11 results on '"Clifton, Vicki L"'
Search Results
2. A decline in planned, but not spontaneous, preterm birth rates in a large Australian tertiary maternity centre during COVID‐19 mitigation measures.
- Author
-
Gallo, Linda A., Gallo, Tania F., Borg, Danielle J., Moritz, Karen M., Clifton, Vicki L., and Kumar, Sailesh
- Subjects
DIABETES complications ,MATERNAL health services ,HYPERTENSION ,PREMATURE infants ,COVID-19 ,ASTHMA ,CONFIDENCE intervals ,ANALYSIS of variance ,TERTIARY care ,GESTATIONAL age ,PERINATAL death ,SOCIOECONOMIC factors ,DISEASE prevalence ,MATERNAL age ,DESCRIPTIVE statistics ,PARITY (Obstetrics) ,CHI-squared test ,BODY mass index ,ETHNIC groups ,LOGISTIC regression analysis ,ODDS ratio ,DISEASE complications - Abstract
Background: Reports from around the world suggest that rates of preterm birth decreased during COVID‐19 lockdown measures. Aims: To compare the prevalence of preterm birth and stillbirth rates during COVID‐19 restriction measures with infants born at the same maternity centre during the same weeks in 2013–2019. Materials and Methods: Deidentified data were extracted from the Mater Mothers' healthcare records database. This is a supra‐regional tertiary perinatal centre. Logistic regressions were used to examine singleton live preterm birth rates during the beginning of COVID‐19 restrictions (16 March‐17 April; 'early'; 6955 births) and during the strictest part of COVID‐19 restrictions (30 March‐1 May; 'late'; 6953 births), according to gestational age subgroups and birth onset (planned or spontaneous). We adjusted for multiple covariates, including maternal age, body mass index, ethnicity, parity, socioeconomic status, maternal asthma, diabetes mellitus and/or hypertensive disorder. Singleton stillbirth rates were also examined between 16 March–1 May. Results: Planned moderate/late preterm births declined by more than half during early COVID‐19 restrictions compared with the previous seven years (29 vs an average of 64 per 1000 births; adjusted odds ratio 0.39, 95% CI 0.22–0.71). There was no effect on extremely or very preterm infants, spontaneous preterm births, or stillbirth rates. Rolling averages from January to June revealed a two‐week non‐significant spike in spontaneous preterm births from late April to early May, 2020. Conclusions: Together with evidence from other nations, the pandemic provides a unique opportunity to identify causal and preventative factors for preterm birth. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
3. Trends in asthma self-management skills and inhaled corticosteroid use during pregnancy and postpartum from 2004 to 2017.
- Author
-
Robijn, Annelies L., Jensen, Megan E., Gibson, Peter G., Powell, Heather, Giles, Warwick B., Clifton, Vicki L., Mattes, Joerg, Peek, Michael J., Barrett, Helen L., Seeho, Sean K., Callaway, Leonie K., Abbott, Alistair, Attia, John, Wark, Peter A., and Murphy, Vanessa E.
- Subjects
ASTHMA ,WORKS councils ,PREGNANT women ,RISK perception ,PREGNANCY - Abstract
Objective: Asthma exacerbations and medication non-adherence are significant clinical problems during pregnancy. While asthma self-management education is effective, the number of education sessions required to maximise asthma management knowledge and inhaler technique and whether improvements persist postpartum, are unknown. This paper describes how asthma knowledge, skills, and inhaled corticosteroid (ICS) use have changed over time. Methods: Data were obtained from 3 cohorts of pregnant women with asthma recruited in Newcastle, Australia between 2004 and 2017 (N = 895). Medication use, adherence, knowledge, and inhaler technique were compared between cohorts. Changes in self-management knowledge/skills and women's perception of medication risk to the fetus were assessed in 685 women with 5 assessments during pregnancy, and 95 women who had a postpartum assessment. Results: At study entry, 41%, 29%, and 38% of participants used ICS in the 2004, 2007, and 2013 cohorts, respectively (p = 0.017), with 40% non-adherence in each cohort. Self-management skills of pregnant women with asthma did not improve between 2004 and 2017 and possession of a written action plan remained low. Maximum improvements were reached by 3 sessions for medications knowledge and one session for inhaler technique, and were maintained postpartum. ICS adherence was maximally improved after one session, but not maintained postpartum. Perceived risk of asthma medications on the fetus was highest for corticosteroid-containing medication; and was significantly reduced following education. Conclusions: There was a high prevalence of non-adherence and poor self-management skills in all cohorts. More awareness of the importance of optimal asthma management during pregnancy is warranted, since no improvements were observed over the past decade. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
