Dr Nicole Reilly

Dr Nicole Reilly

Research Fellow

Faculty of Health and Medicine

Beating the baby blues

Dr Nicole Reilly is investigating how pregnancy and motherhood can impact a woman’s emotional health. Her work has led to nation-wide advancement in the field of perinatal mental health, helping Australian clinicians identify at-risk mothers quickly and provide mental health support when it’s needed most.

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Around one in seven women will experience perinatal anxiety or depression—that’s tens of thousands of families affected in Australia alone each year. Esteemed perinatal mental health researcher, Dr Nicole Reilly has dedicated 15 years to the pursuit of answers on behalf of these families and the health professionals who care for them, seeking to boost support for women during an often highly vulnerable time of their lives.

“My research focuses on improving our understanding of how pregnancy and parenthood can affect a woman’s emotional wellbeing, and how we can work together with clinicians and policymakers to achieve the best outcomes for women, children and families.

“A large part of this work involves investigating how we can best prevent and effectively manage depression, anxiety and psychological distress in pregnant women and new mums.”

In partnership with industry service providers, and fellow perinatal mental health research leaders, Nicole is finding ways to encourage women to speak up about their emotional wellbeing and equip clinicians to respond swiftly when needed.

“Personally, I feel very privileged that my research has been able to tell the stories and explore the journeys of women—and of health professionals—whose voices might not otherwise have been heard.”

Early intervention is key

Nicole has been at the forefront of research, policy and practice in perinatal and maternal mental health since 2007, when she worked closely with a national steering committee to co-write the beyondblue National Action Plan for Perinatal Mental Health. The Plan resulted in the $85 million National Perinatal Depression Initiative in 2008, which aimed to improve prevention and early detection of antenatal and postnatal depression and provide women with better support.

In 2018, Nicole became one of just two Australian Rotary Health postdoctoral research fellowship recipients. A significant portion of her research is focused on helping clinicians identify mental illness symptoms and risk factors during the perinatal period, a time when many women are already in regular contact with their midwife, child health nurse, GP or obstetrician. While a woman’s physical health is monitored closely during this time, her emotional health can too frequently be overlooked.

“Identifying symptoms and risk factors as a routine component of antenatal and postnatal care, and helping women access timely, appropriate support, can be so important for the wellbeing of mums, dads and babies for years to come.”

Nicole’s doctoral research, published in 2013, highlighted a lack of mental health screening for pregnant women who were receiving private sector healthcare. Her work informed the Commonwealth Government’s decision to create Medicare-funded depression screening and psychosocial assessments for women, meaning that at-risk women could be more quickly identified during routine checkups and receive timely support.

Based on her doctoral work, Nicole and her team developed innovative new services with industry partners, including ‘mummatters’, a consumer-led web-based tool for perinatal depression screening and psychosocial assessment.

“Mummatters is an Australian-only health tool. Since it was launched in November 2016, it has been downloaded and used by over 3,000 women.”

While Nicole’s work is contributing to significant progress, further research—and additional prevention and care strategies—are urgently needed in Australia.

“Unfortunately, research continues to show that there is still an enormous amount of shame and stigma that can prevent women from seeking help for their emotional health when they most need it. Yet the perinatal period is a time when the vast majority of women are in regular contact with health professionals, and it provides such a unique window to identify concerns and intervene early.”

Strategies for success

To further bolster important screening processes, Nicole is currently involved in validating a revised version of an enormously important screening tool—the Antenatal Risk Questionnaire (ANRQ), developed by UNSW’s Professor Marie-Paule Austin—which put broader psychosocial wellbeing into Australia’s national guidelines in 2017.

Nicole is also assessing a range of screening tools for anxiety, which she reveals can affect up to 15 per cent of women during pregnancy and 10 per cent of women in the year following birth.

“It is now recognised that antenatal and postnatal anxiety is as common as antenatal and postnatal depression. Australian and international clinical practice guidelines advocate for perinatal anxiety screening; however, few studies have examined the test performance of recommended screening measures using gold standard methodology. I’m working to bridge this gap in the evidence base using data from a large cohort of women in Australia.”

Two of Nicole’s current collaborative projects are Australian-first undertakings. The first will evaluate the clinical performance and cost-effectiveness of two models of integrated psychosocial assessment and depression screening in pregnant women. The other will examine healthcare professionals’ adherence to clinical practice guidelines for perinatal mental health and antenatal care.

The eagerly anticipated results are expected to inform strategies to optimise future guideline adherence, which will ultimately result in better-quality care and improved outcomes for women who give birth in Australia.

“This will, for the first time, quantify the degree to which health professionals work to best practice guidance for maternal mental health and will identify underlying factors associated with adherence and non-adherence attitudes and behaviours.”

Nicole is also interested in the intergenerational impact of maternal mental health. Together with colleagues at the Priority Research Centre for Generational Health and Ageing, she is exploring the impact of childhood trauma and adult violence on a woman’s health and parenting practices—and how it also affects their children. Research shows that, separately, a mother’s experience of adult violence and childhood trauma can be detrimental for their children. This research will take these research findings one step further.

“The project will align these fields of research by examining the potential cumulative impact of maternal exposure to adverse childhood experiences and violence across the life course on outcomes for women and their children.”

Nicole is careful to ensure that all her research projects are informed first and foremost by women’s voices, allowing real-world experiences to guide solution-focused interventions.

“During my time working in this field, so many women have given up their own time to participate in studies both large and small, and invariably say they are happy to do so if it means that the work will help other women and their families in the future. Their generosity of spirit, even in times of real adversity, are an inspiration.”

Looking to the future

In recent years, Nicole has received due attention for her research expertise, speaking at international and national conferences such as the Marcé Society for Perinatal Mental Health Conference 2019. In the same year, Nicole became one of only 15 people accepted into the inaugural International Marcé Society Mentorship Program.

“I’m honoured to be part of this program, especially as I’ve been paired with Jane Honikman, an inspirational leader and founder of Postpartum Support International, and co-founder of the Postpartum Action Institute.”

Alongside her growing research portfolio, Nicole is also heavily invested in mentoring the next generation, guiding higher degree research students in novel areas such as Indigenous perinatal health support services and the role of preconception health on mental health outcomes during pregnancy and the postpartum.

“The future of perinatal mental health research is exciting! We are starting to see real recognition now of how critical the emotional wellbeing of parents is during pregnancy and early childhood, and a more dedicated focus on the mental health and wellbeing of dads and partners.”

Beating the baby blues

Dr Nicole Reilly is investigating how pregnancy and motherhood can impact a woman’s emotional health. Her work has led to nation-wide advancement in the field of perinatal mental health, helping Australian clinicians identify at-risk mothers quickly and provide mental health support when it’s needed

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Career Summary

Biography

Dr Nicole Reilly is a Research Fellow at the University of Newcastle’s Priority Research Centre for Generational Health and Ageing (RCGHA). Her research is focused on improving perinatal mental health prevention and early intervention programs across Australia. Over her 15-year career, Dr Reilly has been involved in informing and developing numerous prevention and care guidelines and interventions, many of which are Australia-first projects.

