519 results on '"McAuliffe F"'
Search Results
152. Placental Villus Morphology in Relation to Maternal Hypoxia at High Altitude
- Author
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Espinoza, J., primary, Sebire, N.J., additional, McAuliffe, F., additional, Krampl, E., additional, and Nicolaides, K.H., additional
- Published
- 2001
- Full Text
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153. Outcome of Diabetic Pregnancy With Spontaneous Labour After 38 Weeks
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McAuliffe, F. M., primary, Foley, M., additional, Firth, R., additional, Drury, I., additional, and Stronge, J. M., additional
- Published
- 2000
- Full Text
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154. Novel placental ultrasound assessment: potential role in pre-gestational diabetic pregnancy.
- Author
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Moran, M, Mulcahy, C, Daly, L, Zombori, G, Downey, P, and McAuliffe, F M
- Abstract
Objectives: Management of women with pre-gestational diabetes continues to be challenging for clinicians. This study aims to determine if 3D power Doppler (3DPD) analysis of placental volume and flow, and calculation of placental calcification using a novel software method, differ between pregnancies with type 1 or type 2 diabetes and normal controls, and if there is a relationship between these ultrasound placental parameters and clinical measures in diabetics.Methods: This was a prospective cohort study of 50 women with diabetes and 250 controls (12-40 weeks gestation). 3DPD ultrasound was used to evaluate placental volume, vascularisation index (VI), flow index (FI) and vascularisation-flow index (VFI). Placental calcification was calculated by computer analysis. Results in diabetics were compared with control values, and correlated with early pregnancy HbA1c, Doppler results and placental histology.Results: Placental calcification and volume increased with advancing gestation in pre-gestational diabetic placentae. Volume was also found to be significantly higher than in normal placentae. VI and VFI were significantly lower in diabetic pregnancies between 35 and 40 weeks gestation. A strong relationship was seen between a larger placental volume and both increasing umbilical artery pulsatility index and decreasing middle cerebral artery pulsatility index. FI was significantly lower in cases which had a booking HbA1c level ≥6.5%. Ultrasound assessed placental calcification was reduced with a histology finding of delayed villous maturation. No other correlation with placental histology was found.Conclusions: This study shows a potential role for 3D placental evaluation, and computer analysis of calcification, in monitoring pre-gestational diabetic pregnancies. [ABSTRACT FROM AUTHOR]- Published
- 2014
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155. Understanding of Growth Monitoring Charts by Literate and Illiterate Mothers in Northeast Brazil
- Author
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McAuliffe, F., primary, Falcao, L., additional, BS, B., additional, and Duncan, B., additional
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- 1993
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156. Thoraco-Amniotic Shunting for Fetal Pleural Effusion -- A Case Series.
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Walsh, J., Mahony, R., Higgins, S., McParland, P., Carroll, S., and McAuliffe, F.
- Published
- 2011
157. Successful Fetoscopic Laser Coagulation for Twin-to-Twin Transfusion Syndrome under Local Anaesthesia.
- Author
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Cooley, S., Walsh, J., Mahony, R., Carroll, S., Higgins, S., McParland, P., and McAuliffe, F.
- Published
- 2011
158. Troponin T and Pro-B-Type Natriuretic Peptide in Fetuses of Type 1 Diabetic Mothers.
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Russell, Noirin E., Higgins, Mary F., Amaruso, Michael, Foley, Michael, and McAuliffe, F. M.
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PROTEINS ,ATRIAL natriuretic peptides ,FETUS ,GESTATIONAL diabetes ,PEOPLE with diabetes ,HYPERGLYCEMIA ,CARDIOMYOPATHIES ,DIABETES in women - Abstract
OBJECTIVE -- Cardiomyopathy is noted in up to 40% of infants of diabetic mothers, and the exact mechanisms are unknown. The aim of this study was to determine whether fetal serum markers of cardiac function differ between normal and type 1 diabetic pregnancies and to examine the relationship between these markers and fetal cardiac structure and function. RESEARCH DESIGN AND METHODS-- This was a prospective observational study of 45 type 1 diabetic pregnancies and 39 normal pregnancies. All participants had concentrations of fetal pro-B-type natriuretic peptide (proBNP) and troponin-T (TnT) measured at the time of delivery. All patients with type 1 diabetes had Doppler evaluation of the umbilical artery, middle cerebral artery, and ductus venosus in the third trimester, and a subset (n = 21) had detailed fetal echocardiograms performed in each trimester. RESULTS -- Fetal proBNP and TnT concentrations were higher in the diabetic cohort than in the normal cohort (P < 0.05). ProBNP correlated positively with interventricular septum thickness (P < 0.05) but not with cardiac function indexes in the third trimester. In patients with poor glycemic control, there was a significant positive correlation (P < 0.05) between fetal TnT and the third trimester umbilical artery pulsatility index. There were also increased levels of fetal TnT in infants with poor perinatal outcome (P < 0.05). CONCLUSIONS-- Biochemical markers of cardiac dysfunction are elevated in infants of diabetic mothers, especially those with cardiomyopathy or poor perinatal outcome. Hyperglycemia in early pregnancy may affect myocardial and placental development, thus contributing to the susceptibility to hypoxia seen in these infants. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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- View/download PDF
159. Maternal cardiac function in twin pregnancy.
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Kametas NA, McAuliffe F, Krampl E, Chambers J, Nicolaides KH, Kametas, Nikos A, McAuliffe, Fionnuala, Krampl, Elisabeth, Chambers, John, and Nicolaides, Kypros H
- Abstract
Objective: To investigate maternal cardiac function in twin pregnancy.Methods: We conducted a cross-sectional study of 119 pregnant women with twin pregnancies at 10-40 weeks' gestation. Two-dimensional and M-mode echocardiography of the left ventricle was performed in the left lateral decubitus position to assess left ventricular longitudinal and transverse systolic function. The measurements were compared with those obtained from 128 women with singleton pregnancies previously reported.Results: In twin pregnancies, compared with singletons, maternal cardiac output was greater by 20% (P <.001), because of a greater stroke volume (15%, P <.001) and heart rate (3.5%; P =.04). Furthermore, in women with twins there were greater left ventricular end-diastolic and left ventricular end-systolic dimensions, left ventricular mass (13.5%; P <.001), fractional shortening (3%; P =.04), and ejection fraction (2.5%; P =.04). Mean arterial pressure and global time to shortening in women with twins, compared with singletons, were less in the first trimester by approximately 2%, but after midpregnancy they increased progressively, so that at term the measurements were greater by 3% and 5.7%, respectively (P =.03). Conversely, long axis shortening in women with twins, compared with singletons, was greater in the first trimester by approximately 6.5%, but at term it was 3% less (P =.01). Twin pregnancies that subsequently developed preeclampsia had a hemodynamic profile similar to the rest of the twin population.Conclusion: Twin pregnancy is characterized by an even more hyperdynamic circulation than singleton pregnancy. Left ventricle longitudinal systolic function and mean arterial pressure are more abruptly affected after 20 weeks compared with singleton pregnancies. [ABSTRACT FROM AUTHOR]- Published
- 2003
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160. Routine obstetric ultrasound services.
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Walsh, C A, McAuliffe, F, Kinsella, V, and McParland, P
- Published
- 2013
161. Blood gases in pregnancy at sea level and at high altitude
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McAuliffe, F., Kametas, N., Krampl, E., Ernsting, J., and Nicolaides, K.
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- 2001
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162. Dieta de bajo índice glicémico en embarazadas para prevenir macrosomía (ROLO study): Un estudio clínico randomizado.
