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4. Investigating discrepancies in findings between rigorous randomized trials and meta‐analyses evaluating pregnancy interventions to limit gestational weight gain.

Author

Dodd, Jodie M., Deussen, Andrea R., Poprzeczny, Amanda J., Slade, Laura J., Mitchell, Megan, and Louise, Jennie

Subjects
*GESTATIONAL diabetes, *WEIGHT gain, *BODY mass index, *PREGNANCY outcomes, *BIRTH weight
Abstract

Summary: Introduction: Robust randomized trials consistently demonstrate little impact from diet and physical activity interventions on gestational weight gain (GWG) and clinical outcomes, although meta‐analyses report some benefit. Our aim was to evaluate the effect of trial quality on treatment effect estimates and review conclusions. Methods: We conducted a systematic review of dietary and/or physical activity interventions for pregnant women with a body mass index ≥18.5 kg/m2. We assessed studies for risk of bias and methodological features impacting reliability. Outcomes included GWG; gestational diabetes mellitus (GDM); pre‐eclampsia; caesarean birth; and birth weight measures. For each outcome, a sequence of meta‐analyses was performed based on intervention group and level of potential bias in the effect estimate. Results: We identified 128 eligible studies. The most robust estimate from a combined diet and physical activity behavioral intervention, with only studies at negligible risk of bias, was a difference in GWG of 1.10 kg (95% CI −1.62 to −0.58; 17,755 women). There was no evidence of an effect on any clinical outcomes. Conclusions: Our findings highlight discrepancies produced by the indiscriminate inclusion of studies with methodological flaws in previous systematic reviews. Regular weighing of pregnant women is futile in the absence of clinical benefit. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Nudging towards COVID-19 and influenza vaccination uptake in medically at-risk children: EPIC study protocol of randomised controlled trials in Australian paediatric outpatient clinics

Author

Wang, Bing, primary, Andraweera, Prabha, additional, Danchin, Margaret, additional, Blyth, Christopher C, additional, Vlaev, Ivo, additional, Ong, Jason, additional, Dodd, Jodie M, additional, Couper, Jennifer, additional, Sullivan, Thomas R, additional, Karnon, Jonathan, additional, Spurrier, Nicola, additional, Cusack, Michael, additional, Mordaunt, Dylan, additional, Simatos, Dimi, additional, Dekker, Gustaaf, additional, Carlson, Samantha, additional, Tuckerman, Jane, additional, Wood, Nicholas, additional, Whop, Lisa J, additional, and Marshall, Helen, additional

Published
2024
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8. The effects of dietary and lifestyle interventions among pregnant women with overweight or obesity on early childhood outcomes: an individual participant data meta-analysis from randomised trials

Author

Louise, Jennie, Poprzeczny, Amanda J., Deussen, Andrea R., Vinter, Christina, Tanvig, Mette, Jensen, Dorte Moller, Bogaerts, Annick, Devlieger, Roland, McAuliffe, Fionnuala M., Renault, Kristina M., Carlsen, Emma, Geiker, Nina, Poston, Lucilla, Briley, Annette, Thangaratinam, Shakila, and Dodd, Jodie M.

Published
2021
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19. Gestational weight gain outside the Institute of Medicine recommendations and adverse pregnancy outcomes: analysis using individual participant data from randomised trials

Author

Rogozińska, Ewelina, Zamora, Javier, Marlin, Nadine, Betrán, Ana Pilar, Astrup, Arne, Bogaerts, Annick, Cecatti, Jose G., Dodd, Jodie M., Facchinetti, Fabio, Geiker, Nina R. W., Haakstad, Lene A. H., Hauner, Hans, Jensen, Dorte M., Kinnunen, Tarja I., Mol, Ben W. J., Owens, Julie, Phelan, Suzanne, Renault, Kristina M., Salvesen, Kjell Å., Shub, Alexis, Surita, Fernanda G., Stafne, Signe N., Teede, Helena, van Poppel, Mireille N. M., Vinter, Christina A., Khan, Khalid S., Thangaratinam, Shakila, and for the International Weight Management in Pregnancy (i-WIP) Collaborative Group

