Advancing maternal and child health in Romania: an integrated assessment of the determinants of pregnancy outcomes

MAIA

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Advancing Maternal and Child Health in Romania: an integrated assessment of the determinants of pregnancy outcomes initiative, also known as the MAIA Project, aims to explore and explain the impact of psychosocial stress and biological factors on pregnancy outcomes in Romania.

The MAIA project pursues to answer complex questions on the prevalence and determinants of pregnancy outcomes, in a large cohort of pregnant women, recruited from five different clinical settings in Romania. The power of the study lays in its integrated approach which controls for the relation of inter-dependent pregnancy risk factors (medical history, social and living conditions, stress and depression, smoking and substance abuse) to explain birth outcomes. In addition, a cross-sectional component of the study will bring data on an extended sample in order to assess the prevalence of selected risk factors and their determinants in the Romanian context, where such population-based data is extremely limited.

Starting / Ending Date

October 2011 – December 2016

Project Coordinator

Babeș-Bolyai University from Cluj-Napoca – Romania

Funding

Funder: Executive Unit for financing education Higher, Research Development and innovation (UEFISCDI)
Grant Number: PN-II-ID-PCE-2011-3-0942
Total Amount: 347.517 EUR
BBU Amount: 347.517 EUR

Staff from Department of Public Health

Assistant Professor

Project Partners

The MAIA Project is implemented with the support of five clinical settings situated in four cities in Romania (Cluj-Napoca, Reghin, Sighişoara and Targu-Mureş). The sample is comprised of both small municipal and large academic hospitals, as well as state and private healthcare providers. Samples from each hospital are based on quotas, calculated using the number of yearly deliveries in each setting.

The five clinical settings were recruited in the study between 2011-2012 and are currently recruiting study participants and implementing the MAIA protocol. The study is administered in each clinic by a trained local coordinator and data collection team. This team works in close collaboration with the core project team from Babes-Bolyai University in order to maximize the reliability of the study’s results. The clinical partners of the MAIA Study are:

County Emergency Clinical Hospital Cluj-Napoca, Gynecology Clinic II

County Emergency Clinical Hospital Tîrgu Mureș, Gynecology Clinic

Reghin City Hospital

Nova Vita Hospital

Sighișoara City Hospital

Project Outputs

Project Reports

2011 Scientific Report

In the first three months of the project (October-December 2011), the study team contacted the seven clinics to be included in the study and developed and pre-tested (on a sample of 50 pregnant women seeking antenatal care in one of the clinics enrolled in the study) the data collection instrument to be used in the process of data collection.

The quantifiable results of the project for the year of 2011 consisted of the partnerships established with the clinics and hospitals to be enrolled in the study, the submission of an article for publication, as well as the increase of the study’s visibility through the development of a website. All the contract objectives of the project for 2011 were met. A summary of the report in English can be found here. Download here

2012 Scientific Report

In the second year of the study, the project team developed all of the documents needed to assure a systematic data collection process in all of the clinics enrolled in the study, such as: the Standard Operating Procedure Manual, the Study Registry (a monitoring system for data collection and data linkage), and biological sample collection and shipment protocols. The team also recruited and trained one data collector from each clinic in the second year. The project team also installed and administered data collection points and initiated data collection in the seven locations (questionnaires for phases I, II, and III and associated biomarker collections for the cohort).

A poster presentation was submitted at the European Public Health Association Conference, organized in Malta in 7-10 November 2012. The abstract of the presentation was presented in a moderated poster session and published in the Supplement of the European Journal of Public Health. All contract objectives of the project for 2012 were met. A summary of the report in English can be found here. Download here.

2013 Scientific Report

In the third year of the study, the project team continued the data collection process and monitoring for both the screening and cohort samples, collected biological samples from the women enrolled in the cohort and analyzed them, conducted abstracting of birth certificates, and developed an analytical plan for the analyses to be conducted on the study datasets.

An oral presentation was held at the 6th European Public Health Association Conference, organized in Brussels, in November 2013. The abstract of the presentation was published in the Supplement of the European Journal of Public Health. Also, the project was disseminated by participating in the “Wring for maternity services, research, theory, policy, and practice: Integrating new theoretical insights from the iR4B COST Action” scientific writing workshop, organized by the Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care ISO907 COST Action and attended by more than 35 European researchers and editors activating the area of maternal and child health. All contracts objectives of the project for 2013 were met. A summary of the report in English can be found here. Download here.

2014 Scientific Report

In this year of the study, the project team continued the data collection process and monitoring for both the screening and cohort samples, collected biological samples from the women enrolled in the cohort and analyzed them, conducted abstracting of birth certificates, and developed an analytical plan for the analyses to be conducted on the study datasets.

Two manuscripts have been submitted for publication to international, peer-reviewed, ISI journals. Also, the website of the project was constantly updated with new information about the project.The dissemination of the project at the European level was conducted by two of the team members, who became members in the recently launched IS1405 COST Action – Building Intrapartum Research Through Health – an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH). A summary of the report in Romanian can be found here. Download here.

