Sonographers can help enhance parents' emotional connection to the unborn baby during pregnancy

A systematic review of twenty-three studies suggests that, during pregnancy, expectant parents' feelings towards their unborn baby (fetus) can be positively enhanced by sonographers (specialist healthcare professionals who are trained to perform pregnancy ultrasound scans) making imaging examinations a truly parent-centered experience. Such an experience can allay feelings of anxiety and stress in the parents, helping them to feel more informed about the health and well-being of their unborn baby, and reassured of their emotional investment in the ongoing pregnancy. Conducted by the Centre for Maternal and Child Health Research at City, University of London, the review provides a holistic interpretation of the current evidence on the effect of antenatal (before birth) imaging on expectant parents' feelings towards their unborn baby. To date, whilst the provision of ultrasound scans during pregnancy has been generally regarded as a positive experience for parents, and may predict the quality of the parent-child relationship after birth, there is evidence to suggest that the experience may also lead to increased anxiety and stress in parents, particularly those who are unable to interpret the scan images. Seventeen of the studies analyzed in the review related to the mother's experience only, five included both parents and one study recruited fathers only. Six central themes were developed from analysis of the included studies: the scan experience begins before the scan appointment; including parents looking forward to the scan, but being simultaneously apprehensive of the potential to receive unexpected news about their baby the scan as a pregnancy ritual; parents regarded scans as a milestone event, which they expected, and wanted feeling actively involved in the scan; with the presence of fathers at scans important, not only for maternal support, but also as attending fathers felt closer to their unborn baby than those who were not parents' priorities for knowledge and understanding of the scan change during pregnancy; at earlier stages of pregnancy, parents prioritized knowing that their pregnancy was viable, at later stages it was important for parents to know about the presence of fetal anomalies the importance of the parent–sonographer partnership during scanning; parents' confidence in their sonographer was linked with narration of the scan, and limiting the use of non-medical terminology humanized the fetus, and implied to parents that the sonographer recognized their unborn baby as an individual rather than a medical entity scans help to create a social identity for the unborn baby; many parents centered their news about pregnancies around a scan, with some waiting until their first scan to tell friends and family about their pregnancies, and sharing their scan pictures or videos so that their support circle had a sense of knowing the baby even before birth Related Stories COVID-19 pandemic has increased pregnancy complications and maternal death during delivery Study investigates the effect of vitamin D and fish oil on croup High-throughput proteomics reveals pregnancy-specific responses to COVID-19 The review also identified a lack of published research studies exploring the impact of fetal MRI (magnetic resonance imaging) on expectant parents' emotional connection to their unborn baby. Fetal MRI is becoming more commonly used to complement ultrasound imaging when a fetal anomaly is suspected. Hence, the authors stress that more research needs to be undertaken in this area to help understand the acceptability of this type of scan to parents and its potential effect on their feelings towards their unborn child. Lead author, Emily Skelton, is a sonographer, lecturer and College of Radiographers Doctoral Fellow within the Department of Radiography and Midwifery at City, University of London. We know how important scans during pregnancy are to provide clinical information about fetal growth and development, but there are additional benefits for expectant parents, who, in their transition to parenthood, may feel closer to their unborn babies after "seeing" them on scan. This review highlights the integral role of the sonographer in facilitating the developing connection between expectant parents and their unborn babies, through an informative, supportive and inclusive parent-centred approach to care that parents feel actively involved in."

