Jeffrey Robinson

University of Adelaide · Discipline of Obstetrics and Gynaecology

Background: Antenatal corticosteroids given to women before preterm birth improve infant survival and health. However, whether dexamethasone or betamethasone have better maternal, neonatal, and childhood health outcomes remains unclear. We therefore aimed to assess whether administration of antenatal dexamethasone to women at risk of preterm birth...

Objective: Our objective was to evaluate the effect of an antenatal dietary and lifestyle intervention in pregnant women who are overweight or obese on child outcomes at age 18 months. Methods: We conducted a follow-up study of children at 18 months of age who were born to women who participated in the Limiting Weight Gain in Overweight and Obes...

Background: The immediate impact of providing an antenatal dietary intervention during pregnancy has been extensively studied, but little is known of the effects beyond the neonatal period. Our objective was to evaluate the effect of an antenatal dietary intervention in overweight or obese women on infant outcomes 6 months after birth. Methods:...

The contribution of paternal obesity to pregnancy outcomes has been little described. Our aims were to determine whether the effect of an antenatal maternal dietary and lifestyle intervention among women who are overweight or obese on newborn adiposity, was modified by paternal obesity. We conducted a secondary analysis of a multicenter randomised...

Background Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity. The withdrawal of progesterone, either actual or functional, is thought to be an antecedent to the onset of labour. There remains limited information on clinically relevant health outcomes as to whether vaginal pr...

Trial protocol for the PROGRESS study. (DOCX)

Consolidated Standards of Reporting Trials (CONSORT) statement. (DOCX)

Background Maternal overweight and obesity during pregnancy is associated with insulin resistance, hyperglycaemia, hyperlipidaemia and a low-grade state of chronic inflammation. The aim of this pre-specified analysis of secondary outcome measures was to evaluate the effect of providing antenatal dietary and lifestyle advice on cardiometabolic and i...

Objective: To evaluate the effect of providing antenatal dietary and lifestyle advice on neonatal anthropometry, and to determine the inter-observer variability in obtaining anthropometric measurements. Design: Randomised controlled trial. Setting: Public maternity hospitals across metropolitan Adelaide, South Australia. Population: Pregnant...

Introduction: Our aim was to evaluate the effect of dietary and lifestyle advice to women who were overweight or obese during pregnancy on maternal quality of life, anxiety and risk of depression, and satisfaction with care. Material and methods: We conducted a randomized trial, involving pregnant women with body mass index >25kg/m(2) , recruite...

Background Overweight and obesity during pregnancy is common, although robust evidence about the economic implications of providing an antenatal dietary and lifestyle intervention for women who are overweight or obese is lacking. We conducted a health economic evaluation in parallel with the LIMIT randomised trial. Women with a singleton pregnancy...

Objective To determine the use of pharmacologic analgesia during childbirth when antenatal hypnosis is added to standard care. Design Randomised controlled clinical trial, conducted from December 2005 to December 2010. Setting The largest tertiary referral centre for maternity care in South Australia. Population A cohort of 448 women at >34 weeks o...

Overweight and obesity during pregnancy represents a considerable health burden. While research has focused on interventions to limit gestational weight gain, there is little information describing their impact on neonatal health. Our aim was to investigate the effect on a range of pre-specified secondary neonatal outcomes of providing antenatal di...

Overweight and obesity is a significant health concern during pregnancy. Our aim was to investigate the effect of providing antenatal dietary and lifestyle advice to women who are overweight or obese on components of maternal diet and physical activity. We conducted a randomised controlled trial, in which pregnant women with a body mass index ≥25 k...

To determine the effect of antenatal dietary and lifestyle interventions on health outcomes in overweight and obese pregnant women. Multicentre randomised trial. We utilised a central telephone randomisation server, with computer generated schedule, balanced variable blocks, and stratification for parity, body mass index (BMI) category, and hospita...

To determine the use of pharmacologic analgesia during childbirth when antenatal hypnosis is added to standard care. Randomised controlled clinical trial, conducted from December 2005 to December 2010. The largest tertiary referral centre for maternity care in South Australia. A cohort of 448 women at >34 weeks of gestation, with a singleton pregna...

Background Australian Aboriginal and Torres Strait Islander women are between two to five times more likely to die in childbirth than non-Aboriginal women, and two to three times more likely to have a low birthweight infant. Babies with a low birthweight are more likely to have chronic health problems in adult life. Currently, there is limited rese...

