BackgroundAbnormal placental cord insertion (PCI) includes marginal cord insertion (MCI) and velamentous cord insertion (VCI). VCI has been shown to be associated with adverse pregnancy outcomes. This systematic review and meta-analysis aims to determine the association of abnormal PCI and adverse pregnancy outcomes.MethodsEmbase, Medline, CINAHL, Scopus, Web of Science, ClinicalTrials.gov, and Cochrane Databases were searched in December 2016 (from inception to December 2016). The reference lists of eligible studies were scrutinized to identify further studies. Potentially eligible studies were reviewed by two authors independently using the following inclusion criteria: singleton pregnancies, velamentous cord insertion, marginal cord insertion, and pregnancy outcomes. Case reports and series were excluded. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. Outcomes for meta-analysis were dichotomous and results are presented as summary risk ratios with 95% confidence intervals.ResultsSeventeen studies were included in the systematic review, all of which were assessed as good quality. Normal PCI and MCI were grouped together as non-VCI and compared with VCI in seven studies. Four studies compared MCI, VCI, and normal PCI separately. Two other studies compared MCI with normal PCI, and VCI was excluded from their analysis. Studies in this systematic review reported an association between abnormal PCI, defined differently across studies, with preterm birth, small for gestational age (SGA), low birthweight (< 2500 g), emergency cesarean delivery, and intrauterine fetal death. Four cohort studies comparing MCI, VCI, and normal PCI separately were included in a meta-analysis resulting in a statistically significant increased risk of emergency cesarean delivery for VCI (pooled RR 2.86, 95% CI 1.56–5.22, P = 0.0006) and abnormal PCI (pooled RR 1.77, 95% CI 1.33–2.36, P < 0.0001) compared to normal PCI.ConclusionsThe available evidence suggests an association between abnormal PCI and emergency cesarean delivery. However, the number of studies with comparable definitions of abnormal PCI was small, limiting the analysis of other adverse pregnancy outcomes, and further research is required.Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0641-1) contains supplementary material, which is available to authorized users.

Background: Accurate early risk-prediction for gestational diabetes mellitus (GDM) would target intervention and prevention in women at the highest risk. We evaluated maternal risk-factors and parameters of body-composition to develop a prediction model for GDM in early gestation. Methods: A prospective observational study was undertaken. Pregnant women aged between 18 and 50 y of age with gestational age between 10 and 16 weeks were included in the study. Women aged 18 y, twin-pregnancies, known foetal anomaly or pre-existing condition affecting oedema status were excluded. 8-point-skinfold thickness (SFT), mid-upper-arm-circumference (MUAC), waist, hip, weight and ultrasound measurements of subcutaneous (SAT) and visceral abdominal-adipose (VAT) were measured. Oral-glucose-tolerance-test (OGTT) for GDM diagnosis was undertaken at 28 weeks gestation. Binomial logistic-regression models were used to predict GDM. ROC-analysis determined discrimination and concordance of model and individual variables.

The level of knowledge of Listeria among mothers in Ireland is unknown. This prospective questionnaire study aims to evaluate the level of knowledge of recently delivered mothers regarding Listeria infection and its potential prevention. A response rate of 98% was achieved. A total of 271 (43.9%) mothers had heard about Listeria infection but only 187 (30.3%) knew that it was a food-borne pathogen. In total, 83 (13.5%) mothers recalled being told about Listeria infection by a midwife or doctor and 33 (5.3%) recalled receiving written information. A total of 224 (36.3%) of mothers were aware of the increased risk of listeriosis during pregnancy, while 250 (40.5%) knew the potential complications to the unborn fetus. A grand total of 505 (81.8%) mothers knew that they should avoid certain high-risk foods during pregnancy but 342 (55.4%) admitted to having consumed high-risk foods during their pregnancy. In conclusion, mothers' knowledge about listeriosis and its prevention was limited. Many mothers ate high-risk food during pregnancy. Antenatal advice regarding Listeria prevention needs to be improved.

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