Dr Reilly’s solutions-focused work has led to practical outcomes for women and their families since day one. In 2007, she co-wrote the beyondblue National Action Plan for Perinatal Mental Health, which resulted in the $85 million National Perinatal Depression Initiative. Dr Reilly was also a consultant to beyondblue for the development of Australia’s first clinical practice guidelines for perinatal mental health. In 2013, Dr Reilly co-developed an options paper as part of an NHMRC Partnership Project, which ultimately resulted in three items for antenatal depression screening and psychosocial assessment being included in an agreed set of Australian Institute of Health and Welfare priority data items for improving national perinatal data collection. In the same year, Dr Reilly published her doctoral work. Based on her findings, Dr Reilly instigated the measurement of perinatal mental health screening and service access in the Australian Longitudinal Study for Women’s Health—Australia’s largest longitudinal survey of women. Her ground-breaking results were also included in a report prepared for the Department of Health relating to major mental health findings.

In 2018, Dr Reilly was awarded one of just two highly competitive Australian Rotary Health postdoctoral research fellowships. Her current four-year program of work will be the most comprehensive population-level examination of the impact of preventative programs and service improvements for maternal mental health conducted in Australia to date. It includes an evaluation of the extent to which national prevention and early intervention investments have influenced the mental health outcomes of women who have given birth in Australia over the past 20 years and examines health professional adherence to clinical best practice guidelines for perinatal mental health. In collaboration with RCGHA and UNSW’s Professor Marie-Paule Austin, an internationally recognised expert in the field of perinatal mental health, Dr Reilly will also validate a clinical tool to support the early identification of psychosocial risk during pregnancy.

Dr Reilly is a named investigator on projects totalling over $3 million in competitive research funding and has presented her work at 15 conferences and seminars since 2010. She has authored or co-authored over 30 peer-reviewed publications and is a co-author on two book chapters relating to psychosocial assessment in the perinatal period. She is also a reviewer for more than 10 peer-reviewed journals and is a member of a range of academic societies.

Alongside her role with the University of Newcastle, Dr Reilly holds a Conjoint Senior Lecturer appointment at the School of Psychiatry, University of New South Wales. In 2014, Dr Reilly was awarded the UNSW Faculty of Medicine Dean’s List Award for Outstanding Research.


Qualifications

  • Doctor of Philosophy, University of New South Wales
  • Bachelor of Psychology (Honours), University of New South Wales

Keywords

  • depression screening
  • early intervention
  • perinatal mental health
  • policy evaluation
  • postnatal
  • pregnancy
  • prevention
  • psychosocial assessment

Fields of Research

Code Description Percentage
111714 Mental Health 60
111799 Public Health and Health Services not elsewhere classified 20
160508 Health Policy 20

Professional Experience

UON Appointment

Title Organisation / Department
Research Fellow University of Newcastle
Faculty of Health and Medicine
Australia

Professional appointment

Dates Title Organisation / Department
1/01/2013 - 16/03/2018 Senior Research Associate St John of God Burwood Hospital & School of Psychiatry, UNSW
Perinatal & Women’s Mental Health Unit
Australia
1/01/2009 - 31/12/2012 Research Associate St John of God Burwood Hospital & School of Psychiatry, UNSW
Perinatal & Women’s Mental Health Unit
Australia
1/01/2008 - 31/12/2008 Research Officer UNSW
Perinatal and Reproductive Epidemiology Research Unit, School of Women's and Children's Health
Australia
1/01/2008 - 31/12/2008 Consultant/National Program Officer Beyond Blue Ltd
National Perinatal Depression Initiative (NPDI)
1/01/2007 - 31/12/2007 National Project Officer Beyond Blue Ltd & St John of God Health Care
National Action Plan for Perinatal Mental Health
Australia
1/05/2003 - 31/12/2008 Research Officer University of New South Wales
School of Psychiatry
Australia

Awards

Award

Year Award
2014 UNSW Faculty of Medicine Dean’s List Award for Outstanding Research
University of New South Wales
2012 UNSW Research Support Scheme Award
University of New South Wales
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Chapter (2 outputs)

Year Citation Altmetrics Link
2014 Austin MP, Fisher J, Reilly N, 'Psychosocial Assessment and Integrated Perinatal Care', Identifying Perinatal Depression and Anxiety: Evidence-Based Practice in Screening, Psychosocial Assessment, and Management 121-138 (2014)

© 2015 John Wiley & Sons, Ltd. All rights reserved. It is increasingly recognized that perinatal mental health is multifaceted and should not be limited to screening for a p... [more]

© 2015 John Wiley & Sons, Ltd. All rights reserved. It is increasingly recognized that perinatal mental health is multifaceted and should not be limited to screening for a possible diagnosis of postnatal depression. This chapter discusses the background to, and role of, psychosocial assessment as a component of universal, mainstream antenatal and postnatal care. It highlights the importance of inquiring about broad risk factors including complex psychosocial comorbidities such as interpersonal violence, substance misuse, and history of adverse childhood experiences (e.g., childhood sexual abuse) which are known to impact on maternal mental health, parenting function, and infant outcomes. Concepts central to the implementation of effective integrated perinatal psychosocial assessment and care, and principles for establishing such programs in well-resourced primary care settings, are described. Specific consideration is also given to the challenges and complexities associated with the delivery of integrated perinatal mental health care for women living in resource-constrained settings. Current controversies and future directions are discussed.

DOI 10.1002/9781118509722.ch8
Citations Scopus - 8
2012 Protopopescu X, Austin M-P, Reilly N, Barnett B, 'Screening and psychosocial assessment for perinatal depression, distress, and dysfunction.', Perinatal Mental Health: A clinical guide, eKindle ed: M&K Publishing, United Kingdom 307-322 (2012)

Journal article (34 outputs)

Year Citation Altmetrics Link
2019 Reilly NM, Turner G, Taouk J, Austin M-P, ''Singing with your baby': an evaluation of group singing sessions for women admitted to a specialist mother-baby unit', Archives of Women`s Mental Health, 22 123-127 (2019)
Citations Scopus - 2
2019 Reilly N, Brake E, Kalra H, Austin M-P, 'Insights into implementation of routine depression screening and psychosocial assessment in a private hospital setting: A qualitative study.', Aust N Z J Obstet Gynaecol, (2019)
DOI 10.1111/ajo.13083
2019 Reilly N, Brake E, Briggs N, Austin M-P, 'Trajectories of clinical and parenting outcomes following admission to an inpatient mother-baby unit.', BMC Psychiatry, 19 336 (2019)
DOI 10.1186/s12888-019-2331-0
2019 Reilly N, Talcevska K, Black E, Matthey S, Austin MP, 'A comparison of the interviewer-administered phone and self-complete online versions of the computerized eMINI 6.0 in a sample of pregnant women', Journal of Affective Disorders, 242 265-269 (2019)

© 2018 Elsevier B.V. Background: This study compares the prevalence rates of depressive and anxiety disorders identified during pregnancy using an interviewer-administered phone v... [more]

© 2018 Elsevier B.V. Background: This study compares the prevalence rates of depressive and anxiety disorders identified during pregnancy using an interviewer-administered phone version and a self-complete online version of the computerized eMINI 6.0. Methods: 888 pregnant women completed the computerized eMINI 6.0 (interviewer-administered phone, n = 253; self-complete online, n = 635). Results: There were no significant differences in the proportions of women meeting eMINI 6.0 criteria for current major depression, any current anxiety disorder, or lifetime panic or depressive disorder, by mode of administration. However, a greater proportion of women in the interviewer-administered phone group than in the self-complete online group met criteria for current minor depression (2.0% vs 0.2%, p =.008). Limitations: Study limitations include its non-randomized design, overall low prevalence of depressive and anxiety disorders in the sample and inclusion of only a select number of eMINI 6.0 modules. Conclusions: This study demonstrated few differences in the rates of DSM-IV depressive and anxiety disorders identified between the interviewer-administered and self-administered versions of the eMINI 6.0. Findings provide preliminary support the practical value of self-completed computerized interviews in large scale studies examining common mental disorders in pregnant women.