Pregnancy duration food A mother's diet during pregnancy is linked to her child's food preferences

Diet during pregnancy is an important factor in determining the health of the developing fetus and neonate after birth. However, there is little known about how diet quality during pregnancy affects the development of food-related traits in the offspring. A recent Appetite journal study examines the relationship between the quality of the mother’s diet during pregnancy and with appetitive traits of offspring at five years. Study: Maternal Dietary Quality During Pregnancy and Child Appetitive Traits At 5-Years-Old: Findings from The ROLO Longitudinal Birth Cohort Study. Image Credit: Dusan Petkovic / Shutterstock.com Study: Maternal Dietary Quality During Pregnancy and Child Appetitive Traits At 5-Years-Old: Findings from The ROLO Longitudinal Birth Cohort Study. Image Credit: Dusan Petkovic / Shutterstock.com Introduction Appetitive traits refer to sustained predispositions towards food. This can include food approach traits, such as food responsiveness, emotional overeating, and food enjoyment, as well as food avoidant traits, like the speed of eating, satiety responsiveness, and food fussiness. Diet during pregnancy is key to promoting a healthy birth and growth in the neonatal period. However, the impact of the mother’s diet during pregnancy could have more significant implications. Genetics & Genomics eBook Compilation of the top interviews, articles, and news in the last year. Download a copy today According to the “Development of Origins of Health and Diseases” theory, brief exposures during early life, including a poor maternal diet during pregnancy or even before conception, may influence the development of the offspring and risk for diseases later in life. There is some evidence suggesting an association between maternal food intake and fetal growth and development, as well as the effect of prenatal influences on the child’s acceptance of foods in early life. Appetitive traits are classified as either genetic or learned, with fussy eating and food responsiveness considered genetic traits, whereas emotional undereating and overeating are often learned from the child’s environment. Both of these traits interact with each other to determine food habits that persist throughout the child’s life. Sweet foods are typically preferred in infancy, whereas bitter flavors are often rejected. This preference could be explained as an innate mechanism to preserve an adequate intake of energy-rich foods while rejecting potential toxins. In addition to this inborn response, children develop patterns of taste and flavor acceptance from the maternal diet during pregnancy and breastfeeding. Thus, it is theorized that early repeated exposures to multiple flavors may promote a wider range of food acceptance later on. Taste buds become functional only during the third trimester and can then be stimulated by foods eaten by the mother through the amniotic fluid. However, the fetus experiences food odors and flavors earlier than this, which may determine food preferences later in life. About the study Earlier research has shown a strong correlation between excessive weight gain in childhood and the mother’s diet during pregnancy. Since appetitive traits are also important in childhood obesity, the current study examined how maternal diet was related to appetitive traits at five years of age in the offspring. The current study used the Alternative Healthy Eating Index (AHEI-P) by the United States Department of Agriculture. AHEI-P was modified for pregnancy to determine maternal diet quality from three-day food diaries. The researchers also examined the intake of sugar-sweetened beverages (SSBs) over the same period. The appetitive traits of the offspring were assessed by the Children’s Eating Behavior Questionnaire (CEBQ), which is parent-reported and includes eight eating behaviors and 35 items overall. Demographic information, breastfeeding, period of weaning, the point when solid food was started, and maternal educational levels were also recorded. Study findings The women included in the current study had a median age of 33 years and had an average maternal BMI of about 25. At the five-year time point, more than half of the women and about 25% of the children were considered overweight. The mean AHEI-P was 54 in pregnancy and 55 for the group who also had CEBQ data after five years. Notably, mothers with higher AHEI-P scores during the first and second trimesters of pregnancy had lower mean ‘Desire to Drink’ scores in their children at five years of age. The only association found in this analysis was for the Desire to Drink, with other appetitive traits failing to reveal any associations. Although little is known about how the presence of ‘Desire to Drink’ in children might contribute to their developmental and behavioral traits later in life, this characteristic may have long-term impacts on their appetite and dietary intake. Less than half of the women with CEBQ data drank SSBs in pregnancy. In the first two trimesters, this was associated with a higher Desire to Drink in children at five years of age. Women with the poorest diet quality were younger and had higher body weight at their first antenatal visit and after five years. However, the birthweight of the child, weight at five years, as well as other indices, failed to show any association with maternal diet quality.

