The long-lasting impact of postnatal depression on families

A new piece of research is the first to consider the impact of postnatal depression (PND) on the mother-child relationship in the longer-term, and on intergenerational relationships. (via Science Daily)

mother-3166806_1920The researchers from the University of Kent surveyed over 300 women (predominantly from the UK and US) with  an average age of 60 and who had given birth to an average of 2.2 children. Their children ranged in age from 8 to 48, with an average age of 29 and many of whom now had their own children. This wide-ranging data set allowed them to assess the impact of PND over a longer time frame than has been hitherto examined. They used their responses to this retrospective questionnaire study to assess the consequences of PND across two generations, the original mother-child relationship (generation 1) across the life of the child (generation 2) and the quality of the relationship they had with their child’s child/ren (generation 3).

 

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A guide to support maternity champions

NHS Improvement have published this guide to support maternity safety champions at every levels (fron line, trust board and regional).  It outlines the role descriptions and responsibilities for maternity safety champions,  suggests activities to promote best practice, and also signposts existing safety initiatives and improvements that can offer support. The full guide is available from NHS Improvement here .

maternity guide
Image source: NHS Improvement 

 

 

Maternity care guideline

Intrapartum care for a positive childbirth experience | The World Health Organization

intra
Image source: http://www.who.int

This guideline brings together new and existing WHO recommendations that, when delivered as a package, will ensure good-quality and evidence-based care irrespective of the setting or level of health care.

It highlights the importance of woman-centred care to optimize the experience of labour and childbirth for women and their babies.

Full document: Intrapartum care for a positive childbirth experience

 

Additional links: WHO press release | Royal College of Midwives press release

A school-based lifestyle intervention didn’t help children avoid unhealthy weight gain

Wyatt K, Lloyd J, Creanor S, et al. Cluster randomised controlled trial and economic and process evaluation to determine the effectiveness and cost-effectiveness of a novel intervention [Healthy Lifestyles Programme (HeLP)] to prevent obesity in school children. Public Health Res. 2018;6(1).

The Healthy Lifestyle Programme delivered to 9-10-year-old school children did not reduce their weight over the course of two years. Around a third remained overweight or obese, the same as iBiken schools that followed the standard syllabus.

This trial, funded by the NIHR, assigned schools across Devon to follow a lifestyle programme in Year five. The comprehensive curriculum included drama and activity workshops, personal goal setting and parental involvement.

Children made better food choices, but this did not affect weight outcomes. It was almost certain the programme wouldn’t give value for money.

Programmes addressing the wider school environment or delivered at the community or population level may have greater scope for preventing obesity.

Takeaways linked to increased cardiovascular risk factors and obesity in children

Donin AS, Nightingale CM, Owen CG, et al. Takeaway meal consumption and risk markers for coronary heart disease, type 2 diabetes and obesity in children aged 9-10 years: a cross-sectional study. Arch Dis Child. 2017

Children who eat takeaways once or more each week have more body fat and higher low-density lipoprotein (LDL) “bad” cholesterol levels than those who never or hardly evefish-and-chipsr eat them. Their diets were also higher in fat and lower in protein and calcium.

This cross-sectional study looked in depth at eating habits and risk markers for coronary heart disease, obesity and diabetes in 2,529 children in England. Though this type of study can only show an association between takeaways and risk markers, it is one of the first of its type, and the results do give cause for concern.

Increasing numbers of people are eating takeaways in the UK. Local authorities and healthcare professionals are well placed to encourage parents and children to choose healthier foods, in line with current national guidance.

Healthy Child Programme: rapid review on safeguarding

Public Health England, 12 February 2018

The Healthy Child Programme sets out the recommended framework of universal and progressive services for children and young people in England to promote their health and wellbeing.

The purpose of this rapid review is to update the evidence regarding safeguarding guidance, focusing on prevention and early intervention.

The review looks at relevant systematic review level evidence, supplemented with some primary impact evaluations in the areas of preventing or intervening early with:

  • child abuse and neglect
  • child sexual abuse and exploitation
  • intimate partner violence
  • female genital mutilation
  • gang violence

How common are fetal alcohol spectrum disorders?

May, P. , A.  et al. | Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities | JAMA| 2018| 319| Vol. 5| DOI: 10.1001/jama. 2017.21896

Researchers from University Of California,  Sand Diego School of Medicine looked at 4 regions in the US between 2010 and 2016, examined the incidence of fetal alcohol spectrum disorders (FASD); found that a significant number had fetal alcohol spectrum disorders.  The findings of this study, may represent more accurate prevelance rates of  FASD  than previous studies indicate.

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Abstract

Importance  Fetal alcohol spectrum disorders are costly, life-long disabilities. Older data suggested the prevalence of the disorder in the United States was 10 per 1000 children; however, there are few current estimates based on larger, diverse US population samples.

Objective  To estimate the prevalence of fetal alcohol spectrum disorders, including fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder, in 4 regions of the United States.

Design, Setting, and Participants  Active case ascertainment methods using a cross-sectional design were used to assess children for fetal alcohol spectrum disorders between 2010 and 2016. Children were systematically assessed in the 4 domains that contribute to the fetal alcohol spectrum disorder continuum: dysmorphic features, physical growth, neurobehavioral development, and prenatal alcohol exposure. The settings were 4 communities in the Rocky Mountain, Midwestern, Southeastern, and Pacific Southwestern regions of the United States. First-grade children and their parents or guardians were enrolled.

Exposures  Alcohol consumption during pregnancy.

Main Outcomes and Measures  Prevalence of fetal alcohol spectrum disorders in the 4 communities was the main outcome. Conservative estimates for the prevalence of the disorder and 95% CIs were calculated using the eligible first-grade population as the denominator. Weighted prevalences and 95% CIs were also estimated, accounting for the sampling schemes and using data restricted to children who received a full evaluation.

Results  A total of 6639 children were selected for participation from a population of 13 146 first-graders (boys, 51.9%; mean age, 6.7 years [SD, 0.41] and white maternal race, 79.3%). A total of 222 cases of fetal alcohol spectrum disorders were identified. The conservative prevalence estimates for fetal alcohol spectrum disorders ranged from 11.3 (95% CI, 7.8-15.8) to 50.0 (95% CI, 39.9-61.7) per 1000 children. The weighted prevalence estimates for fetal alcohol spectrum disorders ranged from 31.1 (95% CI, 16.1-54.0) to 98.5 (95% CI, 57.5-139.5) per 1000 children.

Conclusions and Relevance  Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach.

The full article is available for Rotherham NHS staff from the hospital library or can be requested here