21 research outputs found
User engagement in the delivery and design of maternity services
No full textUser engagement is defined as a mutual exchange of information between the patient and the health professional, which has shown to improve patient experience as well as outcomes. Engaging the patient is vital for the healthcare system to remain sustainable. The National Health Service has attempted to incorporate and enhance patient engagement in the delivery of maternity services for the last decade. The financial crisis, changing socio-demographic status, increase in birth rate and public expectations-engaging the patient to take responsibility of their own health has not been achieved. Through in-depth examinations of these barriers we are able to draw conclusions as to why current policies have failed and recommend potential solutions. (C) 2013 Elsevier Ltd. All rights reserved.</p
68 This programe was delivered through the GSTT school of improvement (postgraduate medical education) in a london teaching hospital with a large cohort of foundation and specialist trainee doctors. The most recent national trainee survey 2018 has documented
No full textLearning from low-resource maternity care using pregnancy outcomes from the Solomon Islands
No full text70 Tomorrows leaders, maximising potential – an integrated leadership training programme
No full textUsing Trust databases to identify predictors of late booking for antenatal care within the UK
No full textObjectives: To identify predictors of late booking for antenatal care using routinely collected data. Study design: Retrospective cohort study. Methods: Variables were selected with reference to comprehensive literature review. Data were extracted from a London hospital case-note database, and predictors of late booking were identified using logistic regression. Results: In total, 5629 women were included in the study. Median gestation at booking was 14 weeks, and 31% of women booked after 18 weeks of gestation. Variables with insufficient data recorded included language abilities, nationality and social risk. Women aged between 15 and 19 years, women with more than four children, and women belonging to the ethnic group 'other' were all significantly more likely to book late. Women with a body mass index >= 30kg/m(2) were 1.5 times more likely to book late (not significant). Conclusion: Case-note databases are a potentially easy and effective way to analyse access to care and provider compliance with quality standards. Current deficits in routine data collection need to be addressed urgently in order to make this possible.</p
Existing maternal obesity guidelines may increase inequalities between ethnic groups: a national epidemiological study of 502,474 births in England
No full text<p>Background:
Asians are at increased risk of morbidity at a lower body mass index (BMI) than European Whites, particularly relating to metabolic risk. UK maternal obesity guidelines use general population BMI criteria to define obesity, which do not represent the risk of morbidity among Asian populations. This study compares incidence of first trimester obesity using Asian-specific and general population BMI criteria.</p>
<p>Method:
A retrospective epidemiological study of 502,474 births between 1995 and 2007, from 34 maternity units across England. Data analyses included a comparison of trends over time between ethnic groups using Asian-specific and general population BMI criteria. Logistic regression estimated odds ratios for first trimester obesity among ethnic groups following adjustment for population demographics.</p>
<p>Results:
Black and South Asian women have a higher incidence of first trimester obesity compared with White women. This is most pronounced for Pakistani women following adjustment for population structure (OR 2.19, 95% C.I. 2.08, 2.31). There is a twofold increase in the proportion of South Asian women classified as obese when using the Asian-specific BMI criteria rather than general population BMI criteria. The incidence of obesity among Black women is increasing at the most rapid rate over time (p=0.01).</p>
<p>Conclusion:
The twofold increase in maternal obesity among South Asians when using Asian-specific BMI criteria highlights inequalities among pregnant women. A large proportion of South Asian women are potentially being wrongly assigned to low risk care using current UK guidelines to classify obesity and determine care requirements. Further research is required to identify if there is any improvement in pregnancy outcomes if Asian-specific BMI criteria are utilised in the clinical management of maternal obesity to ensure the best quality of care is provided for women irrespective of ethnicity.</p>
A prospective study of pregnancy outcome and biomarkers of oxidative stress in nulliparous obese women
No full textOBJECTIVE: We sought to investigate pregnancy outcome and biomarkers of oxidative stress in nulliparous obese pregnant women. STUDY DESIGN: Pregnancy outcome and blood biomarkers were assessed prospectively in 385 obese nulliparous women from the placebo arm of a randomized controlled trial. RESULTS: Body mass index was associated with higher rates of preeclampsia (PE) (P = .010) and cesarean section (P = .016). In all, 18.8% of infants were small for gestational age (<10th adjusted birthweight centile), 13.4% were large for gestational age (> 90th centile), and 11.9% were preterm. The plasma ascorbic acid concentration was inversely related to small-for-gestational-age delivery (P <.025), and increased plasma triglyceride concentrations with later PE (P <.0001). Plasma uric acid concentration (P = .043) and the gamma- tocopherol: alpha-tocopherol ratio (P = .023) were related to body mass index. CONCLUSION: A previously unreported risk of fetal growth restriction associated with reduced plasma ascorbic acid concentration was identified in nulliparous obese women. The high incidence of PE and preterm birth were unrelated to oxidative stress markers
Existing maternal obesity guidelines may increase inequalities between ethnic groups: a national epidemiological study of 502,474 births in England
No full textAbstract Background: Asians are at increased risk of morbidity at a lower body mass index (BMI) than European Whites, particularly relating to metabolic risk. UK maternal obesity guidelines use general population BMI criteria to define obesity, which do not represent the risk of morbidity among Asian populations. This study compares incidence of first trimester obesity using Asian-specific and general population BMI criteria. Method: A retrospective epidemiological study of 502,474 births between 1995 and 2007, from 34 maternity units across England. Data analyses included a comparison of trends over time between ethnic groups using Asian-specific and general population BMI criteria. Logistic regression estimated odds ratios for first trimester obesity among ethnic groups following adjustment for population demographics
