High blood pressure in pregnancy linked to mother’s heart function

University of Bristol | July 2018 | High blood pressure in pregnancy linked to mother’s heart function

Research carried out by scientists at Imperial College London, the Universities of Cambridge and Bristol  indicates that high blood pressure in pregnancy may be due to the heart pumping less blood with each beat. 

The researchers followed over 200 women prior to and during their pregnancies. Before becoming pregnant all the participants were assessed to test their heart function and blood circulation. They compared the 15 women who developed pre-eclampsia during pregnancy with women who had a healthy pregnancy.

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The results revealed that although the women’s heart and blood pressure were still in the healthy range, their hearts pumped 16 per cent less blood per minute than the women who had healthy pregnancies, and their blood vessels were 17 per cent more  resistant to blood flow. This caused their blood pressure to be slightly higher, but still normal.

These findings indicate that expectant mothers who develop high blood pressure (pre-eclampsia), or fetal growth restriction (where a baby’s growth slows or stops before birth), may have differences in their blood circulation (via University of Bristol).

The full news article is available from the University of Bristol 
The research findings have now been published in the journal Hypertension where the article is available to read in full.

Abstract

Preeclampsia and fetal growth restriction during pregnancy are associated with increased risk of maternal cardiovascular disease later in life. It is unclear whether this association is causal or driven by similar antecedent risk factors. Clarification requires recruitment before conception which is methodologically difficult with high attrition rates and loss of outcome numbers to nonconception/miscarriage. Few prospective studies have, therefore, been adequately powered to address these questions. We recruited 530 healthy women (mean age: 35.0 years) intending to conceive and assessed cardiac output, cardiac index, stroke volume, total peripheral resistance, mean arterial pressure, and heart rate before pregnancy. Participants were followed to completion of subsequent pregnancy with repeat longitudinal assessments. Of 356 spontaneously conceived pregnancies, 15 were affected by preeclampsia and fetal growth restriction. Women who subsequently developed preeclampsia/fetal growth restriction had lower preconception cardiac output  and cardiac index  while mean arterial pressure  and total peripheral resistance were higher. Longitudinal trajectories for cardiac output and total peripheral resistance were similar between affected and healthy pregnancies, but the former group showed a more exaggerated fall in mean arterial pressure in the first trimester, followed by a steeper rise and a steeper fall to postpartum values. Significant relationships were observed between cardiac output, total peripheral resistance, and mean arterial pressure and gestational epoch. We conclude that in healthy women, an altered prepregnancy hemodynamic phenotype is associated with the subsequent development of preeclampsia/fetal growth restriction.

Full reference:

Fung L. Foo|2018| Association Between Prepregnancy Cardiovascular Function and Subsequent Preeclampsia or Fetal Growth Restriction | https://doi.org/10.1161/HYPERTENSIONAHA.118.11092

 

Pregnant women invited to take part in pioneering diabetes prevention research

NIHR |July 2018 | Pregnant women invited to take part in pioneering diabetes prevention research

Pregnant women visiting maternity clinics in Berkshire, Buckinghamshire, Milton Keynes and Oxfordshire are being invited to participate in a new study, The INvestigating Genetic Risk for type 1 Diabetes (INGR1D), to identify the risk of their child developing type 1 diabetes.
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Mothers of infants identified to have a higher risk of type 1 diabetes will then be offered an opportunity to take part in the Primary Oral Insulin Trial (POInT trial) to see if giving  high-risk children small doses of insulin powder can prevent them from developing type 1 diabetes.

Participants on the trial are given the powder or a placebo, to compare the two. Parents are asked to give their children insulin powder daily until they are three years old. They will have visits from the research team to monitor the child’s health.

The scientists hope that this intervention can train the immune system to tolerate the body’s own insulin to prevent the onset of type 1 diabetes (Source: NIHR).

Full details are available from NIHR 

In the news:

BBC News Stopping type 1 diabetes from birth

Infectious diseases in pregnancy screening checks and audits

Public Health England | July 2018 | Infectious diseases in pregnancy screening checks and audits

Public Health England (PHE) has released new guidance which outlines the checks that are needed at each stage to ensure the individual moves seamlessly and safely through the pathway unless they choose not to.