- Author
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Walsh, J. M., McGowan, C. A., Mahony, R., Foley, M. E., McAuliffe, F. M., Pohlhammer I., Simone, Vera P.-G., Claudio, and Carvajal C., Jorge
- Abstract
Copyright of Revista Chilena de Obstetricia y Ginecología is the property of Revista Chilena de Obstetricia y Ginecologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2012
163. Obstetric outcome with low molecular weight heparin therapy during pregnancy.
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Donnelly J, Byrne J, Murphy K, and McAuliffe F
- Published
- 2012
164. Maternal weight characteristics influence recurrence of fetal macrosomia in women with normal glucose tolerance.
- Author
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Mahony R, Foley M, McAuliffe F, and O'herlihy C
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- 2007
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165. Evidence for differences in erythrocyte surface receptors for the malarial parasites, Plasmodium falciparum and Plasmodium knowlesi.
- Author
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Miller, L H, Haynes, J D, McAuliffe, F M, Shiroishi, T, Durocher, J R, and McGinniss, M H
- Abstract
Human erythrocytes lacking various blood group determinants were susceptible to invasion by Plasmodium falciparum including Duffy-negative erythrocytes that are refractory to invasion by Plasmodium knowlesi. Erythrocytes treated with trypsin or neuraminidase had reduced susceptibility of P. falciparum and normal susceptibility to P. knowlesi. Chymotrypsin treatment (0.1 mg/ml) blocked invasion only by P. knowlesi. The differential effect of enzymatic cleavage of determinats from the erythrocyte surface on invasion by these parasites suggests that P. falciparum and P. knowlesi interact with different determinants on the erythrocyte surface.
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- 1977
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166. Characterization of antigens on mosquito midgut stages of Plasmodium gallinaceum. I. Zygote surface antigens
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KAUSHAL, D, primary, CARTER, R, additional, HOWARD, R, additional, and MCAULIFFE, F, additional
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- 1983
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167. Response to 'Inconsistencies and inaccuracies in reporting on choice of endpoints and of statistical results in RCT of maternal diet by Lewis et al.'.
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Donnelly, J. MT., Segurado, R., and McAuliffe, F. M.
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ANTHROPOMETRY ,DIET ,OBESITY ,PEDIATRICS ,REPORT writing - Abstract
A response from the authors of the article "Impact of maternal diet on neonatal anthropometry: a randomized controlled trial" is presented.
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- 2016
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168. Enablers and barriers to physical activity in overweight and obese pregnant women: an analysis informed by the theoretical domains framework and COM-B model.
- Author
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Flannery, C., McHugh, S., Anaba, A. E., Clifford, E., O'Riordan, M., Kenny, L. C., McAuliffe, F. M., Kearney, P. M., and Byrne, M.
- Subjects
OVERWEIGHT women ,GESTATIONAL diabetes ,MATERNAL health ,PHYSICAL activity ,MOTIVATION (Psychology) - Abstract
Background: Obesity during pregnancy is associated with increased risk of gestational diabetes mellitus (GDM) and other complications. Physical activity is a modifiable lifestyle factor that may help to prevent these complications but many women reduce their physical activity levels during pregnancy. Interventions targeting physical activity in pregnancy are on-going but few identify the underlying behaviour change mechanisms by which the intervention is expected to work. To enhance intervention effectiveness, recent tools in behavioural science such as the Theoretical Domains Framework (TDF) and COM-B model (capability, opportunity, motivation and behaviour) have been employed to understand behaviours for intervention development. Using these behaviour change methods, this study aimed to identify the enablers and barriers to physical activity in overweight and obese pregnant women.Methods: Semi-structured interviews were conducted with a purposive sample of overweight and obese women at different stages of pregnancy attending a public antenatal clinic in a large academic maternity hospital in Cork, Ireland. Interviews were recorded and transcribed into NVivo V.10 software. Data analysis followed the framework approach, drawing on the TDF and the COM-B model.Results: Twenty one themes were identified and these mapped directly on to the COM-B model of behaviour change and ten of the TDF domains. Having the social opportunity to engage in physical activity was identified as an enabler; pregnant women suggested being active was easier when supported by their partners. Knowledge was a commonly reported barrier with women lacking information on safe activities during pregnancy and describing the information received from their midwife as 'limited'. Having the physical capability and physical opportunity to carry out physical activity were also identified as barriers; experiencing pain, a lack of time, having other children, and working prevented women from being active.Conclusion: A wide range of barriers and enablers were identified which influenced women's capability, motivation and opportunity to engage in physical activity with "knowledge" as the most commonly reported barrier. This study is a theoretical starting point in making a 'behavioural diagnoses' and the results will be used to inform the development of an intervention to increase physical activity levels among overweight and obese pregnant women. [ABSTRACT FROM AUTHOR]- Published
- 2018
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169. Clinical disparity of haemolytic disease of the fetus and newborn in twin pregnancy.
- Author
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MONE, F., QUIGLEY, J., DOYLE, B., LAMBERT, M., WOOLFSON, M., DOWNEY, P., CARROLL, S., HIGGINS, S., MAHONY, R., MCAULIFFE, F. M., FITZGERALD, J., and MCPARLAND, P.
- Subjects
FETAL abnormalities ,BLOOD diseases - Abstract
A letter to the editor which discusses the case of 32-year-old Caucasian and pregnant woman who experience clinical disparity of her twin fetus that was diagnosed with hemolytic disease.
- Published
- 2015
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170. Association between maternal blood lipids during pregnancy and offspring growth trajectories in a predominantly macrosomic cohort: findings from the ROLO longitudinal birth cohort study.
- Author
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Yelverton, C. A., O'Keeffe, L. M., Bartels, H. C., McDonnell, C., Geraghty, A. A., O'Brien, E. C., Killeen, S. L., Twomey, P., Kilbane, M., Crowley, R. K., McKenna, M., and McAuliffe, F. M.
- Subjects
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BLOOD lipids , *HDL cholesterol , *LDL cholesterol , *COHORT analysis , *PREGNANCY - Abstract
The purpose of this study is to examine associations between maternal lipid profiles in pregnancy and offspring growth trajectories in a largely macrosomic cohort. This is a secondary analysis of the ROLO birth cohort (n = 293), which took place in the National Maternity Hospital, Dublin, Ireland. Infants were mostly macrosomic, with 55% having a birthweight > 4 kg. Maternal mean age was 32.4 years (SD 3.9 years), mean BMI was 26.1 kg/m2 (SD 4.4 kg/m2) and 48% of children born were males. Total cholesterol, high density lipoprotein cholesterol (HDL-cholesterol), low density lipoprotein cholesterol (LDL-cholesterol) and triglycerides were measured from fasting blood samples of mothers at 14 and 28 week gestation. The change in maternal lipid levels from early to late pregnancy was also examined. Offspring abdominal circumference and weight were measured at 20- and 34-week gestation, birth, 6 months, 2 years and 5 years postnatal. Linear spline multilevel models examined associations between maternal blood lipid profiles and offspring growth. We found some weak, significant associations between maternal blood lipids and trajectories of offspring growth. Significant findings were close to the null, providing limited evidence. For instance, 1 mmol/L increase in maternal triglycerides was associated with faster infant weight growth from 20- to 34-week gestation (0.01 kg/week, 95% CI − 0.02, − 0.001) and slower abdominal circumference from 2 to 5 years (0.01 cm/week, 95% CI − 0.02, − 0.001). These findings do not provide evidence of a clinically meaningful effect. Conclusion: These findings raise questions about the efficacy of interventions targeting maternal blood lipid profiles in pregnancies at risk of macrosomia. New studies on this topic are needed. What is Known: • Maternal fat accumulation during early pregnancy may potentially support fetal growth in the third trimester by providing a reserve of lipids that are broken down and transferred to the infant across the placental barrier. • There are limited studies exploring the impact of maternal lipid profiles on infant and child health using growth trajectories spanning prenatal to postnatal life. What is New: • Maternal blood lipid profiles were not associated with offspring growth trajectories of weight and abdominal circumference during pregnancy up to 5 years of age in a largely macrosomic cohort, as significant findings were close to the null, providing limited evidence for a clinically meaningful relationship. • Strengths of this work include the use of infant growth trajectories that span prenatal to postnatal life and inclusion of analyses of the change of maternal lipid levels from early to late pregnancy and their associations with offspring growth trajectories from 20-week gestation to 5 years of age. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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171. Blood gases in pregnancy at sea level and at altitude.
