Datamama, bringing pregnancy research into the future: design, development, and evaluation of a citizen science pregnancy mobile application

Background: Pregnancy mobile applications (apps) have grown in popularity over the past decade, with some being used to promote study recruitment or health behaviors. However, no app serves as an all-in-one solution for collecting general data for research purposes and providing women with useful and desirable features. Aim: To create and develop a Swiss pregnancy mobile app as an innovative means to collect research data and provide users with reliable information. Methods: Determining the key features of the app involved a review of the literature and assessment of popular apps in the Swiss AppStore. A team of engineers developed the app, which includes a pregnancy timeline, questionnaires for data collection, medical and psychological articles and a checklist with appointment reminders. The content was written and reviewed by healthcare providers considered experts in the topics adressed. The questionnaires are distributed based on the user’s gestational age, by a chatbot. The project was authorized by the ethics commission in the canton of Vaud. An online survey of ten questions, advertised on Datamama’s home screen, was conducted to assess the users’ use of the app (27.11- 19.12.2022). Results: A review of 84 articles and 25 popular apps showed the need for a comprehensive pregnancy app. The development of Datamama took 2 years and included the creation of 70 medical and psychological articles and 29 questionnaires covering 300 unique variables. Six months after the launch, there were 800 users with a 73% average participation rate in the questionnaires. Sixty-five women completed the survey, with 70.8% using the app once to multiple times per week. The primary reason for using the app was to help research by answering the questionnaires, followed by access to reliable medical information. The reason most frequently ranked first for using the app was to help research by answering the questionnaires (42/65, 67% of women rated it first), followed by access to reliable medical information (34/65, 54% women rated it second). Women rated the information as clear, understandable, and interesting with a trust rating in data handling at 98.5%. The average grade for recommending the app was 8/10, with suggestions for increasing the amount of medical content and tailoring it based on gestational age. Conclusion: Datamama is the first pregnancy app to address the needs of both patients and researchers. Initial feedback from users was positive, highlighting future challenges for success. Future work will consist in improving the app, validating the data and use it to answer specific pregnancy-related research questions

Patisiran exposure in early pregnancy: a case report.

We describe here the first case of exposure to patisiran treatment, a small interfering RNA molecule, during early pregnancy of a 36-year-old woman with symptomatic hereditary transthyretin-related amyloidosis. There were no major complications during pregnancy and delivery, except for a postpartum hemorrhage due to uterine atony. Vitamin A levels had to be closely monitored during pregnancy, and vitamin A substitution adapted accordingly. There was no sign of minor or major congenital abnormalities of the baby. One month after delivery, the patient showed slight clinical and electrophysiological signs of neuropathy progression due to patisiran treatment withdrawal. Patisiran infusions were resumed 3 months after delivery. Due to the unknown teratogenic potential of patisiran, the risk of neuropathy worsening associated with withholding treatment must of course be weighed against a potential teratogenic risk of treatment during pregnancy. Vitamin A levels need to be closely assessed, and substitution must be adapted accordingly, to avoid embryofetal adverse outcome due to vitamin A deficiency or toxicity

Evaluation d'une prise en charge simplifiée des femmes ayant un test de dépistage positif pour le diabète gestationnel

Le dépistage du diabète gestationnel n est pas consensuel. L objectif de cette étude rétrospective observationnelle est d évaluer une approche originale, où le dépistage par un test de O Sullivan est suivi s il est positif par des glycémies veineuses à jeun et post-prandiale. L objectif secondaire est d étudier parmi les patientes ayant un dépistage positif les facteurs prédictifs de macrosomie. 1278 patientes ont un test de O Sullivan positif, 324 patientes, ont une glycémie double perturbée, soit une prévalence du diabète gestationnel de 6,8 % et 15 % des patientes diagnostiquées diabétiques sont mises sous insuline. Le diabète gestationnel multiplie par 2 le risque de macrosomie, même en tenant compte des autres facteurs de risque (indice de masse corporelle, origine géographique, parité, âge gestationnel et prise de poids). La glycémie à jeun est corrélée de façon linéaire au poids de naissance et au risque de macrosomie. Elle ressort comme l élément capital à équilibrerScreening for gestational diabetes is not consensual. The aim of this retrospective observational study was to evaluate a novel approach where the screening test is followed O'Sullivan if positive by glycemias fasting and post-prandial glucose. The secondary objective is to study among patients who screened positive predictors of macrosomia. 1278 patients test positive O'Sullivan, 324 patients have impaired glucose twice a prevalence of gestational diabetes of 6.8% and 15% of patients diagnosed with diabetes are put on insulin. Gestational diabetes multiplies by 2 the risk of macrosomia, even taking into account other risk factors (body mass index, geographic origin, parity, gestational age and weight). Fasting glucose is linearly related to birth weight and risk of macrosomia. It emerges as the crucial element to balanceST QUENTIN EN YVELINES-BU (782972101) / SudocSudocFranceF

