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Postnatal parental education for optimizing infant general health and parent‐infant relationships

The benefits of post‐birth parental education for infant health or care and parent‐infant relationships remain unclear.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Caesarean section versus vaginal delivery for preventing mother to infant hepatitis C virus transmission

No good evidence to support using caesarean section for reducing mother to baby transmission of hepatitis C during labour and birth.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Body position and apnoea in the preterm infant

Apnoea is a condition in which an infant stops breathing. Apnoea is rare in infants born at term but the incidence increases with decreasing gestational age. Apnoea is generally thought to be a normal occurrence in the well preterm infant. However, the long term effects of frequent apnoea that lead to lower oxygen levels in unwell preterm infants remain unknown. In addition, there is little agreement about what degree of apnoea is acceptable. It has been proposed that body position can prevent apnoea. Therefore, the purpose of this review was to see if different body positions could prevent apnoea. The review authors searched the medical literature and identified five eligible studies that recruited a total of 114 infants. We found no clear evidence that any one body position is effective. This review is unable to recommend the use of one body position over another due to a lack of evidence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Hepatitis B vaccination during pregnancy for preventing infant infection

Hepatitis B is an infection caused by the hepatitis B virus and occurs worldwide. For infants and children, the two main sources of the infection are transmission from an infected mother or living in an infected household. Perinatal transmission is common in highly endemic areas. Hepatitis B vaccines are available and require a series of three doses over six months. The most common side effects are pain at the vaccination site and mild to moderate fever. Maternal hepatitis B vaccine immunization may be a way of preventing hepatitis B infection in infants before hepatitis B vaccine can be administered and provide protection to the infant. Infected hepatitis B virus infants are more likely to develop complications such as chronic infection, cirrhosis or liver cancer (hepatocellular carcinoma). This review found no evidence from randomized controlled trials regarding the effects of hepatitis B vaccine for preventing infant infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Breast milk expression during pregnancy by women with diabetes for improving infant outcomes

Babies born to women who have diabetes during pregnancy, either already existing or gestational, are at increased risk of low blood sugars after birth. This is because the babies have been exposed to higher than usual blood sugar (glucose) levels during the pregnancy and so have been producing relatively high levels of insulin. Some of these babies require additional breast milk, formula feeds or transfer to a special care nursery for intravenous fluids to correct the low blood sugar levels.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interconception care for women with a history of gestational diabetes for improving maternal and infant outcomes

Gestational diabetes mellitus (GDM) is a condition in which high blood sugar (hyperglycaemia) occurs, or is first recognised, during pregnancy. GDM is associated with complications for the mother and her baby both during and after pregnancy. Women with GDM are at an increased risk of developing pre‐eclampsia (high blood pressure and protein in the urine during pregnancy), having a caesarean birth, and developing type 2 diabetes in the future. Babies of women with GDM are at an increased risk of macrosomia (birthweight greater than 4000 g), birth trauma because of their size, respiratory distress syndrome, and other health complications. They are also at risk of future obesity and type 2 diabetes. GDM typically resolves after birth, but women with GDM are at risk of developing GDM again in future pregnancies. It is possible that women may benefit from interventions such as education, dietary and lifestyle advice, or drug treatment in the interconception period (the time between the end of one pregnancy and the beginning of the next one), to improve their health outcomes in future pregnancies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Preconception care for diabetic women to improve maternal and infant health

Current guidelines in many countries including Australia, the United Kingdom and United States recommend preconception care of diabetic women. Pregnant women with type I or type II diabetes are at a greater risk of adverse outcomes in pregnancy such as high blood pressure (gestational hypertension) and preterm births. Pregnancy can also accelerate the development of diabetic complications (retinopathy, nephropathy, neuropathy, ischaemic heart disease, cerebrovascular disease, peripheral vascular disease). Babies born to mothers with type I or type II diabetes diagnosed before pregnancy may be larger and are at greater risk of infant death and congenital abnormality (such as neural tube defects including anencephaly and spina bifida). These infants are also at risk of developing type II diabetes in the long term. Because of the strong association between good control of a woman’s blood sugars (glycaemic control), as measured by haemoglobin A1c, and reduced congenital anomalies, glycaemic targets are central to preconception care.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Antibiotic use before amniotomy (artificially rupturing the membranes) for reducing infections in mother and infant

The artificial rupture of the membranes (amniotomy) is a common obstetrical procedure. It may be done to either initiate or to augment labour, with or without oxytocin. This invasive procedure allows vaginal micro‐organisms access into the uterine cavity, which can in turn lead to infections in both the mother and the infant. A greater time interval between rupture of membranes and delivery, as with induction of labour, increases the chances of an infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Separate care for new mother and infant versus rooming in for increasing duration of breastfeeding

In the early part of the 20th century when hospitals became the place of birth for babies the practice of providing separate care for the infant and mother became established in industrialised countries. Babies were kept securely in a separate nursery. The infant is brought to the mother’s room for breastfeeding, on demand or during scheduled feeding times, or the baby’s mother walks to the nursery to breastfeed her infant. Breast‐milk production begins immediately after parturition. Its regulation is controlled by the mother’s physical and psychological condition, the frequency of breastfeeding, effective infant's suckling, the stimulus of the sight and sound of the baby's cry, and self‐confidence and contact with the baby.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Specialised antenatal clinics for women with a multiple pregnancy for improving maternal and infant outcomes

'Specialised' antenatal clinics versus 'standard' antenatal care for women with a multiple pregnancy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Infant position in neonates receiving mechanical ventilation