- Author
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McAuliffe, F., Kametas, N., Ernstine, J., and Nicolaides, K.
- Subjects
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BLOOD gases , *PREGNANCY , *BIOLOGICAL adaptation , *ALTITUDES , *SEA level - Abstract
The article presents an abstract of the study "Blood gases in pregnancy at sea level and at altitude." It examines the added effect of pregnancy during chronic adaptation to high altitude. It highlights that the oxygen saturation, decline at altitude but showed no change at sea level and pregnancy at altitude increases ventilation volume with no change in respiratory rate.
- Published
- 2000
172. P32 Experiences of women from a lower socioeconomic background when using healthy eating mobile apps: a qualitative interview study
- Author
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Flaherty, SJ, McCarthy, M, Collins, A, and McAuliffe, F
- Abstract
BackgroundMobile apps offer a potentially effective approach to support healthier food behaviours if adequately designed and informed by behaviour change theory. Individuals from a lower socioeconomic background often report unhealthier dietary patterns and consequently may benefit from a mobile app intervention supporting healthier food behaviours. However, there is limited evidence available on the use of mobile health apps in this group. Previous work suggests that a reasonable standard of health and nutrition literacy is required for effective use of existing healthy eating mobile apps but this knowledge is often low in those from a lower socioeconomic background. Consequently, it is unclear if existing mobile apps are appropriate for this population group. The aim of this study is to explore the experiences of women from a lower socioeconomic background when using healthy eating mobile apps and the individual-level and mobile-specific factors that influence their experiences.MethodsA purposive sample of 15 women from a lower socioeconomic background and aged between 18–50 years were selected to participate. Participants completed a questionnaire assessing nutrition knowledge before using the assigned mobile apps. A total of three mobile apps were assessed in this study and were of varying quality in relation to nutrition content, behaviour change and user quality. Each participant was assigned to use two different mobile apps and used each for one week only. Assignment order was randomised. After the two-week period, semi-structured interviews were conducted with participants to discuss their experiences. Interviews were audio-recorded, transcribed verbatim, and analysed using a thematic analysis approach.ResultsPreliminary analysis suggests that overall mobile app quality is adequate but there is a need to improve the customisability of mobile apps to ensure they fit users’ needs. The food lives of participants vary and mobile apps need to be flexible to reflect this variety for integration of mobile apps into everyday life. The language used in a mobile app was a reason for discontinuing use as it was not clearly understood by users or was viewed as irrelevant.ConclusionExisting mobile apps may support healthier food behaviours in women from a lower socioeconomic background but changes in design may be required. A user-centred approach is recommended where users from a lower socioeconomic background are engaged at all stages of the design process. This may improve their relevance to this population group and increase their effectiveness in supporting healthier food behaviours.
- Published
- 2017
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173. Preconception low-dose aspirin and pregnancy outcomes: results from the EAGeR randomized trial.
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Mone, F and McAuliffe, F M
- Published
- 2015
174. Placenta percreta presenting as a uterine tumour and persistent vaginal bleeding in the first.
- Author
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Mcauliffe, F, Bhal, P S, Richards, C J, and Evans, A S
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DIAGNOSIS of placenta diseases - Abstract
Presents a case report on diagnosis of placenta accreta during the first trimester of pregnancy. Major risk factors for placenta percreta.
- Published
- 1997
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175. CLINICAL ASSOCIATIONS OF PLACENTAL DELAYED VILLOUS MATURATION.
- Author
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Higgins, M. F., Mooney, E. E., and McAuliffe, F. M.
- Published
- 2008
176. POSTNATAL RE-ADMISSIONS: THE INCIDENCE, CAUSES AND LENGTH OF STAY IN A LARGE ANTENATAL POPULATION.
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Geisler, M., Murphy, C. M., Brophy, C., and McAuliffe, F. M.
- Published
- 2008
177. A PILOT STUDY OF THE FEASIBILITY OF A RANDOMISED TRIAL OF LOW GLYCAEMIC DIET VERSUS NORMAL DIET FROM EARLY PREGNANCY IN EUGLYCAEMIC WOMEN.
- Author
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Mahony, R., Byrne, J., Curran, S., O'Herlihy, C., and McAuliffe, F.
- Published
- 2008
178. FETAL TROPONIN-T AND PRO-BRAIN NATRIURETIC PEPTIDE IN FETUSES OF MOTHERS WITH TYPE 1 DIABETES.
- Author
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Russell, N., Higgins, M., Amaruso, M., Foley, M., Firth, R. G., and McAuliffe, F.
- Published
- 2008
179. Lung function in singleton pregnancy.
- Author
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McAuliffe, F., Kametas, N., Greenough, A., and Nicolaides, K.
- Subjects
- *
PULMONARY function tests , *PREGNANCY , *GESTATIONAL age , *OBSTETRICS - Abstract
The article presents an abstract of the study "Lung function in singleton pregnancy." It investigates the occurrence of respiratory changes during normal pregnancy, although some changes such as vital and total lung capacity is still unclear. It highlights the performed pulmonary function tests for healthy pregnant women in a cross-sectional manner from 10 to 40 weeks gestational ages.
- Published
- 2000
180. Lung function in pregnancy at altitude.
- Author
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McAuliffe, F., Kametas, N., Greenough, A., and Nicolaides, K.
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PULMONARY function tests , *PREGNANCY , *ALTITUDES , *SEA level - Abstract
The article presents an abstract of the study "Lung function in pregnancy at altitude." It examine the added effect of pregnancy during chronic adaptation to high altitude. It highlights the conducted study of healthy pregnant women in Peru which determine that the women at altitude level have larger lungs than those at sea level.
- Published
- 2000
181. Lung function in twin pregnancy.
- Author
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McAuliffe, F., Kametas, N., Greenough, A., and Nicolaides, K.
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PULMONARY function tests , *PREGNANCY , *RESPIRATORY organs , *OBSTETRICS - Abstract
The article presents an abstract of the study "Lung function in twin pregnancy." It examines the respiratory function in 68 women with twin pregnancy and 140 women with a singleton pregnancy. It highlights that the respiratory function in twin pregnancies is very similar to singleton pregnancies, it suggest that the respiratory system copes well with the extra demand placed on it.
- Published
- 2000
182. Gas transfer in pregnancy at sea level and at altitude.
- Author
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McAuliffe, F., Kametas, N., Ernstine, J., and Nicolaides, K.
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GAS research , *PREGNANT women , *ALTITUDES , *SEA level , *OBSTETRICS - Abstract
The article presents an abstract of the study "Gas transfer in pregnancy at sea level and at altitude." It examined the healthy women in London, Great Britain and Peruvian Andes throughout pregnancy. It has determined that at sea level in London no change was observed with pregnancy. While gas transfer at altitude was more than double that at sea level in both non-pregnant and pregnant women in Peruvian Andes. Possible causes include increased carbon dioxide reaction rate and less ventilation.
- Published
- 2000
183. Relative validity of a food frequency questionnaire to assess nutrient intake in pregnant women.
- Author
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McGowan, C. A., Curran, S., and McAuliffe, F. M.
