{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:29:16Z","timestamp":1787020156946,"version":"build-2736575974"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National Institute for Health and Care Research (NIHR) Policy Research Programme","award":["PR-PRU-1217-21202"],"award-info":[{"award-number":["PR-PRU-1217-21202"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast milk has significant benefits for preterm babies, but \u2018very preterm\u2019 babies are unable to feed directly from the breast at birth. Their mothers have to initiate and sustain lactation through expressing milk for tube feeding until their babies are developmentally ready to feed orally. There are wide disparities between neonatal units in England in rates of breast milk feeding at discharge. This study explored health professionals\u2019 experiences of barriers and facilitators to their role in supporting breast milk feeding and breastfeeding for very preterm babies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>12 health professionals were interviewed, from four neonatal units in England with high or low rates of breast milk feeding at discharge. Interviews were analysed using comparative thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five themes were developed: \u2018The role of the infant feeding specialist\u2019, \u2018Achieving a whole team approach to breast milk feeding\u2019, \u2018Supporting initiation of breastfeeding\u2019 \u2018Supporting long-term expressing\u2019, \u2018Supporting the transition to breastfeeding\u2019. There were notable differences between neonatal units in the time allocated to specialist feeding support, the team\u2019s sense of collective responsibility for supporting feeding, leadership, the use of external standards as levers for change, and training for the multi-disciplinary team. The feeding challenges faced by mothers of very preterm babies could be made worse where there was no joined-up working between neonatal and postnatal staff; inadequate facilities for mothers to stay with their babies; and when opportunities were missed to give information about the importance of early initiation of expressing and to support mothers\u2019 confidence during the transition to direct breastfeeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Effective support can be influenced by having a supernumerary post dedicated to infant feeding; strong leadership that champions breast milk feeding and breastfeeding within Family Integrated Care; maintaining accountability by using existing quality improvement tools and accredited standards for neonatal units; and training for the whole multi-disciplinary team that encourages and enables every member of staff to take an appropriate share of responsibility for consistently informing and assisting mothers with expressing and breastfeeding. Joined-up working between staff on antenatal and postnatal wards and neonatal units is important to enable integrated feeding support for the mother-baby dyad.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-024-07039-0","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T07:04:59Z","timestamp":1735196699000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Differences between neonatal units with high and low rates of breast milk feeding for very preterm babies at discharge: a qualitative study of staff experiences"],"prefix":"10.1186","volume":"24","author":[{"given":"Jenny","family":"McLeish","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Aloysius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Gale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Quigley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Kurinczuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Alderdice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"issue":"7","key":"7039_CR1","doi-asserted-by":"publisher","first-page":"e2221608","DOI":"10.1001\/jamanetworkopen.2022.21608","volume":"5","author":"MB Belfort","year":"2022","unstructured":"Belfort MB, Knight E, Chandarana S, Ikem E, Gould JF, Collins CT, et al. Associations of maternal milk feeding with neurodevelopmental outcomes at 7 years of age in former Preterm infants. JAMA Netw Open. 2022;5(7):e2221608.","journal-title":"JAMA Netw Open"},{"key":"7039_CR2","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s40748-017-0062-0","volume":"3","author":"SM Gephart","year":"2017","unstructured":"Gephart SM, Hanson C, Wetzel CM, Fleiner M, Umberger E, Martin L, et al. NEC-zero recommendations from scoping review of evidence to prevent and foster timely recognition of necrotizing enterocolitis. Maternal Health Neonatology Perinatol. 