Health visitor support may help women who quit smoking during pregnancy remain smoke-free after giving birth, research suggests.

The BabyBreathe programme was designed to help women who stopped smoking before or during pregnancy avoid returning to smoking after childbirth.

The programme was funded by the National Institute for Health and Care Research and tested by a team led by the University of East Anglia.

Professor Michael Ussher of the University of Stirling’s Institute for Social Marketing and Health was a senior investigator on the study and led recruitment at two trial sites.

Ussher said: “This study is the first to show that an intervention focussing on support from a health visitor may help women avoid returning to smoking.

“These findings are important as many women stop smoking in pregnancy but then return to smoking soon after their baby is born.”

BabyBreathe provides one-to-one support from trained health visitors alongside digital tools, text message support, a dedicated website and app and a relapse-prevention kit sent to families after birth.

Women who received the intervention as intended, with support from trained health visitors, were significantly more likely to remain smoke-free 12 months after giving birth than those without health visitor support.

A total of 886 women from England and Scotland who had successfully stopped smoking before or during pregnancy took part in the large-scale randomised controlled trial.

Participants were randomly assigned to receive either BabyBreathe or usual care, which offered no advice or support aimed at preventing smoking relapse.

BabyBreathe was not delivered as intended to around one in five participants because of health visitor workforce pressures, missed appointments or administrative problems.

Health visitors provided tailored one-to-one advice and support to women in the intervention group towards the end of pregnancy and immediately after their baby was born.

The support included advice on alternatives women could try if they experienced urges to smoke again, as well as advice for partners and family members and access to digital resources including the BabyBreathe app and website.

A relapse-prevention kit was also posted to women immediately after their baby was born.

Support continued for up to 12 months after childbirth during routine health visitor appointments.

The intervention followed more than a decade of research and development involving women, families, health professionals and researchers who worked together to design, develop and test the support package.

Among participants who received the intervention as intended, 57.6 per cent remained smoke-free after 12 months, compared with 49.9 per cent of those receiving usual care.

Researchers said the findings suggest health visiting services could play a significant role in providing consistent relapse-prevention support and helping more mothers remain smoke-free after giving birth.

Lead researcher Professor Caitlin Notley, professor of addiction sciences at UEA’s Norwich Medical School, said: “Women of childbearing age who quit and stay non-smoking can reduce their risks of developing a smoking-related disease to almost the same level of risk as non-smokers.

“There are also great benefits for babies and children brought up by parents who do not smoke in avoiding exposure to second-hand smoke, and in helping to prevent the next generation from taking up smoking.

“Until now, health visitors had no training on smoking relapse prevention.

“This meant that when women had made the extremely important and difficult health behaviour change of quitting smoking during pregnancy, no one picked up on this and gave them positive praise and support.

“This new approach extends the intensive support for initially quitting smoking that pregnant women are offered, going one step further to help women to stay smokefree in the long term.”

Researchers noted several limitations that affected the primary analysis, including incomplete delivery of BabyBreathe and low engagement with some parts of the programme.

The participant group was also more highly educated and less socioeconomically deprived than the wider population, which may have affected the programme’s overall effectiveness and limit how broadly the findings can be applied.

The Institute of Health Visiting worked with UEA on the BabyBreathe study.

Vicky Gilroy, director of innovation and research at the Institute of Health Visiting, said: “Health visitors and their teams are uniquely placed to support women in preventing smoking relapse as part of their universal offer.

“It has been a privilege to contribute to the BabyBreathe study and help develop the evidence of the importance of their role. The findings reinforce the need for all health visitors to receive training in this important area.”

A single day of inhaled psychedelic treatment may relieve postpartum depression symptoms, with effects lasting for a week, early research suggests.

Postpartum depression is a severe mood disorder that affects women after giving birth. Symptoms can include extreme sadness, anxiety, changes in sleep and eating habits and difficulty bonding with a baby.

The condition affects up to one in five mothers globally. If untreated, it can have lasting effects on a mother’s psychological wellbeing and a child’s cognitive development.

Standard antidepressants, including selective serotonin reuptake inhibitors, a common type of antidepressant, often take four to six weeks to start working.

They can also cause side effects including weight gain, nausea and sexual dysfunction.

The only medication specifically approved by the US Food and Drug Administration for postpartum depression is zuranolone. It works faster than standard antidepressants but requires a 14-day daily course and carries warnings about drowsiness.

Researchers are exploring psychoactive compounds as possible alternatives for faster relief.

Mebufotenin, also known as 5-MeO-DMT, is a psychedelic compound that acts on serotonin receptors in the brain. Serotonin is a chemical messenger involved in functions including mood, sleep and digestion.

Previous early-stage trials found that an inhaled synthetic formulation called GH001 produced very rapid antidepressant effects in people with treatment-resistant depression.

Lead authors Martin Johnson of St Pancras Clinical Research and Kristina M. Deligiannidis of the Feinstein Institutes for Medical Research investigated whether the treatment could safely help women with severe postpartum depression.

The trial assessed its safety, side effects and impact on maternal functioning. It was funded by GH Research, the company developing the drug.

Researchers enrolled 10 women aged 18 to 45. All had major depressive disorder that began shortly before or after giving birth and were at least four weeks postpartum.

Participants also had to score at least 28 on a standard depression questionnaire, indicating moderate to severe depression.

Treatment was given on a single day using a specialised vaporisation system, with patients inhaling the medication from a collection balloon.

Doses were adjusted according to each woman’s response.

Participants first received 6mg. Those who tolerated the drug but did not experience a sufficiently intense psychoactive effect could receive 12mg one hour later, followed by 18mg after another hour if needed.