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ANTHROPOMETRY , *CHI-squared test , *STATISTICAL correlation , *RESEARCH methodology , *NUTRITIONAL assessment , *QUESTIONNAIRES , *RESEARCH funding , *T-test (Statistics) , *WOMEN'S health , *RESEARCH methodology evaluation , *FOOD diaries , *DATA analysis software , *DESCRIPTIVE statistics ,RESEARCH evaluation - Abstract
Background To date, there are no food frequency questionnaires that have been validated to assess nutrient intakes in pregnant women in Ireland. The present study aimed to assess the relative validity of a self-administered food frequency questionnaire during pregnancy. Methods The food frequency questionnaire was administered once during pregnancy between 12 and 34 weeks. Participants also completed a 3-day food diary during each trimester of pregnancy (reference method) and intakes from both the food frequency questionnaire and the mean of the 3-day food diaries were compared in a sample of 130 participants from the control arm of an intervention study. Results Energy-adjusted Pearson's correlation coefficients ranged from 0.24 ( riboflavin) to 0.59 ( magnesium) and were all statistically significant ( P < 0.05). The food frequency questionnaire tended to report higher energy and nutrient intakes compared to the food diaries. On average, 74% of participants were classified into the same ± 1 quartile and 7% into opposing quartiles by the two methods. Conclusions Overall, our food frequency questionnaire showed good relative validity. We conclude that a single administration of a food frequency questionnaire is a valid tool for ranking women in accordance with their nutrient intakes during pregnancy. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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184. 335 Obstetric care for environmental migrants – how to optimise pregnancy outcomes for mother and baby.
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Lee, S., Corbett, G., and McAuliffe, F.
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- *
ENVIRONMENTAL refugees , *PREGNANCY outcomes , *MOTHERS , *INFANTS - Published
- 2022
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185. Pregnancies in women with Turner syndrome: a retrospective multicentre UK study.
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Cauldwell, M, Steer, PJ, Adamson, D, Alexander, C, Allen, L, Bhagra, C, Bolger, A, Bonner, S, Calanchini, M, Carroll, A, Casey, R, Curtis, S, Head, C, English, K, Hudsmith, L, James, R, Joy, E, Keating, N, MacKiliop, L, and McAuliffe, F
- Subjects
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TURNER'S syndrome , *PREGNANCY outcomes , *ABORTION , *PREGNANCY , *CESAREAN section , *AORTIC valve insufficiency , *AORTIC dissection - Abstract
Objective: To determine the characteristics and outcomes of pregnancy in women with Turner syndrome. Design: Retrospective 20‐year cohort study (2000–20). Setting: Sixteen tertiary referral maternity units in the UK. Population or sample: A total of 81 women with Turner syndrome who became pregnant. Methods: Retrospective chart analysis. Main outcome measures: Mode of conception, pregnancy outcomes. Results: We obtained data on 127 pregnancies in 81 women with a Turner phenotype. All non‐spontaneous pregnancies (54/127; 42.5%) were by egg donation. Only 9/31 (29%) pregnancies in women with karyotype 45,X were spontaneous, compared with 53/66 (80.3%) pregnancies in women with mosaic karyotype 45,X/46,XX (P < 0.0001). Women with mosaic karyotype 45,X/46,XX were younger at first pregnancy by 5.5–8.5 years compared with other Turner syndrome karyotype groups (P < 0.001), and more likely to have a spontaneous menarche (75.8% versus 50% or less, P = 0.008). There were 17 miscarriages, three terminations of pregnancy, two stillbirths and 105 live births. Two women had aortic dissection (2.5%); both were 45,X karyotype with bicuspid aortic valves and ovum donation pregnancies, one died. Another woman had an aortic root replacement within 6 months of delivery. Ten of 106 (9.4%) births with gestational age data were preterm and 22/96 (22.9%) singleton infants with birthweight/gestational age data weighed less than the tenth centile. The caesarean section rate was 72/107 (67.3%). In only 73/127 (57.4%) pregnancies was there documentation of cardiovascular imaging within the 24 months before conceiving. Conclusions: Pregnancy in women with Turner syndrome is associated with major maternal cardiovascular risks; these women deserve thorough cardiovascular assessment and counselling before assisted or spontaneous pregnancy managed by a specialist team. Pregnancy in women with Turner syndrome is associated with an increased risk of aortic dissection. Pregnancy in women with Turner syndrome is associated with an increased risk of aortic dissection. Linked article This article is commented on by RN Brown, pp. 804 in this issue. To view this minicommentary visit https://doi.org/10.1111/1471-0528.17022. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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186. Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries.
- Author
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Lindsay, K. L., Gibney, E. R., and Mcauliffe, F. M.
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MALNUTRITION , *ACCULTURATION , *ANEMIA , *LOW birth weight , *DIETARY calcium , *CINAHL database , *DEFICIENCY diseases , *DIET , *EMIGRATION & immigration , *FOLIC acid , *HEALTH attitudes , *HEALTH services accessibility , *HYPERTENSION , *INFANT mortality , *MEDICAL information storage & retrieval systems , *IRON deficiency anemia , *MEDICAL care , *EVALUATION of medical care , *MEDLINE , *MATERNAL mortality , *NEURAL tube defects , *NUTRITION disorders , *OBESITY , *ONLINE information services , *POVERTY , *PREGNANCY , *PREGNANCY complications , *RESEARCH funding , *RICKETS , *VISION disorders , *VITAMIN A deficiency , *VITAMIN B12 , *VITAMIN D , *WOMEN'S health , *SYSTEMATIC reviews , *EVIDENCE-based medicine , *PROFESSIONAL practice , *CULTURAL values , *FOOD security ,DEVELOPING countries ,DEVELOPED countries - Abstract
Lindsay K.L., Gibney E.R. & McAuliffe F.M. (2012) Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries. J Hum Nutr Diet. Abstract Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted. [ABSTRACT FROM AUTHOR]
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- 2012
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187. Probiotic therapy in couples with infertility: A systematic review.
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Corbett, GA, Crosby, DA, McAuliffe, FM, Corbett, G A, Crosby, D A, and McAuliffe, F M
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REPRODUCTIVE technology , *INFERTILITY , *REPRODUCTIVE health , *BACTERIAL vaginitis , *PROBIOTICS , *PREGNANCY , *THERAPEUTIC use of probiotics , *BIRTH rate , *SYSTEMATIC reviews , *SPERM motility , *PREGNANCY outcomes - Abstract
The reproductive microbiome is becoming increasingly recognised for its influence on fertility. While there has been much work to investigate the treatment of bacterial vaginosis and disordered microbiomes in optimizing outcomes in Assisted Reproductive Technology (ART), the role of routinely prescribed probiotics is yet to be established. The therapeutic potential of probiotic therapy remains an exciting opportunity in ART and this review endeavours to summarise its evidence to date. A systematic review of MEDLINE (Pubmed), Allied Health Literature (CINAHL), EMBASE, Web of Science and the Cochrane database was performed on 7th May 2019, and repeated on 26th August 2019. The search was built using the terms 'subfertility;' 'probiotic therapy;' 'clinical pregnancy rate' and 'assisted reproductive outcomes.' The primary outcome was change in clinical pregnancy rate. Secondary outcomes included improvements in male and female fertility parameters and microbial assessment. The initial search found 882 articles, of which 26 full manuscripts were reviewed. Four articles were eligible for inclusion. Of the two studies that reported the primary outcome, only one study found probiotics increased the clinical pregnancy rate non-significantly (48.0%-58.8%, p = 0.47). It also found higher miscarriage rate (30 % vs 16.6 %, p = 0.47) in the group treated with probiotics. Both studies on males with oral probiotic found significantly improved sperm motility. While benefit in sperm motility has been observed with male probiotic therapy, there is conflicting evidence on the efficacy of probiotic therapy for women undergoing assisted reproduction. High quality randomized studies are needed to definitively examine probiotic therapy and establish its benefit for couples undergoing assisted reproduction. [ABSTRACT FROM AUTHOR]
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- 2021
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188. DASH (Dietary Approaches to Stop Hypertension) dietary pattern and maternal blood pressure in pregnancy.
