labor in pregnant women with anemia increases the risk of postpartum hemorrhage (PPH) and whether this risk varied by indications for labor induction/augmentation and by anemia severity in pregnancy.

Methods: In a prospective cohort study of 9420 pregnant women from 13 hospitals across India, we measured hemoglobin concentrations at recruitment (≥28 weeks of gestation) and blood loss after childbirth during follow-up and collected clinical information about PPH. Clinical obstetric and childbirth information at both visits were extracted from medical records.

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Article Synopsis
  • Mothers of very preterm babies face challenges in breastfeeding due to the need for early milk expression and transitioning from tube feeding to breastfeeding after birth.
  • The study interviewed 23 mothers from different neonatal units in England to understand how staff support and unit facilities influence breastfeeding behaviors, using the COM-B framework to analyze factors like capability, opportunity, and motivation.
  • Key findings highlighted that mothers' motivation was significantly impacted by information from staff on the benefits of breast milk, encouragement, and the availability of resources, indicating that tailored support is essential for improving breastfeeding success in preterm infants.
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Despite Nigeria's stillbirth rate reducing from 28.6 to 22.5 per 1,000 births from 2000-2021, progress trails comparable indicators and regional variations persist.

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Objective: To investigate the association between postpartum haemorrhage (PPH) and subsequent cardiovascular disease.

Design: Population-based retrospective cohort study, using record linkage between Aberdeen Maternity and Neonatal Databank (AMND) and Scottish healthcare data sets.

Setting: Grampian region, Scotland.

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Article Synopsis
  • This study investigated the factors influencing labor induction and augmentation among 9,305 pregnant women in India, exploring both clinical and non-clinical elements.
  • Findings showed that over 42% of participants underwent labor induction, with more than 27% experiencing augmentation, and many lacked clinical indications for these procedures.
  • Multivariable logistic regression indicated that women with fewer or no clinical indications were significantly less likely to have labor induced or augmented, highlighting a need for awareness around informed decision-making in these processes.
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Background: Perinatal exposure to SARS-CoV-2 may affect neurodevelopment before 12 months of age, but longer-term outcomes remain unknown. We examined whether antenatal or neonatal SARS-CoV-2 exposure compared with non-exposure is associated with neurodevelopment, respiratory symptoms, and health care usage in early childhood.

Methods: This prospective national population-based cohort study was conducted in England and Wales, United Kingdom.

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Article Synopsis
  • * Findings revealed that severe perinatal outcomes were more frequent in women with moderate to severe COVID-19, particularly during the delta variant phase, and in those who were unvaccinated.
  • * The study emphasizes the need for ongoing surveillance of pregnancy outcomes in future pandemics and strongly supports the vaccination of pregnant women to safeguard both mothers and infants.
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Background: Ethnic disparities in maternal mortality are consistently reported. This study aimed to investigate the contribution of known risk factors including age, socioeconomic status, and medical comorbidities to observed ethnic disparities in the United Kingdom (UK).

Methods: A cohort of all women who died during or up to six weeks after pregnancy in the UK 2009-2019 were identified through national surveillance.

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Objective: This study aimed to investigate the incidence of and risk factors for stillbirth in an Indian population.

Methods: We conducted a secondary data analysis of a hospital-based cohort from the Maternal and Perinatal Health Research collaboration, India (MaatHRI), including pregnant women who gave birth between October 2018-September 2023. Data from 9823 singleton pregnancies recruited from 13 hospitals across six Indian states were included.

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Background: Sub-Saharan Africa (SSA) alone contributed to 42% of global stillbirths in 2019, and the rate of stillbirth reduction has remained slow. There has been an increased uptake of community-based interventions to combat stillbirth in the region, but the effects of these interventions have been poorly assessed. Our objectives were to examine the effect of community-based interventions on stillbirth in SSA.

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Objectives: To conduct a systematic review of the impact of antenatal and neonatal exposure to SARS-CoV-2 on developmental outcomes in preterm and term-born infants.

Methods: We searched Embase, Emcare, MEDLINE, PsycINFO, Web of Science and grey literature on May 27, 2022 and updated on May 8, 2023. Studies defining exposure with a positive SARS-CoV-2 protein or genetic material, used a contemporaneous non-exposed cohort, and reported developmental outcomes up to 2 years of age were included.

