Postnatal mental illness

The National Childbirth Trust (NCT) has published The hidden half: bringing postnatal mental illness out of hiding.

pnd

Image source: http://www.nct.org.uk

The Hidden Half campaign surveyed 1,000 women who had recently had a baby and found that half had a mental health or emotional problem postnatally or during pregnancy. Of these, nearly half hadn’t had their problem identified by a health professional and hadn’t received any help or treatment. Many of these new mothers said they were too embarrassed or afraid of judgement to seek help.

The document can be downloaded here

Additional link: RCGP press release

Women’s Smoking Status at Time of Delivery

This report presents the latest results and trends from the women’s smoking status at time of delivery (SATOD) data collection in England. 

The results provide a measure of the prevalence of smoking among pregnant women at Commissioning Region, Region and Clinical Commissioning Group level.

Key facts

In 2016/17:

  • 10.5 per cent of pregnant women were known to be smokers at the time of delivery. This compares to 10.6 per cent for the previous year (2015/16), and is down from 15.1 per cent in 2006/07.
  • This is the second consecutive year that the proportion has been below the national ambition of 11 per cent.
  • The CCGs with the lowest proportion of women known to be smokers at the time of delivery were NHS West London (2.3 per cent), NHS Richmond (2.5) and NHS Hammersmith and Fulham (2.7).
  • The CCGs with the highest proportion were NHS Blackpool (28.1 per cent), NHS Hull (22.9) and NHS North East Lincolnshire (22.3).
  • 104 out of 209 CCGs met the national ambition of 11 per cent or less.

The report can be viewed here

Lithium Use in Pregnancy and the Risk of Cardiac Malformations

There has been concern that exposure to lithium early in pregnancy may be associated with a marked increase in the risk of Ebstein’s anomaly (a right ventricular outflow tract obstruction defect) in infants and overall congenital cardiac defects, but data are conflicting and limited | NEJM

https://www.flickr.com/photos/ephotography29/3093917122/

Image source: Erin – Flickr // CC BY-NC-ND 2.0

Methods: We conducted a cohort study involving 1,325,563 pregnancies in women who were enrolled in Medicaid and who delivered a live-born infant between 2000 and 2010. We examined the risk of cardiac malformations among infants exposed to lithium during the first trimester as compared with unexposed infants and, in secondary analyses, with infants exposed to another commonly used mood stabilizer, lamotrigine. Risk ratios and 95% confidence intervals were estimated with control for psychiatric and medical conditions, medications, and other potential confounders.

Conclusions: Maternal use of lithium during the first trimester was associated with an increased risk of cardiac malformations, including Ebstein’s anomaly; the magnitude of this effect was smaller than had been previously postulated

Full reference: Patorno, E. et al. (2017) Lithium Use in Pregnancy and the Risk of Cardiac Malformations. New England Journal of Medicine. 376 pp. 2245-2254

Is it safe to express milk before giving birth?

Some women, especially with diabetes, are recommended to express milk while still pregnant and to save it for their newborn, yet no evidence exists for this practice.

A study published in today’s Lancet aimed to determine the safety and efficacy of antenatal expressing in women with diabetes in pregnancy.

pregnancy-466129_1920 The study found that expressing while pregnant is safe for women with diabetes in low-risk pregnancies in late pregnancy (from around 36 weeks). After studying over 600 women, the authors found no increase in early births or admissions to neonatal intensive care. However, one in four women couldn’t collect any colostrum.

Before the trial, researchers had only run three small studies of expressing colostrum while pregnant, and no randomised trials for women without diabetes.

The authors advice to women with questions about expressing while pregnant is to ask their health care professional about their individual situation.

Read more at The Conversation

Full reference: Forster, Della A et al. | Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial | The Lancet , Volume 389 , Issue 10085 , 2204 – 2213

Alcohol abstention advice to pregnant women is wrong, say campaigners

Health officials and experts are wrong to tell women that they should completely abstain from drinking alcohol during pregnancy, according to campaigners | OnMedica

wineglass-553467_960_720.jpg

Telling women that small quantities of alcohol in pregnancy can cause irreparable damage to a developing foetus has no basis in evidence and can cause needless anxiety, claimed academics and women’s advocates speaking at a conference in Canterbury, Kent.

The conference, Policing pregnancy: who should be a mother?, is a collaboration between the British Pregnancy Advisory Service (BPAS) charity, the Centre for Parenting Culture Studies (CPCS), maternal rights campaign group Birthrights, and engaging sociology.

Currently, pregnant women are warned that even light alcohol consumption can cause problems for them and long-term harm to their foetus, such as stunted growth, and eventual learning difficulties and behavioural problems. Warnings also include the possibility of liver damage to the baby and increased risk of the mother having a miscarriage.

Read the full overview here

Related news article by the Guardian available here

Pregnant women encouraged to ‘Always Ask’

The Royal College of Midwives has endorsed a new campaign called ‘Always Ask’ which is designed to empower pregnant women to overcome fears of asking health professionals questions. The campaign is designed to reduce the number of women who have serious pregnancy complications, or a loss that could have been prevented.

For more information click here

Mindfulness-Based Interventions During Pregnancy

Dhillon, A. et al. Mindfulness | Published online 17 April 2017

yoga-1883321_960_720

This systematic review aims to assess the effect of mindfulness-based interventions carried out during pregnancy exploring mindfulness and mental health outcomes.

Pooled results of the non-RCTs reporting anxiety, depression and perceived stress showed a significant benefit for the mindfulness group. Mindfulness as an outcome was assessed in four RCTs for which the pooled results show a significant difference in favour of the mindfulness intervention when compared to a control group. The pooled results of the four non-RCTs also indicate a significant difference following mindfulness intervention.

Results suggest that mindfulness-based interventions can be beneficial for outcomes such as anxiety, depression, perceived stress and levels of mindfulness during the perinatal period. Further research would be useful to explore if such benefits are sustained during the post-natal period.

Read the article here