Background: Both dexamethasone and betamethasone, given to women at risk of preterm birth, substantially improve short-term neonatal health, increase the chance of the baby being discharged home alive, and reduce childhood neurosensory disability, remaining safe into adulthood. However, it is unclear which corticosteroid is of greater benefit to m...

Objective: To evaluate whether for women with an uncomplicated twin pregnancy, elective birth at 37 weeks of gestation was associated with reduced risk of death or serious outcomes for babies, without increasing harm. Design: Randomised controlled trial. Setting: Maternity hospitals across Australia, New Zealand and Italy. Population: A tota...

Abstract Background The Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) showed that treatment of pregnant women with mild gestational diabetes mellitus is beneficial for both women and their infants. It is still uncertain whether there are benefits of similar treatment for women with borderline gestational diabetes. This trial...

Key points Children born preterm commonly experience motor and cognitive difficulties, but the physiology underlying this dysfunction is unknown. We used transcranial magnetic stimulation techniques and age‐appropriate assessments of motor skills development to investigate neurodevelopment in 151 children born between 25 and 41 weeks of gestation....

The World Health Organization has identified substance use in the top 20 risk factors for ill health. Risks in pregnancy are compounded, with risk to the woman's health, to pregnancy progression and on both the foetus and the newborn. Intrauterine exposure can result in negative influences on offspring development, sometimes into adulthood. With ef...

Objective To evaluate whether for women with an uncomplicated twin pregnancy, elective birth at 37 weeks of gestation was associated with reduced risk of death or serious outcomes for babies, without increasing harm. Design Randomised controlled trial. Setting Maternity hospitals across Australia, New Zealand and Italy. Population A total of 235 wo...

Poor growth before birth is associated with impaired insulin sensitivity later in life, increasing the risk of type 2 diabetes. The tissue sites at which insulin resistance first develops after intrauterine growth restriction (IUGR), and its molecular basis, are unclear. We have therefore characterized the effects of placental restriction (PR), a m...

Objective To evaluate whether for women with an uncomplicated twin pregnancy, elective birth at 37 weeks of gestation was associated with reduced risk of death or serious outcomes for babies, without increasing harm. Design Randomised controlled trial. Setting Maternity hospitals across Australia, New Zealand and Italy. Population A total of...

Background: Uncertainty exists about benefits and harms of a planned vaginal birth after caesarean (VBAC) compared with elective repeat caesarean (ERC). We conducted a prospective restricted cohort study consisting of a patient preference cohort study, and a small nested randomised trial to compare benefits and risks of a planned ERC with planned...

CONSORT statement. (PDF)

Protocol. (PDF)

OBJECTIVES: To investigate the utility of the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) Version (V) 3.0 for identifying substance use disorders in pregnancy. METHODS: ASSIST V3.0's performance was assessed, focussed on nicotine, alcohol, and cannabis, using a 2-pronged harm categorization: risk t...

Obesity is a significant global health problem, with the proportion of women entering pregnancy with a body mass index greater than or equal to 25 kg/m2 approaching 50%. Obesity during pregnancy is associated with a well-recognised increased risk of adverse health outcomes both for the woman and her infant, however there is more limited information...

To determine the effect of increasing maternal body mass index (BMI) during pregnancy on maternal and infant health outcomes. The South Australian Pregnancy Outcome Unit's population database, 2008 was accessed to determine pregnancy outcomes according to maternal BMI. Women with a normal BMI (18.5-24.9 kg/m(2) ) formed a reference population, to w...

Measures of stressful life events and social health issues and perceived discrimination. A complete list of the items used in this survey to measure stressful life events and social health issues and the five questions adapted from the Measure of Indigenous Racism Experience to elicit information about women's experience of discrimination by health...

Commentary on: BeyerleinASchiesslBLackN. Associations of gestational weight loss with birth-related outcome: a retrospective cohort study.BJOG2011;118:55–61.

Investment in strategies to promote 'a healthy start to life' has been identified as having the greatest potential to reduce health inequalities across the life course. The aim of this study was to examine social determinants of low birthweight in an Australian population-based birth cohort and consider implications for health policy and health car...

There is a well recognized risk of complications for both women and infants of a twin pregnancy, increasing beyond 37 weeks gestation. Preterm birth prior to 37 weeks gestation is a recognized complication of a twin pregnancy, however, up to 50% of twins will be born after this time. The aims of this randomised trial are to assess whether elective...

