A systematic review of pregnancy studies has revealed that pregnancy smoking cessation programmes have a high rate of relapse.
The review by the National Institute for Health Research has revealed ways to better care for new mothers, especially from disadvantaged areas.
Pregnancy smoking cessation programmes have high rates of relapse, with only 13% of women not smoking at delivery, and 43% of these smoking again six months later. However, psychosocial interventions enabled women to stop smoking during pregnancy and reduced low birthweight and preterm births.
A review confirmed folic acid supplements, taken before and during early pregnancy, reduce the risk of neural tube defects in the baby. Women from disadvantaged groups are less likely to take folic acid or other supplements.
Dietary and lifestyle interventions for obese pregnant women reduce maternal weight gain and some risks for woman and baby. Giving non-diabetic obese pregnant women Metformin did not reduce risk of high birth weight.
Offering support with breastfeeding (from either professionals or peers) increased the length of time mothers breastfed for. Peer support programmes for women on low incomes were particularly effective in helping them to start.
Psychological interventions delivered by health visitors reduced symptoms of postnatal depression in women at risk of developing it. Another study suggested early treatment with antidepressants had clinical benefits for reducing postnatal depression.
Brief advocacy interventions, based on empowering women, may improve short-term mental health and reduce domestic abuse in pregnancy.
Offering a doula improved care experiences and breastfeeding rates amongst disadvantaged women.
'Best possible start'
Dr Peter Davidson, director of the NIHR Dissemination Centre, which produced the report said: ‘A healthy pregnancy helps a child to get the best possible start in life but there are a number of risk factors that can affect both mother and child, from pre-conception, through pregnancy, and into early childhood.
‘Research funded by the NIHR sheds light on how we can go about supporting parents to mitigate some of these risks. It also highlights opportunities and mechanisms to improve health and wellbeing during this pivotal time.’