Pregnancy outcomes after COVID-19 vaccination and infection

In a recent study posted to the Research Square* preprint server, researchers assessed early pregnancy outcomes after coronavirus disease 2019 (COVID-19) vaccination and infection. Study: Early pregnancy outcomes following COVID-19 vaccination and SARS-CoV-2 infection: a national population-based matched cohort study. Image Credit: M M Vieira/Shutterstock Study: Early pregnancy outcomes following COVID-19 vaccination and SARS-CoV-2 infection: a national population-based matched cohort study. Image Credit: M M Vieira/Shutterstock Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has proven effective against the risk of contracting severe COVID-19 in pregnant women. However, studies have reported high levels of vaccine hesitancy among the pregnant population. Several factors potentially enforce COVID-19 vaccine hesitancy among pregnant women, such as the exclusion of pregnant women from vaccine trials in the initial phases, leading to inconsistent guidance in the early phases of the vaccination program due to a lack of safety-related data during those times. There is an urgent requirement to obtain concrete evidence concerning COVID-19 vaccine safety in early pregnancy to develop better vaccination policies. About the study In the present study, researchers performed a population-level matched cohort study that evaluated the association of miscarriage and ectopic pregnancy with COVID-19 vaccination. The team obtained data from the population-based and dynamic report on COVID-19 in the Pregnancy in Scotland (COPS) cohort, which comprised all ongoing and completed pregnancies recorded from 1 January 2015 onwards in Scotland. The data included information related to pregnancies, such as the estimated conception dates, while the completed pregnancies included information related to gestational age and pregnancy outcome. This data was extracted for all pregnant women aged between 11 and 55 at conception. National data related to COVID-19 infections and vaccination were also incorporated using unique identifiers into the study group. The COPS database included pregnancies having an estimated conception date up till 28 September 2021 and detected outcomes that occurred up to 31 January 2022. The team considered the primary exposure to the COVID-19 vaccine as the receipt of any SARS-CoV-2 vaccine available in Scotland, including BNT162b2, messenger ribonucleic acid (mRNA)-1273, and ChAdOx1-S at any dose such as first, second, et cetera. Eligible participants were vaccinated from six weeks before conception until the end of the outcome-specific period, defined as the period between 19 weeks and six days of gestation (19 + 6 weeks) for miscarriage and a duration of 2 + 6 weeks for ectopic pregnancy. Concerning study outcomes, all pregnancies were classified as ongoing or completed at 19 + 6 weeks. All completed pregnancies were further groups as per outcomes such as either miscarriage, ectopic pregnancy, or termination. The outcomes of interest were verified according to the International Classification of Diseases (ICD)-10 or Read Coded Clinical Terms diagnostic codes reported on the hospital discharge records. Related Stories Italian study finds SARS-CoV-2 in clinical samples collected before December 2019 Scientists develop a novel solution to evaluate airborne transmission of SARS-CoV-2 What is currently known about immune responses to COVID-19 vaccines and cellular immune responses against SARS-CoV-2? Furthermore, the team compared early pregnancy outcomes among women who did and did not have a confirmed COVID-19 infection. The exposure of interest for the study was confirmed COVID-19 diagnosis from six weeks before conception until the end of the outcome-specific period tested via reverse transcription (RT) polymerase chain reaction (PCR) test or a lateral flow device (LFD) test. Results The COPS study database comprised data related to 556,167 pregnancies reported by 361,606 women among which only 526,608 pregnancies were eligible for the study. These included 399,652 pregnancies recorded in the pre-pandemic period while 126,956 pregnancies were recorded in the contemporary pandemic period. The team noted that 18,780 pregnant women were immunized with the COVID-19 vaccine between six weeks before conception and 19 + 6 weeks of gestation. The study results showed that BNT162b2 vaccine was most frequently received by the pregnant women while one-fourth of the study cohort were vaccinated with two or more doses during the exposure period. Notably, by 19 + 6 weeks of gestation, almost 9% of the pregnancies from the vaccinated group ended in miscarriage as compared to 9.9% and 10.0% of pre-pandemic and contemporary controls. Moreover, primary analyses performed using pre-pandemic controls showed no considerable difference in the occurrence of miscarriage among vaccinated pregnant women. Compared to mRNA-vaccinated pregnant women, women who received the ChAdOx1-S vaccine had a higher chance of being categorized as either clinically or extremely vulnerable since they belonged to the most deprived regions. The subgroup analyses displayed no evidence that mRNA-vaccinated women were more likely to suffer from a miscarriage as compared to the pre-pandemic or contemporary controls. The team did observe that women vaccinated with ChAdOx1-S were more likely to experience a miscarriage in comparison to the pre-pandemic controls but not the contemporary controls. Furthermore, 10,570 pregnant women were vaccinated between six weeks before conception and 2 + 6 weeks of gestation. By 19 + 6 weeks of gestation, ectopic pregnancies accounted for almost 1.2% of the pregnancies in the vaccinated, 1.2% of pregnancies in the pre-pandemic controls, and 1.1% of pregnancies in the contemporary control groups. The team found no evidence favoring that women vaccinated during pregnancy had a higher chance of experiencing an ectopic pregnancy. Additionally, no evidence was found supporting that women infected with SARS-CoV-2 during pregnancy had a higher chance of suffering from ectopic pregnancy or miscarriage. Overall, the study findings showed no evidence of a higher risk of ectopic pregnancy or miscarriage among pregnant women after COVID-19 vaccination or infection. *Important notice Research Square publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

How is the COVID pandemic affecting perinatal mental health?