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Courtney, A. U., O'Brien, E. C., Crowley, R. K., Geraghty, A. A., Brady, M. B., Kilbane, M. T., Twomey, P. J., McKenna, M. J., and McAuliffe, F. M.
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ANALYSIS of variance , *BLOOD pressure , *CONFIDENCE intervals , *HYPERTENSION , *INGESTION , *SCIENTIFIC observation , *SALT , *DASH diet - Abstract
Background: High blood pressure (BP) in pregnancy is associated with significant adverse outcomes. In nonpregnant populations, the DASH (Dietary Approaches to Stop Hypertension) diet is associated with reductions in blood pressure. The present study investigated the relationship between the DASH dietary pattern and maternal BP in pregnancy. Methods: This is an observational study of 511 women who participated in the ROLO study (Randomized cOntrol trial of LOw glycaemic index diet for the prevention of recurrence of macrosomia), 2007–2011, Dublin, Ireland. Auscultatory blood pressure, systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements were taken. Mean arterial pressure (MAP) was calculated. Dietary intakes were recorded using 3‐day food diaries in each trimester. DASH scoring criteria were used to score and rank participants from low to high intakes of foods recommended in the DASH diet. Statistical analysis using analysis of variance and multiple linear regression were used to determine the relationship between maternal BP and DASH scores. Results: Dietary intake more closely resembling the DASH dietary recommendations throughout pregnancy was associated with a lower DBP (mmHg) in trimesters 1 [B: −0.70; 95% confidence interval (CI) = −1.21 to −0.18] and 3 (B: −0.68; 95% CI = −1.19 to −0.17), as well as lower MAP (mmHg) in trimesters 1 (B: −0.78; 95% CI = −1.33 to −0.25) and 3 (B: −0.54; 95% CI = −1.04 to −0.04), controlling for body mass index, age, education, energy intake and intervention grouping. Conclusions: The DASH dietary pattern was associated with lower maternal BP in pregnancy among healthy women without hypertensive disorders of pregnancy. Despite the observational nature of these findings, the results demonstrate the potential for healthcare professionals to intervene to promote cardiovascular health in pregnancy. [ABSTRACT FROM AUTHOR]
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- 2020
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189. Fetal Growth Trajectories and Their Association with Maternal, Cord Blood, and 5-year Child Adipokines.
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Bartels, H. C., Geraghty, A. A., O'Brien, E. C., Kranidi, A., Mehegan, J., Yelverton, C., McDonnell, C. M., and McAuliffe, F. M.
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FETAL development , *ADIPOKINES , *SERUM , *BIRTH weight , *BIOMARKERS , *FETAL growth disorders , *CORD blood - Abstract
Background. The growth of the fetus is a complex process influenced by multiple factors. Studies have highlighted the important role of biochemical growth markers such as leptin and adiponectin on fetal growth. Objective. To compare fetal growth trajectories with biochemical growth markers from maternal blood samples at 28 weeks' gestation, cord blood samples at birth, and in child blood samples at 5 years of age from mother-infant pairs who were part of the longitudinal ROLO study. Methods. 781 mother-infant pairs from the ROLO and ROLO Kids study were included. Ultrasound measurements and birth weight were used to develop fetal growth trajectory groups for estimated abdominal circumference and estimated weight. Blood serum levels of leptin, adiponectin, insulin, TNF-alpha, and IL-6 from maternal, cord, and 5-year child samples were recorded. ANOVA and chi-square tests were applied to test the associations between fetal growth trajectory membership and maternal and child biochemical growth indicators. The influence of child sex was also investigated. Results. Male sex was associated with a faster weight trajectory compared to females (p = 0.001). At 28 weeks' gestation, maternal leptin levels were significantly higher in mothers with a fetus on a slower estimated abdominal circumference trajectory compared to fast (25616 [IQR: 11656.0 to 35341.0] vs. 14753.8 [IQR: 8565.4 to 24308.1], p < 0.001) and maternal adiponectin levels were lower in fetuses on a slower estimated abdominal circumference trajectory compared to a fast trajectory (22.4 [IQR: 13.6 to 35.9] vs. 27.6 [IQR: 17.6 to 46.3], p = 0.027). No associations were noted with inflammatory markers. No associations were identified between fetal growth trajectories and growth markers at 5 years of age. Conclusions. This study shows that male sex is associated with an accelerated estimated weight trajectory. Furthermore, high leptin and low adiponectin in maternal serum in late gestation are associated with a slower fetal growth trajectory. No associations were identified with blood growth markers after pregnancy. [ABSTRACT FROM AUTHOR]
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- 2020
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190. Dysregulation of the interleukin-17A pathway in endometrial tissue from women with unexplained infertility affects pregnancy outcome following assisted reproductive treatment.
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Crosby, D A, Glover, L E, Brennan, E P, Kelly, P, Cormican, P, Moran, B, Giangrazi, F, Downey, P, Mooney, E E, Loftus, B J, McAuliffe, F M, Wingfield, M, O'Farrelly, C, and Brennan, D J
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FERTILIZATION in vitro , *INFERTILITY , *FALSE discovery rate , *BLOOD proteins , *PREGNANCY , *MEDICAL research - Abstract
Study Question: Which transcriptomic alterations in mid-luteal endometrial scratch biopsies, taken prior to the assisted reproductive treatment (ART) treatment cycle are associated with unsuccessful pregnancy?Summary Answer: Dysregulated interleukin-17 (IL-17) pathway components are demonstrated in women who fail to become pregnant after ART.What Is Known Already: Implantation failure is now recognised as a critical factor in unexplained infertility and may be an important component of failed ART.Study Design, Size, Duration: Using a prospective longitudinal study design, 29 nulliparous women with unexplained infertility undergoing ART were recruited between October 2016 and February 2018. Mid-luteal stage endometrium and matched serum samples were collected, and patients underwent a single embryo transfer in the subsequent cycle. RNA-seq analysis of endometrial biopsies was performed on the discovery cohort (n = 20).Participants/materials, Setting, Methods: Gene set enrichment analysis of the differentially expressed genes (DEGs) was performed. Endometrium and serum were then prepared for IL-17A analysis by ELISA.Main Results and the Role Of Chance: There were 204 differentially expressed protein-coding genes identified in tissue from women who became pregnant (n = 9) compared with tissue from women who failed to become pregnant (n = 11) (false discovery rate; P < 0.05). Of the 204 DEGs, 166 were decreased while 38 were increased in the pregnant compared to the non-pregnant groups. Gene set enrichment analysis of the DEGs identified an over-representation of IL-17 and Pl3K-Akt signalling pathways. All the DEGs within the IL-17 signalling pathway (MMP3, MMP1, IL1β, LCN2, S100A9 and FOSL1) demonstrated decreased expression in the pregnant group. Serum IL-17 protein levels were increased in the non-pregnant discovery cohort (n = 11) and these findings were confirmed a validation cohort (n = 9).Limitations, Reasons For Caution: Limitations of our study include the cohort size and the lack of aneuploidy data for the embryos; however, all embryos transferred were single good or top-quality blastocysts.Wider Implications Of the Findings: These findings demonstrate dysregulated IL-17 pathway components in women who fail to become pregnant after ART. Elevated serum levels of the pro-inflammatory cytokine IL-17 may predict failure of ART in women with unexplained infertility. Future trials of anti-IL-17 therapies in this cohort warrant further investigation.Study Funding/competing Interest(s): Funding from the UCD Wellcome Institutional Strategic Support Fund, which was financed jointly by University College Dublin and the SFI-HRB-Wellcome Biomedical Research Partnership (ref 204844/Z/16/Z), is acknowledged. The authors have no competing interests.Trial Registration Number: NA. [ABSTRACT FROM AUTHOR]- Published
- 2020
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191. Holoprosencephaly: antenatal and postnatal diagnosis and outcome.