Published
2019
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34. Type 1 diabetes: a disease of developmental origins

Author

Phillips, Jessica E., Couper, Jennifer J., Penno, Megan A.S., Harrison, Leonard C., Anderson, Heather, Bandala‐Sanchez, Esther, Barry, Simon C, Baskerville, Tracey, Battersby, Rachel, Bediaga, Naiara G, Bezuidenhout, Debra, Brownrigg, Emma, Catteau, Jacki, Choo, Ace, Colman, Peter G, Cotterill, Andrew, Couper, Jennifer J, Craig, Maria E, Curran, Sheryl, Davis, Elizabeth A, Dodd, Jodie M, Edwards, Danielle, French, Jane, Gibson, Emily, Giles, Lynne C, Gwiazdzinski, Alison, Harris, Mark, Harrison, Leonard C, Haynes, Aveni, Hope, Christopher M, Hsieh, Cecilia, Huang, Dexing, Hu, William, Keytash, Azita, Krieg, Meredith, Law, Soi C, Lloyd‐Johnsen, Catherine, Morahan, Grant, Neale, Alana M, Ngui, Katrina, Papenfuss, Anthony T, Penno, Megan AS, Poth, Megan, Ramoso, Benjamin, Rawlinson, William D, Roberts, Alison, Sadlon, Timothy J, Schulze, Alexandra, Penington, Jocelyn Sietsma, Sinnott, Richard O, Spooner, Kelly, Stone, Natalie L, Thomson, Rebecca L, Toome, Sarah, Tully, Alexandra, Vuillermin, Peter J, Watson, Kelly, Wentworth, John M, and Wilson, Julianne

Published
2017
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35. Maternal and neonatal outcomes following the introduction of the Fetal Pillow at a tertiary maternity hospital: A retrospective cohort study.

Author

Chooi, Kathrina Y.L., Deussen, Andrea R., Louise, Jennie, Cash, Sarah, and Dodd, Jodie M.

Subjects
SURGICAL blood loss, LENGTH of stay in hospitals, CONFIDENCE intervals, BIRTH injuries, NEONATAL jaundice, PROTECTIVE clothing, PEDIATRICS, RETROSPECTIVE studies, FISHER exact test, REGRESSION analysis, PREGNANCY outcomes, DESCRIPTIVE statistics, RESEARCH funding, CESAREAN section, APGAR score, SEIZURES (Medicine), WOMEN'S health, LONGITUDINAL method, UTERINE rupture, DISEASE complications
Abstract

Background: Caesarean birth at full cervical dilatation can be technically challenging and may be associated with increased risks of maternal and neonatal morbidity, often secondary to difficulties in delivering a deeply impacted fetal head. The Fetal Pillow is a device designed to elevate an impacted fetal head out of the pelvis and reduce birth trauma. Aims: To evaluate birth outcomes following the introduction of the Fetal Pillow at a tertiary maternity hospital. Materials and Methods: This retrospective cohort study included all caesarean births at full cervical dilatation where the Fetal Pillow was utilised and compared with caesarean births where the Fetal Pillow was not used from October 2018 to December 2019. Maternal outcomes included uterine incision extension, blood loss, high dependency unit admission and postoperative length of stay. Neonatal outcomes included Apgar scores, resuscitation, cord arterial blood pH and lactate, nursery admission, birth trauma, jaundice and seizures. Results: There were 53 caesarean births where the Fetal Pillow was utilised and 48 where it was not. Baseline characteristics were similar between groups with mean maternal age across both groups of 30.4 (±5.3) years, mean gestational age at birth of 39.5 (±1.2) weeks and mean infant birth weight of 3543 (±441) g. There were no statistically significant differences between the two study groups for the maternal and neonatal outcomes considered. Conclusions: There was no evidence that use of the Fetal Pillow to elevate an impacted fetal head during caesarean birth when cervical dilatation is >7 cm was associated with a reduced rate of adverse maternal and neonatal outcomes. [ABSTRACT FROM AUTHOR]

Published
2023
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39. Regular weighing of pregnant women: a relic from a bygone era.