A recent review published in the journal Progress in Neurology and Psychiatry discusses the adverse effects of the ongoing coronavirus disease 2019 (COVID-19) pandemic on perinatal mental health. Study: Perinatal mental health during the COVID‐19 pandemic. Image Credit: Pormezz / Shutterstock.com Study: Perinatal mental health during the COVID‐19 pandemic. Image Credit: Pormezz / Shutterstock.com Background The initial few weeks following childbirth are physically, emotionally, and mentally taxing. Perinatal depression can occur as early as before conception or as late as approximately one-year post-delivery. Although women with pre-existing mental disorders are at an increased risk of relapse during the perinatal period, these disorders may also arise for the first time in women with no prior history of the condition. In fact, mental disorders, which are associated with poor maternal and child outcomes, are considered a major complication that women endure during the perinatal period and affect nearly one in five pregnant women. The impact of the COVID-19 pandemic on perinatal mental health During the COVID-19 pandemic, pregnant women were especially vulnerable to the psychological effects of lockdowns and other restrictions that were put in place to reduce the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Increased social isolation due to lockdowns and social distancing measures, combined with other socioeconomic stressors like financial hardships and occupational changes, have contributed to the development of mental health disorders, particularly in the perinatal population. Additional factors were also found to increase the likelihood of mental disorders in perinatal women during the COVID-19 pandemic. Travel restrictions, for example, increased the potential for relationship conflict, controlling behaviors, and, in some instances, domestic abuse and violence. Furthermore, social distancing limited contact with friends, family, and support from healthcare providers, which also contributed to anxiety in these individuals. Despite the need for moral and emotional support from their peers, pregnant women often remained isolated from their support systems during the pandemic. Related Stories Scientists develop a novel solution to evaluate airborne transmission of SARS-CoV-2 Study investigates the effect of vitamin D and fish oil on croup What is currently known about immune responses to COVID-19 vaccines and cellular immune responses against SARS-CoV-2? The replacement of in-person maternity care and perinatal mental health services with virtual visits, as well as new policies prohibiting partners from accompanying patients to their in-person visits, also contributed to the isolation of expectant mothers. The absence of customary birthing experiences also caused grief for many. Concerns regarding the exposure of pregnant women and their unborn children to SARS-CoV-2 also increased anxiety in this patient population. In general, pregnant women with COVID-19 are more likely to necessitate intensive care unit (ICU) admission than non-pregnant women with COVID-19 of the same reproductive age. Due to persisting disparities amongst various socioeconomic populations, pregnant women of minority ethnic groups are at a heightened risk for acquiring COVID-19 during the perinatal period as compared to pregnant women of other races. Alcohol consumption has also been found to increase in the general population during the pandemic. In fact, one non-perinatal American study reported that this increase is more pronounced in women than men. It should be noted that the potential for domestic violence, abuse, and mental illness increases with alcohol abuse. Global surveys report that healthcare personnel who were working in perinatal mental health settings at the onset of the pandemic identified several obstacles to assessing and providing care to perinatal women, as well as their infants and extended families. During remote consultations and follow-ups, staff often reported challenges regarding their ability to detect early signs of mental illness. Additional concerns on how to assess and encourage the interactions between the mother and infant through teleconsultations have also been described. Guidance for improving clinical care The COVID-19 pandemic has highlighted the importance of improving current perinatal mental healthcare services. For example, it is evident that virtual appointments are beneficial to some working mothers. The current pandemic also emphasized the need for collaborative care between professionals in mental health and other organizations capable of assisting vulnerable perinatal women. Several organizations have proposed guidelines to improve support for women suffering mental health problems during the pandemic. These guidelines emphasize the importance of recognizing the unpredictability of the current political climate and empowering women with information so that they can be equipped to handle the continuously changing situation. A better understanding of the experiences of perinatal women during the pandemic could guide the adaptation and formulation of services for providing support aimed at improving perinatal mental health.