4. Asthma control in pregnancy is associated with pre-conception dietary patterns.
- Author
-
Grieger, Jessica A, Grzeskowiak, Luke E, Wood, Lisa G, and Clifton, Vicki L
- Subjects
ASTHMA in pregnancy ,DIETARY supplements ,NUTRITION in pregnancy ,ACQUISITION of data ,RETROSPECTIVE studies ,LOGISTIC regression analysis ,ASTHMA treatment ,PREVENTION of pregnancy complications ,ASTHMA ,DIET ,FOOD habits ,PRECONCEPTION care ,DISEASE management ,CROSS-sectional method ,ODDS ratio - Abstract
Objective: To examine pre-conception dietary patterns in pregnant asthmatic women and to identify associations between maternal diet and asthma control during pregnancy.Design: Cross-sectional study. Pre-conception food frequency data were collected retrospectively. Asthma control was assessed using the Global Initiative for Asthma guidelines. Dietary patterns were derived using factor analysis. Binary logistic regression analyses were used to test the association between uncontrolled asthma and each dietary pattern (Z-score), with values presented as odds ratio and 95 % confidence interval.Setting: Antenatal clinic in a tertiary hospital, Adelaide, Australia, May 2009-July 2013.Subjects: One hundred and fifty-eight asthmatic pregnant women.Results: Three dietary patterns were identified: (i) 'high protein/fruit' (strong food group loadings for fish, meat, chicken, fruit); (ii) 'high fat/sugar/takeaway' (takeaway foods, crisps, refined grains); and (iii) 'vegetarian-type' (vegetables, fruit, soya milk, whole grains). A 1 sd increase in score on the high fat/sugar/takeaway pattern was associated with increased likelihood of uncontrolled asthma (adjusted OR=1·54; 95 % CI 1·07, 2·23; P=0·022). Women with uncontrolled asthma (n 115) had higher energy-adjusted intakes of saturated fat, monounsaturated fat, carbohydrate, sugar and fibre compared with women with controlled asthma (n 43, all P≤0·05).Conclusions: Pre-pregnancy dietary patterns may influence maternal asthma control. Our work highlights the importance of achieving a healthy diet before pregnancy that is low in saturated fat, sugar and takeaway foods, and therefore higher in lean meats, poultry and fish, as well as fruits, vegetables and whole grains. A healthy dietary pattern should be encouraged in all asthmatic women who are of childbearing age, and should additionally be promoted before pregnancy and beyond. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
5. Maternal and neonatal outcomes of pregnancies complicated by asthma in an Australian population.
- Author
-
CLIFTON, Vicki L., ENGEL, Patricia, SMITH, Roger, GIBSON, Peter, BRINSMEAD, Maxwell, and GILES, Warwick B.
- Subjects
- *
ASTHMA in pregnancy , *STILLBIRTH , *PREMATURE labor , *GESTATIONAL age , *MULTIPLE regression analysis , *FETAL development ,SEX differences (Biology) - Abstract
Objective: To determine if there are sex differences in risk and incidence of stillbirth, preterm delivery and small-for-gestational age (SGA) in pregnancies complicated by maternal asthma relative to a non-asthmatic population. Study design: Univariant and multiple regression analysis of the incidence of preterm delivery, SGA and stillbirth in singleton pregnancies complicated by asthma in Newcastle, NSW, Australia, from 1995 to 1999. Results: Asthma complicated 12% of all singleton pregnancies. The incidence of preterm delivery was not significantly different between asthmatic (13%) and non-asthmatic (11%) pregnancies. Male fetuses (53%) were more likely to deliver preterm than female fetuses (47%) in both asthmatic and non-asthmatic populations. There were significantly more male neonates of pregnancies complicated by asthma that were SGA at term relative to those of the non-asthmatic population. There were significantly more preterm female neonates that were SGA in pregnancies complicated by asthma relative to those of the non-asthmatic population. Male fetuses were more likely to be associated with a stillbirth in pregnancies complicated by asthma than female fetuses. Conclusion: The presence of maternal asthma during pregnancy increases the risk of stillbirth for the male fetus and is associated with changes in fetal growth, but does not increase the incidence of a preterm delivery. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
6. Male sex and pre-existing diabetes are independent risk factors for stillbirth.
- Author
-
ENGEL, Patricia J., SMITH, Roger, BRINSMEAD, Maxwell W., BOWE, Stephen J., and CLIFTON, Vicki L.
