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Sample records for late postpartum period

  1. Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

    PubMed Central

    Langan Martin, Julie; McLean, Gary; Cantwell, Roch; Smith, Daniel J

    2016-01-01

    Objective To describe weekly admission rates for affective and non-affective psychosis, major depression and other psychiatric disorders in the early and late postpartum periods. To assess the impact of socioeconomic status, age and parity on admission rates. Methods Scottish maternity records were linked to psychiatric hospital admissions. 3290 pregnancy-related psychiatric admissions were assessed. Weekly admission rates were calculated for the pregnancy period, early postpartum period (6 weeks after birth) and late postpartum period (up to 2 years after birth), and compared with pre-pregnancy rates (up to 2 years before pregnancy). Admission rates were generated by calculating the total number of admissions for each time period divided by the number of weeks in the period. Incidence rate ratios (IRRs) were generated for each time period, using deprivation, age, parity and record of previous psychiatric hospital care-adjusted Poisson regression models. Results Women from more deprived social quintiles accounted for the largest proportion of admissions across all time periods. Compared with pre-pregnancy period, admission rates fell during pregnancy, increased markedly during the early postpartum period, and remained elevated for 2 years after childbirth. Within the most affluent quintile, admission IRRs were higher in the early postpartum period (IRR=1.29, 95% CI 1.02 to 1.59) than in the late postpartum period (IRR=0.87, 95% CI 0.74 to 0.98). For the late postpartum period, there was a positive association between higher maternal age and admission IRRs (ages 20–35 years, IRR=1.35, 95% CI 1.16 to 1.54 and age>40 years IRR=1.72, 95% CI 1.41 to 2.09). Conclusions Rates of psychiatric admission fell during pregnancy and increased in the early postpartum period (particularly during the first 2 weeks after birth), and remained elevated above baseline during the 2-year late postpartum period. An understanding of how social deprivation, age and parity might influence risk of psychiatric admission at different time points could help to target perinatal mental health services more effectively. PMID:26733566

  2. The postpartum period in women with epilepsy.

    PubMed

    Klein, Autumn

    2012-08-01

    For women with epilepsy (WWE), the postpartum period is a vulnerable time owing to medication alterations, disrupted sleep, increased stress, and the challenges of breastfeeding. Sleep deprivation and the stress of having a new child can be challenging for WWE. Concerns over antiepileptic drugs (AEDs) in breast milk and sleep disruption associated with breastfeeding leads some WWE to discontinue breastfeeding. Adjustment of AEDs in the postpartum period can lead to difficulties in seizure control. Postpartum depression is increased in WWE, and patient education about newborn safety remains a concern. This article covers these important topics in postpartum WWE. PMID:22840793

  3. [Endocrinopathies during the postpartum period. Management].

    PubMed

    Gallo-Vallejo, J L; Gallo-Vallejo, F J

    2015-03-01

    The various endocrinopathies that may occur during the postpartum period are described. The most important and common is gestational and pre-gestational diabetes, but other less common, and also very important ones, are mentioned such as hypopituitarism (Sheehan's syndrome and lymphocytic hypophysitis) and thyroid disorders, pre-existing (hyperthyroidism and hypothyroidism), or postpartum onset (postpartum thyroiditis and Graves' disease). After describing their characteristics, the emphasis is placed on the proper management of these endocrine diseases, some of them which exclusively appear during the postpartum period. PMID:24837528

  4. Disposition of firocoxib in late pregnant and early postpartum mares.

    PubMed

    Giguère, S; Macpherson, M L; Benson, S M; Cox, S; McNaughten, J W; Pozor, M A

    2016-04-01

    Pregnancy induces several physiologic changes that might impact the bioavailability, distribution, metabolism, and excretion of drugs. The objective of this study was to determine the effects of pregnancy on the disposition of oral firocoxib in mares. Seven pony mares received oral firocoxib paste at a dose of 0.1 mg/kg during late pregnancy and again 12 to 33 days postpartum. Firocoxib concentrations were measured in plasma by HPLC with ultraviolet detection. Maximum plasma concentrations were significantly lower in pregnant (50.0 ± 21.8 ng/mL) than in postpartum (73.7 ± 25.6 ng/mL) mares. Plasma concentrations 24 h after administration, time to maximum plasma concentrations, and area under the plasma concentration versus time curve were not significantly different between late pregnancy and the postpartum period in mares. PMID:26202842

  5. Comfort with motherhood in late pregnancy facilitates maternal role attainment in early postpartum.

    PubMed

    Nakamura, Yasuka; Takeishi, Yoko; Ito, Naoko; Ito, Mizuki; Atogami, Fumi; Yoshizawa, Toyoko

    2015-01-01

    Quality of life, comfort, and wellbeing during pregnancy are essential for every country in the world. Pregnancy is considered a preparation period for becoming a mother. Maternal role development, including confidence and satisfaction as a mother, is important in the transition to motherhood. Negative psychosocial affect, such as increased anxiety and distress, during pregnancy adversely influences the childbirth experience and childcare, which contributes to postpartum depression. However, the impact of positive feelings on the maternal role development remains unclear. Therefore, the study purpose was to clarify the relationship between comfort in late pregnancy and maternal role attainment and childcare during early postpartum. We designed a descriptive, longitudinal, correlational study by using the Prenatal Comfort Scale, the Postpartum Maternal Role Confidence Scale, and the Postpartum Maternal Satisfaction Scale. Among 339 participants who had received care at a university hospital located in Sendai city in Japan, 215 subjects completed the longitudinal study by answering a questionnaire for the respective Scale late in their pregnancy or during early postpartum. The subjects consisted of 114 primipara (32.0 5.4 years) and 101 multipara (33.4 4.9 years). In primipara, comfort with motherhood was significantly correlated with maternal confidence regarding knowledge and childcare skills and maternal satisfaction. In multipara, comfort in late pregnancy was related to maternal confidence and satisfaction. Positive affect was related to maternal confidence and maternal satisfaction in early postpartum. Therefore, a prenatal nursing intervention helps women become more comfortable with impending motherhood, thereby promoting maternal role attainment after delivery. PMID:25744529

  6. Babinski-Nageotte Syndrome Diagnosed in Postpartum Period

    PubMed Central

    Oruç, Serdar; Demirbaş, Hayri; Güzel, Abdullah; Beker Acay, Mehtap; Yaman, Mehmet

    2016-01-01

    Babinski-Nageotte Syndrome (BNS) is one of the brainstem syndromes characterized by muscle weakness in the opposite half of the body with classic Wallenberg findings. According to our literature survey, only a few cases have been reported and none of them was in the postpartum period. We report a case of a typical BNS in a postpartum woman with an ischemic lesion in the medulla oblongata shown on magnetic resonance imaging. PMID:26989533