SARS-CoV-2 prime and booster vaccinations found to improve pregnancy and birth outcomes

In a recent study posted to the medRxiv* preprint server, researchers evaluated the impact of coronavirus disease 2019 (COVID-19) prime vaccination and booster vaccination during pregnancy on maternal and fetal health outcomes. Study: The effect of COVID-19 vaccination and booster on maternal-fetal outcomes: a retrospective multicenter cohort study. Image Credit: Natalia Deriabina/Shutterstock Study: The effect of COVID-19 vaccination and booster on maternal-fetal outcomes: a retrospective multicenter cohort study. Image Credit: Natalia Deriabina/Shutterstock Studies have reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections during pregnancy have worsened maternal and fetal health outcomes with increased mortality and morbidity from maternal SARS-CoV-2 infections. However, data on the protective role of COVID-19 prime and booster vaccinations during pregnancy are lacking since there have been concerns regarding the potential adverse effects of vaccines on the health of mothers and their fetuses. About the study In the present retrospective cohort study, researchers evaluated the immune protection conferred by prime and booster COVID-19 vaccinations during pregnancy for improved pregnancy and birth outcomes. The multicenter study was conducted on women aged 18 to 45 who delivered at PJSH (providence St. Joseph health, n=86,833) sites in California, Alaska, Oregon, Montana, Texas, Washington, and New Mexico between 26 January 2021 and 11 July 2022. Data were obtained from PJSH electronic health records (EHRs) of all participants with singleton pregnancies and delivery ≥20 weeks post-gestation. The study participants were categorized based on their status of vaccination during delivery as follows: (i) unvaccinated individuals (n=48,492), (ii) propensity score matched (PSM)-unvaccinated individuals (n=26,790), (iii) prime-vaccinated individuals (n=26,792; double vaccination with Moderna’s messenger ribonucleic acid (mRNA)-1273 or Pfizer-BioNTech’s BNT162b2 ≥2 weeks before delivery), and (iv) booster-vaccinated individuals (n=7,616). The prime study outcome was the maternal SARS-CoV-2 infection rate. Secondary maternal outcomes were the duration between breakthrough SARS-CoV-2 infection and complete vaccinations, COVID-19-associated hospital admission rates, oxygen supplementation requirements, vasopressor usage, SARS-CoV-2 infection severity, and medications. Other maternal health outcomes included rates of gestational hypertension, gestational diabetes, and preeclampsia. The secondary birth outcomes assessed were preterm births, stillbirths, gestational age at delivery, rates of low birth weight (below 2500g), and very low birth weight (below 1500g). COVID-19 was diagnosed based on polymerase chain reaction (PCR) reports. Results Related Stories Herpesvirus-6 and Epstein–Barr virus reactivation across acute SARS-CoV-2 patients What is currently known about immune responses to COVID-19 vaccines and cellular immune responses against SARS-CoV-2? Researchers find evidence of negative repercussions of immune history in SARS-CoV-2 infection The majority of maternal SARS-CoV-2 infection cases were reported in the unvaccinated cohort and a few individuals who received prime and/or booster vaccinations developed breakthrough SARS-CoV-2 infections before the SARS-CoV-2 Omicron variant became predominant. However, a few cases of maternal SARS-CoV-2 infections were reported among boosted individuals even during Omicron predominance. A significantly lower number of maternal COVID-19 cases were reported among booster-vaccinated individuals compared to prime-vaccinated individuals and significantly lesser maternal SARS-CoV-2 infections among vaccinated individuals compared to the unvaccinated PSM-matched or unmatched individuals. The vaccinated cohort with maternal SARS-CoV-2 infections during Omicron predominance showed a lower likelihood of seeking emergency care, with a greater likelihood of receiving care in outpatient settings compared to unvaccinated individuals. The vaccinated cohort showed a significantly lower likelihood of requiring vasopressors and oxygen supplementation than the unvaccinated matched cohort. Significantly lower rates of stillbirths, very low birth weight, and preterm births were reported for vaccinated individuals compared to the unvaccinated cohort. Three COVID-19-associated maternal deaths were reported, all of which were among unvaccinated individuals. Significantly lower rates of maternal SARS-CoV-2 infections were reported among boosted individuals with a lower likelihood of requiring hospital admissions and a longer duration between complete vaccination and breakthrough SARS-CoV-2 infections compared to prime vaccinated individuals. In addition, birth outcomes such as preterm births, stillbirths, very low birth weights and small gestational age were significantly lower among booster vaccinated individuals than in the prime vaccinated cohort. Vaccinated individuals showed an increased likelihood of being elder, non-Hispanics or Asians, residing in urban settings, with higher body mass index (BMI) values, insurance, lower socioeconomic vulnerability, negative history of chronic diabetes, gestational diabetes, preterm births, chronic