- Subjects
STILLBIRTH ,FETAL development ,PREGNANCY ,PEOPLE with diabetes ,PREGNANT women ,GYNECOLOGY ,OBSTETRICS - Abstract
Aim: To determine whether the risk of stillbirth is associated with male fetal sex, fetal growth and maternal factors in an Australian population. Methods: A retrospective secondary data analysis of 16 445 singleton births was performed using a tertiary referral centre obstetric database (1995–1999). Univariate and multiple logistic regression analyses were performed. Results: Stillbirth complicated 1% of the pregnancies in the study population, and 59% of stillbirths were associated with a male fetus. Significant characteristics associated with stillbirth were intrauterine growth restriction (IUGR), birth defects, gestational age, Aboriginal ethnicity, previous stillbirth, parity greater than three and placental abruption. Male stillbirths were more likely to occur at a later gestation (median gestation 30.5 weeks, range 20–43 weeks) compared to females (median 25 weeks, range 20–40 weeks), P = 0.01. Sixty per cent of IUGR fetuses were female ( P < 0.001). Male sex (odds ratio (OR) 1.5, confidence interval (CI) 1.01, 2.17, P = 0.04) and maternal type 1 diabetes (OR 4.7, CI 1.58, 14.19, P = 0.006) were independently associated with stillbirth. Conclusion: Male fetal sex and pre-existing diabetes are independent risk factors for stillbirth. Diabetes remains a significant risk for stillbirth even with contemporary monitoring and clinical management. Those diabetic pregnancies where the fetus is male require appropriate monitoring and timely interventions to achieve an optimal outcome. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
7. Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: a double-blind, randomised controlled trial.
- Author
-
Powell, Heather, Murphy, Vanessa E., Taylor, D. Robin, Hensley, Michael J., McCaffery, Kirsten, Giles, Warwick, Clifton, Vicki L., and Gibson, Peter G.
- Subjects
- *
ASTHMA treatment , *DISEASE exacerbation , *THERAPEUTIC use of nitric oxide , *DRUG delivery devices , *DRUG delivery systems , *RANDOMIZED controlled trials - Abstract
The article presents an Australian randomised controlled trial which looks into the significant role played by a validated fraction of exhaled nitric oxide (FENO) in the management of asthma exacerbations during pregnancy. The trial discovers that there is a lower exacerbation rate in the FENO group compared to the control group. However, researchers call for further study on the application of the algorithm in other clinical settings.
- Published
- 2011
- Full Text
- View/download PDF
8. Dietary supplements, guideline alignment and biochemical nutrient status in pregnancy: Findings from the Queensland Family Cohort pilot study.
- Author
-
Gallo LA, Steane SE, Young SL, de Jersey S, Schoenaker DAJM, Borg DJ, Lockett J, Collins CE, Perkins AV, Kumar S, Clifton VL, and Wilkinson SA
- Subjects
- Female, Humans, Pregnancy, Australia, Iron, Longitudinal Studies, Micronutrients, Nutrients, Pilot Projects, Prospective Studies, Queensland, Dietary Supplements, Folic Acid
- Abstract
In high-income nations, multiple micronutrient (MMN) supplementation during pregnancy is a common practice. We aimed to describe maternal characteristics associated with supplement use and daily dose of supplemental nutrients consumed in pregnancy, and whether guideline alignment and nutrient status are related to supplement use. The Queensland Family Cohort is a prospective, Australian observational longitudinal study. Maternal characteristics, nutrient intake from food and supplements, and biochemical nutrient status were assessed in the second trimester (n = 127). Supplement use was reported by 89% of participants, of whom 91% reported taking an MMN supplement. Participants who received private obstetric care, had private health insurance and had greater alignment to meat/vegetarian alternatives recommendations were more likely to report MMN supplement use. Private obstetric care and general practitioner shared care were associated with higher daily dose of supplemental nutrients consumed compared with midwifery group practice. There was high reliance on supplements to meet nutrient reference values for folate, iodine and iron, but only plasma folate concentrations were higher in MMN supplement versus nonsupplement users. Exceeding the upper level of intake for folic acid and iron was more likely among combined MMN and individual supplement/s users, and associated with higher plasma concentrations of the respective nutrients. Given the low alignment with food group recommendations and potential risks associated with high MMN supplement use, whole food diets should be emphasized. This study confirms the need to define effective strategies for optimizing nutrient intake in pregnancy, especially among those most vulnerable where MMN supplement use may be appropriate., (© 2023 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
9. Response to Letter to the Editor 'Adverse perinatal outcomes in the Australian Indigenous population, the role of asthma'.