  7. Ovarian follicular activity during late gestation and postpartum in guanaco (Lama guanicoe).

    PubMed

    Riveros, J L; Schuler, G; Urquieta, B; Hoffmann, B; Bonacic, C

    2015-02-01

    This study evaluated ovarian activity in late gestation and post-partum in guanacos in captivity. Follicular dynamics was monitored every second day from 40 days before and other 40 after delivery by transrectal sonography and by plasma steroids concentrations. Seven out of eight (87.5%) of gestating females presented ovarian follicular activity under progesterone levels >3 nmol/l with maximum follicular size of 8.42 0.83 mm from days 23 to 1 before delivery. After delivery, all females have follicular wave development from day 0 to 38, with larger follicular size and longer follicular wave phases and interwave interval when compared with pre-partum data. During post-partum period, there was a close relationship between follicle size and estradiol-17? concentration, with r = 0.69 at the beginning of growth phase and r = 0.86 in association with the largest dominant follicle. Plasma estradiol-17? concentration varied from 11.92 to 198.55 pmol/l. Plasma estrone sulfate, free estrone and progesterone returned to baseline concentrations during peripartal period and remained basal thereafter. The results described follicular activity during late gestation and early post-partum period. These findings provide relevant information to understand physiological changes occurring during this reproductive key period in seasonal breeders with long gestation duration as New and Old World camelids. PMID:25528969

  8. Transitions in the early-life of late preterm infants: vulnerabilities and implications for postpartum care.

    PubMed

    Premji, Shahirose Sadrudin; Young, Marilyn; Rogers, Carol; Reilly, Sandra

    2012-01-01

    The focus of this article is on the transition of late preterm infants from hospital to home. The current state of literature related to mortality, morbidities, emergency department visits, and rehospitalization underscores the vulnerability of late preterm infants following discharge from hospital. Universal provision of postpartum care to late preterm infants is viewed as an environmental support intended to facilitate transition of these vulnerable infants from hospital to home. Gaps in provision of postpartum care of late preterm infants are situated within the discussion of guidelines and models of postpartum care (home vs clinic) of late preterm infants. PMID:22293643

  9. [The course of postpartum period after mandatory ambulatory labor].

    PubMed

    Kierkegaard, O; Engstrm, H; Naested, H; Briand, A

    1992-01-13

    Mandatory early discharge for all normal multiparae was introduced as a trial arrangement in the County of Ringkbing from 1.1.1990. A total of 113 early discharged women and 90 patients who remained in hospital participated in a questionnaire investigation comprising 41 questions about problems and need for support during the first postpartum period and about satisfaction with the postpartum period. A total of 64% of all the multiparae were early discharged and were discharged 4.2 hours after the delivery. On the whole, the women were satisfied with the postpartum period and only few problems in infants or mothers occurred. The early discharged group, however, as compared with the control group, stated that they had received less satisfactory support concerning breast-feeding (p less than 0.005) and that, in general, they had received less support from friends (p less than 0.01) and hospital staff (p = 0.04). The group of early discharged felt that they had received less satisfactory information (p less than 0.005) and, on the whole, they were less satisfied with the postpartum period (p less than 0.005). In addition, the group who were early discharged had 67% more telephone conversations with and 127% more visits from the midwife, health nurse or practitioner. PMID:1738950

  10. Women's Perceptions of Breastfeeding Barriers in Early Postpartum Period: A Qualitative Analysis Nested in Two Randomized Controlled Trials

    PubMed Central

    Barnett, Josephine; Bonuck, Karen

    2014-01-01

    Abstract Objectives: This study examined women's perceptions of early infant feeding experiences and identified early postpartum barriers to successful breastfeeding. Subjects and Methods: We conducted semistructured exit interviews at 6 months postpartum with a subsample of participants (n=67) enrolled in two randomized controlled trials of breastfeeding promotion. Study arms included (1) routine pre- and postnatal visits with an International Board Certified Lactation Consultant (IBCLC) (LC group), (2) electronically prompted guidance from prenatal care providers (EP group), (3) EP+LC combined, and (4) standard of care (control group). Interview transcripts were coded using grounded theory and analyzed in MAXqda. Code matrices were used to identify early postpartum breastfeeding barriers and were further examined in relation to treatment group using a mixed methods analysis. Results: The majority of the participants reported experiencing at least one barrier to breastfeeding. Barriers to breastfeeding were more commonly reported in the early postpartum than late postpartum period. The most common barrier during the early postpartum period was the perception of inadequate milk supply (“lactational”) (n=18), followed by problems with latch, medical problems that were perceived as precluding breastfeeding, and medical staff and hospital practices. Participants frequently reported that the IBCLCs assisted them in anticipating, managing, and overcoming these barriers. Conclusions: Our findings underscore the importance of integrating IBCLCs into routine pre- and postpartum care because they provide critical support that effectively addresses early postpartum barriers to breastfeeding. PMID:24304033

  11. Cortical visual loss in posterior reversible encephalopathy syndrome in late postpartum eclampsia: Case series

    PubMed Central

    Karuppannasamy, Divya; Vikrant, K; Raghuram, A; Kumaar, T M Sathish

    2014-01-01

    The purpose of this study was to determine the prevalence of visual disturbances in patients with posterior reversible encephalopathy syndrome (PRES) associated with late postpartum eclampsia. We retrospectively reviewed the clinical records of late postpartum eclampsia patients with features of PRES for the presence of visual disturbances and location of radiological abnormalities. We found a higher prevalence of cortical visual loss in patients with PRES associated with late postpartum eclampsia. Bilateral symmetrical vasogenic edema of the parieto-occipital lobe was the most common magnetic resonance imaging (MRI) abnormality noted. No significant differences were observed in the extent of edema in patients with and without visual loss. PMID:24881617

  12. Reassessing Unmet Need for Family Planning in the Postpartum Period.

    PubMed

    Rossier, Clémentine; Bradley, Sarah E K; Ross, John; Winfrey, William

    2015-12-01

    Despite renewed interest in postpartum family planning programs, the question of the time at which women should be expected to start contraception after a birth remains unanswered. Three indicators of postpartum unmet need consider women to be fully exposed to the risk of pregnancy at different times: right after delivery (prospective indicator), after six months of amenorrhea (intermediate indicator), and at the end of amenorrhea (classic indicator). DHS data from 57 countries in 2005-13 indicate that 62 percent (prospective), 43 percent (intermediate), and 32 percent (classic) of women in the first year after a birth have an unmet need for contraception (40 percent when including abstinence). While the protection afforded by postpartum abstinence and lactational amenorrhea lowers unmet need, further analysis shows that women also often rely on these methods without being actually protected. Programs should acknowledge these methods' widespread use and inform women about their limits. Also, the respective advantages of targeting the postnatal period, the end of six months of amenorrhea/exclusive breastfeeding, or the resumption of sexual intercourse to offer contraceptive services should be tested. PMID:26643487

  13. Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women.