hypertension, low parity, cesarean section delivery and fetus of the male sex. Vaccinated individuals were less likely to smoke or use non-illicit drugs. No significant differences were observed in the rates of severe or non-severe preeclampsia and gestational hypertension between the vaccinated cohort and unvaccinated cohort individuals. Overall, the study findings showed that COVID-19 vaccinations protect against poor maternal and fetal outcomes and vaccine boosters enhance the immune protection against SARS-CoV-2 infections. Therefore, pregnant women must be prioritized for SARS-CoV-2 prime and booster vaccinations. Further research must be conducted for exploring the immune benefit of fourth COVID-19 vaccinations during pregnancy. *Important notice medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Pregnancy information Sonographers can help enhance parents' emotional connection to the unborn baby during pregnancy

A systematic review of twenty-three studies suggests that, during pregnancy, expectant parents' feelings towards their unborn baby (fetus) can be positively enhanced by sonographers (specialist healthcare professionals who are trained to perform pregnancy ultrasound scans) making imaging examinations a truly parent-centered experience. Such an experience can allay feelings of anxiety and stress in the parents, helping them to feel more informed about the health and well-being of their unborn baby, and reassured of their emotional investment in the ongoing pregnancy. Conducted by the Centre for Maternal and Child Health Research at City, University of London, the review provides a holistic interpretation of the current evidence on the effect of antenatal (before birth) imaging on expectant parents' feelings towards their unborn baby. To date, whilst the provision of ultrasound scans during pregnancy has been generally regarded as a positive experience for parents, and may predict the quality of the parent-child relationship after birth, there is evidence to suggest that the experience may also lead to increased anxiety and stress in parents, particularly those who are unable to interpret the scan images. Seventeen of the studies analyzed in the review related to the mother's experience only, five included both parents and one study recruited fathers only. Six central themes were developed from analysis of the included studies: the scan experience begins before the scan appointment; including parents looking forward to the scan, but being simultaneously apprehensive of the potential to receive unexpected news about their baby the scan as a pregnancy ritual; parents regarded scans as a milestone event, which they expected, and wanted feeling actively involved in the scan; with the presence of fathers at scans important, not only for maternal support, but also as attending fathers felt closer to their unborn baby than those who were not parents' priorities for knowledge and understanding of the scan change during pregnancy; at earlier stages of pregnancy, parents prioritized knowing that their pregnancy was viable, at later stages it was important for parents to know about the presence of fetal anomalies the importance of the parent–sonographer partnership during scanning; parents' confidence in their sonographer was linked with narration of the scan, and limiting the use of non-medical terminology humanized the fetus, and implied to parents that the sonographer recognized their unborn baby as an individual rather than a medical entity scans help to create a social identity for the unborn baby; many parents centered their news about pregnancies around a scan, with some waiting until their first scan to tell friends and family about their pregnancies, and sharing their scan pictures or videos so that their support circle had a sense of knowing the baby even before birth Related Stories Study investigates the effect of vitamin D and fish oil on croup A mother's diet during pregnancy is linked to her child's food preferences Dolutegravir-based regimen more effective for treating pregnant people with HIV-1 The review also identified a lack of published research studies exploring the impact of fetal MRI (magnetic resonance imaging) on expectant parents' emotional connection to their unborn baby. Fetal MRI is becoming more commonly used to complement ultrasound imaging when a fetal anomaly is suspected. Hence, the authors stress that more research needs to be undertaken in this area to help understand the acceptability of this type of scan to parents and its potential effect on their feelings towards their unborn child. Lead author, Emily Skelton, is a sonographer, lecturer and College of Radiographers Doctoral Fellow within the Department of Radiography and Midwifery at City, University of London. We know how important scans during pregnancy are to provide clinical information about fetal growth and development, but there are additional benefits for expectant parents, who, in their transition to parenthood, may feel closer to their unborn babies after "seeing" them on scan. This review highlights the integral role of the sonographer in facilitating the developing connection between expectant parents and their unborn babies, through an informative, supportive and inclusive parent-centred approach to care that parents feel actively involved in."

