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3Objectives: Successful implementation of preconception and interconception care contributes to optimizing pregnancy outcomes. While interconception care to new mothers could potentially be provided by Preventive Child Health Care services, this care is currently not routinely available in the Netherlands. The purpose of this study was to identify facilitators and barriers for implementation of interconception care in Preventive Child Health Care services. Methods: We organized four focus groups in which Preventive Child Health Care physicians and nurses, related health care professionals and policymakers participated. A semi-structured interview approach was used to guide the discussion. The transcribed discussions were analyzed. Results: All four groups agreed that several facilitators are present, such as the unique position to reach women and the expertise in preventive health care. Identified barriers include unfamiliarity with interconception care among patients and health care providers, as well as lack of consensus about the concept of interconception care and how it should be organized. A broad educational campaign, local adaptation, and general agreement or a guideline for standard procedures were recognized as important for future implementation. Conclusions for practice: This study identifies potentially important facilitators and barriers for the implementation of interconception care in Preventive Child Health Care services or comparable pediatric settings. These factors should be considered and strategies developed to achieve successful implementation of interconception care.
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Objective To investigate trends in low Apgar scores in (near) term singletons using the Dutch Perinatal Registry. Methods In a cohort of 1,583,188 singletons liveborn ≥35 weeks of gestation in the period 2010–2019, we studied trends in low 5-min Apgar scores (<7 and <4) using Cochrane Armitage trend tests. Results The proportion of infants with low Apgar scores <7 and <4 increased significantly between 2010–2019 (1.04–1.42% (p < 0.001), 0.17–0.19% (p = 0.009), respectively). Neonatal mortality remained unchanged. Induction of labour, epidural analgesia and planned caesarean section showed an increasing trend. Instrumental vaginal delivery and emergency caesarean section were performed less frequently over time, but these intervention subgroups showed the highest relative increase in infants with low Apgar scores. Conclusions In the Netherlands, the risk of a low 5-min Apgar score increased over the last decade. The highest relative increase was observed in subgroups of instrumental vaginal delivery and emergency caesarean section.
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Objective To examine the association between intrapartum synthetic oxytocin and child behavioral and emotional problems and to assess if maternal depressive or anxious symptoms or mother-to-infant bonding play a mediating role in this association. Design Prospective cohort study. Setting Population-based Pregnancy Anxiety and Depression Study. Participants Pregnant women in their first trimester of pregnancy visiting a total of 109 primary and nine secondary obstetric care centers in the Netherlands between 2010 and 2014 were invited to participate. Follow-up measures used for the present study were collected from May 2010 to January 2019. Women with multiple gestations and with a preterm birth were excluded. Measurements Intrapartum synthetic oxytocin exposure status was based on medical birth records and was defined as its administration (Yes/No), either for labour induction or augmentation. Child behavioral and emotional problems were measured with the Child Behavior Checklist at up to 60 months postpartum. Maternal depressive symptoms, anxiety and mother-to infant bonding were measured with the Edinburgh Postnatal Depression Scale, State Trait Anxiety Inventory and the Mother-to-Infant Bonding Scale from 6 months postpartum. We used multivariable linear regression models to estimate standardized beta coefficients and unique variance explained. Findings 1,528 women responded. In total 607 women received intrapartum synthetic oxytocin. Intrapartum synthetic oxytocin administration was not associated with child behavioral and emotional problems, mother-to-infant bonding nor with postnatal anxiety. Intrapartum synthetic oxytocin was however significantly but weakly associated with more postnatal depressive symptoms (β=0.17, 95%CI of 0.03 to 0.30) explaining 0.6% of unique variance. Maternal postnatal depressive symptoms, postnatal anxiety symptoms and suboptimal mother-to-infant bonding were positively associated with child behavioral and emotional problems. Key conclusions and implications for practice We found no evidence that intrapartum synthetic oxytocin is associated with child behavioral and emotional problems, mother-to-infant bonding, or with postnatal anxiety symptoms. Because there was no association between intrapartum synthetic oxytocin and behavioral and emotional problems in children no mediation analysis was carried out. However, intrapartum synthetic oxytocin was positively but weakly associated with postnatal depressive symptoms. The clinical relevance of this finding is negligible in the general population, but unknown in a population with a high risk of depression.
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Huilen is de manier waarop een pasgeboren baby communiceert met zijn of haar omgeving. Met inzicht in redenen waarom pasgeborenen huilen, kunnen ouders hun handelen beter leren af te stemmen op de behoeftes van de baby. Het doel van dit artikel is om (1) inzicht te geven in vijf soorten babygeluiden die
wijzen naar vijf verschillende fysieke behoeftes van de pasgeborene en om (2) de relatie te beschrijven tussen Dunstan Babytaal, de uitgangspunten van de Hanenmethode en voeding.
Dunstan Babytaal onderscheidt in de voorfase van het huilen, voordat het luide ‘gefrustreerde’ huilen losbarst, vijf kenmerkende reflexgeluiden met ieder een heel specifieke betekenis. Er is een geluid voor honger hebben, moe zijn, een boertje moeten laten, darmkrampjes hebben of ongemak hebben aan de
huid (bijvoorbeeld een vieze luier, te warm, te koud) en/of overprikkeld zijn. Met behulp van Dunstan Babytaal kunnen de uitgangspunten van de Hanenmethodiek al vanaf de geboorte worden gevolgd; in de allereerste communicatie tussen ouder en kind. Bovendien kunnen ouders met Dunstan Babytaal signalen die hun baby afgeeft wanneer hij honger heeft of juist geen behoefte heeft aan voeding leren herkennen. Hiermee kunnen voedingsproblemen voorkomen worden. Logopedisten kunnen met kennis van Dunstan Babytaal een preventieve rol innemen op het gebied van voeding en interactie en ook kunnen zij betrokken zijn bij de allereerste fase van de communicatieve ontwikkeling.
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This thesis focuses on topics such as preterm birth, variation in gross motor development, factors that influence (premature) infant gross motor development, and parental beliefs and practices. By gaining insight into these topics, this thesis aims to contribute to clinical decision-making of paediatric physiotherapists together with parents, and with that shape early intervention.
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