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Objective: Neonatal infection with wildtype SARS-CoV-2 is rare and good outcomes predominate. We investigated neonatal outcomes using national population-level data to describe the impact of different SARS-CoV-2 variants.

Design: Prospective population-based cohort study.

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Background: Mental health conditions are common during pregnancy and the first year after childbirth. Early detection allows timely support and treatment to be offered, but identifying perinatal mental health conditions may be challenging due to stigma and under-recognition of symptoms. Asking about symptoms of mental health conditions during routine antenatal and postnatal appointments can help to identify women at risk.

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Objectives: To determine the baseline trends in the total birth prevalence of neural tube defects (NTDs) in England (2000-2019) to enable the impact of folic acid fortification of non-wholemeal wheat flour to be monitored.

Design: Population-based, observational study using congenital anomaly (CA) registration data for England curated by the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).

Setting: Regions of England with active registration in the time period.

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Article Synopsis
  • The study looked at whether children born after ART (Assisted Reproductive Technology) cost more in healthcare than those born to mothers without fertility issues.
  • Researchers found that ART babies visited doctors more often and had higher hospital costs, especially in their first year.
  • They used a large amount of health data from over 368,000 families in England to compare four groups of babies based on their mothers' fertility treatments.
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Objectives: To estimate the incidence of, and investigate risk factors for, postpartum haemorrhage (PPH) requiring transfer to obstetric care following birth in midwifery units (MU) in the UK; to describe outcomes for women who experience PPH requiring transfer to obstetric care.

Methods: We conducted a national population-based case-control study in all MUs in the UK using the UK Midwifery Study System (UKMidSS). Between September 2019 and February 2020, 1501 women with PPH requiring transfer to obstetric care following birth in an MU, and 1475 control women were identified.

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Background: Community-based interventions are increasingly being implemented in Sub-Saharan Africa (SSA) for stillbirth prevention, but the nature of these interventions, their reporting and acceptability are poorly assessed. In addition to understanding their effectiveness, complete reporting of the methods, results and intervention acceptability is essential as it could potentially reduce research waste from replication of inadequately implemented and unacceptable interventions. We conducted a systematic review to investigate these aspects of community-based interventions for preventing stillbirths in SSA.

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Objectives: Most research about outcomes following postpartum haemorrhage (PPH) has focused on immediate outcomes. There are fewer studies investigating longer-term maternal morbidity following PPH, resulting in a significant knowledge gap. This review aimed to synthesize the evidence about the longer-term physical and psychological consequences of primary PPH for women and their partners from high income settings.

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Background: Facility-based stillbirth review provides opportunities to estimate incidence, evaluate causes and risk factors for stillbirths, and identify any issues related to the quality of pregnancy and childbirth care which require improvement. Our aim was to systematically review all types and methods of facility-based stillbirth review processes used in different countries across the world, to examine how stillbirth reviews in facility settings are being conducted worldwide and to identify the outcomes of implementing the reviews. Moreover, to identify facilitators and barriers influencing the implementation of the identified facility-based stillbirth reviews processes by conducting subgroup analyses.

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Objective: To examine the prevalence of novel newborn types among 165 million live births in 23 countries from 2000 to 2021.

Design: Population-based, multi-country analysis.

Setting: National data systems in 23 middle- and high-income countries.

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Objective: Currently used estimates of survival are nearly 10 years old and relate to only those babies admitted for neonatal care. Due to ongoing improvements in neonatal care, here we update estimates of survival for singleton and multiple births at 22 to 31 weeks gestational age across the perinatal care pathway by gestational age and birth weight.

Design: Retrospective analysis of routinely collected data.

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Objective: To compare the severity of maternal infection and perinatal outcomes during periods in which wildtype, alpha variant, and delta variant of SARS-CoV-2 were dominant in the UK.

Design: Prospective cohort study.

Setting: 194 obstetric units across the UK, during the following periods: between 1 March and 30 November 2020 (wildtype dominance), between 1 December 2020 and 15 May 2021 (alpha variant dominance), and between 16 May and 31 October 2021 (delta variant dominance).

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Background: Newborns may be affected by maternal SARS-CoV-2 infection during pregnancy. We aimed to describe the epidemiology, clinical course and short-term outcomes of babies admitted to a neonatal unit (NNU) following birth to a mother with confirmed SARS-CoV-2 infection within 7 days of birth.

Methods: This is a UK prospective cohort study; all NHS NNUs, 1 March 2020 to 31 August 2020.

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