Background The interconception period is considered a time when parents are likely to engage with health messages and are in frequent contact with healthcare professionals. Objectives Through this literature review and policy analysis, we synthesised articles and guidelines on interconception care to provide recommendations to improve health outcomes for parents, infants and future generations. Search Strategy Four databases were searched systematically, using MeSH and free-text terms based on ‘interconception’ and ‘postpartum’. Selection Criteria Selected articles included reviews, pilot studies and guidelines on interconception and postpartum interventions published in English by UK public health organisations and government agencies between 1st January 2010-12th January 2021. Data Collection and Analysis 30% of titles, abstracts and full-text papers were double-screened. The description table of identified guidelines were qualitatively analysed to generate categories, later developed into a framework of six domains. Findings are described using a narrative synthesis approach. Main Results We found 47 documents with guidelines, 29 reviews and six pilot studies on interconception and postpartum care. Interconception care opportunities include the postpartum period, family planning, routine practice, and risk assessments. Health and non-healthcare professionals have a role to play in the interconception period including GPs, health visitors, dieticians, nutritionists, health psychologists, community groups, local authorities and charities such as Tommy’s and First Step Nutrition. Conclusions The interconception and postpartum periods offer crucial opportunities to intervene to reduce possible long-term effects of suboptimal nutrition. Though the policy analysis for this review focused on the UK, the recommendations can have wider implications for other countries.

Objective We profile the maternal and fetal response to SARS-CoV-2 infection in symptomatic and asymptomatic pregnant women and make an assessment of passive immunity to the neonate, Design Multicentre prospective study. Setting Dublin, Ireland Methods RT-PCR for viral RNA via a nasopharyngeal swab was performed using the Cobas SARS-CoV-2 6800 platform. Maternal, and fetal serological antibody response, via umbilical cord bloods, was measured using both the Elecsys® immunoassay, Abbott SARS-CoV-2 IgG Assay and the IgM Architect assay. Main outcome Measure Prevalence of RT PCR positive SARS-CoV-2. Assessment of IgM and IgG anti-SARS-CoV-2 serology antibodies. Results Ten of twenty three symptomatic women had SARS-CoV-2 RNA in a nasopharyngeal swab. Five (5/23, 21.7%) demonstrated serological evidence of anti-SARS-CoV-2 IgG antibodies and seven (30.4%, 7/23) were positive for IgM antibodies. In the asymptomatic cohort, the prevalence of SARS-CoV-2 infection in RNA was 0.16% (1/608). IgG SARS-CoV-2 antibodies were detected in 1·67% (10/598, 95% CI 0·8%-3·1%) and IgM in 3·51% (21/598, 95% CI 2·3–5·5%). Nine women had repeat testing between post baseline. Four (4/9, 44%) remained IgM positive, one IgG positive. IgG anti SARS-CoV-2 antibodies were detectable in cord bloods from babies born to five seropositive women who delivered during the study. Conclusion Using two independent serological assays, we present a comprehensive illustration of the antibody response to SARS-CoV-2 in pregnancy, and show a low prevalence of asymptomatic SARS-CoV-2. Transplacental migration of anti-SARS-CoV-2 antibodies was identified in cord blood of women who demonstrated antenatal anti-SARS-CoV-2 antibodies, raising the possibility of passive immunity.

Design: Qualitative research Setting: Two University Hospitals and one District Hospital in Ireland Population: Participants interviewed ranged from first year trainees to consultant obstetricians. Methods: Interviews using open ended questions. Interviews were recorded on audio and later transcribed. Main outcome measures: Thematic analysis was performed until saturation. Results: 35 obstetricians were interviewed. The median number of years of experience was 5 years (range 3-20 years). The median number of OVD was 200 (range 20-1000+). Vacuum was the preferred choice amongst junior trainees. Preference shifted to forceps with increasing clinical experience. Seven clear themes emerged. Three themes were common to all participants: firstly, that all clinicians reported respect for the primiparous OVD in anticipation of possible complications, secondly the wish for senior midwifery support and finally the importance of clinical experience and exposure. Four themes were common to trainees only. Female clinicians in training reported significant self-doubt in their ability to perform an OVD and had concerns about causing harm. Clinicians in training wished to be trained by consultants during their first year on the labour ward. Experience was important. The final theme was a wish for more training in forceps OVD by clinicians in training. Conclusion: This qualitative study identified factors that can be used to design education and training in OVD in order to improve care for the woman and baby.