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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2020

01-12-2020 | Public Health | Research article

Preventive health counselling during antenatal care using the pregnancy risk assessment monitoring system (PRAMS) in Ireland

Authors: Marion Murphy, Sheena McHugh, Linda M. O’Keeffe, Richard A. Greene, Paul Corcoran, Patricia M. Kearney

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

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Abstract

Background

Maternal behaviours during pregnancy have short- and long-term consequences for maternal and infant health. Pregnancy is an ideal opportunity to encourage positive behaviour change. Despite this, limited information exists about the nature and content of lifestyle advice provided by healthcare professionals during antenatal care. Pregnancy Risk Assessment Monitoring System (PRAMS) Ireland is based on the Centers for Disease Control and Prevention (CDC) developed PRAMS that monitors maternal behaviours and experiences before, during and after pregnancy. The aim of the study was to assess the prevalence of preventive health counselling during pregnancy.

Methods

Secondary data analysis of the PRAMS Ireland study. Using hospital discharge records, a sampling frame of 2424 mother-infant pairs was used to alternately sample 1212 women whom had recently given birth. Preventive health counselling was defined as advice during antenatal care on smoking, alcohol, infant feeding and weight gain. Self-reported maternal behaviours (smoking/alcohol cessation, gestational weight gain, infant feeding). Univariate and multivariable analyses were conducted, adjusting for maternal characteristics.

Results

Among 718 women (61% response rate), the reported counselling rates were 84.8% for breastfeeding (n = 592), 48.4% for alcohol (n = 338), 47.6% for smoking (n = 333) and 31.5% for weight gain (n = 218). Women who smoked pre–pregnancy (23.7%, n = 170) were more likely to receive counselling on its effects compared to non-smokers (Adjusted Odds Ratio (AOR) 2.72 (95% Confidence Interval (CI), 1.84–4.02)). In contrast, women who did not breastfeed (AOR 0.74, 95%CI 0.44–1.26) and those who reported alcohol consumption pre-pregnancy (AOR 0.94, 95%CI 0.64–1.37) were not more likely to receive counselling on these topics.