    PubMed

    Nakić Radoš, Sandra; Herman, Radoslav; Tadinac, Meri

    2016-01-01

    The researchers' aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period. PMID:25558954

  14. Use of psychotropic medication during pregnancy and the postpartum period.

    PubMed

    Pearlstein, Teri

    2013-11-01

    Women with active psychiatric disorders who become pregnant face treatment dilemmas. Although results from studies are inconsistent, small but significant, risks on birth outcomes occur with exposure to untreated disorders, as well as to psychotropic medications. Prenatal antidepressant medication exposure may increase the risk for spontaneous miscarriage, preterm birth, cardiac malformations, persistent pulmonary hypertension of the newborn and postnatal adaptation syndrome. The use of valproate is contraindicated during pregnancy due to teratogenicity and neurocognitive delay and deficits. This review of selected studies will highlight some of the current issues with the use of psychotropic medications during pregnancy and the postpartum period. PMID:24161312

  15. Posterior Reversible Encephalopathy Syndrome in late postpartum eclampsia.

    PubMed

    Pezzi, M; Le Piane, E; Giglio, A M; Pagnotta, L; Scozzafava, A; Tortorella, V; Sergi, A; Verre, M

    2015-01-01

    Posterior Reversible Encephalopathy Syndrome (PRES) is a neurological complication associated with several medical conditions and it has been described in clinical findings of seizures, headache, vomiting, altered mental status, and visual changes and focal neurologic deficit, in conjunction with radiological findings of primarily posterior cerebral white matter edema of both cerebral hemispheres. PRES can develop in a wide array situations including pregnancy and postpartum in patients with or without symptoms and signs of eclampsia. A prompt diagnosis of PRES by magnetic resonance imaging and an immediate antihypertensive and anticonvulsant therapy can help to prevent serious complications. The clinical case presented deals with a 35 year-old pregnant woman whose history of eclampsia was observed after a cesarean section. PMID:25945433

  16. Altering ewe nutrition in late gestation: I. The impact on pre- and postpartum ewe performance.

    PubMed

    McGovern, F M; Campion, F P; Lott, S; Boland, T M

    2015-10-01

    The present study was conducted to examine the effects of offering a single diet rationed to 80% (80% ME), 100% (100% ME), or 120% (120% ME) of recommended ME requirements from d 119 of gestation to lambing, with concurrent changes in other dietary nutrients. The effects on pre- and postpartum ewe performance, including estimated milk yield and milk fatty acid concentrations, were monitored. Sixty twin-bearing ewes were allocated to 1 of 3 dietary treatments ( = 20 per treatment) and individually fed for the final 4 wk of gestation. Metabolizable energy requirements were individually calculated for each ewe and amended according to treatment. Ewes were rationed daily on the basis of their treatment ME allocation, which led to concurrent alterations in other nutrient intakes. Diets were grass silage based and supplemented with concentrates to meet treatment ME allocation on an individual ewe basis. Ewes offered the 80% ME treatment had a lower liveweight ( = 0.04) and BCS ( = 0.03) at 24 h postpartum when compared with ewes offered the 120% ME diet. Although there was no difference in liveweight at either d 40 ( = 0.18) or 98 postpartum ( = 0.20), the difference in BCS persisted until d 40 postpartum ( = 0.02). Colostrum yield at 1 h postpartum ( = 0.03) and total yield up to 18 h postpartum ( = 0.04) was greater for ewes offered the 120% ME diet than either of the other treatment groups. Similarly, these ewes had a greater estimated milk yield during wk 3 of lactation ( = 0.04) and elevated concentrations of short-chain SFA ( = 0.02) and long-chain SFA ( ? 0.05) from wk 2 through 6 of lactation. In summary, the negative impact of applying a dietary insult to ewes in late gestation is reflected in colostrum and estimated milk yield and fatty acid composition, thus potentially influencing postpartum growth and development of the offspring. PMID:26523579

  17. The Broken Thread of Health Promotion and Disease Prevention for Women During the Postpartum Period

    PubMed Central

    Walker, Lorraine O.; Murphey, Christina L.; Nichols, Francine

    2015-01-01

    ABSTRACT Postpartum maternal health affects maternal functional status, future pregnancy outcomes, maternal chronic disease development, and infant health. After pregnancy, however, many mothers may find that they face gaps in care related to their health and caregiving roles. Research shows that they were unprepared, uninformed, and unsupported during the postpartum period as they struggle with physical and emotional symptoms, infant caregiving, breastfeeding concerns, and lifestyle adjustments. Limited follow-up after a diagnosis of gestational hypertension or gestational diabetes and screening for postpartum depression are additional gaps in preventive and supportive care. Integrative reviews revealed modest efficacy and limitations of recent postpartum health promotion and disease prevention interventions. System, clinical, and community strategies are identified to address these gaps in women’s postpartum health services. PMID:26957891

  18. Characteristics of mothers with depressive symptoms outside the postpartum period.

    PubMed

    Rosenthal, David G; Learned, Nicole; Liu, Ying-Hua; Weitzman, Michael

    2013-08-01

    Numerous studies have investigated the deleterious effects of maternal depression on child outcomes. Knowledge of characteristics of these mothers is incomplete, as most studies utilize small samples or limit investigation to the postpartum period. Utilizing data from a nationally representative sample of 7,211 fathers and mothers living in households with children aged 5-17 years who participated in the Medical Expenditure Panel Survey (MEPS) 2004-2006, the Patient Health Questionnaire-2 (PHQ-2) was used to assess parental depressive symptoms, the Short Form-12 (SF-12) was used to examine paternal and maternal physical health, and the Columbia Impairment Scale was used to measure child behavioral or emotional problems. In multivariate analyses, maternal unemployment (AOR 1.76, 95 % CI 1.31-2.35); living with smokers (AOR 1.82, 95 % CI 1.12-2.94); poor maternal physical health (AOR 2.31; 95 % CI 1.81-2.94); living with children with behavioral or emotional problems (AOR 2.95, 95 % CI 2.30-3.96); and paternal depressive symptoms (AOR 5.11, 95 % CI 1.97-13.25) each were independently associated with increased rates of maternal depressive symptoms. This paper is the first we are aware of to use a nationally representative sample to investigate characteristics associated with maternal depressive symptoms and found that maternal unemployment, living with smokers, poor maternal physical health, having children with behavioral or emotional problems, and paternal depressive symptoms are each independently associated with maternal depressive symptoms. In these data, paternal depressive symptoms are associated with the greatest risk of mothers exhibiting depressive symptoms, a finding that we believe has never before been shown. PMID:22878534

  19. Successful Intra-Arterial Thrombolysis for Acute Ischemic Stroke in the Immediate Postpartum Period: Case Report

    SciTech Connect

    Mendez, Jose C. Masjuan, J.; Garcia, N.; Lecinana, M. de

    2008-01-15

    Stroke in pregnancy and the puerperium is a rare but potentially devastating event. We present the case of a previously healthy woman who underwent a cesarean delivery and experienced a middle cerebral artery thrombosis in the immediate postpartum period that was subsequently lysed with intra-arterial urokinase. The patient made a complete neurologic recovery. To the best of our knowledge, this is the first reported case of successful intra-arterial thrombolysis for ischemic stroke in the postpartum period.