DOI 10.1016/j.jad.2018.08.055
2019 Reilly N, Kingston D, Loxton D, Talcevska K, Austin M-P, 'A narrative review of studies addressing the clinical effectiveness of perinatal depression screening programs.', Women Birth, (2019)
DOI 10.1016/j.wombi.2019.03.004
Citations Scopus - 3
Co-authors Deborah Loxton
2019 Forder PM, Rich J, Harris S, Chojenta C, Reilly N, Austin MP, Loxton D, 'Honesty and comfort levels in mothers when screened for perinatal depression and anxiety', Women and Birth, (2019)

© 2019 Australian College of Midwives Purpose: To evaluate the degree of honesty and level of comfort reported by women when questioned about their emotional wellbeing during the ... [more]

© 2019 Australian College of Midwives Purpose: To evaluate the degree of honesty and level of comfort reported by women when questioned about their emotional wellbeing during the perinatal period; to investigate if honesty and comfort are associated with perinatal depression or perinatal anxiety; and to examine the reasons why women may not always respond honestly. Methods: Qualitative and quantitative data from 1597 women from the cross-sectional perinatal mental health substudy (part of the Australian Longitudinal Study on Women's Health)were analysed using a mixed methods approach. Results: When questioned by their health practitioner about their emotional wellbeing in the perinatal period, 20.7% of women indicated they had not always responded honestly. Reasons for not being honest reflected four main themes: normalizing of symptoms/coping; negative perceptions (self-and others); fear of adverse repercussions; and fear of involvement of health services (trust and confidentiality). The 38.9% of women who did not feel comfortable when questioned by their health practitioner about their emotional wellbeing were four times more likely to report perinatal depression (odds ratio = 4.09; 95% confidence interval = 2.55, 6.57)and nearly twice as likely to report perinatal anxiety (odds ratio = 1.90; 95% confidence interval = 1.24, 2.94)than other women. Conclusions: Women who are most likely to need mental health care during the perinatal period are also those least likely to be honest about their mental health. A non-judgemental, open and reassuring approach by clinicians may help to reduce the stigma and fears contributing to lack of honest responses, and improve early diagnosis and treatment of mental health problems.

DOI 10.1016/j.wombi.2019.04.001
Citations Scopus - 1
Co-authors Catherine Chojenta, Deborah Loxton, Peta Forder, Jane Rich
2018 Farrell JM, Nee AF, Francis K, Reilly N, 'Measuring the impact of pastoral services on patients in a private psychiatric hospital', Health and Social Care Chaplaincy, 6 95-113 (2018) [C1]

© Equinox Publishing Ltd 2018. This study explores the impact of pastoral care interventions on the mental and emotional health of inpatients at a private psychiatric hospital in ... [more]

© Equinox Publishing Ltd 2018. This study explores the impact of pastoral care interventions on the mental and emotional health of inpatients at a private psychiatric hospital in Sydney. A total of 99 patients completed study questionnaires over a three month period. Feedback for the service was overwhelmingly positive, with the vast majority of patients reporting benefits during and after their meetings, regardless of their religious beliefs. Almost 88% of patients reported a lessening of anxiety after their meetings with pastoral care practitioners, with 85% suggesting that their interactions with the pastoral team had a significant and positive impact on their mental health. These findings were contextualized further with free text responses from respondents. The study results clearly demonstrate the importance of pastoral services interventions in mental health settings.

DOI 10.1558/hscc.31831
2018 Chambers GM, Randall S, Mihalopoulos C, Reilly N, Sullivan EA, Highet N, et al., 'Mental health consultations in the perinatal period: a cost-analysis of Medicare services provided to women during a period of intense mental health reform in Australia', AUSTRALIAN HEALTH REVIEW, 42 514-521 (2018)
DOI 10.1071/AH17118
Citations Scopus - 1Web of Science - 1
Co-authors E Sullivan
2018 Kalra H, Reilly N, Austin MP, 'An evaluation of routine antenatal depression screening and psychosocial assessment in a regional private maternity setting in Australia', Australian and New Zealand Journal of Obstetrics and Gynaecology, 58 629-635 (2018)

© 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Background: There is limited information relating to routine depression screening and psych... [more]

© 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Background: There is limited information relating to routine depression screening and psychosocial assessment programs in private maternity settings in Australia. Aims: To describe the psychosocial profile of a sample of private maternity patients who participated in a depression screening and psychosocial risk assessment program as part of routine antenatal care, and to explore women's experience of receiving this component of pregnancy care. Materials and methods: We conducted a retrospective medical records audit of 455 consecutive women having a routine psychosocial assessment and referral. Assessment was undertaken using the Edinburgh Postnatal Depression Scale (EPDS) and the Antenatal Risk Questionnaire (ANRQ) for psychosocial risk; 101 women completed a feedback survey about their experience of receiving routine psychosocial care. Results: Of the 87.7% of women who completed both EPDS and ANRQ, 4.3% scored 13 or more on the EPDS. On the ANRQ, 25.3% of women endorsed one risk factor, 11.6% two risk factors and 10.5% three or more risk factors. Elevated EPDS scores were associated with major stresses in the last 12¿months, high trait anxiety and significant past mental health issue/s. Acceptability of depression screening and psychosocial risk assessment was high. Conclusions: This study highlights the need for, and acceptability of, depression and psychosocial assessment in the private maternity sector. These findings are particularly timely given the provision of new Medicare Benefits Scheme items for obstetricians to undertake psychosocial assessment (both antenatally and postnally) in line with recommended clinical best practice.

DOI 10.1111/ajo.12777
Citations Scopus - 2
2017 Reilly N, Black E, Chambers GM, Schmied V, Matthey S, Farrell J, et al., 'Study protocol for a comparative effectiveness trial of two models of perinatal integrated psychosocial assessment: The PIPA project', BMC Pregnancy and Childbirth, 17 (2017)

© 2017 The Author(s). Background: Studies examining psychosocial and depression assessment programs in maternity settings have not adequately considered the context in which psych... [more]

© 2017 The Author(s). Background: Studies examining psychosocial and depression assessment programs in maternity settings have not adequately considered the context in which psychosocial assessment occurs or how broader components of integrated care, including clinician decision-making aids, may optimise program delivery and its cost-effectiveness. There is also limited evidence relating to the diagnostic accuracy of symptom-based screening measures used in this context. The Perinatal Integrated Psychosocial Assessment (PIPA) Project was developed to address these knowledge gaps. The primary aims of the PIPA Project are to examine the clinical- and cost-effectiveness of two alternative models of integrated psychosocial care during pregnancy: 'care as usual' (the SAFE START model) and an alternative model (the PIPA model). The acceptability and perceived benefit of each model of care from the perspective of both pregnant women and their healthcare providers will also be assessed. Our secondary aim is to examine the psychometric properties of a number of symptom-based screening tools for depression and anxiety when used in pregnancy. Methods: This is a comparative-effectiveness study comparing 'care as usual' to an alternative model sequentially over two 12-month periods. Data will be collected from women at Time 1 (initial antenatal psychosocial assessment), Time 2 (2-weeks after Time 1) and from clinicians at Time 3 for each condition. Primary aims will be evaluated using a between-groups design, and the secondary aim using a within group design. Discussion: The PIPA Project will provide evidence relating to the clinical- and cost- effectiveness of psychosocial assessment integrated with electronic clinician decision making prompts, and referral options that are tailored to the woman's psychosocial risk, in the maternity care setting. It will also address research recommendations from the Australian (2011) and NICE (2015) Clinical Practice Guidelines. Trial Registration :ACTRN12617000932369.