Early noninvasive prenatal paternity testing by targeted fetal DNA analysis

Abstract Today the challenge in paternity testing is to provide an accurate noninvasive assay that can be performed early during pregnancy. This requires the use of novel analytical methods capable of detecting the low fraction of circulating fetal DNA in maternal blood. We previously showed that forensic compound markers such as deletion/insertion polymorphisms-short tandem repeats (DIP-STR) can efficiently resolve complex mixed biological evidence including the target analysis of paternally inherited fetal alleles. In this study, we describe for the first time the validation of this type of markers in the first trimester of pregnancies, in addition to defining the statistical framework to evaluate paternity. To do so, we studied 47 DIP-STRs in 87 cases, with blood samples collected throughout gestation starting from the seven weeks of amenorrhea. Fetal DNA detection in the first trimester shows a false negative rate as low as 6%. The combined paternity index (CPI) results indicate that seven markers with fully informative genotypes are sufficient to determine the paternity. This study demonstrates that DIP-STR markers can be used from early pregnancy and that a small set of markers (about 40) is sufficient to address the question of paternity. The novel method offers substantial improvements over similar approaches in terms of reduced number of markers, lower costs and increased accuracy

Assuring a human-centred transition to Industry 4.0 in the textile-clothing sector

International audienceIn France, the textile-clothing sector is one of the most affected by the relocation phenomenon ongoing since the 1960s and has been greatly impacted by supply disruptions due to the COVID-19 pandemic. This research proposes using 4.0 technologies to promote the relocation of textile production in France while keeping people at the heart of the industry. This paper first explains the “human vs machine” paradox by analyzing previous research on human responsiveness to Industry 4.0 technologies and then presents the study case results with a collaborative robot (cobot) within a clothing workshop. The case study allowed the understanding of human needs in Industry 4.0 and contributed to a successful improvement in productivity. The article concludes by highlighting good practices for human management to have a successful application in 4.0 projects

Assuring a human-centred transition to Industry 4.0 in the textile-clothing sector

International audienceIn France, the textile-clothing sector is one of the most affected by the relocation phenomenon ongoing since the 1960s and has been greatly impacted by supply disruptions due to the COVID-19 pandemic. This research proposes using 4.0 technologies to promote the relocation of textile production in France while keeping people at the heart of the industry. This paper first explains the “human vs machine” paradox by analyzing previous research on human responsiveness to Industry 4.0 technologies and then presents the study case results with a collaborative robot (cobot) within a clothing workshop. The case study allowed the understanding of human needs in Industry 4.0 and contributed to a successful improvement in productivity. The article concludes by highlighting good practices for human management to have a successful application in 4.0 projects

What do mothers think about their antenatal classes? A mixed-method study in Switzerland

Abstract Problem Research so far has evaluated the effect of antenatal classes, but few studies have investigated its usefulness from the perspective of mothers after birth. Background Antenatal classes evolved from pain management to a mother-centred approach, including birth plans and parenting education. Evaluating the perception of the usefulness of these classes is important to meet mother’s needs. However, so far, research on the mothers’ perception of the usefulness of these classes is sparse, particularly when measured after childbirth. Given that antenatal classes are considered as adult education, it is necessary to carry out this evaluation after mothers have had an opportunity to apply some of the competences they acquired during the antenatal classes during their childbirth. Aim This study investigated mothers’ satisfaction and perceived usefulness of antenatal classes provided within a university hospital in Switzerland, as assessed in the postpartum period. Methods Primiparous mothers who gave birth at a Swiss university hospital from January 2018 to September 2020 were contacted. Those who had attended the hospital’s antenatal classes were invited to complete a questionnaire consisting of a quantitative and qualitative part about usefulness and satisfaction about antenatal classes. Quantitative data were analysed using both descriptive and inferential statistics. Qualitative data were analysed using thematic analysis. Findings Among the 259 mothers who answered, 61% ( n = 158) were globally satisfied with the antenatal classes and 56.2% ( n = 145) found the sessions useful in general. However, looking at the utility score of each theme, none of them achieved a score of usefulness above 44%. The timing of some of these sessions was questioned. Some mothers regretted the lack of accurate information, especially on labour complications and postnatal care. Discussion Antenatal classes were valued for their peer support. However, in their salutogenic vision of empowerment, they did not address the complications of childbirth, even though this was what some mothers needed. Furthermore, these classes could also be more oriented towards the postpartum period, as requested by some mothers. Conclusion Revising antenatal classes to fit mothers’ needs could lead to greater satisfaction and thus a better impact on the well-being of mothers and their families

