• Brominated and fluorinated organic pollutants in the breast milk of first-time Irish mothers: is there a relationship to levels in food?

      Pratt, Iona; Anderson, Wayne; Crowley, Dominique; Daly, Sean; Evans, Rhodri; Fernandes, Alwyn; Fitzgerald, Margaret; Geary, Michael; Keane, Declan; Morrison, John J; et al. (2013)
      Brominated flame retardants - polybrominated diphenyl ethers (PBDEs), polybrominated biphenyls (PBBs), hexabromocyclododecane (HBCD) and others - have been measured in 11 pooled breast milk samples from 109 first-time mothers in Ireland. Additionally, the study has measured levels of polybrominated dibenzo-p-dioxins and furans (PBDD/Fs), mixed halogenated dioxins (PXCC/Fs) and biphenyls (PXBs), polychlorinated naphthalenes (PCNs) and perfluoroalkylated substances (PFAS) in these samples. The mean sum of 19 PBDEs including BDE-209 was 4.85 ng g(-1) fat, which is comparable with that found in other European countries. BDE-47, BDE-153, BDE-209, BDE-99 and BDE-100 were found at the highest concentrations. The only PBBs detected consistently were BB-77, BB-126 and BB-153, with highest concentrations being found for BB-153 (mean = 0.13 ng g(-1) fat). The mean sum of HBCD enantiomers was 3.52 ng g(-1) fat, with α-HBCD representing over 70% of the total. Of the other brominated flame retardants - tetrabromobisphenol-A (TBBP-A), hexabromobenzene (HBB), decabromodiphenylethane (DBDPE) and bis(2,4,6-tribromophenoxyethane) (BTBPE) - examined, only TBBP-A was detected above the limit of detection (LOD), in two of the 11 pools analysed. All measured PBDF congeners were observed (at 0.02-0.91 pg g(-1) fat), but 2,3,7,8-tetrabromo-dibenzodioxin (TeBDD) was the only PBDD detected, with a mean concentration of 0.09 pg g(-1) fat. The occurrence of the mixed chlorinated/brominated dibenzodioxins, dibenzofurans and biphenyls, 2-B-3,7,8-CDD, 2,3-B-7,8-CDF, 4-B-2,3,7,8-CDF, PXB 105, PXB 118, PXB 126 and PCB 156 in breast milk in the current study may indicate that levels of these contaminants are increasing in the environment. Polychlorinated naphthalenes were detected in all samples, but not perfluorooctane sulfonate (PFOS) and other PFAS. The pattern of occurrence of these brominated and fluorinated persistent organic pollutants (POPs) in Irish breast milk shows a general relationship to their occurrence in food, as reported in a number of surveillance studies carried out by the Food Safety Authority of Ireland.
    • Comparison of outcomes of twins conceived spontaneously and by artificial reproductive therapy.

      Anbazhagan, Akila; Hunter, Alyson; Breathnach, Fionnuala M; Mcauliffe, Fionnuala M; Geary, Michael P; Daly, Sean; Higgins, John R; Morrison, John J; Burke, Gerard; Higgins, Shane; et al. (2014-03)
      To compare the outcomes of twin pregnancies conceived by artificial reproductive techniques (ART) with those of spontaneous conception.
    • The customized fetal growth potential: a standard for Ireland.

      Unterscheider, Julia; Geary, Michael P; Daly, Sean; McAuliffe, Fionnuala M; Kennelly, Mairead M; Dornan, James; Morrison, John J; Burke, Gerard; Francis, Andre; Gardosi, Jason; et al. (2013-01)
      To identify maternal and pregnancy-related physiological and pathological variables associated with fetal growth and birthweight in Ireland and to develop customized birthweight centile charts for the Irish population that will aid in appropriate identification and selection of growth-restricted fetuses requiring increased antenatal surveillance.
    • Definition and management of fetal growth restriction: a survey of contemporary attitudes.

      Unterscheider, Julia; Daly, Sean; Geary, Michael P; Kennelly, Mairead M; McAuliffe, Fionnuala M; O'Donoghue, Keelin; Hunter, Alyson; Morrison, John J; Burke, Gerard; Dicker, Patrick; et al. (2014-03)
      To evaluate opinions among Irish obstetricians and obstetric trainees regarding the optimal definition, assessment and management of pregnancies affected by intrauterine growth restriction (IUGR).
    • Definition of intertwin birth weight discordance.

