INFANT Research Centre - Journal Articles

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    The association between threatened miscarriage in early pregnancy and depression or anxiety in offspring in late adolescence
    (Elsevier B.V., 2025) Kidd, Ciara; O'Driscoll, David; O'Byrne, Laura J.; O'Keeffe, Gerard W.; Khashan, Ali S.; Maher, Gillian M.; INFANT Research Centre, University College Cork
    Background: Adolescent mental health is a known determinant of health across the lifespan underscoring the importance of identifying determining factors. Threatened miscarriage is a common pregnancy complication, yet its influence on child mental health outcomes is unclear. Here we examined the association between pregnancies complicated by threatened miscarriage and the risk of offspring depression or anxiety in late adolescence using the representative longitudinal UK Millennium Cohort Study. Methods: Maternal reported data on threatened miscarriage and potential confounders were collected at 9-months postpartum. Data on depression and anxiety were collected as one variable when children were aged 17 years using self-reported doctor diagnosis. Multivariable logistic regression adjusted for several maternal and sociodemographic factors. We examined separate interaction effects for threatened miscarriage and hypertensive disorders of pregnancy, small for gestational age (SGA) and preterm birth. Results: N = 9521 mother-child dyads were included in the analyses, with n = 574 (6 %) women experiencing a threatened miscarriage, and 978 (10.3 %) children reported depression or anxiety diagnosis. Adjusted results suggested that threatened miscarriage was associated with a 34 % increase in the odds of depression or anxiety (OR: 1.34, 95 % CI 1.03, 1.73). An interaction effect was observed for threatened miscarriage and SGA (OR: 2.09, 95 % CI: 1.01, 4.36) and threatened miscarriage and preterm birth (OR:2.23, 95 % CI: 1.26, 3.95). Conclusion: Threatened miscarriage was associated with an increased odds of depression or anxiety in offspring by age 17 years, albeit residual and unmeasured confounding cannot be ruled out. Future research should examine the potential biological mechanisms mediating this association. © 2025 The Authors
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    The effect of maternal position on cerebral oxygenation in premature infants during Kangaroo care: a randomised controlled trial
    (Springer Nature, 2025-04-05) Stapleton, Iyshwarya; Murphy, Sarah; Vaughan, Susan; Walsh, Brian Henry; Natchimuthu, Kannan; Livingstone, Vicki; Dempsey, Eugene
    Objective: To assess whether there was an optimal maternal position (30° versus 60° incline) for kangaroo mother care. Design: Single centre cross-over randomised controlled trial. Mothers were randomly assigned to start at either a 30° or 60° angle. Primary outcomes were the mean cerebral near-infrared spectroscopy (NIRS) values. Secondary outcomes included median peripheral saturations and heart rates. Results: Twenty infants were included in the final analysis: median gestational age at birth was 28+1 weeks and median birth weight was 985 g. No significant differences were observed in the primary outcomes or the secondary outcomes at either angle. Conclusions: Maternal positioning at a 30° or 60° incline did not impact on cerebral oxygenation values in very preterm infants. Either position was associated with clinical stability. Trial Registration Number: ClinicalTrials.gov ID NCT05686252
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    Conflicts of interest in public health research and publications
    (Oxford University Press, 2025-02-07) Thomas, Samantha; Hennessy, Marita; Frazer, Kate; Wild, Cervantée; Haynes, Ashleigh; Kavanagh, Shane; Okan, Orkan; Daube, Mike
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    Introducing outcome-based education in obstetrics and gynaecology training: Perspectives of trainees and trainers
    (Elsevier Ltd., 2025-01-08) O'Sullivan, Orfhlaith E.; Leitao, Sara; S. Harney; M.E. Abdalla; O’Donoghue, Keelin
    Background and aims: Outcome-based education (OBE) focuses on clearly defined learner goals, offering a structured framework to achieve competency. This study explores the perspectives of trainees and trainers in Obstetrics and Gynaecology (O&G) in Ireland regarding facilitators, barriers, and challenges to implementing OBE. Methods: A national cross-sectional survey was distributed to O&G trainees and trainers in Ireland. Responses were analysed using descriptive statistics and chi-squared tests, and qualitative thematic analysis. Results: A total of 151 trainees and trainers participated in the study. While 61.2% of respondents reported familiarity with the concept of OBE, only 22.4% accurately identified its primary focus on learner goals. Participants highlighted several key benefits of OBE, including the establishment of clearly defined goals and the development of competency in essential skills. However, significant challenges were also identified, such as the perception of unattainable goals for trainees and insufficient training facilities. Additionally, trainer engagement and the lack of allocated time for both trainers and trainees to attend training courses were recognized as major barriers to the successful implementation of OBE. Conclusion: OBE presents a promising educational framework for O&G training, with the potential to modernize and enhance learning outcomes. However, its successful implementation hinges on comprehensive education about its principles and benefits, substantial investment in educational facilities and resources, and the prioritization of training through dedicated and protected time for both trainees and trainers.
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    Left atrial mechanics following preeclamptic pregnancy
    (Lippincott Williams & Wilkins, 2024-07) O’Driscoll, Jamie M.; McCarthy, Fergus P.; Giorgione, Veronica; Jalaludeen, Navazh; Seed, Paul T.; Gill, Carolyn; Sparkes, Jenie; Poston, Lucilla; Marber, Mike; Shennan, Andrew H.; Chappell, Lucy C.; Thilaganathan, Basky; Leeson, Paul
    BACKGROUND: Preterm preeclampsia is a pregnancy complication associated with myocardial dysfunction and premature cardiovascular disease morbidity and mortality. Left atrial (LA) strain is a noninvasive index of left ventricular end diastolic pressure and an early marker of heart failure risk. This study aimed to evaluate LA strain during the postpartum period in participants with and without preterm preeclampsia and to assess whether this varied in the presence of hypertension, cardiac dysfunction or both. METHODS: In this longitudinal cohort study, 321 women from 28 hospitals with preterm preeclampsia (cases) underwent cardiovascular assessment 6 months postpartum. This is a secondary analysis of the PHOEBE study (ISRCTN01879376). An uncomplicated pregnancy control group (n=30) was recruited from a single center for comparison. A full cross-sectional transthoracic echocardiogram was performed, and from these images, the myocardial strain of the left atrium, including reservoir, conduit, and contractile strain, as well as LA stiffness, were calculated. RESULTS: At 6 months postpartum, compared with controls, prior preeclampsia was associated with a significantly attenuated LA reservoir, conduit, and contractile strain, as well as increased LA stiffness (all P<0.001). LA strain was further reduced in preeclamptic women who had and had not developed hypertension, systolic, or diastolic dysfunction at 6 months postpartum (all P<0.05). CONCLUSIONS: LA mechanics were significantly attenuated at 6 months postpartum in participants with preterm preeclampsia, whether or not they remained hypertensive or had evidence of ventricular dysfunction. Further studies are needed to determine whether postnatal LA strain may identify women at greater risk for future cardiovascular disease.