THE MAMMI STUDY (Maternal health And Maternal Morbidity in Ireland)

INTRODUCTION

The MAMMI Study is a multi-centre multi-strand mixed method study exploring the health of, and morbidities experienced by, 2600 first-time mothers in Ireland.

PROGRESS TO DATE THE MAMMI STUDY September 2015

Prof Cecily Begley,1 Dr Deirdre Daly,1 Prof Agnes Higgins, 1 Associate Prof Margaret Carroll, 1 Prof Mike Clarke2

CONTEXT

There are no publically available data on maternal health and health problems following discharge from the maternity hospitals in Ireland.

Women’s attendances at health services or readmissions to hospitals are not linked to their maternity records (i.e. there is no connectivity between their records).

THE MAMMI STUDY STRANDS September 2011

OBJECTIVESi. to identify prevalence of morbidities up to 12 months

postpartum for women having their first babyii. to identify associated factors e.g., age; Body Mass Index

(BMI); mode of birth; birth weight iii. to identify the health service-seeking and self-help

behaviours of sub-samples of women experiencing morbidities

iv. to identify the risk factors for morbidities that may be amenable to intervention.

Deirdre Daly, Post doctoral researcher - Urinary Incontinence Strand Margaret Carroll, Associate Professor in Midwifery – Researcher, MAMMI 2 Study in Galway Prof Agnes Higgins, Professor in Mental Health Nursing, PhD and MSc supervisor Deirdre O Malley, HRB HPF Fellow – PhD student, Sexual Health Strand Francesca Wuytack, PhD student - Pelvic Girdle Pain Strand Sunita Panda, PhD student - Caesarean Section Strand Louise Rafferty, MSc Research student - Mental Health Strand Jamile Marchi, PhD student - Nutrition Strand

Women’s knowledge and practice of Pelvic Floor Muscle Exercises (PFME) and their opinions of PFME education at the Rotunda Hospital

Women’s knowledge of PFME and opinions of four self-help educational videos

The PLEASE Study - Postnatal Leaking, Exercise and Activity Shorts Evaluation

SITE 1

Study commenced 31 January 2012 and recruitment closed 3 October 2014

1839 women recruited. Postpartum follow-up is ongoing

1 Trinity College Dublin. 2 Queen’s University Belfast

Professor Cecily Begley is PI on all MAMMI StudiesProfessor Mike Clarke is co-PI of MAMMI Study 1 (Rotunda Hospital)

Dr Deirdre Daly is post-doctoral researcher on MAMMI Studies 1 and 3Associate Prof Margaret Carroll is researcher on MAMMI Study 2

Prof Agnes Higgins is co-Applicant on MAMMI Study 2, and PhD/MSc supervisor

AIMThe study aims to explore the health and health problems experienced by 2600 primiparous women before and during pregnancy, and at 3, 6, 9 and 12 months postpartum.

STUDY DESIGN, MATERIALS AND METHODS

i. Self-completion questionnaires administered at 6 time points: twice antenatally and at 3, 6, 9 and 12 months postpartum (6th survey on diet and physical activity introduced in 3rd site)

ii. Data collection from women’s records

iii. Interviews with women experiencing morbidities postpartum

~40% of primiparous women were offered information on the MAMMI study

Of those given the information, about two in five complete the survey

RECRUITMENT AND RETENTION RATES

RECRUITMENT AND RETENTION RATES

~40% of primiparous women were offered information on the MAMMI study

Of those given the information, just over two in five complete the survey

SITE 2

Study commenced 1 October 2013 and recruitment closed 31 July 2015

325 women recruited. Postpartum follow-up is ongoing

SITE 3

Recruitment commenced 26 August 2015

Study includes addition of 2nd antenatal survey on diet and physical activity in pregnancy

SOURCE OF FUNDING 2011 SITE 1

The MAMMI Study (UI) strand was funded by the Health Research Board (HRB) Research Training Fellowships for Healthcare Professionals Grant HPF 2011/18

SITE 1

HRB KEDS 2012-2013: UI Strand – production of four self-help videos on UI and Pelvic Floor Muscle Exercises (PFME)

HRB HPF 2013-2016: Sexual Health Strand

PhD Student stipend (TCD) 2013-2016: Pelvic Girdle Pain Strand

Friends of the Rotunda Hospital 2014-2016: Mental Health Strand

SITE 2

HRB Health Research Award (HRA) 2012-2015: All Strands

SITE 3

Friends of the Coombe Hospital 2013-2018: Caesarean Section Strand

Science Without Borders (Brazilian Government) 2014-2018: Nutrition Strand

14 international and 5 national oral presentations 6 international poster presentations 5 peer-review journal publications 2 non-peer reviewed journal presentations

SHARING THE INFORMATION

Funders

Information on 96 outcomes are abstracted from consenting women’s pregnancy, labour and birth and postpartum medical records

Included for 3rd site

In-depth one-to-one interviews completed with women experiencing urinary incontinence (UI) (n=24), pelvic girdle pain (n=25), and planned for women with other morbidities

DISSEMINATON

MEDIA COVERAGE

SOURCES OF FUNDING AND FUNDING AWARDED

€920,310

ADDITIONAL FUNDING AWARDED

ACKNOWLEDGEMENTS

MAMMI STUDY RELATED RESEARCH IN PROGRESS

Professor Stephanie Brown, MCRI, Melbourne, Victoria, Australia for granting permission to use and modify the surveys in an Irish setting

Sincerest thanks to the women who are participating in the study The midwives and midwifery students who are giving the women the information

RESEARCHERS, PhD and MSc STUDENTS

Extensive media coverage achieved in 2015

AUTHORS CONTACTDr Deirdre Daly

Assistant Professor in MidwiferySchool of Nursing and Midwifery

Trinity College Dublin2 Clare Street

Dublin 2

Email: dalyd8@tcd.ie+353 1 8962604