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New guidelines for pregnancy care


GPs and obstetricians are being recommended to discuss a woman’s weight gain during pregnancy under new national medical guidelines for the care of expectant mothers.

The guidelines, announced by Health Minister Greg Hunt on Friday, also encourage routine Hepatitis C testing at the first antenatal visit, and discourage routine testing for Vitamin D status in the absence of a specific indication.

Mr Hunt said the evidence-based recommendations – designed to support midwives, obstetricians and GPs – are about ensuring the health of both mother and baby, and follow extensive work by medical experts.

“The guidelines recognise that body mass index prior to pregnancy, and weight gain during pregnancy, are among important determinants of health for both mothers and babies,” Mr Hunt said in a statement.

“Health professionals are recommended to discuss weight gain, diet and physical activity with all pregnant women.

“They also say all women should be offered the opportunity to be weighed at every antenatal visit, and also encourage self-monitoring of weight.”

Body mass index (BMI) is a tool used to measure obesity, which is linked to several pregnancy complications such as gestational diabetes, preeclampsia (a high blood pressure disorder) and a higher chance of emergency caesarean section.

Also announced by Mr Hunt at the National Women’s Health Summit was the launch of a new National Strategic Approach to Maternity Services, led by the Commonwealth Chief Nursing and Midwifery Officer, Professor Debra Thoms.

“To be finalised by mid-2019, the strategy will guide national maternity services policy, aligning delivery of services with available evidence and monitoring performance and outcomes so that progress can be measured and improvements identified,” Mr Hunt said in Sydney.

The new guidelines can be accessed here.

Maternal vaccine highly effective against pertussis

A large US study is the first to provide strong evidence that vaccinating expecting mothers against pertussis protects their newborns.

Data from nearly 150,000 newborns born between 2010 to 2015 showed a 91% efficacy of a maternal vaccine during the first two months of life – a crucial period since babies are only vaccinated at two months.

In the study, of 17 cases of pertussis recorded in the first two months of life, only one involved a newborn whose mother had been vaccinated before birth.

Maternal vaccination continued to protect even after the newborn had been immunised, with a 69% efficacy over the entire first year of life.

The researchers from Kaiser Permanente in Oakland, California, found no evidence of interference between maternal and newborn vaccines.

“The strategy of immunising pregnant women to boost maternal antibody transfer appears to be more effective for protecting young infants against pertussis than are attempts at ‘cocooning’ in which mothers and other persons in close contact with newborns are vaccinated,” they write in the journal Pediatrics.

In Australia, which has one of the highest reported rates of pertussis in the world, the immunisation handbook was updated in 2015 to include a recommendation to vaccinate pregnant women in their third trimester, regardless of their vaccination history.

Although this recommendation, coupled with new funding, significantly boosted vaccination uptake, over a quarter of pregnant women in Australia are still not vaccinated during their pregnancy, report Melbourne researchers writing in the ANZ Journal of Obstetrics and Gynaecology.

The most common reasons for pregnant women not getting vaccinated are that their healthcare provider doesn’t offer it or that they are unaware of the recommendation, the researchers found.

Social media could play a role in boosting vaccination rates in pregnant women, they suggest.

You can read these two studies in the journals Pediatrics and the ANZ Journal of Obstetrics and Gynaecology.