Pregnancy Exercise and Nutrition With Smartphone Application Support: A Randomized Controlled Trial.

Objective: To evaluate the effect of a healthy lifestyle package (an antenatal behavior change intervention supported by smartphone application technology) on the incidence of gestational diabetes mellitus (GDM) in overweight and obese women.

Methods: Women with body mass indexes (BMIs) 25-39.9 were enrolled into this randomized controlled trial.

Maternal metabolic response to dietary treatment for impaired glucose tolerance and gestational diabetes mellitus.

Background: Dietary advice is a standard component of treatment for pregnant women with impaired glucose tolerance (IGT) and gestational diabetes (GDM), yet few studies report glycemic profiles in response to dietary therapies and the optimal dietary approach remains uncertain.

Aim: To assess changes in maternal glycemic profile and pregnancy outcomes among women with diet-controlled IGT and GDM.

Methods: Pregnant women who had one or more elevated values on a 3-h oral glucose tolerance test were enrolled.

A feasibility study of a multidimensional breastfeeding-support intervention in Ireland.

Background: Breastfeeding is the optimum mode of infant feeding. Despite this, most global populations do not achieve the World Health Organisation's recommendation of exclusive breast milk for the first 6 months of life. Irish breastfeeding rates are among the lowest in Europe, necessitating a well-designed breastfeeding-support intervention.

A prospective pilot study of Dilapan-S compared with Propess for induction of labour at 41+ weeks in nulliparous pregnancy.

Background: The incidence of labour induction has risen worldwide over the past decade, and this may contribute to the rising caesarean delivery rate. The mechanisms for induction of labour are generally divided into two categories: mechanical and pharmacological.

Aims: The objective of this study was to determine if mechanical induction with Dilapan-S is an acceptable, safe method of induction of labour in post-dates uncomplicated nulliparous pregnancy.

Can existing mobile apps support healthier food purchasing behaviour? Content analysis of nutrition content, behaviour change theory and user quality integration.

Objective: To assess the quality of nutrition content and the integration of user quality components and behaviour change theory relevant to food purchasing behaviour in a sample of existing mobile apps.

Design: Descriptive comparative analysis of eleven mobile apps comprising an assessment of their alignment with existing evidence on nutrition, behaviour change and user quality, and their potential ability to support healthier food purchasing behaviour.

Setting: Mobile apps freely available for public use in GoogePlay were assessed and scored according to agreed criteria to assess nutrition content quality and integration of behaviour change theory and user quality components.

Maternal and fetal blood lipid concentrations during pregnancy differ by maternal body mass index: findings from the ROLO study.

Background: Pregnancy is a time of altered metabolic functioning and maternal blood lipid profiles change to accommodate the developing fetus. While these changes are physiologically necessary, blood lipids concentrations have been associated with adverse pregnancy outcomes such as gestational diabetes, pregnancy-induced hypertension and high birth weight. As blood lipids are not routinely measured during pregnancy, there is limited information on what is considered normal during pregnancy and in fetal blood.

Lower education predicts poor response to dietary intervention in pregnancy, regardless of neighbourhood affluence: secondary analysis from the ROLO randomised control trial.

Objective: To determine if response to a low glycaemic index (GI) dietary intervention, measured by changes in dietary intake and gestational weight gain, differed across women of varying socio-economic status (SES).

Design: Secondary data analysis of the ROLO randomised control trial. The intervention consisted of a two-hour low-GI dietary education session in early pregnancy.

Can promoting awareness of fetal movements and focusing interventions reduce fetal mortality? A stepped-wedge cluster randomised trial (AFFIRM).

Background: In 2013, the stillbirth rate in the UK was 4.2 per 1000 live births, ranking 24th out of 49 high-income countries, with an annual rate of reduction of only 1.4% per year.

Effects of antenatal diet and physical activity on maternal and fetal outcomes: individual patient data meta-analysis and health economic evaluation.

Background: Diet- and physical activity-based interventions in pregnancy have the potential to alter maternal and child outcomes.

Objectives: To assess whether or not the effects of diet and lifestyle interventions vary in subgroups of women, based on maternal body mass index (BMI), age, parity, Caucasian ethnicity and underlying medical condition(s), by undertaking an individual patient data (IPD) meta-analysis. We also evaluated the association of gestational weight gain (GWG) with adverse pregnancy outcomes and assessed the cost-effectiveness of the interventions.

Gestational weight gain in obese pregnancy: impact on maternal and foetal metabolic parameters and birthweight.

The aim of this prospective, observational study was to investigate the impact of gestational weight gain (GWG) among euglycaemic obese pregnant women on maternal and foetal metabolic parameters and neonatal outcome. Total GWG was recorded for 101 obese, non-diabetic women with a singleton pregnancy. At 28 weeks of gestation, fasting maternal blood samples were analysed for glucose, insulin, c-peptide and lipids.

Season and vitamin D status are independently associated with glucose homeostasis in pregnancy.

Background: Vitamin D status and season are intrinsically linked, and both have been proposed to be associated with glucose homeostasis in pregnancy, with conflicting results. We aimed to determine if exposure to winter and low maternal 25 hydroxyvitamin D (25OHD) in early pregnancy were associated with maternal glucose metabolism.

Methods: This is a secondary data analysis of 334 pregnant women enrolled in the ROLO study, Dublin.

An examination of whether associations exist between maternal and neonatal 25OHD and infant size and adiposity at birth, 6-9 months and 2-2.5 years of age - a longitudinal observational study from the ROLO study.