2015 Scientific Report

In the fourth year of the project, the study team has finalized the data collection process for the screening and cohort samples, conducted semi-structured interviews with the data collectors in the clinics enrolled in the study, abstracted information from medical birth certificates for a part of the sample, and conducted preliminary analyses on the collected data.

The visibility of the project was ensured by maintaining and updating the project’s website and by participating in the 1st International Conference on Non-Communicable Diseases (19-20 May 2015) with an oral presentation. All contract objectives for 2015 were met. A summary of the report in Romanian can be found here. Download here.

2016 Scientific Report

In the last year of the project, the research team continued the abstracting of medical birth certificates for the babies of women enrolled in the study, conducted biomarker analyses for the women enrolled in the study’s cohort, finalized all project databases, and conducted data analyses. The dissemination of the project was conducted by publishing a manuscript in an ISI journal, by submitting a manuscript for publication to a scientific, ISI journal, by maintain and participating in two international conferences with one oral and one poster presentation, by publishing two press releases, and by maintaining and updating the project’s website.

All contract objectives of the project were met. A summary report in Romanian of all project activities conducted between 2011 and 2016 can be found here. Download here.


Scientific Conferences

Conference: 5th European Public Health Conference in Malta (7 – 10 November 2012)

Presentation Title: Maternal lifestyles and risk factors for adverse pregnancy outcomes: a pilot study in Cluj-Napoca, Romania

Type: Poster presentation

Authors: Negura D, Brinzaniuc A, Suciu AM, Pop OM, Vladut C, Chereches RM, Wallis A.

Published in conference proceedings: Yes (Supplement of the European Journal of Public Health 22:279)

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Conference: 6th European Public Health Conference in Brussels (13 – 16 November 2013)

Presentation Title: Prevalence and determinants of prenatal depression symptoms in a Romanian sample of pregnant women: a comparative analysis across socioeconomic groups

Type: Oral presentation

Authors: A Brinzaniuc, OM Pop, IA Rus, RM Chereches, A Baber-Wallis.

Published in conference proceedings: Yes (Supplement of the European Journal of Public Health)

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Conference: 1st International Conference on Non-Communicable Diseases (19-20 May 2015)

Presentation Title: Secondhand smoke exposure during pregnancy: what can we learn from self-reported exposure?

Type: Oral presentation

Authors: A Baber-Wallis, A Brinzaniuc.

Published in conference proceedings: No (the conference did not publish a conference proceeding)

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Conference: 9th National Congress on Perinatal Medicine (11-14 May 2016, Bucharest, Romania)

Presentation Title: Prevalence and patterns of self-reported tobacco consumption before and during pregnancy

Type: Poster presentation

Authors: Oana M. Blaga, Alexandra Brînzaniuc, Ioana A. Rus, Răzvan M. Cherecheș, Anne Baber Wallis

Published in conference proceedings: No (the conference did not publish a conference proceeding)

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Conference: The European Society for Nicotine and Tobacco Research Annual Meeting (9-11 September 2016, Prague, Czech Republic)

Presentation Title: Secondhand tobacco smoke exposure and depressive symptoms during pregnancy

Type: Oral presentation

Authors: Alexandra Brînzaniuc, Oana M. Blaga, Ioana A. Rus, Răzvan M. Cherecheș, Anne Baber Wallis

Published in conference proceedings: No (the conference did not publish a conference proceeding)


Scientific Publications

Within the fourth year of the project, the research team has developed a publication plan, focusing on both preliminary, as well as final results. The manuscripts which are currently in progress are:

Smoking and Quitting During Pregnancy: Analysis from a Hospital-Based Cohort of Pregnant Women in Romania

Key words: Tobacco, Smoking, Cessation, Pregnancy, Romania

Target Journal: Journal of Community Health (IF: 1.71)

Status: Published

Full citation: Blaga, O. M., Brînzaniuc, A., Rus, I. A., Cherecheș, R. M., & Wallis, A. B. (2016). Smoking and Smoking Cessation During Pregnancy. An Analysis of a Hospital Based Cohort of Women in Romania. Journal of Community Health, 1-11. DOI: 10.1007/s10900-016-0259-6

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The social patterning of prenatal depression: results from a hospital-based study in Eastern Europe

Keywords: Pregnancy depression, socioeconomic position, EPDS, Eastern Europe

Target Journal: Archive of Women’s Mental Health (IF: 2.16)

Status: Submitted and under review

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Validity and Reliability of a Romanian version of the Pregnancy Experience Scale

Target Journal: Maternal and Child Health Journal (IF: 2.24)

Status: Work in progress

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Impact of prior pregnancy loss on depressive symptoms in a subsequent pregnancy

Target Journal: Women and Health (IF: 1.194)

Status: Work in progress