Researchers used a specialised scale to assess the intensity of the psychedelic experience, including feelings of losing control and how profound the experience felt.

Further doses were stopped once participants reached a predefined score.

Patients were monitored for changes in vital signs, psychiatric symptoms and overall comfort.

The psychedelic effects lasted for an average of around 20 to 25 minutes after each dose.

Participants also had to arrange for a trusted adult to care for their baby while they received treatment.

The main measure was the change in depression scores between the start of the study and day eight. Researchers also measured symptoms two hours after the final dose and on day two.

Four participants were lactating, allowing researchers to test their breast milk and assess how quickly the drug was eliminated from their bodies.

All 10 women experienced at least a 50 per cent reduction in depression symptoms two hours after their final dose.

By day eight, average depression scores had fallen by around 96 per cent and every participant met the study criteria for remission, meaning they no longer met the clinical threshold for depression.

Participants also reported improvements in maternal functioning.

Scores on a questionnaire assessing psychological wellbeing, self-care and mother-child interaction improved by around 56 per cent by day eight, with gains seen across almost all areas measured.

No serious adverse events were reported.

The most common side effect was mild to moderate headache, experienced by five of the 10 women.

The treatment did not cause lingering sedation and all participants were able to return home on the day they received it.

Among the four lactating women, levels of the drug and its byproducts in breast milk peaked around one hour after the final dose and fell below detectable levels after about 10 hours.

Researchers said this suggests mothers may only need to pause breastfeeding for a relatively short period on the day of treatment, although further research is needed before firm clinical recommendations can be made.

The trial was open-label, meaning both participants and researchers knew the active drug was being given.

There was no placebo comparison group, making it impossible to rule out the possibility that expectations about the treatment influenced the reported improvements.

The sample was also small and lacked demographic diversity, with nine of the 10 participants identified as white.

Almost none of the women were taking other psychiatric medications during the trial, meaning the findings may not reflect how a broader and more diverse group of mothers with postpartum depression would respond.

Researchers followed the women for only one week after treatment, leaving questions about how long the antidepressant effects may last.

Future studies will need to follow patients for several months to assess whether depression returns or additional doses are needed.

Larger trials will also need to randomly assign participants to receive either the active treatment or a placebo.

These studies will be needed to confirm the treatment’s safety and determine whether the drug itself is responsible for the rapid reduction in symptoms.

One in eight mothers in England is now diagnosed with gestational diabetes, after diagnoses of the condition rose by 60 per cent in just five years, according to a major study.

The research found that rates of gestational diabetes increased from around 8 per cent of pregnancies in 2018 to more than 12 per cent in 2022.

Gestational diabetes mellitus (GDM) develops when the body cannot produce enough insulin to regulate blood sugar levels during pregnancy.

It is the most common complication to occur during pregnancy and is associated with a heightened risk of preterm birth, emergency caesarean section, and babies being born either larger or smaller than expected for their gestational age.

The condition is also linked to longer-term health risks for both mothers and their children.

Laura Magee is professor of women’s health at King’s College London and co-investigator on the study.

She said: “Pregnancy outcomes for women with gestational diabetes are still worse than those for women without gestational diabetes.

“Further work is required to address how control of blood sugar and timed birth can address the excess of adverse pregnancy outcomes, compared with the general maternity population.

“Follow-up after birth is also essential, as women with prior gestational diabetes are at increased risk of cardiometabolic disease, including type 2 diabetes mellitus, but also high blood pressure and elevated blood cholesterol, starting within the first year after birth.”

For the study, researchers analysed routinely collected NHS maternity data covering more than 2.3 million mothers and around 2.8 million births across 184 hospitals in England between 2018 and 2022, making it one of the largest investigations of its kind.

The study uncovered marked inequalities in both the prevalence of gestational diabetes and pregnancy outcomes more broadly.

The sharpest rises in diagnoses were recorded among Asian women, among whom rates reached around 23 per cent, and among women living in the most deprived areas, where rates climbed to about 14 per cent.

The disparities extended beyond gestational diabetes.

Black mothers were found to be more likely to experience an emergency caesarean birth, women in deprived areas were more likely to give birth prematurely, and Asian mothers were more likely to have babies born small for their gestational age.

Among these higher-risk groups, researchers found that a diagnosis of gestational diabetes further compounded the risk of preterm birth.

Rising maternal age, increasing rates of obesity and improvements in how data is captured by the NHS are all likely to be contributing to the growing prevalence of the condition, the researchers said.

Notably, they found that changes to gestational diabetes screening introduced during the Covid-19 pandemic did not meaningfully affect the overall upward trend in diagnoses, suggesting the rise reflects genuine underlying changes in the population rather than shifts in testing practice.

The researchers said the findings pointed to an urgent need to strengthen maternity services and improve support for the women at greatest risk.

Experts said the findings also carried implications that extend well beyond pregnancy itself.

Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, said the study was part of a wider pattern of research using large-scale health data to uncover hidden risks.

“Big data research studies like this, which can now analyse millions of healthcare records, are uncovering a concerning rise in conditions which raise people’s chances of having a future heart attack or stroke,” she said.

“Gestational diabetes often goes away after pregnancy, but it can increase women’s risk of future cardiovascular disease.”

Dr Babu-Narayan called on healthcare professionals to routinely ask women about pregnancy-related risk factors, regardless of how long ago the pregnancy took place.

“Healthcare professionals who want to fully understand people’s risk of heart attack and stroke should routinely ask women about risk factors unique to them, such as diabetes or high blood pressure in pregnancy – even if that pregnancy was decades earlier,” she said.

“If you are a woman who has had diabetes or high blood pressure during pregnancy, it is especially important to attend health checks when invited.”