Robin Bell

Antenatal and intrapartum antecedents of cerebral palsy: a case-control study

To identify antenatal and intrapartum factors contributing to the aetiology of cerebral palsy (CP).

Relaxin in paired samples of serum and milk from women after term and preterm delivery.

In a study to determine if relaxin could be measured in milk and if so to correlate concentrations in milk and serum, paired samples of milk and serum were collected from 12 women 3 days after term delivery (term group), from 16 women 3 days after preterm delivery (preterm group), and from some of these patients 6 weeks after delivery (eight term and six preterm). Relaxin was measured by specific human relaxin radioimmunoassay. Relaxin from milk and sera behaved similarly in the relaxin radioimmunoassay and reverse-phase high-performance liquid chromatography. Concentrations of relaxin in sera and milk collected 3 days after delivery did not differ significantly within the term or preterm groups. Neither were there differences in relaxin levels in sera and milk between the term and preterm groups. At 6 weeks postpartum, relaxin was not measured in any sera but was measured in milk from six of eight patients in the term group and five of six patients in the preterm group. Relaxin concentrations in milk were higher in the preterm group. The presence of relaxin in milk at 6 weeks postpartum suggests a nonluteal site of synthesis.

Antenatal exercise and birthweight

Does strenuous antenatal exercise reduce birth‐weight? Does reducing maternal exercise increase birthweight? What to advise about exercise during pregnancy?

Factors identified during the neonatal period associated with risk of cerebral palsy

Objective:  To identify factors during the neonatal period that are associated with the subsequent development of cerebral palsy (CP).

People who influence women's decisions and preferred sources of information about prenatal testing for birth defects

Background:  More than half of Victorian pregnant women are undergoing prenatal testing for birth defects, although little is known about the factors that are influencing their decisions.

A randomized community intervention trial to increase awareness and knowledge of the role of periconceptional folate in women of child‐bearing age

Objectives To determine the effect of a consumer‐directed information campaign to increase knowledge of folate for the prevention of neural tube defects among women of child‐bearing age, and to measure women’s recall of sources of information and knowledge about folate.

Cervical surveillance as an alternative to elective cervical cerclage for pregnancy management of suspected cervical incompetence

Objective:  The aim of the present study was to compare the outcome of pregnancies among patients with suspected cervical incompetence treated either by elective cervical cerclage or an alternative management program involving cervical surveillance.

A Randomized Controlled Trial of a Smoking Cessation Intervention During Pregnancy

This study was a randomized controlled trial of a smoking cessation intervention for pregnant smokers. Women who reported smoking at their first antenatal visit and satisfied the inclusion criteria were asked to participate in the trial. Analysis was restricted to 393 evaluable women in the control group (received usual antenatal care) and 339 women to the study group (received usual antenatal care plus the intervention). The primary hypotheses were that the intervention would result in a higher proportion of quitters and that the mean birth‐weight of babies born to women receiving the intervention would be greater than that of babies born to women in the control group. The outcome measures were smoking status based on self‐report combined with a urinary cotinine level of <115 ng/mL, and birth‐weight. There was no significant difference in quit rate between women receiving the intervention and women in the control group (11.9% versus 9.8% p=0.41). Babies born to women receiving the intervention were on average 84 g heavier than babies born to controls (p=0.04). The factors that contribute to the lack of a significant increase in smoking cessation in the intervention group and the possible explanation for the changes in birth‐weight are discussed.

The increasing knowledge of the role of periconceptional folate in Victorian women of child-bearing age: follow-up of a randomised community intervention trial.

Objectives: To determine the changes since 1996 in knowledge of folate for the prevention of neural tube defects (NTDs) among women of child‐bearing age and measure the residual effect of an earlier consumer‐directed information campaign.

Do women know that prenatal testing detects fetuses with Down syndrome

This questionnaire-based study in Victoria, Australia, examined the responses of pregnant women, aged 37 years and over, to a question about what they expected prenatal testing (screening and/or diagnosis) for birth defects to tell them about their pregnancy. Content analysis showed that, of the 432 tested women, 61.3% mentioned Down syndrome, chromosomal abnormalities or trisomies. Women undergoing both screening and diagnosis were more likely than those having one or other test to mention Down syndrome (adjusted OR = 1.6, P = 0.06), having adjusted for age, marital status, education, residence and parity. Similarly, those from an English-speaking background were more likely to mention Down syndrome, etc. compared to women from a non-English-speaking background (adjusted OR = 3.5, P < 0.001). Down syndrome, a fundamental piece of information about prenatal tests, was not mentioned in nearly 40% of womens responses. This suggests that pregnant women need clearer information about prenatal testing, including the conditions that might be detected.