Safety and efficacy of a suction cervical stabilizer for intrauterine contraceptive device insertion : Results from a randomized, controlled study

Objectives: To compare patient-reported pain, bleeding, and device safety between intrauterine contraceptive device (IUD) insertion procedures employing a suction cervical stabilizer or single-tooth tenaculum. Study design: This was a randomized, prospective, single-blinded study conducted at two centers, enrolling women aged 18 years or older, eligible for IUD insertion. The primary end point measure was patient-reported pain, measured on a 100-mm Visual Analogue Scale. Safety was assessed on the amount of bleeding, adverse events, and serious adverse events. Results: One hundred women were randomized, 48 to the investigational device and 52 to control. There were no statistically significant differences between the groups in factors potentially associated with pain on IUD insertion. IUD insertion was successful in 94% of all subjects. Subjects in the investigational device group reported pain scores ≥14 points lower than in the control group at cervix grasping (14.9 vs 31.3; p &lt; 0.001) and traction (17.0 vs 35.9; p &lt; 0.001), and smaller differences in pain scores at the IUD insertion (31.5 vs 44.9; p = 0.021) and cervix-release (20.6 vs 30.9; p = 0.049) steps. Nulliparous women experienced the greatest pain differences to control. Mean blood loss was 0.336 (range 0.022-2.189) grams in the investigational device group and 1.336 (range 0.201-11.936) grams in the control group, respectively (p = 0.03 for the comparison). One adverse event (bruising and minor bleeding) in the investigational device group was considered causally related to the study device. Conclusions: The suction cervical stabilizer had a reassuring safety profile and its use was associated with significant reductions in pain during the IUD insertion procedure compared with standard single-tooth tenaculum use, particularly among nulliparous women. Implications: Pain can be an important barrier to greater use of IUD devices among prescribers and users, particularly nulliparous women. The suction cervical stabilizer may provide an appealing alternative to currently available tenacula, filling an important unmet need.</p

Psychiatrie périnatale: Articulation des soins psychiatriques périnataux au sein de la maternité du CHUV en cas de psychopathologie parentale: le rôle du pédopsychiatre de liaison

Cet article décrit le rôle du pédopsychiatre de liaison intervenant dans le champ de la périnatalité, au sein de la maternité du CHUV. Il se concentre principale ment sur les situations de vulnérabilité parentale, comme les psychopathologies maternelles, et détaille la prise en charge effectuée par la pédopsychiatrie de liaison dans un continuum allant du pré-partum ou post-partum, tant en termes d’évaluation que de trai tement. Cet article insiste également sur l’importance capitale d’une prise en charge multidisciplinaire et coordonnée, notamment avec les collègues de la psy chiatrie de liaison adulte, mais également avec les obstétriciens, les pédiatres et les équipes soignantes impliqués au sein de la maternité. La nécessité de construire une articulation avec le réseau de soins à l’extérieur de la maternité est finalement soulignée afin d’assurer la meilleure continuité possible des soins pour les patients et leur famille en favorisant au maximum l’alliance thérapeutique

Accès au lait de donneuses en Suisse et création de la première banque de lait maternel romande au CHUV ::enjeux et perspectives

Le lait maternel (LM) est idéal pour la croissance et la santé des nourrissons. En l’absence de LM, le lait de donneuses (LD) est préférable au lait artificiel pour les nouveau-nés (NN) à risques, prématurés ou présentant certaines pathologies, au vu de ses effets protecteurs. Les banques de lait (BL) collectent, sécurisent, traitent et distribuent le LD. Il existe en Suisse une insuffisance et une inégalité d’accès au LD, faute de cadre national. Avec le soutien de l’État de Vaud, le CHUV et la Transfusion interrégionale de la Croix-Rouge suisse ouvriront en 2022 la première BL romande. Cette BL propose un système novateur en Suisse, fondé sur une complémentarité d’expertises, afin d’optimiser la qualité et la sécurité du LD et de soutenir la promotion de l’allaitement et du don.Mother’s own milk (MOM) is ideal for infant growth and health. When MOM is unavailable, donor human milk (DHM), rather than infant formula, is recommended for at-risk, preterm or sick neonates (NN), in view of its protective effects. Human milk banks (HMB) collect, secure, process and distribute DHM. In Switzerland, there is insufficient and unequal access to DHM in the absence of a national policy framework. With the support of the State of Vaud, the CHUV and the Interregional Blood Transfusion of the Swiss Red Cross will open the first HMB in Romandy in 2022. This HMB offers an innovative system in Switzerland, based on complementary expertise, in order to guarantee the quality and safety of DHM and to support the promotion of breastfeeding and human milk donation