2017;3:23.","journal-title":"Maternal Health Neonatology Perinatol"},{"key":"7039_CR3","doi-asserted-by":"crossref","unstructured":"Dimitroglou M, Iliodromiti Z, Christou E, Volaki P, Petropoulou C, Sokou R et al. Human breast milk: the Key Role in the maturation of Immune, gastrointestinal and central nervous systems: a narrative review. Diagnostics (Basel Switzerland). 2022;12(9).","DOI":"10.3390\/diagnostics12092208"},{"issue":"6","key":"7039_CR4","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1097\/ANC.0000000000000232","volume":"15","author":"R Ikonen","year":"2015","unstructured":"Ikonen R, Paavilainen E, Kaunonen M. Preterm infants\u2019 mothers\u2019 experiences with milk expression and breastfeeding: an integrative review. Adv Neonatal Care. 2015;15(6):394\u2013406.","journal-title":"Adv Neonatal Care"},{"issue":"7","key":"7039_CR5","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1089\/bfm.2024.0041","volume":"19","author":"C Liu","year":"2024","unstructured":"Liu C, Pan M, Lu X, Gao Y, Xu J, Chen X. Breastfeeding barriers for Preterm infants in neonatal intensive care unit environments: a systematic Assessment and Meta-Analysis. Breastfeed Med. 2024;19(7):505\u201314.","journal-title":"Breastfeed Med"},{"issue":"1","key":"7039_CR6","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1111\/jep.12721","volume":"24","author":"W Lubbe","year":"2018","unstructured":"Lubbe W. Clinicians guide for cue-based transition to oral feeding in preterm infants: an easy-to-use clinical guide. J Eval Clin Pract. 2018;24(1):80\u20138.","journal-title":"J Eval Clin Pract"},{"issue":"9","key":"7039_CR7","doi-asserted-by":"publisher","first-page":"e108208","DOI":"10.1371\/journal.pone.0108208","volume":"9","author":"R Maastrup","year":"2014","unstructured":"Maastrup R, Hansen BM, Kronborg H, Bojesen SN, Hallum K, Frandsen A, et al. Breastfeeding progression in preterm infants is influenced by factors in infants, mothers and clinical practice: the results of a national cohort study with high breastfeeding initiation rates. PLoS ONE. 2014;9(9):e108208.","journal-title":"PLoS ONE"},{"issue":"3","key":"7039_CR8","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1038\/jp.2011.78","volume":"32","author":"LA Parker","year":"2012","unstructured":"Parker LA, Sullivan S, Krueger C, Kelechi T, Mueller M. Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study. J Perinatol. 2012;32(3):205\u20139.","journal-title":"J Perinatol"},{"key":"7039_CR9","doi-asserted-by":"crossref","unstructured":"Levene I, Quigley MA, Fewtrell M, O\u2019Brien F. Does extremely early expression of colostrum after very preterm birth improve mother\u2019s own milk quantity? A cohort study. Arch Dis Child Fetal Neonatal Ed. 2024;109(5):475\u201380.","DOI":"10.1136\/archdischild-2023-326784"},{"issue":"4","key":"7039_CR10","doi-asserted-by":"publisher","first-page":"e12618","DOI":"10.1111\/mcn.12618","volume":"14","author":"J Ericson","year":"2018","unstructured":"Ericson J, Eriksson M, Hoddinott P, Hellstr\u00f6m-Westas L, Flacking R. Breastfeeding and risk for ceasing in mothers of preterm infants-long-term follow-up. Matern Child Nutr. 2018;14(4):e12618.","journal-title":"Matern Child Nutr"},{"issue":"1","key":"7039_CR11","doi-asserted-by":"publisher","first-page":"e12657","DOI":"10.1111\/mcn.12657","volume":"15","author":"C Bonnet","year":"2019","unstructured":"Bonnet C, Blondel B, Piedvache A, Wilson E, Bonamy A-KE, Gortner L, et al. Low breastfeeding continuation to 6 months for very preterm infants: a European multiregional cohort study. Matern Child Nutr. 2019;15(1):e12657.","journal-title":"Matern Child Nutr"},{"key":"7039_CR12","doi-asserted-by":"crossref","unstructured":"Foster