- Author
-
Clifton VL, Das J, Flenady V, and Rae K
- Subjects
- Australia epidemiology, Female, Humans, Parturition, Pregnancy, Asthma complications, Asthma epidemiology, Indigenous Peoples, Pregnancy Outcome
- Published
- 2022
- Full Text
- View/download PDF
10. The impact of Aboriginal status, cigarette smoking and smoking cessation on perinatal outcomes in South Australia.
- Author
-
Hodyl NA, Grzeskowiak LE, Stark MJ, Scheil W, and Clifton VL
- Subjects
- Adult, Australia epidemiology, Cohort Studies, Female, Fetal Growth Retardation epidemiology, Fetal Membranes, Premature Rupture epidemiology, Humans, Infant, Newborn, Infant, Small for Gestational Age, Intensive Care Units, Neonatal statistics & numerical data, Obstetric Labor, Premature epidemiology, Oxygen Inhalation Therapy statistics & numerical data, Postpartum Hemorrhage epidemiology, Pregnancy, Premature Birth epidemiology, Resuscitation statistics & numerical data, Retrospective Studies, Smoking Prevention, Stillbirth epidemiology, Urinary Tract Infections epidemiology, Young Adult, Native Hawaiian or Other Pacific Islander, Smoking adverse effects, Smoking Cessation
- Abstract
Objective: To assess the impact of Aboriginal status, active cigarette smoking and smoking cessation during pregnancy on perinatal outcomes., Design: Retrospective cohort study from 1 January 1999 to 31 December 2008., Setting: All singleton births in South Australia., Participants: Population-based birth records of pregnancies to Aboriginal women (n = 4245) and non-Aboriginal women (n = 167 746)., Main Outcome Measures: Adjusted odds ratios (aORs) and 95% CIs for adverse maternal and neonatal outcomes according to Aboriginal status and maternal smoking in pregnancy., Results: Active cigarette smoking during pregnancy was associated with an increased risk of adverse perinatal outcomes, including premature labour (Aboriginal, 1-10 cigarettes per day: aOR, 1.69; 95% CI, 1.28-2.23; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.46; 95% CI, 1.34-1.58), preterm birth (Aboriginal, 1-10 cigarettes per day: aOR, 1.40; 95% CI, 1.14-1.73; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.48; 95% CI, 1.39-1.57), intrauterine growth restriction (Aboriginal, 1-10 cigarettes per day: aOR, 2.33; 95% CI, 1.77-3.08; non-Aboriginal, 1-10 cigarettes per day: aOR, 2.65; 95% CI, 2.48-2.83) and small for gestational age (Aboriginal, 1-10 cigarettes per day: aOR, 2.49; 95% CI, 2.06-3.00; non-Aboriginal, 1-10 cigarettes per day: aOR, 2.29; 95% CI, 2.20-2.40). For both Aboriginal and non-Aboriginal women who smoked 11 or more cigarettes per day the aOR for these outcomes increased. Smoking cessation in the first trimester reduced these risks to levels comparable with non-smokers. The risk of each adverse outcome was greater in Aboriginal than non-Aboriginal women for all smoking categories; however, interactions between Aboriginal status and smoking were not significant, indicating an equal contribution of smoking to poor outcomes in both populations., Conclusions: Smoking cessation or reduction during pregnancy would significantly improve outcomes in both Aboriginal and non-Aboriginal women. This should be made a clear priority to improve pregnancy outcomes for all women.
- Published
- 2014
- Full Text
- View/download PDF
11. The impact of iodine supplementation and bread fortification on urinary iodine concentrations in a mildly iodine deficient population of pregnant women in South Australia.
- Author
-
Clifton VL, Hodyl NA, Fogarty PA, Torpy DJ, Roberts R, Nettelbeck T, Ma G, and Hetzel B
- Subjects
- Adolescent, Adult, Australia, Body Mass Index, Female, Humans, Iodine deficiency, Malnutrition drug therapy, Nutritional Status, Pregnancy, Prospective Studies, Sodium Chloride, Dietary administration & dosage, South Australia epidemiology, Thyroid Diseases drug therapy, Thyroid Diseases epidemiology, Young Adult, Bread, Dietary Supplements, Food, Fortified, Iodine administration & dosage, Iodine urine, Malnutrition epidemiology
- Abstract
Mild iodine deficiency during pregnancy can have significant effects on fetal development and future cognitive function. The purpose of this study was to characterise the iodine status of South Australian women during pregnancy and relate it to the use of iodine-containing multivitamins. The impact of fortification of bread with iodized salt was also assessed. Women (n = 196) were recruited prospectively at the beginning of pregnancy and urine collected at 12, 18, 30, 36 weeks gestation and 6 months postpartum. The use of a multivitamin supplement was recorded at each visit. Spot urinary iodine concentrations (UIC) were assessed. Median UICs were within the mildly deficient range in women not taking supplements (<90 μg/L). Among the women taking iodine-containing multivitamins UICs were within WHO recommendations (150-249 μg/L) for sufficiency and showed an increasing trend through gestation. The fortification of bread with iodized salt increased the median UIC from 68 μg/L to 84 μg/L (p = .011) which was still in the deficient range. Pregnant women in this region of Australia were unlikely to reach recommended iodine levels without an iodine supplement, even after the mandatory iodine supplementation of bread was instituted in October 2009.
- Published
- 2013
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.