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The NHS infectious diseases in pregnancy screening (IDPS) programme aims to:

  • ensure a high quality, accessible screening programme throughout England;
  • support people to make informed choices during pregnancy and ensure timely transition into appropriate follow-up and treatment;
  • promote greater understanding and awareness of the conditions and the value of screening.

The guidance is available in full from PHE 

Related documents:

Childhood vulnerability

Over two million children in England are growing up in families where there are serious risks, major study from Children’s Commissioner reveals

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Image source: http://www.childrenscommissioner.gov.uk/

The Children’s Commissioner has published Vulnerability report 2018 which brings together a range of information held by various government departments, agencies and others to reveal the scale of child vulnerability in England.  It estimates that 2.1 million of England’s 11.8 million children – one in six – are living in families with risks so serious that they need some level of help.

The study also warns that for 1.6 million of those vulnerable children, the support is effectively ‘invisible’ – we don’t know if they are actually getting any coordinated help, despite the difficulties they are growing up with. Some of the risks these children face include parents with mental health problems or parents who are alcoholics or have substance abuse problems.

The 2.1 million children growing up in families with these complex needs includes:

  • 890,000 children with parents suffering serious mental health problems
  • 825,000 children living in homes with domestic violence
  • 470,000 children whose parents use substances problematically
  • 100,000 children who are living in a family with a “toxic trio” (mental health problems, domestic violence and alcohol and/or substance abuse)
  • 470,000 children living in material deprivation
  • 170,000 children who care for their parents or siblings

Full detail: Children’s Commissioner’s annual study of childhood vulnerability in England

Summary document: Vulnerability Report 2018

 

 

Working together to safeguard children

Revised statutory guidance on inter-agency working to safeguard and promote the welfare of children.  It sets out new legal requirements for local police, councils and health services who will be required to make joint safeguarding decisions | Department for Education

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Children at risk of abuse or neglect will now be protected through improved partnerships between local police, councils and health services.

Strengthened guidance published by the Department for Education sets new legal requirements for the three safeguarding partners, who will be required to make joint safeguarding decisions to meet the needs of local children and families.

Senior police, council and health leaders will jointly be responsible for setting out local plans to keep children safe and will be accountable for how well agencies work together to protect children from abuse and neglect.

The new advice is aimed at all professionals who come in to contact with children and families and includes guidance on current threats to child protection, such as sexual and criminal exploitation, gangs and radicalisation.

Full detail: The Department of Education | Working together to safeguard children

Additional link: Press release

Reproductive health and pregnancy planning

A resource focusing on reproductive choice and ensuring that pregnancy, if desired, occurs at the right time and when health is optimised | Public Health England

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Image source: http://www.gov.uk

This resource for professionals working with women and men that may have children in the future focuses on reproductive choice and ensuring that pregnancy, if desired, occurs at the right time and when health is optimised. Effective contraception and planning for pregnancy mean that women and men stay healthy throughout life and take steps to improve the health of the baby.

Survey reveals 31 % of women experience severe reproductive health issues

Public Health England | 2018 | Information about the gaps in data and services in reproductive health and healthcare for women.

A  new publication from Public Health England (PHE) report is the first of its kind to report  the impact of women’s reproductive health issues on the nation’s physical, mental and social wellbeing. The survey of 7,367 women reveals that 31% had experienced severe reproductive health symptoms in the last 12 months, ranging from heavy menstrual bleeding to menopause, incontinence to infertility.The report shows  the impact these issues have on women’s ability to work and go about their daily lives and will form the basis of a cross-governmental 5-year action plan on reproductive health (Source: PHE).

Dr Sue Mann, Public Health Consultant in Reproductive Health, from PHE said:
“Women’s reproductive health concerns can fundamentally influence physical and mental well-being throughout their whole life course. Our research has highlighted that while individual reproductive health issues and concerns change throughout a woman’s life, the feelings of stigmatisation and embarrassment were almost universal.”
“The report reveals the need for an open and supportive approach in the workplace and in the health system. We encourage women to seek support from their workplace, and for workplace management to be aware of how reproductive health symptoms can affect women’s daily health.”

The full press release can be read from PHE 

A consensus statement Reproductive health is a public health issue  

What do women say? Reproductive health is a public health issue