DOI 10.1186/s12884-017-1354-0
Citations Scopus - 3
2017 Austin MP, Christl B, McMahon C, Kildea S, Reilly N, Yin C, et al., 'Moderating effects of maternal emotional availability on language and cognitive development in toddlers of mothers exposed to a natural disaster in pregnancy: The QF2011 Queensland Flood Study', Infant Behavior and Development, 49 296-309 (2017)

© 2017 Elsevier Inc. Background Prenatal maternal stress exposure has been linked to sub-optimal developmental outcomes in toddlers, while maternal emotional availability is assoc... [more]

© 2017 Elsevier Inc. Background Prenatal maternal stress exposure has been linked to sub-optimal developmental outcomes in toddlers, while maternal emotional availability is associated with better cognitive and language abilities. It is less clear whether early care-giving relationships can moderate the impact of prenatal stress on child development. The current study investigates the impact of stress during pregnancy resulting from the Queensland Floods in 2011 on toddlers¿ cognitive and language development, and examines how maternal emotional availability is associated with these outcomes. Methods Data were available from 131 families. Measures of prenatal stress (objective hardship, cognitive appraisal, and three measures of maternal subjective stress) were collected within one year of the 2011 Queensland floods. Maternal emotional availability was rated from video-taped mother-child play sessions at 16 months: sensitivity (e.g., affective connection, responsiveness to signals) and structuring (e.g., scaffolding, guidance, limit-setting). The toddlers¿ cognitive and language development was assessed at 30 months. Interactions were tested to determine whether maternal emotional availability moderated the relationship between prenatal maternal stress and toddler cognitive and language functioning. Results Prenatal stress was not correlated with toddlers¿ cognitive and language development at 30 months. Overall, the higher the maternal structuring and sensitivity, the better the toddlers¿ cognitive outcomes. However, significant interactions showed that the effects of maternal structuring on toddler language abilities depended on the degree of prenatal maternal subjective stress: when maternal subjective stress was above fairly low levels, the greater the maternal structuring, the higher the child vocabulary level. Conclusion The current study highlights the importance of maternal emotional availability, especially structuring, for cognitive and language development in young children. Findings suggest that toddlers exposed to higher levels of prenatal maternal stress in utero may benefit from high maternal structuring for their language development.

DOI 10.1016/j.infbeh.2017.10.005
Citations Scopus - 3
2017 Reilly N, 'Stress, depression and anxiety during pregnancy: how does it impact on children and how can we intervene early?', International Journal of Birth and Parent Education, 5 29-32 (2017)
2016 Chambers GM, Randall S, Hoang VP, Sullivan EA, Highet N, Croft M, et al., 'The National Perinatal Depression Initiative: An evaluation of access to general practitioners, psychologists and psychiatrists through the Medicare Benefits Schedule', Australian and New Zealand Journal of Psychiatry, 50 264-274 (2016)

© 2015 The Royal Australian and New Zealand College of Psychiatrists. Objective: To evaluate the impact of the National Perinatal Depression Initiative on access to Medicare servi... [more]

© 2015 The Royal Australian and New Zealand College of Psychiatrists. Objective: To evaluate the impact of the National Perinatal Depression Initiative on access to Medicare services for women at risk of perinatal mental illness. Method: Retrospective cohort study using difference-in-difference analytical methods to quantify the impact of the National Perinatal Depression Initiative policies on Medicare Benefits Schedule mental health usage by Australian women giving birth between 2006 and 2010. A random sample of women of reproductive age enrolled in Medicare who had not given birth where used as controls. The main outcome measures were the proportions of women giving birth each month who accessed a Medicare Benefits Schedule mental health items during the perinatal period (pregnancy through to the end of the first postnatal year) before and after the introduction of the National Perinatal Depression Initiative. Results: The proportion of women giving birth who accessed at least one mental health item during the perinatal period increased from 88 to 141 per 1000 between 2007 and 2010. The difference-in-difference analysis showed that while there was an overall increase in Medicare Benefits Schedule mental health item access as a result of the National Perinatal Depression Initiative, this did not reach statistical significance. However, the National Perinatal Depression Initiative was found to significantly increase access in subpopulations of women, particularly those aged under 25 and over 34 years living in major cities. Conclusion: In the 2 years following its introduction, the National Perinatal Depression Initiative was found to have increased access to Medicare funded mental health services in particular groups of women. However, an overall increase across all groups did not reach statistical significance. Further studies are needed to assess the impact of the National Perinatal Depression Initiative on women during childbearing years, including access to tertiary care, the cost-effectiveness of the initiative, and mental health outcomes. It is recommended that new mental health policy initiatives incorporate a planned strategic approach to evaluation, which includes sufficient follow-up to assess the impact of public health strategies.

DOI 10.1177/0004867415580154
Citations Scopus - 6Web of Science - 6
Co-authors E Sullivan
2015 Christl B, Reilly N, Yin C, Austin M-P, 'Clinical profile and outcomes of women admitted to a psychiatric mother-baby unit.', Arch Womens Ment Health, 18 805-816 (2015)
DOI 10.1007/s00737-014-0492-x
Citations Scopus - 14Web of Science - 9
2015 Reilly N, Yin C, Monterosso L, Bradshaw S, Neale K, Harrison B, Austin MP, 'Identifying psychosocial risk among mothers in an Australian private maternity setting: A pilot study', Australian and New Zealand Journal of Obstetrics and Gynaecology, 55 453-458 (2015)

© 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Background Psychosocial assessment and depression screening are recommended for all pregna... [more]

© 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Background Psychosocial assessment and depression screening are recommended for all pregnant and postnatal women in Australia. However, women who give birth in private maternity settings remain less likely to participate in psychosocial assessment programs, making it difficult to comment on the potential resource implications. Aims To describe the psychosocial profile of a sample of women who had recently given birth in a private hospital and to examine the acceptability and feasibility of introducing psychosocial assessment as a routine component of maternity care. Materials and Methods Two hundred and twenty participants were recruited in a four-month period from a private tertiary hospital located in Murdoch, Western Australia. All participants completed the Edinburgh Depression Scale (EDS) and a Antenatal Risk Questionnaire (ANRQ) prior to discharge via an iPad. Results The mean total score for the EDS was 4.77 (SD = 3.93), with 5% of women scoring above the recommended cut-off of 13 or more. The mean total score for the ANRQ was 17.73 (SD = 10.72). 45.0% of all women endorsed no significant risk factors. The proportion of women scoring above the recommended ANRQ cut-off of 23 or more was 32.3%. Approximately 11% of women were referred for additional support or treatment. Acceptability of the ANRQ was high at 97.3%. Conclusions This study describes the psychosocial profile of a sample of women who recently gave birth in an Australian private maternity hospital and demonstrates that with additional resources, the implementation of psychosocial assessment as a routine component of maternity care was feasible and highly acceptable in this setting.

