Category Archives: Infant Mortality, CYP Healthcare

Maternal smoking and the risk of still birth: systematic review and meta-analysis

Marufu, T.C et al (2015) BMC Public Health, 15: 239

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Smoking in pregnancy is known to be associated with a range of adverse pregnancy outcomes, yet there is a high prevalence of smoking among pregnant women in many countries, and it remains a major public health concern. We have conducted a systematic review and meta-analysis to provide contemporary estimates of the association between maternal smoking in pregnancy and the risk of stillbirth.


We searched four databases namely MEDLINE, EMBASE, Psych Info and Web of Science for all relevant original studies published until 31st December 2012. We included observational studies that measured the association between maternal smoking during pregnancy and the risk of stillbirth.


1766 studies were screened for title analysis, of which 34 papers (21 cohorts, 8 case controls and 5 cross sectional studies) met the inclusion criteria. In meta-analysis smoking during pregnancy was significantly associated with a 47% increase in the odds of stillbirth (OR 1.47, 95% CI 1.37, 1.57, p < 0.0001). In subgroup analysis, smoking 1-9 cig/day and ≥10 cig/day was associated with an 9% and 52% increase in the odds of stillbirth respectively. Subsequently, studies defining stillbirth at ≥ 20 weeks demonstrated a 43% increase in odds for smoking mothers compared to mothers who do not smoke, (OR 1.43, 95% CI 1.32, 1.54, p < 0.0001), whereas studies with stillbirth defined at ≥ 24 weeks and ≥ 28 weeks showed 58% and 33% increase in the odds of stillbirth respectively.


Our review confirms a dose-response effect of maternal smoking in pregnancy on risk of stillbirth. To minimise the risk of stillbirth, reducing current smoking prevalence in pregnancy should continue to be a key public health high priority.


Health and social care priorities for the Government: 2015-2020

By The Nuffield Trust (2015)

This briefing outlines ten possible key health and social care priorities for the new government, covering funding and finance, quality of care, new models of care and workforce.

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Facing the future: together for child health 2015

By Royal College of General Practitioners (2015)

Children make up more than a quarter of emergency department attendances in the UK and in England alone there has been a 28 per cent increase in admissions for children to hospital over the last ten years. Healthcare professionals are warning that unless there is an overhaul of unscheduled care services, there is a risk that growing demand will result in poorer outcomes for children. This set of standards says that in order to deal with these pressures, and to improve child health outcomes, not only do unscheduled care services need more investment but there also needs to be a shake-up of how services are designed, with more children being cared for outside the hospital, in the community and closer to their home.

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20 ebooks relating to Public Health have been purchased and are all freely accessible to all Public Heath Lancashire staff with an Athens username and password. 

To view these books and apply for an Athens username click on the ‘New eBooks’ tab on the blogs homepage

Family friendly framework: a whole systems approach for the planning, delivery and improvement of services for children and families

By British Association for Community Child Health (2014)

This framework from the British Association for Community Child Health and the British Association for Child and Adolescent Public Health presents a practical whole systems approach to improve outcomes for children, young people and their families.

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Commissioning of public health services for children

By Department of Health (2014)

From 1st October 2015, the responsibility for commissioning children’s public health services, including health visitors, will transfer from NHS England to local authorities. These documents aim to help support local authorities and stakeholders through the transition. The documents identify 6 areas where health visitors have the most impact on children’s health and wellbeing. Local authorities should use this information to ensure that health visiting services are commissioned effectively.

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Why children die: death in infants, children and young people in the UK

By Royal College of Paediatrics & Child Health (2014)

This report published by the Royal College of Paediatrics and Child Health (RCPCH) reviews existing UK evidence on child mortality. It finds that many of the causes of child death, including perinatal deaths and suicides, disproportionately affect the most disadvantaged in society. In response to the report, the College in partnership with the National Children’s Bureau have developed a suite of recommendations to tackle child mortality in England. These recommendations cut across the three domains of government and civil society, health systems and organisations, and health care and public health.

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