  20. High serum testosterone levels during postpartum period are associated with postpartum depression.

    PubMed

    Aswathi, A; Rajendiren, Soundravally; Nimesh, Archana; Philip, R Ravi; Kattimani, Shivanand; Jayalakshmi, D; Ananthanarayanan, P H; Dhiman, Pooja

    2015-10-01

    In view of the reported cases of mood disorders that occur in mothers following childbirth and believing that sex steroid hormones contribute to mood and behavioral changes, this study has been aimed to explore the role of sex steroid hormones as an etiological factor for postpartum depression (PPD). This study was conducted at JIPMER, Puducherry, India between January 2010 and 2011. 103 women were recruited in the study after childbirth, out of which 62 women who were believed to be suffering from PPD were categorized as cases and the remaining 41 with no mood changes as controls, using Edinburgh Postpartum Depression Scale (EPDS) (cases had EPDS score ?10 at 24-28h, controls had score <10 at 24-48h postpartum). The hormones estimated in these two groups included estradiol, progesterone and testosterone, and their levels were compared between these two groups. A significantly high testosterone levels were observed in cases with PPD at 24-28h when compared to controls. Estradiol and progesterone levels did not show significant difference between cases and controls. ROC analysis done at 24-28h showed that testosterone levels beyond 42.71ng/mL predict the development of PPD with 79% sensitivity, 63% specificity, 68% positive predictive value, 74% negative predictive value with AUC being 0.708. This study shows that there is an association between persistent high serum testosterone level in women following childbirth and PPD. PMID:26372084

  1. Social support during the postpartum period: Mothers’ views on needs, expectations, and mobilization of support

    PubMed Central

    Negron, Rennie; Martin, Anika; Almog, Meital; Balbierz, Amy; Howell, Elizabeth A.

    2012-01-01

    Objectives Research has indicated that social support is a major buffer of postpartum depression. Yet little is known concerning women’s perceptions on social support during the postpartum period. The objective of this study was to explore postpartum women’s views and experiences with social support following childbirth. Methods Four focus groups were conducted with an ethnically diverse sample of women (n=33) in a large urban teaching hospital in New York City. Participants had completed participation in a postpartum depression randomized trial and were 6 to 12 months postpartum. Data transcripts were reviewed and analyzed for themes. Results The main themes identified in the focus group discussions were mother’s major needs and challenges postpartum, social support expectations and providers of support, how mothers mobilize support, and barriers to mobilizing support. Women across all groups identified receipt of instrumental support as essential to their physical and emotional recovery. Support from partners and families was expected and many women believed this support should be provided without asking. Racial/ethnic differences existed in the way women from different groups mobilized support from their support networks. Conclusions Instrumental support plays a significant role in meeting women’s basic needs during the postpartum period. In addition, women’s expectations surrounding support can have an impact on their ability to mobilize support among their social networks. The results of this study suggest that identifying support needs and expectations of new mothers is important for mothers’ recovery after childbirth. Future postpartum depression prevention efforts should integrate a strong focus on social support. PMID:22581378

  2. A Counselor's Primer on Postpartum Depression.

    ERIC Educational Resources Information Center

    Pfost, Karen S.; And Others

    1990-01-01

    Notes that women are particularly vulnerable to depression during the postpartum period. Distinguishes postpartum depression from normal postpartum adjustment, postpartum blues, and postpartum psychosis. Describes biological, psychodynamic, and diathesis-stress perspectives on postpartum depression. Encourages counselors to fashion individualized

  3. The pharmacogenetics of codeine pain relief in the postpartum period.

    PubMed

    Baber, M; Chaudhry, S; Kelly, L; Ross, C; Carleton, B; Berger, H; Koren, G

    2015-10-01

    The objective of this study was to examine interindividual variability in codeine requirements and pain management by examining select genetic polymorphisms in the codeine pharmacological pathway. The study included a nested cohort of 98 women who were prescribed codeine following cesarean section. Participants were genotyped for select polymorphisms of the COMT, ABCB1, CYP2D6, UGT2B7 and OPRM1 genes and instructed to describe their level of pain using the visual analog scale (mm) 1?h following each dose of codeine. Analysis revealed that reported pain increases with maternal age (P=0.041). Asians required more codeine than Caucasians (P=0.048). Significant differences in mean dose consumption were seen among the genotypic groups of the OPRM1 A118G (P=0.001) and UGT2B7 C802T (P=0.015) variants. These variants were found to predict codeine consumption in the cohort overall (P=0.000) and among Caucasians (P=0.001). These findings will assist in customizing therapy to effectively manage postpartum pain. PMID:25752520

  4. Relationship between Fathers' Depression and Perceived Social Support and Stress in Postpartum Period

    PubMed Central

    Kamalifard, Mahin; Hasanpoor, Shirin; Babapour Kheiroddin, Jalil; Panahi, Samira; Bayati Payan, Somayeh

    2014-01-01

    Introduction: The evidence suggests that some men experience depression after the childbirth of their wife, and this real and unknown phenomenon will adversely affect them as well as their families. Regarding the lack of understanding about the paternal depression and its complex and multifaceted etiology, the present study was done to assess the paternal postpartum depression and its relationship with perceived stress and social support components. Methods: In this descriptive study, 205 new fathers were assessed from 6th to 12th week postpartum in seven health centers, affiliated to Shahid Beheshti University. Collected data with the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, and the Perceived Social Support Scale were analyzed by descriptive statistics, correlation tests and linear regression analysis. Results: 11.7% of the fathers scored 12 or above in the Edinburgh scale, which indicated depression symptom. The postnatal depression scores had a significant positive correlation with the perceived stress scores and a significant negative correlation with the perceived social support components scores. Perceived stress was key predictor of paternal postpartum depression. Perceived social support components cannot significantly predict the paternal postpartum depression. Conclusion: Assessment of paternal postpartum depression and its risk factors is recommended. Healthcare providers should pay more attention to the increasing public awareness, stress management and communication skills training, and support of fathers during the postnatal period. PMID:25276749

  5. Imaging manifestations of a dreaded obstetric complication in the immediate postpartum period

    PubMed Central

    Zarghouni, Mehrzad; Cannon, Walter

    2014-01-01

    HELLP (hemolysis, elevated liver enzymes, low platelet) syndrome is a dreaded complication that may develop during pregnancy or in the immediate postpartum period. Rarely this syndrome manifests itself with imaging findings. We report a case of HELLP syndrome in which the diagnosis was reaffirmed via imaging findings. PMID:24688204

  6. Lymph Region in the Female Internal Reproductive Organs during the Early Postpartum Period after Normal Pregnancy.

    PubMed

    Dergacheva, T I; Borodin, Yu I; Gorchakov, V N; Konenkov, V I

    2015-11-01

    The structural and functional changes in the lymph region of the female internal reproductive organs in rats were studied during the early postpartum period after normal pregnancy. The results indicated that the main role of the lymph region in pregnancy consisted in supporting sufficient lymph production and drainage in the hypertrophic uterus. PMID:26601833

  7. The relation between prepregnancy sexuality and sexual function during pregnancy and the postpartum period: a prospective study.