DOI 10.1111/ajo.12370
Citations Scopus - 3
2015 King S, Kildea S, Austin MP, Brunet A, Cobham VE, Dawson PA, et al., 'QF2011: A protocol to study the effects of the Queensland flood on pregnant women, their pregnancies, and their children's early development', BMC Pregnancy and Childbirth, 15 (2015)

© 2015 King et al. Background: Retrospective studies suggest that maternal exposure to a severe stressor during pregnancy increases the fetus' risk for a variety of disorders... [more]

© 2015 King et al. Background: Retrospective studies suggest that maternal exposure to a severe stressor during pregnancy increases the fetus' risk for a variety of disorders in adulthood. Animal studies testing the fetal programming hypothesis find that maternal glucocorticoids pass through the placenta and alter fetal brain development, particularly the hypothalamic-pituitary-adrenal axis. However, there are no prospective studies of pregnant women exposed to a sudden-onset independent stressor that elucidate the biopsychosocial mechanisms responsible for the wide variety of consequences of prenatal stress seen in human offspring. The aim of the QF2011 Queensland Flood Study is to fill this gap, and to test the buffering effects of Midwifery Group Practice, a form of continuity of maternity care. Methods/design: In January 2011 Queensland, Australia had its worst flooding in 30 years. Simultaneously, researchers in Brisbane were collecting psychosocial data on pregnant women for a randomized control trial (the M@NGO Trial) comparing Midwifery Group Practice to standard care. We invited these and other pregnant women to participate in a prospective, longitudinal study of the effects of prenatal maternal stress from the floods on maternal, perinatal and early childhood outcomes. Data collection included assessment of objective hardship and subjective distress from the floods at recruitment and again 12 months post-flood. Biological samples included maternal bloods at 36 weeks pregnancy, umbilical cord, cord blood, and placental tissues at birth. Questionnaires assessing maternal and child outcomes were sent to women at 6 weeks and 6 months postpartum. The protocol includes assessments at 16 months, 2 1/2 and 4 years. Outcomes include maternal psychopathology, and the child's cognitive, behavioral, motor and physical development. Additional biological samples include maternal and child DNA, as well as child testosterone, diurnal and reactive cortisol. Discussion: This prenatal stress study is the first of its kind, and will fill important gaps in the literature. Analyses will determine the extent to which flood exposure influences the maternal biological stress response which may then affect the maternal-placental-fetal axis at the biological, biochemical, and molecular levels, altering fetal development and influencing outcomes in the offspring. The role of Midwifery Group Practice in moderating effects of maternal stress will be tested.

DOI 10.1186/s12884-015-0539-7
Citations Scopus - 22
2014 Chojenta C, Harris S, Reilly N, Forder P, Austin MP, Loxton D, 'History of pregnancy loss increases the risk of mental health problems in subsequent pregnancies but not in the postpartum', PLoS ONE, 9 (2014) [C1]

While grief, emotional distress and other mental health conditions have been associated with pregnancy loss, less is known about the mental health impact of these events during su... [more]

While grief, emotional distress and other mental health conditions have been associated with pregnancy loss, less is known about the mental health impact of these events during subsequent pregnancies and births. This paper examined the impact of any type of pregnancy loss on mental health in a subsequent pregnancy and postpartum. Data were obtained from a sub-sample (N = 584) of the 1973-78 cohort of the Australian Longitudinal Study on Women's Health, a prospective cohort study that has been collecting data since 1996. Pregnancy loss was defined as miscarriage, termination due to medical reasons, ectopic pregnancy and stillbirth. Mental health outcomes included depression, anxiety, stress or distress, sadness or low mood, excessive worry, lack of enjoyment, and feelings of guilt. Demographic factors and mental health history were controlled for in the analysis. Women with a previous pregnancy loss were more likely to experience sadness or low mood (AOR = 1.75, 95% CI: 1.11 to 2.76, p = 0.0162), and excessive worry (AOR = 2.01, 95% CI: 1.24 to 3.24, p = 0.0043) during a subsequent pregnancy, but not during the postpartum phase following a subsequent birth. These results indicate that while women who have experienced a pregnancy loss are a more vulnerable population during a subsequent pregnancy, these deficits are not evident in the postpartum. © 2014 Chojenta et al.

DOI 10.1371/journal.pone.0095038
Citations Scopus - 22Web of Science - 21
Co-authors Peta Forder, Catherine Chojenta, Deborah Loxton
2014 Xu F, Austin MP, Reilly N, Hilder L, Sullivan EA, 'Length of stay for mental and behavioural disorders postpartum in primiparous mothers: A cohort study', International Journal of Environmental Research and Public Health, 11 3540-3552 (2014)

Background: Previous research showed that there was a significant increase in psychiatric hospital admission of postpartum mothers. The aim of the current study is to describe the... [more]

Background: Previous research showed that there was a significant increase in psychiatric hospital admission of postpartum mothers. The aim of the current study is to describe the length of hospital stays and patient days for mental and behavioural disorders (MBD) of new mothers in the first year after birth. Method: This was a cohort study based on linked population data between the New South Wales (NSW) Midwives Data Collection (MDC) and the NSW Admitted Patients Data Collection (APDC). The study population included primiparous mothers aged from 18 to 44 who gave birth between 1 July 2000 and 31 December 2005. The Kaplan-Meier method was used to describe the length of hospital stay for MBD. Results: For principal diagnoses of MBD, the entire length of hospital stay in the first year postpartum was 11.38 days (95% CI: 10.70-12.06) for mean and 6 days (95% CI: 5.87-6.13) for median. The length of hospital stay per admission was 8.47 days (95% CI: 8.03-8.90) for mean and 5 days (95% CI: 4.90-5.10) for median. There were 5,129 patient days of hospital stay per year for principal diagnoses of postpartum MBD in new mothers between 1 July 2000 and 31 December 2005 in NSW, Australia. Conclusions: MBD, especially unipolar depressions, adjustment disorders, acute psychotic episodes, and schizophrenia, or schizophrenia-like disorders during the first year after birth, placed a significant burden on hospital services due to long hospital stays and large number of admissions. © 2014 by the authors; licensee MDPI, Basel, Switzerland.

DOI 10.3390/ijerph110403540
Citations Scopus - 2Web of Science - 2
Co-authors E Sullivan
2014 Reilly N, Harris S, Loxton D, Chojenta C, Forder P, Austin MP, 'The impact of routine assessment of past or current mental health on help-seeking in the perinatal period', Women and Birth, (2014) [C1]

Background: Clinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value o... [more]

Background: Clinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value of this line of enquiry in increasing engagement with support services, as required, remains controversial. Aim: The current study aimed to examine whether assessment of past or current mental health, received with or without referral for additional support, is associated with help-seeking during pregnancy and the postpartum. Methods: A subsample of women drawn from the Australian Longitudinal Study on Women's Health (young cohort) who reported experiencing significant emotional distress during pregnancy (N = 398) or in the 12 months following birth (N = 380) participated in the study. Results: Multivariate analysis showed that women who were not asked about their emotional health were less likely to seek any formal help during both pregnancy (adjOR = 0.09, 95%CI: 0.04-0.24) and the postpartum (adjOR = 0.07, 95%CI: 0.02-0.13), as were women who were asked about these issues but who were not referred for additional support (antenatal: adjOR = 0.26, 95%CI: 0.15-0.45; postnatal: adjOR = 0.14, 95%CI: 0.07-0.27). However, considerable levels of consultation with general practitioners, midwives and child health nurses, even in the absence of referral, were evident. Conclusion: This study demonstrates that enquiry by a health professional about women's past or current mental health is associated with help-seeking throughout the perinatal period. The clinical and resource implications of these findings for the primary health care sector should be considered prior to the implementation of future routine perinatal depression screening or psychosocial assessment programmes. © 2014 Australian College of Midwives.