Conclusion

Pregnancy is an ideal opportunity to encourage positive behaviour change. Preventive health counselling during pregnancy is not routinely provided and rates vary widely depending on the health behaviour. This study suggests that additional strategies are needed to promote positive behaviour before and during the unique opportunity provided by pregnancy.
Literature
1.
Stotland NE, Hopkins LM, Caughey AB. Gestational weight gain, Macrosomia, and risk of cesarean birth in nondiabetic Nulliparas. Obstet Gynecol. 2004;104(4):671–7.PubMedCrossRef
2.
O’Leary CM, Nassar N, Kurinczuk JJ, Bower C. The effect of maternal alcohol consumption on fetal growth and preterm birth. BJOG Int J Obstet Gynaecol. 2009;116(3):390–400.CrossRef
3.
Li C, Goran MI, Kaur H, Nollen N, Ahluwalia JS. Developmental trajectories of overweight during childhood: role of early life factors. Obesity. 2007;15(3):760–71.PubMedCrossRef
4.
Koletzko B, Brands B, Chourdakis M, Cramer S, Grote V, Hellmuth C, Kirchberg F, Prell C, Rzehak P, Uhl O, et al. The power of programming and the EarlyNutrition project: opportunities for health promotion by nutrition during the first thousand days of life and beyond. Ann Nutr Metab. 2014;64(3–4):187–96.PubMedCrossRef
5.
Phelan S. Pregnancy: a “teachable moment” for weight control and obesity prevention. Am J Obstet Gynecol. 2010;202:135 e131 - e138.PubMedCrossRef
6.
7.
O'Keeffe L, Kearney P, Greene R. Surveillance during pregnancy: methods and response rates from a hospital based pilot study of the pregnancy risk assessment monitoring system in Ireland. BMC Pregnancy Childbirth. 2013;13(1):180.PubMedPubMedCentralCrossRef
8.
O'Keeffe LM, Dahl DL, Murphy M, Greene RA, Harrington JM, Corcoran P, Kearney PM. Positive lifestyle changes around the time of pregnancy: a cross-sectional study. BMJ Open. 2016;6(5):e010233.PubMedPubMedCentralCrossRef
9.
O'Keeffe LM, Kearney PM, McCarthy FP, Khashan AS, Greene RA, North RA, Poston L, McCowan LME, Baker PN, Dekker GA, et al. Prevalence and predictors of alcohol use during pregnancy: findings from international multicentre cohort studies. BMJ Open. 2015;5(7):e006323.PubMedPubMedCentralCrossRef
10.
11.
Walsh JM, McGowan CA, Mahony RM, Foley ME, McAuliffe FM. Obstetric and metabolic implications of excessive gestational weight gain in pregnancy. Obesity. 2014;22(7):1594–600.PubMedCrossRef
12.
Fattah C, Farah N, Barry SC, O'Connor N, Stuart B, Turner MJ. Maternal weight and body composition in the first trimester of pregnancy. Acta Obstet Gynecol Scand. 2010;89(7):952–5.PubMedCrossRef
13.
Restall A, Taylor RS, Thompson JMD, Flower D, Dekker GA, Kenny LC, Poston L, McCowan LME. Risk factors for excessive gestational weight gain in a healthy, Nulliparous Cohort. J Obesity. 2014;2014:9.CrossRef
14.
Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90.PubMedCrossRef
15.
16.
Asbee SM, Jenkins TR, Butler JR, White J, Elliot M, Rutledge A. Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: a randomized controlled trial. Obstet Gynecol. 2009;113(2 Pt 1):305–12.PubMedCrossRef
17.
Jones-Webb R, McKiver M, Pirie P, Miner K. Relationships between physician advice and tobacco and alcohol use during pregnancy. Am J Prev Med. 1999;16(3):244–7.PubMedCrossRef
18.
Krans EE, Davis MM, Schwarz EB. Psychosocial risk, prenatal counseling and maternal behavior: findings from PRAMS, 2004–2008. Am J obstetrics Gynecol. 2013;208(2):141 e141–141. e147.CrossRef
19.
Shipton D, Tappin DM, Vadiveloo T, Crossley JA, Aitken DA, Chalmers J. Reliability of self reported smoking status by pregnant women for estimating smoking prevalence: a retrospective, cross sectional study. BMJ. 2009;339(b4347).PubMedPubMedCentralCrossRef
20.
Kennedy P. Healthcare reform: maternity service provision in Ireland. Health Policy. 2010;97(2):145–51.PubMedCrossRef
21.
O’Keeffe LM, Kearney PM, Greene RA. Pregnancy risk assessment monitoring system in Ireland: methods and response rates. Matern Child Health J. 2014;19(3):480–6.CrossRef
22.
Di Mario SBV, Gori G, Spettoli D. What is the effectiveness of antenatal care? (Supplement). Copenhagen: WHO Regional Office for Europe (Health Evidence Network report); 2005.