Author

Dodd, Jodie M., Deussen, Andrea R., Mitchell, Megan, and Louise, Jennie

Subjects
PREGNANCY outcomes, SMALL for gestational age, PREGNANCY complications, AMNIOTIC liquid, WEIGHT gain
Abstract

The practice of regularly weighing pregnant women originated in the 1940s in the UK as a way to monitor the impact of food rationing on healthy pregnancies. While some countries recommend weighing women only at the beginning and end of pregnancy, others advocate for regular weighing at each prenatal appointment. A recent study found that higher gestational weight gain (GWG) was associated with an increased risk of giving birth to a large baby, while lower GWG was associated with a higher risk of giving birth to a small baby. However, there is debate about the causal relationship between GWG and pregnancy outcomes, with some arguing that GWG is not an appropriate target for intervention. Instead, they suggest focusing on preconception interventions to improve pregnancy outcomes. [Extracted from the article]

Published
2024
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42. Prospective Risk of Stillbirth and Neonatal Complications in Twin Pregnancies: Systematic Review and Meta-analysis

Author

Cheong-See, Fiona, Schuit, Ewoud, Arroyo-Manzano, David, Khalil, Asma, Barrett, Jon, Joseph, K. S., Asztalos, Elizabeth, Hack, Karien, Lewi, Liesbeth, Lim, Arianne, Liem, Sophie, Norman, Jane E., Morrison, John, Combs, C. Andrew, Garite, Thomas J., Maurel, Kimberly, Serra, Vicente, Perales, Alfredo, Rode, Line, Worda, Katharina, Nassar, Anwar, Aboulghar, Mona, Rouse, Dwight, Thom, Elizabeth, Breathnach, Fionnuala, Nakayama, Soichiro, Russo, Francesca Maria, Robinson, Julian N., Dodd, Jodie M., Newman, Roger B., Bhattacharya, Sohinee, Tang, Selphee, Mol, Ben Willem J., Zamora, Javier, Thilaganathan, Basky, and Thangaratinam, Shakila

Published
2017
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48. Childhood follow‐up of the GRoW randomized trial: Metformin in addition to dietary and lifestyle advice for pregnant women with overweight or obesity.

Author

Deussen, Andrea R., Louise, Jennie, and Dodd, Jodie M.

Subjects
OBESITY, LIFESTYLES, CHILDHOOD obesity, PREGNANT women, DIET, PRENATAL exposure delayed effects, RISK assessment, RANDOMIZED controlled trials, CHILDREN'S health, METFORMIN, BODY mass index
Abstract

Summary: Background: Metformin for women with overweight or obesity during pregnancy has been evaluated in randomized trials to reduce adverse pregnancy and birth outcomes. The effect on longer‐term child health remains of interest. Objectives: To evaluate the effect of in‐utero exposure to metformin on child health compared with no exposure. Methods: We assessed children born to 513 women who participated in the Metformin in addition to dietary and lifestyle advice for pregnant women with overweight or obesity: the GRoW randomized trial, where women were randomized to receive either metformin or placebo during pregnancy. Child weight, height, anthropometry, diet, physical activity and neurodevelopment were assessed at six and 18 months and three to five years of age. The main outcome was BMI z‐score > 85th centile for age and sex. Results: The number of children with BMI >85th centile was similar between treatment groups at all time points. At 18 months and three to five years of age, more than half of the children had a BMI z‐score > 85th centile, indicating a high risk of childhood obesity. Conclusions: We did not show evidence of the benefit of metformin for children of women with overweight or obesity during pregnancy adding to the growing literature on the lack of effect of pregnancy interventions in reducing longer‐term risks of childhood obesity. [ABSTRACT FROM AUTHOR]

Published
2023
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