JP, Psaila K, Patterson T. Non-nutritive sucking for increasing physiologic stability and nutrition in preterm infants. Cochrane Database Syst Rev. 2016;10(10):CD001071.","DOI":"10.1002\/14651858.CD001071.pub3"},{"issue":"4","key":"7039_CR13","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1097\/JPN.0b013e31826d928b","volume":"26","author":"H Wataker","year":"2012","unstructured":"Wataker H, Meberg A, Nestaas E. Neonatal family care for 24 hours per day: effects on maternal confidence and breast-feeding. J Perinat Neonatal Nurs. 2012;26(4):336\u201342.","journal-title":"J Perinat Neonatal Nurs"},{"issue":"4","key":"7039_CR14","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1038\/jp.2010.120","volume":"31","author":"R Domanico","year":"2011","unstructured":"Domanico R, Davis DK, Coleman F, Davis BO. Documenting the NICU design dilemma: comparative patient progress in open-ward and single family room units. J Perinatol. 2011;31(4):281\u20138.","journal-title":"J Perinatol"},{"issue":"4","key":"7039_CR15","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/S2352-4642(18)30039-7","volume":"2","author":"K O\u2019Brien","year":"2018","unstructured":"O\u2019Brien K, Robson K, Bracht M, Cruz M, Lui K, Alvaro R, et al. Effectiveness of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial. Lancet Child Adolesc Health. 2018;2(4):245\u201354.","journal-title":"Lancet Child Adolesc Health"},{"key":"7039_CR16","unstructured":"UNICEF UK. Guide to the UNICEF UK Baby Friendly Initiative Neonatal Standards. 2022."},{"key":"7039_CR17","unstructured":"British Association of Perinatal Medicine. Optimising Early Maternal Breast Milk for Preterm Infants: A Quality Improvement Toolkit. London; 2020."},{"key":"7039_CR18","volume-title":"Optimising maternal breast milk for Preterm infants Part 2. To discharge and beyond. A Quality Improvement Toolkit","author":"British Association of Perinatal Medicine","year":"2022","unstructured":"British Association of Perinatal Medicine. Optimising maternal breast milk for Preterm infants Part 2. To discharge and beyond. A Quality Improvement Toolkit. London: British Association of Perinatal Medicine; 2022."},{"key":"7039_CR19","unstructured":"Bliss. Bliss Baby Charter. 2020."},{"key":"7039_CR20","unstructured":"Adams E, Harvey K, Sweeting M. Neonataology - workforce. GRIFT Programme National Speciality Report. NHS England; 2022."},{"key":"7039_CR21","volume-title":"Summary report on 2022 data","author":"National Neonatal Audit Programme","year":"2023","unstructured":"National Neonatal Audit Programme. Summary report on 2022 data. London: RCPCH; 2023."},{"key":"7039_CR22","volume-title":"National Neonatal Audit Programme (NNAP) 2022 data: extended analysis report","author":"National Neonatal Audit Programme","year":"2023","unstructured":"National Neonatal Audit Programme. National Neonatal Audit Programme (NNAP) 2022 data: extended analysis report. London: RCPCH; 2023."},{"issue":"6","key":"7039_CR23","doi-asserted-by":"publisher","first-page":"F450","DOI":"10.1136\/adc.2009.179564","volume":"96","author":"M Bonet","year":"2011","unstructured":"Bonet M, Blondel B, Agostino R, Combier E, Maier RF, Cuttini M, et al. Variations in breastfeeding rates for very preterm infants between regions and neonatal units in Europe: results from the MOSAIC cohort. Archives Disease Child - Fetal Neonatal Ed. 2011;96(6):F450.","journal-title":"Archives Disease Child - Fetal Neonatal Ed"},{"key":"7039_CR24","doi-asserted-by":"crossref","unstructured":"Oakley LL, Renfrew MJ, Kurinczuk JJ, Quigley MA. Factors associated with breastfeeding in England: an analysis by primary care trust. BMJ Open. 2013;3(6).","DOI":"10.1136\/bmjopen-2013-002765"},{"issue":"1","key":"7039_CR25","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1111\/ppe.12536","volume":"33","author":"A Mitha","year":"2019","unstructured":"Mitha A, Piedvache A, Glorieux I, Zeitlin J, Rou\u00e9 JM, Blondel B, et al. Unit policies and breast milk feeding at discharge of very preterm infants: the EPIPAGE-2 cohort study. Paediatr Perinat Epidemiol. 