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Kaliaperumal, Chandrasekaran, Ndoro, Sam, Mandiwanza, Tafadzwa, Reidy, F., McAuliffe, F., Caird, John, and Crimmins, Darach
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HOLOPROSENCEPHALY , *PRENATAL diagnosis , *PUERPERIUM , *MAGNETIC resonance imaging , *PEDIATRICS , *DIAGNOSIS , *PATIENTS - Abstract
Objectives: The objectives of this study are to ascertain the clinical outcome and overall survival of holoprosencephaly (HPE) patients diagnosed antenatally and postnatally, to determine the accuracy of antenatal diagnosis and to determine the role of neurosurgical intervention in HPE. Design: This is a retrospective review over a 10-year period. Patients: Sixty-three patients were included in the study, 45 were diagnosed by antenatal radiological imaging and 18 were diagnosed by postnatal radiological imaging. Patient data was drawn from Temple Street Children's University Hospital (the national paediatric neurosurgery centre), the National Maternity Hospital in Holle's Street, Dublin, and Our Lady of Sick Children Hospital, Dublin. Methods: The study was carried out through a review of antenatal and postnatal radiological imaging and reports, clinical charts, GP letters from patient follow-up and telephone conversations with parents of HPE patients. Results: Four patients in the antenatal diagnosis group had follow-up foetal MRI confirming HPE. Twelve in this group had radiological follow-up postnatally, and in five of these, HPE was confirmed. The remaining seven were identified as false positive. Alobar HPE constituted 55 % (21/38) of patients with 95 % mortality. Fifty-one percent had a normal karyotype. The overall survival in the antenatal diagnosis group was 13 %. In the postnatal group, 18 patients were identified, 67 % (12/18) lobar and 33 % (6/18) semilobar. Normal karyotype was found in 72 % (13/18), with an overall survival rate of 56 % (10/18). Neurosurgical intervention in both groups mainly consisted of CSF diversion in the form of ventriculoperitoneal (VP) or cystoperitoneal shunt (CP) (13/67). Conclusion: Foetal MRI should be routinely performed in suspected cases of HPE, and reliance on ultrasound alone in the antenatal period may not be sufficient. In our study, there is a high early mortality noted in severe cases of HPE, while milder forms of HPE in children tend to survive beyond infancy albeit with associated complications that required neurosurgical intervention and medical management for other associated systemic anomalies. [ABSTRACT FROM AUTHOR]
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- 2016
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192. Impact of maternal diet on neonatal anthropometry: a randomized controlled trial.
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Donnelly, J. M., Walsh, J. M., Byrne, J., Molloy, E. J., and McAuliffe, F. M.
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ACADEMIC medical centers , *ANTHROPOMETRY , *BIRTH weight , *CHI-squared test , *GLYCEMIC index , *MOTHERS , *NUTRITION , *NUTRITIONAL requirements , *T-test (Statistics) , *RANDOMIZED controlled trials , *DESCRIPTIVE statistics , *PREGNANCY - Abstract
Objective Large for gestational age infants are at increased risk of childhood obesity and maternal nutrition impacts birthweight. The aim of this study was to assess the impact of a maternal low glycaemic index ( GI) diet on neonatal anthropometry. Methods The ROLO (Randomised Control Trial of Low Glycaemic Index Diet in Pregnancy) study was a randomized controlled trial to assess the impact of a low GI diet versus usual diet on birthweight. It took place in a tertiary maternity hospital in Ireland and women were randomized to receive either a low GI diet or no dietary intervention from early pregnancy to term. Two hundred sixty-five neonates had anthropometric measurements on day 1-2 of life, 126 in the intervention group and 139 in the control group. Measurements included birthweight, length and circumferences of the head, chest, abdominal, thigh and mid-upper arm. A subgroup of 219 (82%) neonates also had skin-fold measurements. Results Neonates whose mothers had a low GI diet in pregnancy had lower thigh circumference (15.9 ± 1.7 cm vs. 16.6 ± 1.5 cm, P = 0.04). There was no difference between the intervention and control groups in head, chest abdominal or mid-upper arm circumferences. No difference was noted between the two groups for any skin-fold measurements (subscapular, thigh, biceps and triceps). Conclusion Neonatal thigh circumference was altered by maternal low GI diet in pregnancy. These findings suggest that maternal low GI diet is safe in pregnancy and may positively impact infant adiposity. [ABSTRACT FROM AUTHOR]
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- 2015
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193. Mode of delivery in pregnancies complicated by major fetal congenital heart disease: a retrospective cohort study.
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Walsh, C A, MacTiernan, A, Farrell, S, Mulcahy, C, McMahon, C J, Franklin, O, Coleman, D, Mahony, R, Higgins, S, Carroll, S, McParland, P, and McAuliffe, F M
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CESAREAN section , *CONFIDENCE intervals , *CONGENITAL heart disease , *DELIVERY (Obstetrics) , *PREMATURE infants , *LONGITUDINAL method , *VAGINA , *RETROSPECTIVE studies , *CASE-control method , *DATA analysis software , *ODDS ratio - Abstract
Objective:To determine the mode of delivery in pregnancies complicated by complex fetal congenital heart disease (CHD).Study Design:Five-year retrospective cohort study at a tertiary fetal medicine center (2007 to 2011). Cases of complex fetal CHD (n=126) were compared with 45 069 non-anomalous singleton infants ⩾500 g to determine rates of emergency intrapartum cesarean section (CS), preterm delivery and induction of labor.Result:Intrapartum CS is significantly higher in fetal CHD than non-anomalous controls (21% vs 13.5%, odds ratio (OR) 1.7, 95% confidence interval (CI): 1.0 to 2.7; P=0.035), predominantly related to CS for non-reassuring fetal status (OR 2.2, 95% CI: 1.1 to 4.1; P=0.022). Although fetal CHD did not increase emergency CS rates in nulliparous women, CS was significantly increased in multiparous pregnancies (OR 2.4, 95% CI: 1.8 to 4.6; P=0.014). Rates of preterm delivery (OR 3.4, 95% CI: 2.0 to 5.4; P<0.0001) and induction of labor (OR 1.9, 95% CI: 1.3 to 2.9; P=0.001) were higher in the CHD cases.Conclusion:Emergency CS is increased in fetal CHD, attributed to a higher rate of CS for non-reassuring fetal status and seen mostly in multiparous women. [ABSTRACT FROM AUTHOR]
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- 2014
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194. Reassessing critical maternal antibody threshold in RhD alloimmunization: a 16-year retrospective cohort study.
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Walsh, C. A., Doyle, B., Quigley, J., McAuliffe, F. M., Fitzgerald, J., Mahony, R., Higgins, S., Carroll, S., and McParland, P.
