Comparison of ultrasound with biomarkers to identify large-for-gestational age in women screened for gestational diabetes mellitus.

Objective: Large-for-gestational-age (LGA) is associated with both fetal and maternal complications. One of the few modifiable risk factors for LGA is Gestational Diabetes Mellitus (GDM); for this reason, fetal growth is usually monitored by ultrasound in the third trimester. This prospective study compared a panel of ten established biomarkers measured at the time of selective screening for GDM at 26-28 weeks gestation with the ultrasound prediction of LGA.

Trends in private maternity care in Ireland's capital during and after the Great Economic Recession 2009-2017.

Background: Maternity care in hospitals in the Republic of Ireland is funded by a hybrid of public finance and private health insurance.

Aims: The aim of this longitudinal observational study was to investigate the annual trends in maternity care from 2009 to 2017 during and after the Great Economic Recession.

Methods: All women who delivered a singleton baby weighing ≥ 500 g during the 9 years (2009-2017) were included.

Caesarean section rates in women in the Republic of Ireland who chose to attend their obstetrician privately: a retrospective observational study.

Background: Caesarean section (CS) rates are increasing and there are wide variations in rates internationally and nationally. There is evidence that women who attend their obstetrician privately have a higher incidence of CS than those who attend publicly. The purpose of this observational study was to further investigate why CS rates may be higher in women who chose to attend their obstetrician privately.

Reducing Caesarean Section Surgical Site Infection (SSI) by 50%: A Collaborative Approach.

Objective: Caesarean section surgical site infection (SSI) is a surgical wound site infection occurring within 30 days of surgery with a reported incidence of 3-15%. This quality improvement (QI) project aimed to reduce caesarean section SSI by 50% in a tertiary maternity center.

Methods: Using multidisciplinary team approach, the project was designed with evidence-based interventions.

The use of biomarkers at the end of the second trimester to predict Gestational Diabetes Mellitus.

Objective: Previous studies that investigated the relationship between biomarkers and gestational diabetes mellitus (GDM) generally focused on individual biomarkers with significant heterogeneity in terms of the screening methodologies, diagnostic criteria for GDM and sample handling of glucose within these studies. This prospective study used an established panel of ten biomarkers to determine if they could predict the diagnosis of GDM.

Study Design: Women with risk factors for GDM were recruited at their first antenatal visit.

Maternal employment and pregnancy outcomes in a large European maternity hospital.

Objective: Epidemiological studies have previously reported that maternal socioeconomic disadvantage is associated with adverse feto-maternal outcomes. However, little attention has been paid to the question of the woman's employment status. The aim of this observational study was to examine the relationship between maternal employment status at the first antenatal visit and pregnancy outcomes.

Childbirth in Ireland's capital city over sixty years.

Background: Ireland has changed over the past sixty years, and the dynamic practice of obstetrics and gynaecology has changed with it.

Study Design And Methods: To describe these changes, a review was performed of clinical reports of a tertiary referral teaching hospital over six decades.

Results: Since the 1960s, the hospital's total births per annum has risen (3050 to 8362 births).

A Prospective Evaluation of Point-of-Care Measurements of Maternal Glucose for the Diagnosis of Gestational Diabetes Mellitus.

Background: Point-of-care (POC) measurement of glucose is currently recommended only for the monitoring of gestational diabetes mellitus (GDM). This prospective observational study evaluated the use of POC measurements of maternal glucose to diagnose GDM in women being screened selectively with a 1-step 75 g oral glucose tolerance test (OGTT).

Methods: The strictest preanalytic and analytic international laboratory standards were applied to measure maternal plasma glucose at fasting and at 1 and 2 h post glucose load.

Longitudinal Study of Maternal BMI in Successive Pregnancies.

Objective: This longitudinal observational study examined BMI changes between successive pregnancies.

Methods: The computerized medical records of women who attended a large maternity hospital between 2009 and 2017 for their first and second singleton deliveries were analyzed. Women who had their weight first measured after 15 weeks of gestation in either pregnancy were excluded.

Maternal obesity and dyslipidemia associated with gestational diabetes mellitus (GDM).

Objective: The association between gestational diabetes mellitus (GDM) and maternal dyslipidemia is well established, however, the role of obesity in this relationship is not well defined. We examined the relationship between maternal obesity at the first prenatal visit and fasting lipids measured at the time of the oral glucose tolerance test (OGTT) in women screened selectively for GDM.

Study Design: This prospective observational study was conducted in a large university maternity hospital.

Does maternal obesity explain trends in caesarean section rates? Evidence from a large Irish maternity hospital.

Background: A feature of contemporary obstetrics in wealthy countries has been both the continuing increase in caesarean section (CS) rates and the emergence of high levels of maternal obesity.

Aims: The purpose of this study was to examine whether the increasing CS rate in a large university maternity hospital was attributable in part to maternal obesity.

Methods: We studied all women who delivered a baby weighing ≥ 500 g from 2009 to 2014 in one of the largest maternity hospitals in Europe.

A cross-sectional study of maternal-fetal attachment and perceived stress at the first antenatal visit.

Background: Maternal-fetal attachment (MFA) psychologically is well described. Suboptimal attachment may have negative consequences particularly if it is associated with unhealthy maternal behaviour that may potentially increase the risk of adverse pregnancy outcomes. The perception of stress or anxiety is also associated with potential adverse outcomes including preterm birth.