    PubMed

    Y?ld?z, Hatice

    2015-01-01

    This study examined the relation between sexual functions of women in prepregnancy (before conception) and during pregnancy and the postpartum period. This study was conducted on 59 healthy pregnant women. Participants were followed from the eighth week of gestation to 6 months after delivery. Sexual function during pregnancy and the postpartum period was shown to have a significant linear correlation with prepregnancy sexuality. There was no relation between pregnancy and postpartum sexuality. All of the participants who had prepregnancy sexual dysfunction continued to experience it during pregnancy, and the majority of them had a significant level of sexual dysfunction in the postpartum period. Our results showed that prepregnancy sexuality plays an important role in maintaining sexuality during pregnancy and the postpartum period. PMID:24328753

  8. Affective changes during the postpartum period: Influences of genetic and experiential factors.

    PubMed

    Agrati, Daniella; Lonstein, Joseph S

    2016-01-01

    This article is part of a Special Issue "Parental Care". The postpartum period involves some truly transformational changes in females' socioemotional behaviors. For most female laboratory rodents and women, these changes include an improvement in their affective state, which has positive consequences for their ability to sensitively care for their offspring. There is heterogeneity among females in the likelihood of this positive affective change, though, and some women experience elevated anxiety or depression (or in rodents anxiety- or depression-related behaviors) after giving birth. We aim to contribute to the understanding of this heterogeneity in maternal affectivity by reviewing selected components of the scientific literatures on laboratory rodents and humans examining how mothers' physical contact with her infants, genetics, history of anxiety and depression and early-life and recent-life experiences contribute to individual differences in postpartum affective states. These studies together indicate that multiple biological and environmental factors beyond female maternal state shape affective responses during the postpartum period, and probably do so in an interactive manner. Furthermore, the similar capacity of some of these factors to modulate anxiety and depression in human and rodent mothers suggests cross-species conservation of mechanisms regulating postpartum affectivity. PMID:26210061

  9. Effects of different anesthesia protocols on lactation in the postpartum period

    PubMed Central

    Kutlucan, Leyla; Seker, İlknur S.; Demiraran, Yavuz; Ersoy, Özlem; Karagöz, İbrahim; Sezen, Gülbin; Köse, Seyit Ali

    2014-01-01

    Objective Many factors can influence the secretion of breast milk. Cesarean section is a risk factor for late onset of breastfeeding. Material and Methods In our study, we compared the lactation process by mothers who underwent elective cesarean section under general anesthesia, spinal anesthesia, epidural anesthesia, and normal birth; 84 patients between 18–40 years of age with a risk of ASA I–II were included. Randomly patients were divided into four groups: group G (general anesthesia, n:21), group S (spinal anesthesia, n:21), group E (epidural anesthesia, n:21), and group V (vaginal birth, without anesthesia, n:21). Oxytocin and prolactin values of all patients before and after operation or birth were recorded. In addition the initiation time of lactation after delivery or cesarean section were recorded. Results In all groups, there were no significant differences among hormone levels in the prepartum period (p=0.350). Prolactin levels in group G (p=0.011) and oxytocin levels in group V (p=0.012) in the postpartum period were significantly higher than in the other groups. The start of lactation was significantly delayed in group G (p=0.003). Conclusion We consider that the onset time of lactation is delayed in patients undergoing cesarean section with general anesthesia when compared with patients who undergo cesarean section with spinal and epidural anesthesia and with patients who undergo normal vaginal birth. Because of the delay of awakening and recovery of cognitive functions in general anesthesia, communication between the mother and the newborn is delayed and so is the lactation. PMID:25584032

  10. Neurogenesis and anxiety-like behavior in male California mice during the mate's postpartum period.

    PubMed

    Hyer, M M; Hunter, T J; Katakam, J; Wolz, T; Glasper, E R

    2016-03-01

    Our understanding of postpartum anxiety (PPA) in fathers is limited, despite the negative consequences of anxiety on the father and child. Offspring contact reduces PPA in mothers; however, parallel investigations in fathers has gone unaddressed. Adult neurogenesis in the dentate gyrus (DG) contributes to anxiety regulation and is altered during the postpartum period, yet the effects of fatherhood on the production, or survival, of newborn cells in the DG, and the role of adult neurogenesis in PPA regulation, have not been examined. Using the biparental California mouse (Peromyscus californicus), we examined the relationships among postnatal day, anxiety-like behavior and adult neurogenesis in fathers. We hypothesized that attenuated anxiety-like behavior and enhanced adult neurogenesis would be observed when father-offspring contact was increased. We observed a reduction in anxiety-like behavior on the elevated plus-maze, but only at PND 16, a time of peak pup retrieval. Fatherhood reduced 1-week survival of newborn cells; however, surviving cells were maintained until 2 weeks postpartum. In contrast, non-fathers experienced a significant reduction in the survival of newborn cells between 1 and 2 weeks postpartum. Fatherhood also increased the numbers of newborn cells that expressed a neuronal phenotype. Collectively, these findings suggest that offspring interaction contributes to reductions in anxiety-like behavior and the maintenance of newborn neurons in the DG of fathers. These data contribute to our knowledge of the postpartum affective state in fathers, findings that may contribute to improved health of both the father and offspring. PMID:26750200

  11. Aggressive vertebral hemangioma in the postpartum period: an eye-opener

    PubMed Central

    Jain, Rajendra Singh; Agrawal, Rakesh; Srivastava, Trilochan; Kumar, Sunil; Gupta, Pankaj Kumar; Kookna, Jagdeesh Chandra

    2014-01-01

    Pregnancy is a well-known risk factor for incidental or asymptomatic vertebral hemangiomas becoming aggressive or symptomatic, most often during the third trimester of pregnancy, related to hemodynamic and endocrinal changes occurring during pregnancy. Many patients show spontaneous incomplete remission after delivery. We report a rare case of aggressive vertebral hemangioma in the postpartum period in a 26-year-old woman, who presented with upper backache with progressive spastic paraparesis. PMID:25988053

  12. Postpartum Mood Disorders

    PubMed Central

    Misri, Shaila; Burgmann, Allan J.F.

    1992-01-01

    Adjusting to the role of mother, a creative and joyous change for most women, combines with simultaneous physiological and psychological changes to develop into psychiatric problems in some women. Three common syndromes during the postpartum period are postpartum blues, postpartum depression, and postpartum psychosis. Any postpartum condition should be diagnosed rapidly to prevent short- and long-term disorders. PMID:21221273

  13. Personal Care Product Use in Pregnancy and the Postpartum Period: Implications for Exposure Assessment

    PubMed Central

    Lang, Carly; Fisher, Mandy; Neisa, Angelica; MacKinnon, Leona; Kuchta, Sandra; MacPherson, Susan; Probert, Adam; Arbuckle, Tye E.