DOI 10.1016/j.wombi.2014.07.003
Citations Scopus - 16Web of Science - 10
Co-authors Catherine Chojenta, Peta Forder, Deborah Loxton
2013 Austin M-PV, Middleton P, Reilly NM, Highet NJ, 'Detection and management of mood disorders in the maternity setting: the Australian Clinical Practice Guidelines.', Women Birth, 26 2-9 (2013)
DOI 10.1016/j.wombi.2011.12.001
Citations Scopus - 22Web of Science - 21
2013 Christl B, Reilly N, Smith M, Sims D, Chavasse F, Austin MP, 'The mental health of mothers of unsettled infants: Is there value in routine psychosocial assessment in this context?', Archives of Women's Mental Health, 16 391-399 (2013)

This study aims to investigate the (1) pattern of psychosocial risk factors among mothers of unsettled infants, (2) the relationship between these risk factors and current mental ... [more]

This study aims to investigate the (1) pattern of psychosocial risk factors among mothers of unsettled infants, (2) the relationship between these risk factors and current mental health status and (3) acceptability of psychosocial risk assessment in the parentcraft setting. Women with unsettled infants aged up to 12 months were assessed using the Edinburgh Postnatal Depression Scale, a diagnostic interview (Mini-International Neuropsychiatric Interview (MINI)) and a psychosocial assessment tool, the Postnatal Risk Questionnaire (PNRQ). Of the women, 27.5 % met the MINI diagnostic criteria for a current (predominantly) anxiety disorder, and 43.1 %, for a past psychiatric diagnosis. On the Edinburgh Postnatal Depression Scale, 29.9 % of women scored above 12 (mean 9.8; SD 5.1). The most common psychosocial risk factors were high trait anxiety (40.9 %), past mental health problems (40.7 %), perfectionistic traits (38.1 %) and 'abuse trauma' of any kind (31.6 %). The likelihood of meeting diagnostic criteria for a current mental illness was significantly increased for women who experienced emotional abuse during childhood (adj. odds ratio (OR) 3.386; p = 0.006), had high trait anxiety (adj. OR = 2.63, p = 0.003) or had a negative birth experience (adj. OR 2.78; p = 0.015). The majority of women (78 %) felt moderately to very comfortable completing the PNRQ. The results showed high rates of current anxiety disorders (almost twice that of the general postnatal population) and multiple significant psychosocial risk factors among mothers with unsettled infants. Identification of specific psychosocial risk factors in mothers of unsettled infants can help to address issues beyond infant settling difficulties such as mother-infant interaction, especially for mothers with unresolved issues around their own parenting or trauma history. © 2013 Springer-Verlag Wien.

DOI 10.1007/s00737-013-0360-0
Citations Scopus - 15
2013 Reilly N, Harris S, Loxton D, Chojenta C, Forder P, Milgrom J, Austin M, 'Disparities in reported psychosocial assessment across public and private maternity settings: a national survey of women in Australia', BMC Public Health, 13 632 (2013) [C1]
DOI 10.1186/1471-2458-13-632
Citations Scopus - 18Web of Science - 14
Co-authors Peta Forder, Deborah Loxton, Catherine Chojenta
2013 Reilly N, Harris S, Loxton D, Chojenta C, Forder P, Milgrom J, Austin M, 'Referral for Management of Emotional Health Issues During the Perinatal Period: Does Mental Health Assessment Make a Difference?', Birth, 40 297-306 (2013) [C1]
DOI 10.1111/birt.12067
Citations Scopus - 11Web of Science - 7
Co-authors Catherine Chojenta, Peta Forder, Deborah Loxton
2013 Austin MP, Colton J, Priest S, Reilly N, Hadzi-Pavlovic D, 'The antenatal risk questionnaire (ANRQ): Acceptability and use for psychosocial risk assessment in the maternity setting', Women and Birth, 26 17-25 (2013)

Objectives: To assess the value of the Antenatal Risk Questionnaire (ANRQ) as a predictor of postnatal depression, to evaluate its acceptability to pregnant women and midwives, an... [more]

Objectives: To assess the value of the Antenatal Risk Questionnaire (ANRQ) as a predictor of postnatal depression, to evaluate its acceptability to pregnant women and midwives, and to consider its use as part of a model for integrated psychosocial risk assessment in the antenatal setting. Method: This paper further analysed published data from the Pregnancy Risk Questionnaire in a sample of 1196 women. We extracted 12 items from the original 23 item Pregnancy Risk Questionnaire to assess how the shorter ANRQ would perform, and undertook the analysis in the subset who were administered the Composite International Diagnostic Interview (CIDI) at 2 or 4 months postpartum to assess for major depression (N=276). We also sampled a subset of pregnant participants (N=378) and midwives (N=44) to assess the tool's acceptability to these groups respectively. Findings: ROC curve analysis for the ANRQ yielded an acceptable area under the curve of 0.69. The most 'clinically' useful cut off on the ANRQ was a score of 23 or more, yielding a sensitivity of 0.62 and specificity of 0.64 with positive predictive value of 0.3. The odds that a woman scoring 23 or more on the ANRQ is also a case was 6.3 times greater than for a woman scoring less than 23. Acceptability of the ANRQ was high among both women and midwives. Conclusion: The ANRQ is a highly acceptable self-report psychosocial assessment tool which aids in the prediction of women who go on to develop postnatal depression. In combination with a symptom based screening measure (e.g., the Edinburgh Postnatal Depression Scale) and routine questions relating to drug and alcohol use and domestic violence, the ANRQ becomes most useful as a key element of a "screening intervention" aimed at the early identification of mental health risk and morbidity across the perinatal period. Evaluation of this model in terms of clinical outcomes remains to be undertaken. © 2011 Australian College of Midwives.