Being born small due to poor growth before birth increases the risk of developing metabolic disease, including type 2 diabetes, in later life. Inadequate insulin secretion and decreasing insulin sensitivity contribute to this increased diabetes risk. Impaired placental growth, development and function are major causes of impaired fetal growth and d...

Low birth weight and catch-up growth predict increased adiposity in children and adults. This may be due in part to leptin resistance, as adults who were born small exhibit increased plasma leptin concentration relative to adiposity. Placental restriction (PR), a major cause of intrauterine growth restriction, reduces size at birth and increases fe...

Overweight and obesity during pregnancy is an increasing health problem. A systematic review to assess the benefits and harms of antenatal dietary or lifestyle interventions for pregnant women who are overweight or obese. The Cochrane Controlled Trials Register(CENTRAL) was searched (last search January 2010). Reference lists of retrieved studies w...

Gestational diabetes mellitus (GDM) may cause obesity in the offspring. The objective was to assess the effect of treatment for mild GDM on the BMI of 4- to 5-year-old children. Participants were 199 mothers who participated in a randomized controlled trial of the treatment of mild GDM during pregnancy and their children. Trained nurses measured th...

To determine the applicant characteristics that influence success at each application stage for entry to the University of Adelaide Medical School. Retrospective analysis of characteristics associated with a successful outcome to an undergraduate-entry medical school for 6699 applicants from four cohorts (2004-2007). Offer of an interview, offer of...

Background: Maternal folic acid supplementation (mFAS) during early pregnancy is recommended to reduce the incidence of neural tube defects and has recently been associated with improved neurodevelopment in children. However, the effect on neurodevelopment of mFAS from before conception and throughout pregnancy is unknown. We examined the effect of...

Background: Nutrition in early life can influence metabolic functionality in later life, in part via heritable epigenetic changes, which modify gene expression without altering DNA sequence. Folate supplies methyl groups for the methylation of DNA and histones, both major epigenetic marks that change dynamically in utero. We have recently shown tha...

Foetal growth restriction is an important and often under-diagnosed complication of pregnancy with important implications for maternal, infant, child and later health. The key to prevention of foetal growth restriction is the recognition of those women at risk and implementation of effective interventions. Ideally, all women should plan pregnancy,...

Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity during infancy and childhood. Survivors of preterm birth continue to remain at considerable risk of both chronic lung disease and long-term neurological handicap. Progesterone is involved in the maintenance of uterine quiesce...

Poor growth before birth increases the risk of non-insulin-dependent diabetes mellitus (NIDDM) and impairs insulin secretion relative to sensitivity. We investigated the effects of intrauterine growth restriction in sheep on insulin secretion, beta-cell mass, and function from before birth to young adulthood and its molecular basis. Pancreas was co...

Australian substance use data do not demonstrate pregnancy-related changes or distinguish between pregnant and lactating women. To determine such changes by antenatal patients at two South Australian public hospitals accounting for 35% of the state's births. In 2005-2006, all first visit antenatal women at the two hospitals were asked by clinic sta...

To assess the benefits and harm of dietary and lifestyle interventions during pregnancy to improve maternal and infant outcomes for pregnant women who are overweight or obese. Randomized controlled trials comparing any form of dietary or lifestyle intervention during pregnancy for women who are overweight or obese with no treatment to improve mater...

Maternal Hormone Concentrations in Normal PregnancyMaternal Hormone Concentrations after Spontaneous Intrauterine DeathHormone Concentrations in Amniotic FluidEffects of Surgical Manipulations on the Outcome of Pregnancy in MonkeysThe Effects of Exogenous Compounds on the Outcome of Pregnancy in MonkeysConcluding CommentsAcknowledgementsReferencesD...

A recent meta-analysis of randomized trials suggests a lowered risk of neonatal respiratory distress syndrome among children whose mothers received repeat doses of corticosteroids antenatally compared to those whose mothers received a single course, but the longer-term effects—if any—remain uncertain. This study enrolled women at risk of preterm de...

Background We previously reported the results of a randomized, controlled trial showing that repeat doses of antenatal corticosteroids reduced the risk of respiratory distress syndrome and serious neonatal morbidity. However, data have not been available regarding longer-term effects of this treatment. Methods Women who had received an initial cour...

Background: Recommended best practice is that economic evaluation of health care interventions should be integral with randomised clinical trials. We performed a cost-consequence analysis of treating women with mild gestational diabetes mellitus by dietary advice, blood glucose monitoring and insulin therapy as needed compared with routine pregnanc...