      Breathnach, Fionnuala M; McAuliffe, Fionnuala M; Geary, Michael; Daly, Sean; Higgins, John R; Dornan, James; Morrison, John J; Burke, Gerard; Higgins, Shane; Dicker, Patrick; et al. (OVID Lippincott Williams and Wilkins, 2011-07)
      To establish the level of birth weight discordance at which perinatal morbidity increases in monochorionic and dichorionic twin pregnancy.
    • Fetal growth restriction and the risk of perinatal mortality–case studies from the multicentre PORTO study

      Unterscheider, Julia; O’Donoghue, Keelin; Daly, Sean; Geary, Michael P; Kennelly, Mairead M; McAuliffe, Fionnuala M; Hunter, Alyson; Morrison, John J; Burke, Gerard; Dicker, Patrick; et al. (2014)
    • Optimum timing for planned delivery of uncomplicated monochorionic and dichorionic twin pregnancies.

      Breathnach, Fionnuala M; McAuliffe, Fionnuala M; Geary, Michael; Daly, Sean; Higgins, John R; Dornan, James; Morrison, John J; Burke, Gerard; Higgins, Shane; Dicker, Patrick; et al. (2012-01)
      To determine the optimum timing for planned delivery of uncomplicated monochorionic and dichorionic twin pregnancies.
    • The role of brain sparing in the prediction of adverse outcomes in intrauterine growth restriction: results of the multicenter PORTO Study.

      Flood, Karen; Unterscheider, Julia; Daly, Sean; Geary, Michael P; Kennelly, Mairead M; McAuliffe, Fionnuala M; O'Donoghue, Keelin; Hunter, Alyson; Morrison, John J; Burke, Gerard; et al. (2014-05-06)
      The aim of the Prospective Observational Trial to Optimize Pediatric Health in IUGR (PORTO) Study was to evaluate the optimal management of fetuses with estimated fetal weight (EFW) <10(th) centile. The objective of this secondary analysis was to describe the role of the cerebroplacental ratio (CPR) in the prediction of adverse perinatal outcome.
    • The role of growth trajectories in classifying fetal growth restriction.

      Barker, Edward D; McAuliffe, Fionnuala M; Alderdice, Fiona; Unterscheider, Julia; Daly, Sean; Geary, Michael P; Kennelly, Mairead M; OʼDonoghue, Keelin; Hunter, Alyson; Morrison, John J; et al. (2013-08)
      To examine the validity of a growth trajectory method to discriminate between pathologically and constitutionally undergrown fetuses using repeated measures of estimated fetal weight.
    • Teenage pregnancy in type 1 diabetes mellitus.

      Carmody, David; Doyle, Aoife; Firth, Richard G R; Byrne, Maria M; Daly, Sean; Mc Auliffe, Fionnuala; Foley, Micheal; Coulter-Smith, Samuel; Kinsley, Brendan T; Dublin Diabetes in Pregnancy Service, Mater Misericordiae University Hospital, National Maternity Hospital, Coombe Women's Hospital and Rotunda Hospitals, Dublin, Ireland. (2010-03)
      Younger maternal age at delivery has been linked to adverse reproductive outcomes. Pregnancy complicated by type 1 diabetes mellitus (T1DM) is also associated with adverse pregnancy outcomes. Optimising diabetic glycaemic control prior to pregnancy is known to reduce the rate of congenital abnormalities and improve pregnancy outcomes. Teenage pregnancies are not usually planned and little data exist on teenage pregnancy complicated by T1DM. We sought to identify the glycemic control achieved in teenage pregnancy with T1DM and to clarify if there is an associated increase in adverse pregnancy outcomes compared to those seen in older women with T1DM. We compared outcomes in 18 teenagers (TG) with 582 older women with T1DM (CON) from 1995-2007. TG booked to the combined diabetes-obstetrical service at a median gestational age of 11 weeks (range 6-22) compared to 7 weeks in CON (range 4-40, p < 0.02). Glycaemic was worse in TG compared to CON at 13, 26 and 35 weeks gestation, despite higher insulin doses. First trimester miscarriage rate did not differ between groups. Major congenital anomaly rate was 6.2% (1/16) compared to 3.2% in CON. This preliminary study has demonstrated that pregnant teenage women with T1DM book later to specialised care and have worse glycaemic control in pregnancy compared to older women with T1DM. This group also appear to be more insulin resistant than older women in early pregnancy. Our data would suggest that teenagers with type 1 diabetes mellitus may constitute a high-risk group for adverse pregnancy outcomes.