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IMMUNIZATION , *PREGNANT women , *INTRAUTERINE blood transfusion , *COHORT analysis , *FETAL hemoglobin , *DOPPLER ultrasonography - Abstract
ABSTRACT Objective To determine the critical maternal antibody threshold for specialist referral in cases of RhD alloimmunization. Methods This was a retrospective cohort study, covering a 16-year period at the national tertiary fetal medicine center for management of alloimmunization. Data concerning RhD alloimmunized pregnant women were extracted from an institutional database and maternal anti-D antibody levels were cross-checked with the national reference laboratory. Fetal hemoglobin (Hb) levels were determined only at the first intrauterine transfusion ( IUT) and were compared with the pretransfusion maternal anti-D antibody level ( IU/ mL). Sensitivity, specificity and positive and negative predictive values of maternal antibody thresholds for detecting moderate to severe (Hb ≤ 0. 64MoM) fetal anemia were calculated. Results Between 1996 and 2011, 66 women underwent a first IUT for RhD alloimmunization at our institution. The highest serum anti-D antibody level was extracted for 208 RhD alloimmunized women who did not require IUT during the last 10 years of the study period. The traditional maternal antibody threshold of > 15 IU/ mL failed to detect 20% of cases of moderate to severe fetal anemia. The ≥ 4 IU/ mL threshold had 100% sensitivity but a 45% false-positive rate. The optimal anti-D antibody threshold for specialist referral in our population was ≥ 6 IU/ mL; at this level, no case of moderate to severe anemia was missed and specificity was 61%. Use of this threshold would have eliminated 10% of referrals to our fetal medicine unit without compromising fetal outcomes. Conclusions Setting the critical maternal RhD antibody level at >15 IU/ mL does not provide sufficient sensitivity. The lower threshold of ≥ 4 IU/ mL, though sensitive, is associated with a 45% false-positive rate. In our population, a threshold of ≥ 6 IU/ mL minimizes false-positive referrals while maintaining 100% sensitivity for moderate to severe fetal anemia. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]
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- 2014
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195. External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis
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Gordon C. S. Smith, Diane Farrar, François Audibert, Hannele Laivuori, Wessel Ganzevoort, Alberto Galindo, Khalid S. Khan, Luc J.M. Smits, Javier A Ramírez, Kerstin Klipstein-Grobusch, Anne Eskild, Federico Prefumo, Jacques Massé, Christina Anne Vinter, Lionel Carbillon, SeonAe Yeo, Per Magnus, Ignacio Herraiz, Asma Khalil, Anthony Odibo, Claire L Chan, Ragnhild Bergene Skråstad, Richard Hooper, Louise Bjørkholt Andersen, Kjell Å. Salvesen, Henk Groen, Anne Karen Jenum, Karel G. M. Moons, Jane E. Norman, Richard D Riley, Kym I E Snell, Camilla Haavaldsen, Joyce L. Browne, B. Thilaganathan, Peter von Dadelszen, Pia M. Villa, Asif Ahmed, Ben W.J. Mol, Lucy C Chappell, Paul T. Seed, John Kingdom, Marcus Green, Fionnuala M. McAuliffe, Louise C. Kenny, Seppo Heinonen, Lucilla Poston, Anne Cathrine Staff, Jenny Myers, Chie Nagata, Shakila Thangaratinam, Sohinee Bhattacharya, Ahmet A. Baschat, Lisa M. Askie, Melanie Smuk, John Allotey, Kajantie Eero, Akihide Ohkuchi, Fabricio da Silva Costa, Alice R. Rumbold, George Daskalakis, HUS Gynecology and Obstetrics, Genomics of Neurological and Neuropsychiatric Disorders, Institute for Molecular Medicine Finland, Pregnancy and Genes, Department of Medical and Clinical Genetics, Department of Obstetrics and Gynecology, HUS Children and Adolescents, Lastentautien yksikkö, Clinicum, Children's Hospital, Snell, K, Allotey, J, Smuk, M, Hooper, R, Chan, C, Ahmed, A, Chappell, L, Von Dadelszen, P, Green, M, Kenny, L, Khalil, A, Khan, K, Mol, B, Myers, J, Poston, L, Thilaganathan, B, Staff, A, Smith, G, Ganzevoort, W, Laivuori, H, Odibo, A, Arenas Ramirez, J, Kingdom, J, Daskalakis, G, Farrar, D, Baschat, A, Seed, P, Prefumo, F, da Silva Costa, F, Groen, H, Audibert, F, Masse, J, Skrastad, R, Salvesen, K, Haavaldsen, C, Nagata, C, Rumbold, A, Heinonen, S, Askie, L, Smits, L, Vinter, C, Magnus, P, Eero, K, Villa, P, Jenum, A, Andersen, L, Norman, J, Ohkuchi, A, Eskild, A, Bhattacharya, S, Mcauliffe, F, Galindo, A, Herraiz, I, Carbillon, L, Klipstein-Grobusch, K, Yeo, S, Browne, J, Moons, K, Riley, R, Thangaratinam, S, Vergani, P, Smith, Gordon [0000-0003-2124-0997], Apollo - University of Cambridge Repository, RS: CAPHRI - R5 - Optimising Patient Care, Epidemiologie, Value, Affordability and Sustainability (VALUE), Reproductive Origins of Adult Health and Disease (ROAHD), Tampere University, Department of Gynaecology and Obstetrics, Clinical Medicine, APH - Quality of Care, ARD - Amsterdam Reproduction and Development, Obstetrics and Gynaecology, and APH - Digital Health
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Research design ,Calibration (statistics) ,External validation ,Individual participant data ,Pre-eclampsia ,Prediction model ,lcsh:Medicine ,Overfitting ,PLACENTAL PROTEIN 13 ,Risk Assessment ,03 medical and health sciences ,MULTIPLE IMPUTATION ,0302 clinical medicine ,3123 Gynaecology and paediatrics ,Pregnancy ,Statistics ,Medicine ,Humans ,030212 general & internal medicine ,030219 obstetrics & reproductive medicine ,RISK PREDICTION ,business.industry ,UTERINE ARTERY DOPPLER ,lcsh:R ,OBESE PREGNANT-WOMEN ,NULLIPAROUS WOMEN ,DIAGNOSIS TRIPOD ,Reproducibility of Results ,General Medicine ,Prognosis ,R1 ,Confidence interval ,3. Good health ,Pregnancy Complications ,1ST-TRIMESTER PREDICTION ,HYPERTENSIVE DISORDERS ,Research Design ,Meta-analysis ,Female ,MATERNAL CHARACTERISTICS ,Risk assessment ,business ,Predictive modelling ,AVALIAÇÃO DE RISCO ,Cohort study ,Research Article - Abstract
Background Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk during pregnancy is required to plan management. Although there are many published prediction models for pre-eclampsia, few have been validated in external data. Our objective was to externally validate published prediction models for pre-eclampsia using individual participant data (IPD) from UK studies, to evaluate whether any of the models can accurately predict the condition when used within the UK healthcare setting. Methods IPD from 11 UK cohort studies (217,415 pregnant women) within the International Prediction of Pregnancy Complications (IPPIC) pre-eclampsia network contributed to external validation of published prediction models, identified by systematic review. Cohorts that measured all predictor variables in at least one of the identified models and reported pre-eclampsia as an outcome were included for validation. We reported the model predictive performance as discrimination (C-statistic), calibration (calibration plots, calibration slope, calibration-in-the-large), and net benefit. Performance measures were estimated separately in each available study and then, where possible, combined across studies in a random-effects meta-analysis. Results Of 131 published models, 67 provided the full model equation and 24 could be validated in 11 UK cohorts. Most of the models showed modest discrimination with summary C-statistics between 0.6 and 0.7. The calibration of the predicted compared to observed risk was generally poor for most models with observed calibration slopes less than 1, indicating that predictions were generally too extreme, although confidence intervals were wide. There was large between-study heterogeneity in each model’s calibration-in-the-large, suggesting poor calibration of the predicted overall risk across populations. In a subset of models, the net benefit of using the models to inform clinical decisions appeared small and limited to probability thresholds between 5 and 7%. Conclusions The evaluated models had modest predictive performance, with key limitations such as poor calibration (likely due to overfitting in the original development datasets), substantial heterogeneity, and small net benefit across settings. The evidence to support the use of these prediction models for pre-eclampsia in clinical decision-making is limited. Any models that we could not validate should be examined in terms of their predictive performance, net benefit, and heterogeneity across multiple UK settings before consideration for use in practice. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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- 2020