DOI 10.1016/j.wombi.2011.06.002
Citations Scopus - 59
2012 Austin M-P, Reilly N, Sullivan E, 'The need to evaluate public health reforms: Australian perinatal mental health initiatives', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 36 208-211 (2012)
DOI 10.1111/j.1753-6405.2012.00851.x
Citations Scopus - 13Web of Science - 12
Co-authors E Sullivan
2012 Xu F, Austin M-P, Reilly N, Hilder L, Sullivan EA, 'Major depressive disorder in the perinatal period: using data linkage to inform perinatal mental health policy', ARCHIVES OF WOMENS MENTAL HEALTH, 15 333-341 (2012)
DOI 10.1007/s00737-012-0289-8
Citations Scopus - 6Web of Science - 6
Co-authors E Sullivan
2012 Grant KA, Bautovich A, McMahon C, Reilly N, Leader L, Austin MP, 'Parental care and control during childhood: Associations with maternal perinatal mood disturbance and parenting stress', Archives of Women's Mental Health, 15 297-305 (2012)

This study examined the associations between perceived parental care and control in childhood and maternal anxiety, depression and parenting stress during the transition to parent... [more]

This study examined the associations between perceived parental care and control in childhood and maternal anxiety, depression and parenting stress during the transition to parenthood. Eighty-eight women completed the Parental Bonding Instrument, self-report measures of anxiety and depression and a structured diagnostic interview (Mini-plus International Neuropsychiatric Interview) during the third trimester of pregnancy. The MINI-Plus and anxiety and depression measures were re-administered at 7 months postpartum. The Parenting Stress Index was also administered at this time. Significant associations were found between maternal 'affectionless control' and prenatal and postnatal symptom measures of anxiety and depression, p values 0.005. Compared to women who reported optimal parenting, women who recalled maternal 'affectionless control' were also six times more likely to be diagnosed with an anxiety disorder during pregnancy (OR06.1, 95 % CI02.17-30.11) and seven times more likely to be diagnosed with postnatal major depression (OR06.8, 95 % CI01.80-25.37). Paternal 'affectionless control' was associated with significantly higher scores on symptom measures of prenatal and postnatal anxiety, p values 0.005. This study suggests that assessing a woman's own parenting history is important in identifying and managing the risk of prenatal and postnatal affective disorders and parenting stress. © 2012 Springer-Verlag.

DOI 10.1007/s00737-012-0292-0
Citations Scopus - 26
2010 Austin MP, Reilly N, Milgrom J, Barnett B, 'A national approach to perinatal mental health in Australia: Exercising caution in the roll-out of a public health initiative', Medical Journal of Australia, 192 111 (2010)
Citations Scopus - 14
2010 Grant KA, McMahon C, Reilly N, Austin MP, 'Maternal sensitivity moderates the impact of prenatal anxiety disorder on infant responses to the still-face procedure', Infant Behavior and Development, 33 453-462 (2010)

Animal studies have demonstrated the interactive effects of prenatal stress exposure and postnatal rearing style on offspring capacity to manage stress. However, little is known a... [more]

Animal studies have demonstrated the interactive effects of prenatal stress exposure and postnatal rearing style on offspring capacity to manage stress. However, little is known about how parenting quality impacts the association between maternal prenatal anxiety and stress reactivity in human infants. This prospective study examined the impact of prenatal anxiety disorder and maternal caregiving sensitivity on infants' responses to a standardised interactive stressor (still-face procedure). Eighty-four women completed a clinical interview during pregnancy to assess anxiety symptoms meeting DSM-IV diagnostic criteria. At infant age 7 months, maternal sensitivity to infant distress and infant negative affect were observed and coded during the still-face procedure. Maternal postnatal (concurrent) anxiety and depression were also assessed at this time. Results indicated a negative association between maternal sensitivity to infant distress and infant negative affect responses to the still-face procedure. An unexpected finding was a positive association between parity and infant reactivity. The main effect for sensitivity was qualified by a significant interaction, p<05, suggesting that the impact of sensitivity was particularly marked among infants of women who experienced an anxiety disorder during pregnancy. This finding is consistent with a cumulative risk model suggesting that maternal prenatal anxiety and quality of maternal care act in concert to shape infant outcomes. © 2010 Elsevier Inc.

DOI 10.1016/j.infbeh.2010.05.001
Citations Scopus - 29
2010 Grant KA, McMahon C, Reilly N, Austin MP, 'Maternal sensitivity moderates the impact of prenatal anxiety disorder on infant mental development', Early Human Development, 86 551-556 (2010)

Background: Animal studies have shown that postnatal rearing style can modify the association between prenatal stress exposure and offspring neurodevelopmental outcomes. However, ... [more]

Background: Animal studies have shown that postnatal rearing style can modify the association between prenatal stress exposure and offspring neurodevelopmental outcomes. However, little is known about how parenting quality impacts the association between maternal prenatal anxiety and development in human infants. Aim: This prospective study examined the impact of maternal prenatal anxiety disorder and maternal caregiving sensitivity on cognitive and psychomotor development in healthy, full-term, 7-month-old infants. Measures: Women completed a clinical interview during the third trimester of pregnancy to assess anxiety symptoms meeting DSM-IV diagnostic criteria. At infant age 7. months, maternal sensitivity to infant distress and non-distress were observed and coded during the still-face procedure. Maternal postnatal (concurrent) anxiety and depression were also assessed at this time. Infant mental and psychomotor development was assessed at infant age 7. months using the Bayley Scales of Infant Development II. Results: Analyses were based on 77 mother-infant dyads. Maternal sensitivity to infant distress moderated the association between maternal prenatal anxiety disorder and infant mental development, F (1, 77)=5.70, p=.02. Whereas there was a significant positive association between sensitivity and mental development among infants whose mothers were anxious during pregnancy, sensitivity had little impact on mental development among infants of control (non-anxious) women. Results were independent of prenatal depression and postnatal anxiety and depression. A caregiving moderation effect was not found for infant psychomotor development, p>.10. Conclusions: These findings are consistent with a cumulative risk model suggesting that maternal prenatal anxiety and quality of maternal care act in concert to shape infant outcomes. © 2010 Elsevier Ireland Ltd.

DOI 10.1016/j.earlhumdev.2010.07.004
Citations Scopus - 33
2010 Guy RJ, Kong F, Goller J, Franklin N, Bergeri I, Dimech W, et al., 'A new national Chlamydia Sentinel Surveillance System in Australia: evaluation of the first stage of implementation.', Communicable diseases intelligence, 34 319-328 (2010)

The Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) was established with funding from the Department of Health and Ageing to trial the monitoring of... [more]

The Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) was established with funding from the Department of Health and Ageing to trial the monitoring of the uptake and outcome of chlamydia testing in Australia. ACCESS involved 6 separate networks; 5 clinical networks involving sexual health services, family planning clinics, general practices, antenatal clinics, Aboriginal community controlled health services, and 1 laboratory network. The program ran from May 2007 to September 2010. An evaluation of ACCESS was undertaken in early 2010, 2 years after the program was funded. At the time of the evaluation, 76 of the 91 participating sites were contributing data. The jurisdictional distribution of the 76 sites generally matched the jurisdictional distribution of the Australian population. In 2008, the chlamydia testing rates in persons aged 16-29 years attending the 26 general practices was 4.2% in males and 7.0% in females. At the 25 sexual health services, the chlamydia testing rates in heterosexuals aged less than 25 years in 2008 was 77% in males and 74% in females. Between 2004 and 2008, the chlamydia positivity rate increased significantly in heterosexual females aged less than 25 years attending the sexual health services, from 11.5% to 14.1% (P < 0.01). Data completeness was above 85% for all core variables except Aboriginal and/or Torres Strait Islander status and country of birth, which ranged from 68%-100%, and 74%-100%, respectively, per network. There were delays in establishment of the system due to recruitment of 91 sites, multiple ethics applications and establishment of automated extraction programs in 10 different database systems, to transform clinic records into a common, pre-defined surveillance format. ACCESS has considerable potential as a mechanism toward supporting a better understanding of long-term trends in chlamydia notifications and to support policy and program delivery.