    2016-01-01

    Concern regarding the potential for developmental health risks associated with certain chemicals (e.g., phthalates, antibacterials) used in personal care products is well documented; however, current exposure data for pregnant women are limited. The objective of this study was to describe the pattern of personal care product use in pregnancy and the post-partum period. Usage patterns of personal care products were collected at six different time points during pregnancy and once in the postpartum period for a cohort of 80 pregnant women in Ottawa, Canada. The pattern of use was then described and groups of personal care product groups commonly used together were identified using hierarchical cluster analysis. The results showed that product use varied by income and country of birth. General hygiene products were the most commonly used products and were consistently used over time while cosmetic product use declined with advancing pregnancy and post-delivery. Hand soaps and baby products were reported as used more frequently after birth. This study is the first to track personal care product use across pregnancy and into the postpartum period, and suggests that pregnant populations may be a unique group of personal care product users. This information will be useful for exposure assessments. PMID:26751460

  14. Personal Care Product Use in Pregnancy and the Postpartum Period: Implications for Exposure Assessment.

    PubMed

    Lang, Carly; Fisher, Mandy; Neisa, Angelica; MacKinnon, Leona; Kuchta, Sandra; MacPherson, Susan; Probert, Adam; Arbuckle, Tye E

    2016-01-01

    Concern regarding the potential for developmental health risks associated with certain chemicals (e.g., phthalates, antibacterials) used in personal care products is well documented; however, current exposure data for pregnant women are limited. The objective of this study was to describe the pattern of personal care product use in pregnancy and the post-partum period. Usage patterns of personal care products were collected at six different time points during pregnancy and once in the postpartum period for a cohort of 80 pregnant women in Ottawa, Canada. The pattern of use was then described and groups of personal care product groups commonly used together were identified using hierarchical cluster analysis. The results showed that product use varied by income and country of birth. General hygiene products were the most commonly used products and were consistently used over time while cosmetic product use declined with advancing pregnancy and post-delivery. Hand soaps and baby products were reported as used more frequently after birth. This study is the first to track personal care product use across pregnancy and into the postpartum period, and suggests that pregnant populations may be a unique group of personal care product users. This information will be useful for exposure assessments. PMID:26751460

  15. Postpartum responses of dairy cows supplemented with n-3 fatty acids for different durations during the peripartal period.

    PubMed

    Badiei, A; Aliverdilou, A; Amanlou, H; Beheshti, M; Dirandeh, E; Masoumi, R; Moosakhani, F; Petit, H V

    2014-10-01

    The objective of this study was to determine the effect of different durations of n-3 supplementation during the peripartal period on production and reproduction performance of Holstein dairy cows. Thirty-two Holstein dry cows (16 multiparous and 16 primiparous) were blocked within parity for similar expected calving dates 8 wk before calving. Cows within blocks were assigned randomly to 1 of 4 treatments: (1) control without n-3 fatty acid (FA) supplementation during the dry period; (2) n-3 FA supplementation during the whole dry period (8 wk); and (3) n-3 FA supplementation during the early dry period (first 5 wk; far-off), or (4) n-3 FA supplementation during the late dry period (last 3 wk; close-up). All cows received the same diet without n-3 FA after calving for the first 6 wk of lactation. Ovaries of each cow were examined 10, 17, 24, and 34 d from calving (calving=d 0) by transrectal ultrasonography to determine follicular development. Blood samples were collected at 14-d intervals starting on the first day of the dry period (8 wk before expected calving) to determine plasma concentrations of glucose, ?-hydroxybutyrate, nonesterified fatty acids, urea N, aspartate aminotransferase, and insulin. Blood samples were also collected on d 1, 10, 17, 24, 31, and 38 postpartum for determination of progesterone concentration. Milk yield was recorded daily throughout the experiment and samples were taken twice weekly (Monday and Thursday mornings) for analysis of fat, protein, and lactose. Yields of milk and 4% fat-corrected milk and milk composition were similar among treatments except for fat proportion, which tended to be lower in cows that were fed n-3 FA throughout the dry period. We observed no differences among treatments for plasma concentrations of metabolites and hormones. The cows that were fed in the 3 n-3 FA treatments had larger ovulatory follicles compared with those fed the controlled diet. Treatments did not differ significantly in terms of the number of days open, day to first service, or number of services per pregnancy. In conclusion, n-3 FA supplementation throughout the dry period or in the early or late prepartal period had no carryover reproductive postpartum benefits and no effect on the production of Holstein dairy cows. PMID:25064653

  16. Reversal of Peripheral Nerve Injury-induced Hypersensitivity in the Postpartum Period: Role of Spinal Oxytocin

    PubMed Central

    Gutierrez, Silvia; Liu, Baogang; Hayashida, Ken-ichiro; Houle, Timothy T.; Eisenach, James C.

    2012-01-01

    Background Physical injury, including surgery, can result in chronic pain; yet chronic pain following childbirth, including cesarean delivery in women, is rare. The mechanisms involved in this protection by pregnancy or delivery have not been explored. Methods We examined the effect of pregnancy and delivery on hypersensitivity to mechanical stimuli of the rat hindpaw induced by peripheral nerve injury (spinal nerve ligation) and after intrathecal oxytocin, atosiban and naloxone. Additionally, oxytocin concentration in lumbar spinal cerebrospinal fluid was determined. Results Spinal nerve ligation performed at mid-pregnancy resulted in similar hypersensitivity to nonpregnant controls, but hypersensitivity partially resolved beginning after delivery. Removal of pups after delivery prevented this partial resolution. Cerebrospinal fluid concentrations of oxytocin were greater in normal postpartum rats prior to weaning. To examine the effect of injury at the time of delivery rather than during pregnancy, spinal nerve ligation was performed within 24 h of delivery. This resulted in acute hypersensitivity that partially resolved over the next 23 weeks. Weaning of pups resulted only in a temporary return of hypersensitivity. Intrathecal oxytocin effectively reversed the hypersensitivity following separation of the pups. Postpartum resolution of hypersensitivity was transiently abolished by intrathecal injection of the oxytocin receptor antagonist, atosiban. Conclusions These results suggest that the postpartum period rather than pregnancy protects against chronic hypersensitivity from peripheral nerve injury and that this protection may reflect sustained oxytocin signaling in the central nervous system during this period. PMID:23249932

  17. Validity of depression rating scales during pregnancy and the postpartum period: impact of trimester and parity.

    PubMed

    Ji, Shuang; Long, Qi; Newport, D Jeffrey; Na, Hyeji; Knight, Bettina; Zach, Elizabeth B; Morris, Natalie J; Kutner, Michael; Stowe, Zachary N

    2011-02-01

    The objective of the current study was to delineate the optimal cutpoints for depression rating scales during pregnancy and the postpartum period and to assess the perinatal factors influencing these scores. Women participating in prospective investigations of maternal mental illness were enrolled prior to 28 weeks gestation and followed through 6 months postpartum. At each visit, subjects completed self-rated depression scales--Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) and clinician-rated scales--Hamilton Rating Scale for Depression (HRSD(17) and HRSD(21)). These scores were compared to the SCID Mood Module for the presence of fulfilling diagnostic criteria for a major depressive episode (MDE) during 6 perinatal windows: preconception; first trimester; 2nd trimester; 3rd trimester; early postpartum; and later postpartum. Optimal cutpoints were determined by maximizing the sum of each scale's sensitivity and specificity. Stratified ROC analyses determined the impact of previous pregnancy and comparison of initial to follow-up visits. A total of 534 women encompassing 640 pregnancies and 4025 follow-up visits were included. ROC analysis demonstrated that all 4 scales were highly predictive of MDE. The AUCs ranged from 0.857 to 0.971 and were all highly significant (p < .0001). Optimal cutpoints were higher at initial visits and for multigravidas and demonstrated more variability for the self-rated scales. These data indicate that both clinician-rated and self-rated scales can be effective tools in identifying perinatal episodes of major depression. However, the results also suggest that prior childbirth experiences and the use of scales longitudinally across the perinatal period influence optimal cutpoints. PMID:20542520

  18. Uterine involution and progesterone level during the postpartum period in Barbary ewes in north Libya

    PubMed Central

    Medan, M.S.; EL-Daek, T.