2019;33(1):59\u201369.","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"2","key":"7039_CR26","doi-asserted-by":"publisher","first-page":"e0245273","DOI":"10.1371\/journal.pone.0245273","volume":"16","author":"R Maastrup","year":"2021","unstructured":"Maastrup R, Rom AL, Walloee S, Sandfeld HB, Kronborg H. Improved exclusive breastfeeding rates in preterm infants after a neonatal nurse training program focusing on six breastfeeding-supportive clinical practices. PLoS ONE. 2021;16(2):e0245273.","journal-title":"PLoS ONE"},{"key":"7039_CR27","unstructured":"National Neonatal Audit Programme. 2019 annual report on 2018 data. RCPCH:London; 2019."},{"issue":"1","key":"7039_CR28","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1186\/s12884-024-06910-4","volume":"24","author":"J McLeish","year":"2024","unstructured":"McLeish J, Aloysius A, Gale C, Quigley MA, Kurinczuk JJ, Alderdice F. What supports mothers of very preterm babies to start and continue breast milk feeding neonatal units? A qualitative COM-B analysis of mothers\u2019 experiences. BMC Pregnancy Childbirth. 2024;24(1):725.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"3","key":"7039_CR29","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1111\/j.1751-9004.2008.00114.x","volume":"2","author":"D Landridge","year":"2008","unstructured":"Landridge D. Phenomenology and critical social psychology: directions and debates in theory and Research Soc. Personal Psychol Compass. 2008;2(3):1126\u201342.","journal-title":"Personal Psychol Compass"},{"key":"7039_CR30","volume-title":"Doing qualitative analysis in psychology","author":"N Pidgeon","year":"1997","unstructured":"Pidgeon N, Henwood K. Using grounded theory in psychological research. In: Hayes N, editor. Doing qualitative analysis in psychology. Hove: Psychology; 1997."},{"key":"7039_CR31","unstructured":"National Neonatal Audit Programme. 2019 report on 2018 data, data file. https:\/\/www.rcpch.ac.uk\/resources\/national-neonatal-audit-programme-transparency-open-data2019"},{"issue":"13","key":"7039_CR32","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1177\/1049732315617444","volume":"26","author":"K Malterud","year":"2016","unstructured":"Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by Information Power. Qual Health Res. 2016;26(13):1753\u201360.","journal-title":"Qual Health Res"},{"issue":"2","key":"7039_CR33","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77\u2013101.","journal-title":"Qualitative Res Psychol"},{"key":"7039_CR34","unstructured":"NHS England. NHS England Statistical Release Breastfeeding Initiation, Quarter 4 2016\/17. 2017."},{"key":"7039_CR35","unstructured":"Health Innovation West of England. PERIPrem undated [ https:\/\/www.healthinnowest.net\/our-work\/transforming-services-and-systems\/periprem\/"},{"key":"7039_CR36","unstructured":"NHS England. Saving babies\u2019 lives: version 3 2023 [ https:\/\/www.england.nhs.uk\/long-read\/saving-babies-lives-version-3\/"},{"issue":"9","key":"7039_CR37","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1007\/s12098-023-04859-4","volume":"91","author":"T Kalathingal","year":"2024","unstructured":"Kalathingal T, Manerkar S, Mondkar J, Kalamdani P, Patra S, Kaur S, et al. Comparison of two pumping strategies to improve exclusive breastfeeding at discharge in mothers of VLBW infants with low milk output - A pilot randomized controlled trial. Indian J Pediatr. 2024;91(9):906\u201312.","journal-title":"Indian J Pediatr"},{"issue":"5","key":"7039_CR38","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1097\/ANC.0000000000000421","volume":"17","author":"KK Shattnawi","year":"2017","unstructured":"Shattnawi KK. Healthcare Professionals\u02bc attitudes and practices in supporting and promoting the breastfeeding of Preterm infants in NICUs. Adv Neonatal Care. 2017;17(5):390\u20139.","journal-title":"Adv Neonatal Care"},{"key":"7039_CR39","unstructured":"Public Health England DoH. Health visiting and midwifery partnership \u2013 pregnancy and early weeks. 2015."},{"key":"7039_CR40","unstructured":"Public Health England. Care continuity between midwifery and health visiting services: principles for practice. 2021."