We found no clear evidence that particular body positions in newborn babies who need assisted ventilation are effective in producing relevant and sustained improvement. However, putting infants on assisted ventilation in the face down position for a short time slightly improves their oxygenation and infants in the prone position undergo fewer episodes of poor oxygenation. No trials were considered to have a low risk of bias and, in other words, results in which we could put some confidence. Approximately one third of the studies had a high risk of bias, which means we cannot be completely confident with their results.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Effect of taking extra calcium (other than preventing or treating high blood pressure) during pregnancy for improving maternal and infant health

Maternal nutrition during pregnancy is known to have a significant effect on fetal growth and development. In our review, regular intake of extra calcium tablets during pregnancy did not improve the number of preterm births or other infant outcomes, except for a slight increase in infant birthweight in the group of women who received calcium supplementation. Most studies included in this review were assessed as of low risk of bias, and evidence for specific outcomes was graded as of moderate quality, Taking calcium supplementation did not appear to have any obvious side effects. Our review included 25 randomised controlled studies, but only 23 studies involving 18,587 women contributed outcome data. The majority of the evidence was based on fewer numbers of studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Zinc supplementation for improving pregnancy and infant outcome

Taking zinc during pregnancy helps to slightly reduce preterm births, but does not prevent other problems such as low birthweight babies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Music during caesarean section under regional anaesthesia for improving maternal and infant outcomes

Women having a caesarean section under regional anaesthesia are often highly anxious during the operation and may feel some discomfort. Listening to relaxing music of the woman's choice may lead to better outcomes and less need for treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Antithrombotic therapy for improving maternal or infant health outcomes in women considered at risk of placental dysfunction

Pregnancy complications such as pre‐eclampsia and eclampsia, intrauterine fetal growth restriction and placental abruption are thought to be related to abnormalities in the development and function of the placenta. Treatment with heparin to prevent the development of blood clots within the placenta appears to be a promising intervention to prevent these complications. The numbers of pregnant women with pre‐eclampsia, preterm birth, perinatal death and a low birthweight infant (weighing less than the 10th centile for gestational age) were reduced with this treatment. Ten randomised trials involving 1139 women met the inclusion criteria for the review. Nine studies compared heparin (alone or in combination with dipyridamole) with no treatment; and one compared triazolopyrimidine with placebo. The most commonly recognised side effect for women related to this treatment was mild skin bruising. To date, important information about serious adverse infant and long‐term childhood outcomes with using anti‐clotting medications is unavailable. Further research is required.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Parent‐infant psychotherapy for improving parent and infant well‐being

Parent‐infant psychotherapy (PIP) is intended to address problems in the parent‐infant relationship, and problems such as excessive crying and sleeping/eating difficulties. A parent‐infant psychotherapist works directly with the parent and infant in the home or clinic, to identify unconscious patterns of relating and behaving, and influences from the past that are impeding the parent‐infant relationship. Parents may be referred to this service (e.g. by a general practitioner in the UK) or may self refer to privately run services. The intervention is delivered to individual dyads but can also be delivered to small groups of parents and infants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Screening for gestational diabetes and subsequent management for improving maternal and infant health

Gestational diabetes mellitus (GDM) is a form of diabetes that can develop during pregnancy. Having GDM increases the risk of complications during the rest of the pregnancy for the mother and her baby. Women with GDM are more likely to develop pre‐eclampsia (high blood pressure and protein in the urine) and require a caesarean section. For the baby, potential problems include the baby growing larger than it normally would, causing difficulties with birth. The baby can also have low blood sugar levels after birth. Although GDM usually resolves following birth, both mother and child are at risk of developing type II diabetes in the future. There is strong evidence that treating GDM is beneficial and improves health outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Spina bifida repair and infant and maternal health

Spina bifida is the term used to describe a group of neural tube conditions where the fetal spinal cord does not close properly during the first month of pregnancy. With open spina bifida some of the vertebrae are not completely formed but are split or divided and the spinal cord and its coverings (the meninges) protrude through the opening. The most severe is where the spinal cord and meninges come out of the child's back (myelomeningocele). Open spina bifida is often associated with hindbrain herniation, where the cerebellum and brainstem tissue extend into the large opening in the base of the skull, and hydrocephalus (enlargement of the fluid filled cavities in the brain). Resulting disabilities include bladder and bowel incontinence, difficulties in moving about due to limb weakness, paralysis, deformity and loss of sensation. Conventional treatment of spina bifida is surgical repair within two days of birth, which may include the placement of a shunt between the ventricles of the baby’s brain and the belly (peritoneum) to relieve hydrocephalus. Spina bifida can be diagnosed with prenatal ultrasound or maternal serum alpha‐feto protein and in utero treatment could improve outcomes; although it involves surgical incision into the mother’s abdomen and uterus to access the unborn baby.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pneumococcal vaccination during pregnancy for preventing infant infection

There is not enough evidence to assess whether using pneumococcal vaccination during pregnancy can prevent infant infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Acupuncture for newborn babies with hypoxic ischemic encephalopathy (HIE)

Hypoxic ischemic encephalopathy (HIE) occurs in newborn infants when they lack oxygen in the peripartum period. HIE causes significant morbidity and mortality. Effective treatment options are limited. Acupuncture has been tried. We attempted to evaluate the efficacy and safety of acupuncture for HIE through a systematic review of randomized controlled trials (RCTs). However, no RCT was identified in a systematic and comprehensive search of the medical literature. Good evidence regarding the use of acupuncture for neonates with HIE is lacking currently. The safety of acupuncture for HIE in neonates is unknown. High quality RCTs are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

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