life styale Study investigates the effect of vitamin D and fish oil on croup

Babies and children under three years old are less likely to develop croup if their mothers took fish oil and vitamin D supplements during pregnancy, according to new results from a clinical trial. The findings are from a randomized controlled trial – the 'gold standard' for medical research – that will be presented at the European Respiratory Society International Congress in Barcelona, Spain. It is the first large study of its kind to investigate the effects of vitamin D and fish oil on croup. Croup is a viral chest infection that affects young children. It causes a characteristic 'barking' cough, a hoarse voice and difficulty breathing. Croup is common and usually mild, but some children will need hospital treatment and breathing support. The study was presented by Dr Nicklas Brustad, a clinician and postdoctoral researcher working on the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) at Copenhagen University Hospital, Denmark. There is currently no vaccine against the pathogen that causes this disease. Therefore, other preventive strategies are needed, and measures initiated during pregnancy might be important since croup occurs in babies and young children. For such purpose, there is evidence that both vitamin D and fish oil could have an influence on the immune system." Dr Nicklas Brustad, Clinician and Postdoctoral Researcher, Copenhagen University Hospital The study included 736 pregnant women being cared for by COPSAC from 2010. The women were divided up into four groups. One group were given a high-dose vitamin D supplement (2800 international units per day) and fish oil containing long-chain n-3-polyunsaturated fatty acids (2.4 grams), the second group were given high-dose vitamin D and olive oil, the third group were given standard-dose vitamin D (400 international units per day) and fish oil, and the final group were given standard-dose vitamin D and olive oil. All the women took the supplements daily from their 24th week of pregnancy until one week after their babies were born. Neither the women nor the researchers knew which supplements they were taking until the end of the study. Researchers monitored the children until they were three years old and any who were suspected of suffering from croup were diagnosed by a doctor or via their medical records. There was a total of 97 cases of croup amongst the children. Related Stories A mother's diet during pregnancy is linked to her child's food preferences The dynamics of neutralizing antibodies in a cohort of children and adolescents after SARS-CoV-2 infection Mercury level during pregnancy not likely to affect child development provided the mother eats fish Overall, children whose mothers took the fish oil had an 11% risk of croup, compared to 17% in the children whose mothers took olive oil (a 38% decrease). Children whose mothers took high-dose vitamin D had an 11% risk of croup, compared to an 18% risk in those whose mothers took the standard-dose vitamin D (a 40% decrease). Dr Brustad said: "Our findings suggest that vitamin D and fish oil could be beneficial against childhood croup in sufficiently high doses. These are relatively cheap supplements meaning that this could be a very cost-effective approach to improving young children's health. "We are not sure of the exact mechanisms behind the beneficial effects of vitamin D and fish oil, but it could be that they can stimulate the immune system to help babies and young children clear infections more effectively." The research team working at COPSAC have already investigated other potential benefits of vitamin D and fish oil during pregnancy, including its effects on bone development, the central nervous system, body composition and asthma. They will continue to follow the children in the study and plan to investigate why some children are more prone to infections in childhood than others. Professor Rory Morty from the University of Heidelberg is chair of European Respiratory Society's lung and airway developmental biology group and was not involved in the research. He said: "We know that lung health in babies and young children can be influenced during pregnancy. For example, babies whose mothers smoke tend to have worse lung health. We are increasingly seeing that elements of a mother's diet can also help or hinder a baby's lung development. "This research suggests that taking vitamin D and fish oil supplements during pregnancy could have benefits for babies and young children. We would like to see further research in this area to support these findings as this could lead to new recommendations for supplementation during pregnancy. Pregnant women should always speak to their doctor before taking supplements."