    2015-01-01

    The objectives of the present study were to determine the time of uterine involution and ovarian activity using ultrasound examination and progesterone assay. Weekly progesterone levels were measured starting one week postpartum until two weeks after the 1st postpartum estrus in Barbary ewes lambed during winter in AL-Bayda city, north of Libya. A total of 15 Barbary ewes were used in the present study distributed in three groups according to the month of lambing as group 1 (lambed in January), group 2 (lambed in February) and group 3 (lambed in March). Ewes were examined weekly by trans-rectal ultrasound to check involution of the uterus starting one week after lambing until complete uterine involution. Blood samples were collected from the jugular vein, and serum was separated and stored at -20 C until measuring progesterone using ELISA. Results showed that uterine involution completed at day 35 postpartum in groups 1 and 2, while it occurred at day 28 in group 3. The mean progesterone level was basal (less than 1 ng/ml) for a long period and started to increase at days 119, 99 and 77 postpartum in group 1, 2 and 3, respectively. One ewe did not show estrus at all during the period of study in group 2 and there were no growing follicles on their ovaries. The obtained results indicate that, uterine involution as determined by ultrasound completed earlier in ewes lambed in March than those lambed in February or January. Also, progesterone level and ultrasound examination showed that there was no ovarian activity for a longtime after parturition indicating that reproduction in Barbary ewes tends to be seasonal in AL-Bayda city, north Libya. PMID:26623357

  19. Effect of ovulatory follicle size and estradiol supplementation during the preovulatory period on pregnancy rates in postpartum beef cows

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In postpartum beef cows, GnRH-induced ovulation of small dominant follicles decreased pregnancy rates and increased late embryonic/fetal mortality; however, ovulatory follicle size had no apparent effect on the establishment or maintenance of pregnancy when ovulation occurred spontaneously. Further...

  20. Factors in Dry Period Associated with Intramammary Infection and Subsequent Clinical Mastitis in Early Postpartum Cows.

    PubMed

    Leelahapongsathon, Kansuda; Piroon, Tipapun; Chaisri, Wasana; Suriyasathaporn, Witaya

    2016-04-01

    The objective of this study was to determine cow characteristics and farm management factors during the dry period associated with early postparturient intramammary infection (IMI) and subsequent clinical mastitis (CM). Data were collected three times: before drying off (P1), during the dry period (P2), and 5 to 14 days after calving (P3), using questionnaires and farm investigation. Milk samples were aseptically collected for bacterial identification at P1 and P3. Factors associated with IMI and CM were analyzed using multiple logistic regression models. The final model showed that IMI in early postpartum was significantly associated with full insertion of dry cow antibiotic, dry cows in barns with a combination of tie and free stalls, body condition score (BCS) in dry period and after calving, and milk yield before drying off. For IMI cows, factors significantly associated with clinical expression of mastitis were having daily barn cleaning, teat disinfected with alcohol before administration of dry cow therapy, BCS before drying off, milk yield before drying off, and days in milk at drying off. In conclusion, both cow and farm management factors are associated with the IMI rate and subsequent expression of clinical signs of mastitis in early postpartum cows. PMID:26949960

  1. Plasticity of GABAA Receptors during Pregnancy and Postpartum Period: From Gene to Function

    PubMed Central

    Licheri, Valentina; Talani, Giuseppe; Gorule, Ashish A.; Mostallino, Maria Cristina; Biggio, Giovanni; Sanna, Enrico

    2015-01-01

    Pregnancy needs complex pathways that together play a role in proper growth and protection of the fetus preventing its premature loss. Changes during pregnancy and postpartum period include the manifold machinery of neuroactive steroids that plays a crucial role in neuronal excitability by local modulation of specific inhibitory receptors: the GABAA receptors. Marked fluctuations in both blood and brain concentration of neuroactive steroids strongly contribute to GABAA receptor function and plasticity. In this review, we listed several interesting results regarding the regulation and plasticity of GABAA receptor function during pregnancy and postpartum period in rats. The increase in brain levels of neuroactive steroids during pregnancy and their sudden decrease immediately before delivery are causally related to changes in the expression/function of specific GABAA receptor subunits in the hippocampus. These data suggest that alterations in GABAA receptor expression and function may be related to neurological and psychiatric disorders associated with crucial periods in women. These findings could help to provide potential new treatments for these women's disabling syndromes. PMID:26413323

  2. Factors in Dry Period Associated with Intramammary Infection and Subsequent Clinical Mastitis in Early Postpartum Cows

    PubMed Central

    Leelahapongsathon, Kansuda; Piroon, Tipapun; Chaisri, Wasana; Suriyasathaporn, Witaya

    2016-01-01

    The objective of this study was to determine cow characteristics and farm management factors during the dry period associated with early postparturient intramammary infection (IMI) and subsequent clinical mastitis (CM). Data were collected three times: before drying off (P1), during the dry period (P2), and 5 to 14 days after calving (P3), using questionnaires and farm investigation. Milk samples were aseptically collected for bacterial identification at P1 and P3. Factors associated with IMI and CM were analyzed using multiple logistic regression models. The final model showed that IMI in early postpartum was significantly associated with full insertion of dry cow antibiotic, dry cows in barns with a combination of tie and free stalls, body condition score (BCS) in dry period and after calving, and milk yield before drying off. For IMI cows, factors significantly associated with clinical expression of mastitis were having daily barn cleaning, teat disinfected with alcohol before administration of dry cow therapy, BCS before drying off, milk yield before drying off, and days in milk at drying off. In conclusion, both cow and farm management factors are associated with the IMI rate and subsequent expression of clinical signs of mastitis in early postpartum cows. PMID:26949960