23.
Bollini P, Quack-Lötscher K. Guidelines-based indicators to measure quality of antenatal care. J Eval Clin Pract. 2013;19(6):1060–6.PubMedCrossRef
24.
25.
Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. National Research Council. Weight Gain During Pregnancy: Reexamining the Guidelines. In: Rasmussen KMYA, editor. Committee to Reexamine IOM Pregnancy Weight Guidelines. Washington (DC): National Academies Press (US); 2009.
26.
Willcox J, Campbell K, van der Plight P, Hoban E, Pidd D, Wilkinson S. Excess gestational weight gain: an exploration of midwives’ views and practice. BMC Pregnancy Childbirth. 2012;12(1):102.PubMedPubMedCentralCrossRef
27.
Stengel MR, Kraschnewski JL, Hwang SW, Kjerulff KH, Chuang CH. “what my doctor Didn't tell me”: examining health care provider advice to overweight and obese pregnant women on gestational weight gain and physical activity. Womens Health Issues. 2012;22(6):e535–40.PubMedPubMedCentralCrossRef
28.
Whitworth M, Dowswell T. Routine pre-pregnancy health promotion for improving pregnancy outcomes. Cochrane Database Syst Rev. 2009;(4):CD007536.
29.
Padmanabhan U, Summerbell CD, Heslehurst N. A qualitative study exploring pregnant women’s weight-related attitudes and beliefs in UK: the BLOOM study. BMC Pregnancy Childbirth. 2015;15:99.PubMedPubMedCentralCrossRef
30.
Siega-Riz AM, Viswanathan M, Moos M-K, Deierlein A, Mumford S, Knaack J, Thieda P, Lux LJ, Lohr KN. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstetrics Gynecol. 2009;201(4):339.e331–14.CrossRef
31.
Oken E, Rifas-Shiman S, Field A, Frazier A, Gillman M. Maternal gestational weight gain and offspring weight in adolescence. Obstet Gynecol. 2008;112:999–1006.PubMedPubMedCentralCrossRef
32.
33.
Raymond N, Beer C, Glazebrook C, Sayal K. Pregnant women's attitudes towards alcohol consumption. BMC Public Health. 2009;9(1):1–8.CrossRef
34.
National Institute for Health and Care Excellence: Antenatal care: routine care for healthy pregnant women: NICE clinical guidelines 62. In.; 2008.
35.
36.
37.
Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victora CG. Why invest, and what it will take to improve breastfeeding practices? Lancet. 387(10017):491–504.CrossRef
38.
Nolan A, Layte R. The ‘healthy immigrant effect’: breastfeeding behaviour in Ireland. European J Public Health. 2014;25(4):626–31.CrossRef
39.
McCowan LME, Dekker GA, Chan E, Stewart A, Chappell LC, Hunter M, Moss-Morris R, North RA. Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study. BMJ. 2009;338:b1081.PubMedPubMedCentralCrossRef
40.
Tappin D, Bauld L, Purves D, Boyd K, Sinclair L, MacAskill S, McKell J, Friel B, McConnachie A, de Caestecker L, et al. Financial incentives for smoking cessation in pregnancy: randomised controlled trial. BMJ. 2015;350:h134.PubMedCrossRef
41.
Chamberlain C, O'Mara-Eves A, Porter J, Coleman T, Perlen SM, Thomas J, McKenzie JE. Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database Syst Rev. 2017;(2):CD001055.
42.
43.
Stead Lindsay F, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2013;(5):CD000165.
44.
Walker DS, McCully L, Vest V. Evidence-based prenatal care visits: when less is more. J Midwifery Women’s Health. 2001;46(3):146–51.CrossRef
45.
46.
Hawkins S, Stern A, Gillman M. Do state breastfeeding laws in the USA promote breast feeding? J Epidemiol Community Health. 2013;67(3):250–6.PubMedCrossRef
47.
Wilkinson SA, McIntyre HD. Evaluation of the ‘healthy start to pregnancy’ early antenatal health promotion workshop: a randomized controlled trial. BMC Pregnancy Childbirth. 2012;12:131.PubMedPubMedCentralCrossRef
48.
49.
Williams L, Zapata LB, D’Angelo DV, Harrison L, Morrow B. Associations between preconception counseling and maternal behaviors before and during pregnancy. Matern Child Health J. 2012;16(9):1854–61.PubMedCrossRef
Metadata
Title
Preventive health counselling during antenatal care using the pregnancy risk assessment monitoring system (PRAMS) in Ireland
Authors
Marion Murphy
Sheena McHugh
Linda M. O’Keeffe
Richard A. Greene
Paul Corcoran
Patricia M. Kearney
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-2756-y

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