Background: Vitamin D status in pregnancy and offspring bone health effects are well established, yet limited knowledge exists on the effect of maternal vitamin D status on offspring size/adiposity. This study examines the association of early (13 weeks), late (28 weeks) pregnancy and neonatal (umbilical) 25-hydroxyvitamin D (25OHD) on offspring size/adiposity.

Methods: This analysis included mother-infant pairs from the ROLO study at birth ( = 292), 6-9 months ( = 160) and 2-2.

Behaviour change in overweight and obese pregnancy: a decision tree to support the development of antenatal lifestyle interventions.

Objective: Antenatal healthy lifestyle interventions are frequently implemented in overweight and obese pregnancy, yet there is inconsistent reporting of the behaviour-change methods and behavioural outcomes. This limits our understanding of how and why such interventions were successful or not.

Design: The current paper discusses the application of behaviour-change theories and techniques within complex lifestyle interventions in overweight and obese pregnancy.

Fetal anhydramnios following maternal non-steroidal anti-inflammatory drug use in pregnancy.

We present a case report of transient fetal anhydramnios following maternal non-steroidal anti-inflammatory drug use in pregnancy. This reduction in liquor volume resolved following cessation of the medication with no obvious ill-effect on neonatal outcome. The case report is followed by a comprehensive summary of the relevant literature.

Education in Sepsis: A Review for the Clinician of What Works, for Whom, and in What Circumstances.

Sepsis is a major cause of morbidity and mortality in both the general and obstetric populations. Concerns have been raised regarding some cases of substandard care in the management of the septic and there is a real need for continuing multidisciplinary medical education in the recognition and management of the pregnant patient experiencing sepsis. This review aims to summarize studies on medical education in sepsis to both inform clinicians working in obstetrics and gynaecology and to assist in planning educational programs.

Pregnancy-specific stress, fetoplacental haemodynamics, and neonatal outcomes in women with small for gestational age pregnancies: a secondary analysis of the multicentre Prospective Observational Trial to Optimise Paediatric Health in Intrauterine Growth Restriction.

Objectives: To examine associations between maternal pregnancy-specific stress and umbilical (UA PI) and middle cerebral artery pulsatility indices (MCA PI), cerebroplacental ratio, absent end diastolic flow (AEDF), birthweight, prematurity, neonatal intensive care unit admission and adverse obstetric outcomes in women with small for gestational age pregnancies. It was hypothesised that maternal pregnancy-specific stress would be associated with fetoplacental haemodynamics and neonatal outcomes.

Design: This is a secondary analysis of data collected for a large-scale prospective observational study.

Interpregnancy weight changes and impact on pregnancy outcome in a cohort of women with a macrosomic first delivery: a prospective longitudinal study.

Objective: To determine the median interpregnancy maternal weight change between first and second pregnancies, and second and third pregnancies and to assess the impact of this weight change on pregnancy outcome in a cohort of women with a macrosomic first delivery.

Study Design: Prospective longitudinal study conducted over three pregnancies from 2007 to 2015.

Setting: Tertiary referral maternity hospital, Dublin, Ireland.

The influence of socioeconomic status on gestational weight gain: a systematic review.

Background: Despite a large number of publications regarding the association between socioeconomic status (SES) and gestational weight gain (GWG), the literature is inconsistent. We conducted a systematic review of current evidence relating to the association between SES and GWG, according to the Institute of Medicine (IOM) 2009 guidelines.

Methods: Six electronic databases were searched, with the final search run on first July 2016.

The effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on longer-term maternal and early childhood outcomes: protocol for an individual participant data (IPD) meta-analysis.

Background: The aim of this individual participant data meta-analysis (IPDMA) is to evaluate the effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on later maternal and early childhood outcomes at ages 3-5 years.

Methods/design: We will build on the established International Weight Management in Pregnancy (i-WIP) IPD Collaborative Network, having identified researchers who have conducted randomised dietary and lifestyle interventions among pregnant women who are overweight or obese, and where ongoing childhood follow-up of participants has been or is being undertaken. The primary maternal outcome is a diagnosis of maternal metabolic syndrome.

Influences on the food choices and physical activity behaviours of overweight and obese pregnant women: A qualitative study.

Objective: to qualitatively explore influences identified by overweight/obese pregnant women on food choices and physical activity (PA) behaviours; to determine the impact of pregnancy on these factors; and to inform development of future lifestyle interventions during pregnancy.

Design: cross-sectional interview study.

Setting: maternity hospital, Ireland.

Calcium intake in winter pregnancy attenuates impact of vitamin D inadequacy on urine NTX, a marker of bone resorption.

Purpose: Pregnancy is characterised by increased bone turnover, but high bone turnover with resorption exceeding formation may lead to negative maternal bone remodelling. Recent studies are conflicting regarding the effect of calcium on skeletal health in pregnancy. The aim of this study was to examine the seasonal effect of serum 25-hydroxyvitamin D (25OHD) and dietary calcium on a marker of bone resorption.

Prediction of cesarean delivery in the term nulliparous woman: results from the prospective, multicenter Genesis study.

Background: In contemporary practice many nulliparous women require intervention during childbirth such as operative vaginal delivery or cesarean delivery (CD). Despite the knowledge that the increasing rate of CD is associated with increasing maternal age, obesity and larger infant birthweight, we lack a reliable method to predict the requirement for such potentially hazardous obstetric procedures during labor and delivery. This issue is important, as there are greater rates of morbidity and mortality associated with unplanned CD performed in labor compared with scheduled CDs.