},{"issue":"10","key":"7039_CR41","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1016\/j.arcped.2015.07.005","volume":"22","author":"B Westrup","year":"2015","unstructured":"Westrup B. Family-centered developmentally supportive care: the Swedish example. Arch Pediatr. 2015;22(10):1086\u201391.","journal-title":"Arch Pediatr"},{"issue":"Suppl 1","key":"7039_CR42","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1038\/s41372-023-01812-3","volume":"43","author":"S Klemming","year":"2023","unstructured":"Klemming S, Lilliesk\u00f6ld S, Arwehed S, Jonas W, Lehtonen L, Westrup B. Mother-newborn couplet care: nordic country experiences of organization, models and practice. J Perinatol. 2023;43(Suppl 1):17\u201325.","journal-title":"J Perinatol"},{"issue":"1","key":"7039_CR43","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s12884-024-06323-3","volume":"24","author":"X Li","year":"2024","unstructured":"Li X, Li Y, Qian L, Han P, Feng H, Jiang H. Mothers\u2019 experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence. BMC Pregnancy Childbirth. 2024;24(1):124.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"7039_CR44","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1186\/1471-2393-13-179","volume":"13","author":"R Flacking","year":"2013","unstructured":"Flacking R, Dykes F. Being in a womb\u2019 or \u2018playing musical chairs\u2019: the impact of place and space on infant feeding in NICUs. BMC Pregnancy Childbirth. 2013;13(1):179.","journal-title":"BMC Pregnancy Childbirth"},{"key":"7039_CR45","doi-asserted-by":"crossref","unstructured":"M\u00f6relius E, Sahl\u00e9n Helmer C, Hellgren M, Alehagen S. Supporting Premature Infants\u2019 Oral Feeding in the NICU-A Qualitative Study of Nurses\u2019 Perspectives. Child (Basel Switzerland). 2021;9(1).","DOI":"10.3390\/children9010016"},{"key":"7039_CR46","doi-asserted-by":"crossref","unstructured":"White RD, Consensus Committee on Recommended Design Standards for Advanced Neonatal C. Recommended standards for newborn ICU design, 9th edition. Journal of perinatology: official journal of the California Perinatal Association. 2020;40(Suppl 1):2\u20134.","DOI":"10.1038\/s41372-020-0766-2"},{"issue":"6","key":"7039_CR47","doi-asserted-by":"publisher","first-page":"e006973","DOI":"10.1136\/bmjopen-2014-006973","volume":"5","author":"M Bonet","year":"2015","unstructured":"Bonet M, Forcella E, Blondel B, Draper ES, Agostino R, Cuttini M, et al. Approaches to supporting lactation and breastfeeding for very preterm infants in the NICU: a qualitative study in three European regions. BMJ Open. 2015;5(6):e006973.","journal-title":"BMJ Open"},{"issue":"7","key":"7039_CR48","first-page":"Cd003743","volume":"2015","author":"CT Collins","year":"2015","unstructured":"Collins CT, Makrides M, McPhee AJ. Early discharge with home support of gavage feeding for stable preterm infants who have not established full oral feeds. Cochrane Database Syst Rev. 2015;2015(7):Cd003743.","journal-title":"Cochrane Database Syst Rev"},{"key":"7039_CR49","unstructured":"United Nations. Convention on the Rights of the Child. 1989."}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-07039-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-024-07039-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-024-07039-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T08:02:58Z","timestamp":1735200178000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-024-07039-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,26]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["7039"],"URL":"https:\/\/doi.org\/10.1186\/s12884-024-07039-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4593940\/v1","asserted-by":"object"}]},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,26]]},"assertion":[{"value":"17 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 December 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Health Research Authority East of England \u2013 Essex Research Ethics Committee (reference 21\/EE\/0144) approved the study. Informed consent was obtained from all subjects and all methods were carried out in accordance with the Declaration of Helsinki and relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"863"}}