Maternal obesity trends in a large Irish university hospital.

Objective(s): This study aimed to examine recent trends in maternal obesity.

Study Design: This retrospective observational study used routinely computerised clinical and sociodemographic data of women who presented for antenatal care in a large maternity hospital in Ireland during the eight years 2010-17. Women with complete body mass index (BMI) data who delivered a baby weighing ≥500 g were included in the study.

Fetal growth and maternal alcohol consumption during early pregnancy.

Objective: The relationship between light maternal alcohol consumption and fetal outcome remains contentious and the professional advice women receive is conflicting. The aim of this large epidemiological study was to examine the relationship between fetal growth and maternal alcohol behaviour before and during early pregnancy.

Study Design: Clinical and sociodemographic details of women who delivered a baby weighing ≥500 g during the eight years 2010-18 were analysed.

Development of a novel bedside index for the early identification of severe maternal infection.

Objectives: International consensus reports have recently recommended that the Systemic Inflammatory Response Syndrome (SIRS) criteria for the diagnosis of sepsis should cease and that new bedside criteria need to be developed to improve prevention, early diagnosis and treatment. The aim of this retrospective audit was to evaluate a suite of four bedside clinical criteria, called the Early Maternal Infection Prompts (EMIP), in helping to identify women with a suspected severe infection who were admitted to a High Dependency Unit (HDU) in a large tertiary referral stand-alone maternity hospital.

Study Design: The four EMIP criteria were decided based on existing national obstetric guidelines and a review of the recent literature on maternal critical illnesses.

The interaction between maternal smoking, illicit drug use and alcohol consumption associated with neonatal outcomes.

Background: The adverse effects of smoking on neonatal outcomes, such as small-for-gestational-age (SGA), has been extensively studied however, the consequences of smoking combined with alcohol and/or drug use is less clear.

Methods: This retrospective observational study analyzed clinical and sociodemographic details of 40156 women who delivered a singleton baby between the years 2011 and 2015.

Results: Compared with women who had never smoked, smokers who did not engage in alcohol or drug use had an odds ratio (OR) of delivering a baby who was SGA of 3.

The implications of high carbon monoxide levels in early pregnancy for neonatal outcomes.

Objectives: The aim of this study was to examine the implications of increased maternal Breath Carbon Monoxide (BCO) levels at the first antenatal visit for subsequent birthweight (BW) and neonatal outcomes.

Study Design: Secondary analysis of a prospective, observational study. Pregnant women aged ≥18years who understood English were recruited (n=250).

Feasibility of recruitment to a behavioural smoking cessation intervention combined with ongoing online support.

The aim of this randomized controlled trial was to determine whether a behavioural intervention in pregnancy supported by online information would improve smoking cessation rates. However, due to a number of challenges, recruitment to this trial was reluctantly halted. We aimed to recruit 220 maternal smokers within 2 years and after screening 1995 women, just 22 enrolled over a 8-month period.

A prospective, observational study investigating the use of carbon monoxide screening to identify maternal smoking in a large university hospital in Ireland.

Objectives: This study evaluated breath carbon monoxide (BCO) testing in identifying maternal smokers as well as the difference between disclosers and non-disclosers of smoking status. We also investigated if other extrinsic factors affected the women's BCO levels in pregnancy.

Design: A prospective observational study.

Evaluation of the systemic inflammatory response syndrome criteria for the diagnosis of sepsis due to maternal bacteremia.

Objective: To examine, in the setting of maternal bacteremia, the implications for the diagnosis of maternal sepsis of customizing the systemic inflammatory response syndrome (SIRS) criteria for physiologic changes of pregnancy.

Methods: Women with maternal bacteremia in a tertiary maternity hospital during 2009-2014 were identified. Records were retrospectively reviewed to determine whether they fulfilled the criteria for diagnosis of sepsis based on either the standard SIRS parameters derived from the Surviving Sepsis Campaign or SIRS parameters customized for pregnancy.

Evaluation of point-of-care maternal venous lactate testing in normal pregnancy.

Objective: There is little information about whether the established non-pregnant adult venous lactate reference range is appropriate for pregnancy. This prospective observational study examined whether the non-pregnant adult reference range is appropriate during pregnancy.

Methods: Women attending for routine prenatal appointments or elective cesarean delivery in a tertiary hospital were recruited.

The relationship between unplanned pregnancy and maternal body mass index 2009-2012.

Objective: To analyse the relationship between unplanned pregnancy and maternal Body Mass Index (BMI).

Methods: A prospective case-control study of planned vs. unplanned pregnancies among women who delivered an infant weighing ≥ 500 g during the four years 2009-2012 in a large maternity hospital in Ireland.

The clinical outcomes of unplanned pregnancy in severely obese women.

Objective: The objective of this study was to compare the clinical outcomes of unplanned pregnancies among severely obese women with those of planned pregnancies.

Methods: This prospective cohort study included severely obese women (Body Mass Index [BMI] ≥ 40.0 kg/m(2)) who delivered a baby weighing ≥ 500 g over 5 years 2009-2013 in a large university hospital.

A clinical review of maternal bacteremia.

Objective: To carry out a 4-year review of cases of bacteremia among obstetric patients.

Methods: In a retrospective review, all cases of maternal bacteremia between 2009 and 2012 were identified from the laboratory database of Coombe Women and Infants University Hospital, Dublin, Ireland. The clinical records of each case were assessed.