BACKGROUND: Recommended best practice is that economic evaluation of health care interventions should be integral with randomised clinical trials. We performed a cost-consequence analysis of treating women with mild gestational diabetes mellitus by dietary advice, blood glucose monitoring and insulin therapy as needed compared with routine pregnanc...

We previously reported the results of a randomized, controlled trial showing that repeat doses of antenatal corticosteroids reduced the risk of respiratory distress syndrome and serious neonatal morbidity. However, data have not been available regarding longer-term effects of this treatment. Women who had received an initial course of corticosteroi...

In early pregnancy, the concentrations of IGFs increase in maternal blood. Treatment of pregnant guinea pigs with IGFs in early to midpregnancy enhances placental glucose transport and fetal growth and viability near term. In the current study, we determined whether exogenous IGFs altered placental gene expression, transport, and nutrient partition...

BACKGROUND We previously reported the results of a randomized, controlled trial showing that repeat doses of antenatal corticosteroids reduced the risk of respiratory distress syndrome and serious neonatal morbidity. However, data have not been available regarding longer-term effects of this treatment. METHODS Women who had received an initial cou...

Impaired glucose tolerance in pregnancy and gestational diabetes are associated with increased maternal and fetal risks. There is considerable uncertainty in the literature relating to the merits of screening for gestational diabetes and impaired glucose tolerance, and variable definitions in the cut-off values to be used. To assess different level...

For women who have a caesarean section in their preceding pregnancy, two care policies for birth are considered standard: planned vaginal birth and planned elective repeat caesarean. Currently available information about the benefits and harms of both forms of care are derived from retrospective and prospective cohort studies. There have been no ra...

Prenatal and early postnatal life experiences, reflected by size at birth and postnatal catch-up growth, contribute to the risk of developing the metabolic syndrome in adulthood, but their relative importance is unclear. Therefore, we determined the effects of restricted placental and fetal growth on components of the metabolic syndrome in young ad...

Objective To appraise the costs and consequences of treating women with mild gestational diabetes mellitus by dietary advice, blood glucose monitoring and insulin therapy as needed compared with routine pregnancy care. Design Cost-consequences analysis using patient-level data from within a multi-centre randomized clinical trial. Setting Obstetric...

Follow up of participants in trials of antenatal calcium supplementation has reported an impact on blood pressure among mothers and children. To determine whether blood pressure at 4-7 years follow up would be lower for calcium-supplemented mothers in the Australian Calcium Trial (ACT) and for their children. This follow up targeted 414 of the orig...

Leptin, an important hormonal regulator of body weight, has been shown to stimulate the sympathetic nervous system (SNS) in vitro although the physiological relevance remains unclear. Increased SNS activity has been implicated in the pathogenesis of insulin resistance and an increased cardiovascular risk. We have therefore investigated the relation...

Disclosure statement: Authors have nothing to disclose.

Most children who are short or light at birth due to intrauterine growth restriction (IUGR) exhibit accelerated growth in infancy, termed "catch-up" growth, which together with IUGR, predicts increased risk of type 2 diabetes and obesity later in life. Placental restriction (PR) in sheep reduces size at birth, and also causes catch-up growth and in...

Appropriate partitioning of nutrients between the mother and conceptus is a major determinant of pregnancy success, with placental transfer playing a key role. Insulin-like growth factors (IGFs) increase in the maternal circulation during early pregnancy and are predictive of fetal and placental growth. We have previously shown in the guinea pig th...

Mild gestational diabetes is a common complication of pregnancy, affecting up to 9% of pregnant women. Treatment of mild GDM is known to reduce adverse perinatal outcomes such as macrosomia and associated birth injuries, such as shoulder dystocia, bone fractures and nerve palsies. This study aimed to compare the plasma glucose concentrations and se...

Intrauterine growth restriction (IUGR) is associated with accelerated growth after birth. Together, IUGR and accelerated growth after birth predict reduced lean tissue mass and increased obesity in later life. Although placental insufficiency is a major cause of IUGR, whether it alters growth and adiposity in early postnatal life is not known. We h...

Intrauterine growth restriction (IUGR) in humans increases the risk of lung disease and impaired function suggesting that adverse intra-uterine conditions can alter lung development. We hypothesized that placental restriction (PR) of fetal growth would alter lung structure in late gestation. PR involved removal of implantation sites in pre-pregnant...