196. Technology-supported dietary and lifestyle interventions in healthy pregnant women: a systematic review.
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O'Brien, O A, McCarthy, M, Gibney, E R, and McAuliffe, F M
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MATERNAL health , *FOOD habits , *OBESITY in women , *LIFESTYLES , *PHYSICAL activity , *TECHNOLOGY , *OBESITY risk factors - Abstract
Overweight and obesity are associated with increased risk of adverse maternal and fetal outcomes. However, the actuality of delivering effective lifestyle interventions in clinical practice is hampered by a high demand for resources. The use of technology to assist lifestyle interventions needs to be explored as a valid method of reducing strain on resources, and enhancing the effectiveness and population reach of interventions. The aim was to systematically review the literature on the use of technology-supported lifestyle interventions for healthy pregnant women and their impact on maternal outcomes. Online databases and registries were searched in March 2013. Primary outcomes of selected English language studies were fasting maternal glucose, incidence of gestational diabetes mellitus (GDM) and maternal gestational weight gain. Secondary outcomes were intervention uptake and acceptance, and dietary or physical activity modification. Studies whose subjects were diagnosed with GDM prior to intervention were excluded. The minimal number of eligible studies and varying outcomes precluded formal meta-analysis of the data. Initially, 203 articles were identified and screened. Seven articles, including five randomised controlled trials, met inclusion criteria for the current review. Results demonstrate several potential benefits associated with technology-supported interventions in pregnancy, despite minimal search results. Although communication technology holds potential as a safe therapeutic tool for the support of lifestyle interventions in pregnancy, there is a paucity of data on its effectiveness. Further RCTs examining the effectiveness of communication technology are required, particularly among those most likely to benefit from lifestyle interventions, such as overweight and obese pregnant women. [ABSTRACT FROM AUTHOR]
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- 2014
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197. Relationship between vitamin D knowledge and 25-hydroxyvitamin D levels amongst pregnant women.
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Toher, C., Lindsay, K., McKenna, M., Kilbane, M., Curran, S., Harrington, L., Uduma, O., and McAuliffe, F. M.
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ANALYSIS of variance , *CHI-squared test , *COMPARATIVE studies , *CONFIDENCE intervals , *STATISTICAL correlation , *DIETARY supplements , *ETHNIC groups , *FISHER exact test , *HEALTH attitudes , *HEALTH behavior , *INTERVIEWING , *LONGITUDINAL method , *NUTRITIONAL assessment , *QUESTIONNAIRES , *RESEARCH funding , *STATISTICS , *VITAMIN D , *VITAMIN D deficiency , *WOMEN'S health , *DATA analysis , *STATISTICAL significance , *BODY mass index , *CROSS-sectional method , *HEALTH literacy , *DATA analysis software , *DESCRIPTIVE statistics , *NUTRITIONAL status , *ODDS ratio , *PREGNANCY - Abstract
Background Pregnant women living at northerly latitudes are at risk of suboptimal vitamin D status. There is a paucity of studies correlating knowledge, attitudes and practices of vitamin D with serum levels amongst pregnant women. We aimed to determine the prevalence of suboptimal vitamin D status in pregnant women of various ethnicities attending two Dublin maternity hospitals and to assess levels of knowledge, attitudes and practices concerning vitamin D. Methods We conducted a cross-sectional study of 116 pregnant women of Irish, Asian, Sub-Saharan African and Middle Eastern and North African ( MENA) origin. Vitamin D status was determined by measurement of serum 25-hydroxyvitamin D (25 OHD). We examined knowledge, attitudes and practices concerning vitamin D using an interview-assisted questionnaire. Results The median ( interquartile range) 25 OHD level was 25.9 (16.5-44.7) nmol L-1. Using a cut-off point of <30 nmol L-1, the proportion at risk of deficiency was significantly higher among MENA (88%; P < 0.001) and Sub-Saharan African women (68%; P = 0.019) than Irish women (36%). Eighty-two women (71%) reported they had insufficient knowledge about vitamin D and its sources. Vitamin D containing supplement usage was the strongest predictor of 25 OHD levels ≥30 nmol L-1 ( odds ratio = 18.03, 95% confidence interval = 5.7256.8, P < 0.001). Conclusions Suboptimal vitamin D status is common in this cohort of pregnant women, especially among those of Sub-Saharan African and MENA origin. Awareness of vitamin D dietary sources is poor among all subgroups. Recommending vitamin D containing supplements may be the best strategy at present for improving vitamin D status with a need for increased vitamin D education. [ABSTRACT FROM AUTHOR]
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- 2014
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198. Well-being in pregnancy: an examination of the effect of socioeconomic, dietary and lifestyle factors including impact of a low glycaemic index dietary intervention.
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Horan, M. K., McGowan, C. A., Doyle, O., and McAuliffe, F. M.
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WELL-being , *NUTRITION in pregnancy , *SOCIOECONOMIC factors , *LIFESTYLES & health , *GLYCEMIC index , *MICRONUTRIENTS - Abstract
BACKGROUND/OBJECTIVE: Well-being has been linked to the quality of diet and lifestyle in adults; however, there is a paucity of data in pregnancy. The aim of this study was to examine the relationship between well-being and socioeconomic status, diet and lifestyle during pregnancy and to consider the effect of intervention with low glycaemic index (GI) diet on well-being. SUBJECTS/METHODS: This was a cohort analysis of 619 participants of the ROLO study (Randomised cOntrol trial of LOw GI diet versus no dietary intervention to prevent recurrence of fetal macrosomia). The following data were collected: educational attainment, dietary intakes (food frequency questionnaire), physical activity (self-reported) and well-being (WHO-5-Item Wellbeing Index--expressed as a percentage). RESULTS: Well-being was positively associated with education and physical activity. Third-level education was associated with a 3.07-point higher well-being percentage score, and each day that an individual achieved > 30 min walking per week was associated with a 1.10-point increase in percentage well-being score, R2adj 2 2.4% (F=7.260, P=0.001). The intervention low GI group had a significantly lower percentage well-being score than the usual diet group (56.3% vs 59.9%, P=0.015). No correlation was noted between well-being and GI status calculated from food diaries (P=0.469). Well-being was not associated with micronutrient intake. CONCLUSIONS: Well-being in pregnancy was independently and positively associated with education and physical activity and negatively associated with low GI dietary intervention. These findings have significance not only for women at risk of low mood but also for healthcare professionals when counselling women about the importance of healthy lifestyle in pregnancy. [ABSTRACT FROM AUTHOR]
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- 2014
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199. IDF21-0594 Higher C3 complement protein is associated with cardiometabolic phenotype and biochemical health in women with obesity.
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Killeen, S.L., Byrne, D.F., Geraghty, A.A., Kilbane, M.T., Twomey, P.J., Mckenna, M.J., Yelverton, C.A., Saldova, R., Van Sinderen, D., Cotter, P.D., Murphy, E.F., and Mcauliffe, F.
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OBESITY in women , *WOMEN'S health , *PHENOTYPES , *PROTEINS - Published
- 2022
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200. 409 Associations of maternal dietary inflammatory potential, maternal health markers and pregnancy outcomes: A secondary analysis of the pears study.
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Killeen, S., Philips, C., Yelverton, C., Kennelly, M., Mehegan, J., and McAuliffe, F.
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PREGNANCY outcomes , *MATERNAL health , *SECONDARY analysis - Published
- 2022
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