Citations Scopus - 48
Co-authors E Sullivan
2010 Austin M-PV, Hadzi-Pavlovic D, Priest SR, Reilly N, Wilhelm K, Saint K, Parker G, 'Depressive and anxiety disorders in the postpartum period: How prevalent are they and can we improve their detection?', Archives of Women's Mental Health, 13 395-401 (2010) [C1]
DOI 10.1007/s00737-010-0153-7
Citations Scopus - 102Web of Science - 98
2009 Grant KA, McMahon C, Austin MP, Reilly N, Leader L, Ali S, 'Maternal prenatal anxiety, postnatal caregiving and infants' cortisol responses to the still-face procedure', Developmental Psychobiology, 51 625-637 (2009)

This study prospectively examined the separate and combined influences of maternal prenatal anxiety disorder and postnatal caregiving sensitivity on infants&apos; salivary cortiso... [more]

This study prospectively examined the separate and combined influences of maternal prenatal anxiety disorder and postnatal caregiving sensitivity on infants' salivary cortisol responses to the still-face procedure. Effects were assessed by measuring infant salivary cortisol upon arrival at the laboratory, and at 15-, 25-, and 40-min following the still-face procedure. Maternal symptoms of anxiety during the last 6 months of pregnancy were assessed using clinical diagnostic interview. Data analyses using linear mixed models were based on 88 women and their 7-month-old infants. Prenatal anxiety and maternal sensitivity emerged as independent, additive moderators of infant cortisol reactivity, F (3, 180)=3.29, p=.02, F (3, 179)=2.68, p=.05 respectively. Results were independent of maternal prenatal depression symptoms, and postnatal symptoms of anxiety and depression. Infants' stress-induced cortisol secretion patterns appear to relate not only to exposure to maternal prenatal anxiety, but also to maternal caregiving sensitivity, irrespective of prenatal psychological state. © 2009 Wiley Periodicals, Inc.

DOI 10.1002/dev.20397
Citations Scopus - 72
2005 Austin MP, Leader LR, Reilly N, 'Prenatal stress, the hypothalamic-pituitary-adrenal axis, and fetal and infant neurobehaviour', Early Human Development, 81 917-926 (2005)

Background: Although it has long been acknowledged that chronic HPA axis dysregulation impacts on adult neural function, little attention has been paid to the impact that disturba... [more]

Background: Although it has long been acknowledged that chronic HPA axis dysregulation impacts on adult neural function, little attention has been paid to the impact that disturbances of the maternal HPA axis may have on the developing fetal brain. Aim: This editorial examines the associations between prenatal stress, neuroendocrine functioning, and behavioural outcome in both animal and human offspring, with a particular focus on the relationship between prenatal stress and human fetal and infant neurobehaviour. Study design: Using electronic databases, a computerized search of published and unpublished data was undertaken. Results: There is growing evidence that prenatal stress impacts on offspring neural function and behaviour in animal populations. That these findings may be applicable to human fetal neurobehaviour and infant development and outcome is gaining research attention, and the potential importance of the timing of pregnancy stress is being increasingly highlighted. Conclusions: There is a pressing need for more research into the role of maternal stress and anxiety during pregnancy on human fetal and infant outcomes. Future studies should prospectively pair physiological and psychological measures both pre- and postnatally if the HPA axis function of the mother and her infant is to be more fully understood. © 2005 Elsevier Ireland Ltd. All rights reserved.

DOI 10.1016/j.earlhumdev.2005.07.005
Citations Scopus - 59
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Grants and Funding

Summary

Number of grants 5
Total funding $3,578,000

Click on a grant title below to expand the full details for that specific grant.


20181 grants / $300,000

Prevention and early intervention for maternal mental illness: a research program that will inform policy and clinical practice$300,000

Funding body: Australian Rotary Health

Funding body Australian Rotary Health
Project Team Doctor Nicole Reilly
Scheme Geoffrey Betts Postdoctoral Fellowship
Role Lead
Funding Start 2018
Funding Finish 2021
GNo G1701342
Type Of Funding C3112 - Aust Not for profit
Category 3112
UON Y

20151 grants / $1,060,000

Critical illness in children: Can we afford to neglect the psychosocial risks? The impact, acceptability, and cost-effectiveness of routine psychosocial assessment and stepped care for families of infants with heart disease$1,060,000

Funding body: Australian National Health and Medical Research Council

Funding body Australian National Health and Medical Research Council
Project Team

A/Prof N Kasparian, Prof D Schofield, Prof M-P Austin, A/Prof D Winlaw, Prof A Girgis, A/Prof G Sholler, Dr N Reilly, D Rose, J Blake, J Descallar, K Leclair, K Walker, Dr R Bryant

Scheme Project grant
Role Investigator
Funding Start 2015
Funding Finish 2018
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

20121 grants / $1,100,000

The Australian perinatal mental health reforms: using population data to evaluate their impact on service utilisation and related costeffectiveness$1,100,000

Funding body: Australian National Health and Medical Research Council

Funding body Australian National Health and Medical Research Council
Project Team

Professor Marie-Paule Austin, Dr Nicole Highet, Professor Vera Morgan, A/Prof Cathrine Mihalopoulos, A/Prof Georgina Chambers, A/Prof MAxine Croft, Dr Nicole Reilly, Dr Fenglian Xu, Ms Catherine Knox

Scheme Partnership Project
Role Investigator
Funding Start 2012
Funding Finish 2016
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

20111 grants / $870,000

QF2011: The effects of the Queensland Flood on pregnant women, their pregnancies, and their children's early development$870,000

Funding body: Canadian Institutes of Health Research (CIHR)

Funding body Canadian Institutes of Health Research (CIHR)
Project Team

Prof S King, Prof S Kildea, Prof M-P Austin, Dr A Brunet, Dr E Hurrion, Dr D Laplante, Dr B McDermott, Dr N Reilly, Dr D McIntyre, Dr N Schmitz, Dr H Stapleton, Dr C Vaillancourt et al

Scheme Health Research
Role Investigator
Funding Start 2011
Funding Finish 2015
GNo
Type Of Funding International - Competitive
Category 3IFA
UON N

20101 grants / $248,000

Perinatal mental health assessment: does it improve maternal health outcomes?$248,000

This project examined equity of access to prevention and early intervention mental health initiatives among pregnant and postnatal women participating in the Australian Longitudinal Study for Women’s Health, and the impact of these initiatives on referral activity and help-seeking for emotional health issues.

Funding body: Bupa Foundation

Funding body Bupa Foundation
Project Team

Professor Marie-Paule Austin, Dr Nicole Reilly, Professor Deborah Loxton, Dr Catherine Chojenta, Ms Peta Forder, Professor Jeannette Milgrom

Scheme Bupa Foundation Resarch Grant
Role Investigator
Funding Start 2010
Funding Finish 2014
GNo
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON N
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Research Supervision

Number of supervisions

Completed0
Current3

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2019 PhD Assessing the Effectiveness of Using an ArtsHealth Intervention to Improve the Social and Emotional Welling of Mothers and Carers of Indigenous Children from Birth to School Age PhD (Public Health & BehavSci), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2017 PhD Improving Health Outcomes through Challenging Conversations with Aboriginal Women during the Perinatal and Early Childhood Periods. PhD (Gender & Health), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2017 PhD Healthy Mother, Sustainable Nation: A Study into the Factors Averting Poor Perinatal Mental Health PhD (Gender & Health), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
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Dr Nicole Reilly

Position

Research Fellow
Faculty of Health and Medicine

Contact Details

Email nicole.reilly@newcastle.edu.au
Links Google+
Google+
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