One of our current projects spans our work within maternity care, tobacco control and air quality MORE.
In its report ‘Carbon Monoxide Poisoning: Saving Lives, Advancing Treatment – a call for action across the healthcare sector’, the All Party Parliamentary CO Group recommended that research should be funded to: provide a better understanding of the scale of environmental CO poisoning in pregnancy; gain an understanding of the barriers and facilitators to identification of CO poisoning in pregnant women; understand how better to protect women from CO poisoning by the actions of health professionals and other agencies; and, provide better information to individuals to help them protect themselves’.
Foetal and neonatal death along with congenital malformations and neurological problems can occur with moderate to severe maternal exposure to CO. Studies also conclude that at lower levels of CO, adverse outcomes for the baby cannot be excluded. Washout of CO from foetal blood takes longer than in adults, this and lower partial pressure of oxygen in foetal blood and the resultant relative hypoxia, increases the effects of foetal exposure.
This study seeks to provide an understanding of the scale of the problem and what is required to happen to protect the woman and her unborn child. It will assess potential sources and measure CO levels in the homes of the pregnant woman. This will be used to develop an understanding of the prevalence of exposure, how such exposure occurs and whether the breath test at time of booking can be used as an indicator of exposure in the home. It will also identify the barriers and enablers to protecting women and their unborn child from the harm associated with exposure to CO, thereby providing an understanding and measurement of pregnant women’s and health professionals’ knowledge, attitudes, beliefs and concerns regarding CO and CO exposure.
The study will go on to codesign potential approaches and interventions that could be implemented at scale and used to protect vulnerable families. It will also provide information regarding possible requirements for the protection of pregnant women under schemes delivered by Central Government Departments, Agencies, NHS England and stakeholders in the domestic fuel industry.
Fire and Rescue Service (FRS) Safe and Well Checks will be utilised for the home monitoring. These checks will be used to establish potential sources of CO in the homes of pregnant women and deploy indoor air monitoring equipment that will be left in the house for a period of two weeks. Women are being recruited separately into the qualitative and quantitative elements of the study following a CO breath test undertaken by a midwife at their booking appointment.