  3. Clinical course of pelvic girdle pain postpartum - impact of clinical findings in late pregnancy.

    PubMed

    Robinson, Hilde Stendal; Vllestad, Nina K; Veierd, Marit B

    2014-06-01

    The aims were to study: prevalence of pelvic girdle pain (PGP) one year postpartum; clinical course of PGP, physical functioning (PF) and bodily pain (BP) (from SF-36, 0 (worst) to 100 (best)) from gestation week (GW) 30 to one year postpartum; and whether findings at GW30 were associated with development of PF and BP from GW30 to one year postpartum. 215 pregnant women were followed from GW30 to one year postpartum. Clinical examination and questionnaire were used at GW30, questionnaire only were used at 12 weeks and one year postpartum. The women were categorised by GW30 clinical variables: self-reported PGP, pain locations in the pelvis and response to two clinical tests. Linear mixed models for repeated measures were used to study PF and BP during follow-up, within the categories of clinical variables. PGP prevalence remained unchanged from 12 weeks to one year postpartum (31-30%). PF and BP scores improved markedly from GW30 to 12 weeks postpartum, and marginally thereafter. Median PF scores were 70, 95 and 100 at GW30, 12 weeks and one year postpartum, respectively. Corresponding median BP scores were 52, 84 and 84. We found significant interactions between each clinical variable and time (P ? 0.01) for PF and BP. The most afflicted women at GW30 experienced largest improvement. Despite high PGP prevalence one year postpartum, most women recovered in terms of PF and BP scores. Unfavourable clinical course postpartum did not appear to depend on self-reported PGP, pain locations in the pelvis, or response to clinical tests at GW30. PMID:24508067

  4. Factors associated with depressive symptoms in the early postpartum period among women with recent gestational diabetes mellitus.

    PubMed

    Nicklas, Jacinda M; Miller, Laura J; Zera, Chloe A; Davis, Roger B; Levkoff, Sue E; Seely, Ellen W

    2013-11-01

    Women with gestational diabetes mellitus (GDM) have a substantial risk of subsequently developing type 2 diabetes. This risk may be mitigated by engaging in healthy eating, physical activity, and weight loss when indicated. Since postpartum depressive symptoms may impair a woman's ability to engage in lifestyle changes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent GDM. The participants are part of the baseline cohort of the TEAM GDM (Taking Early Action for Mothers with Gestational Diabetes Mellitus) study, a one-year randomized trial of a lifestyle intervention program for women with a recent history of GDM, conducted in Boston, Massachusetts between June 2010 and September 2012. We administered the Edinburgh Postnatal Depression Scale (EPDS) at 4-15weeks postpartum to women whose most recent pregnancy was complicated by GDM (confirmed by laboratory data or medical record review). An EPDS score ?9 indicated depressive symptoms. We measured height and thyroid stimulating hormone, and administered a questionnaire to collect demographic data and information about breastfeeding and sleep. We calculated body mass index (BMI) using self-reported pre-pregnancy weight and measured height. We reviewed medical records to obtain data about medical history, including history of depression, mode of delivery, and insulin use during pregnancy. We conducted bivariable analyses to identify correlates of postpartum depressive symptoms, and then modeled the odds of postpartum depressive symptoms using multivariable logistic regression. Our study included 71 women (mean age 33years5; 59% White, 28% African-American, 13% Asian, with 21% identifying as Hispanic; mean pre-pregnancy BMI 30kg/m(2)6). Thirty-four percent of the women scored ?9 on the EPDS at the postpartum visit. In the best fit model, factors associated with depressive symptoms at 6weeks postpartum included cesarean delivery (aOR 4.32, 95% CI 1.46, 13.99) and gestational weight gain (aOR 1.21 [1.02, 1.46], for each additional 5 lbs gained). Use of insulin during pregnancy, breastfeeding, personal history of depression, and lack of a partner were not retained in the model. Identifying factors associated with postpartum depression in women with GDM is important since depression may interfere with lifestyle change efforts in the postpartum period. In this study, cesarean delivery and greater gestational weight gain were correlated with postpartum depressive symptoms among women with recent GDM (Clinicaltrials.gov NCT01158131). PMID:23124798

  5. Use of Complementary and Alternative Medicine During Pregnancy and the Postpartum Period: An Analysis of the National Health Interview Survey

    PubMed Central

    Kemper, Kathi J.; Rothman, Russell; Gardiner, Paula

    2014-01-01

    Abstract Introduction: Complementary and alternative medicine (CAM) is commonly used among women, but few national data exist regarding CAM use during pregnancy or the postnatal period. Methods: Data from the 2007 National Health Interview Survey were analyzed for women ages between the ages of 18 and 49 years who were pregnant or had children less than 1 year old. CAM use was identified based on standard definitions of CAM from the National Institutes of Health's National Center for Complementary and Alternative Medicine. CAM use among women who were pregnant or with a child less than 1 year was compared with the other similarly aged female responders. CAM use was examined among these women stratified by sociodemographics, health conditions, and conventional medicine use through bivariable and multivariable logistic regression models. Results: Among pregnant and postpartum women from the ages of 19 to 49 years in the United States, 37% of pregnant women and 28% of postpartum women reported using CAM in the last 12 months compared with 40% of nonpregnant/non-postpartum women. Mind–body practices were the most common CAM modality reported, with one out of four women reporting use. Biological therapies, excluding vitamins and minerals, during the postpartum period were used by only 8% of women. Using multivariable regression modeling, we report no significant difference in CAM use among pregnant compared with non-pregnant women (adjusted odds ratio [AOR], 0.88; [95% confidence interval 0.65–1.20]), but lower CAM use among postpartum women compared with non-pregnant women (AOR 0.67; [0.52–0.88]), while adjusting for sociodemographics. Conclusion: CAM use among pregnancy similar to women who are not pregnant, while postpartum CAM use decreases. Further evaluation of CAM therapies among pregnant and postpartum women is necessary to determine the costs and benefits of integrative CAM therapies in conventional care. PMID:25268759

  6. Biomarkers From Late Pregnancy to 6 Weeks Postpartum in HIV-Infected Women Who Continue Versus Discontinue Antiretroviral Therapy After Delivery

    PubMed Central

    Hoffman, Risa M.; Leister, Erin; Kacanek, Deborah; Shapiro, David E.; Read, Jennifer S.; Bryson, Yvonne; Currier, Judith S.

    2013-01-01

    Background Women who use antiretroviral therapy (ART) solely for the prevention of mother-to-child transmission of HIV discontinue postpartum. We hypothesized that women discontinuing ART by 6 weeks postpartum (discontinuers) would have elevated postpartum inflammatory biomarker levels relative to women remaining on ART postpartum (continuers). Methods Data from HIV-infected pregnant women enrolled in the International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1025 with CD4 counts >350 cells per cubic millimeter before initiating ART or first pregnancy CD4 counts >400 cells per cubic millimeter after starting ART and with available stored plasma samples at >20 weeks of gestation, delivery, and 6 weeks postpartum were analyzed. Plasma samples were tested for highly sensitive C-reactive protein, D-dimer, and interleukin-6. We used longitudinal linear spline regression to model biomarkers over time. Results Data from 128 women (65 continuers and 63 discontinuers) were analyzed. All biomarkers increased from late pregnancy to delivery, then decreased postpartum (slopes different from 0, P < 0.001). Continuers had a steeper decrease in log D-dimer between delivery and 6 weeks postpartum than discontinuers (P = 0.002). Conclusions In contrast to results from treatment interruption studies in adults, both ART continuers and ART discontinuers had significant decreases in the levels of D-dimer, highly sensitive C-reactive protein, or interleukin-6 postpartum. Continuation was associated with a more rapid decline in D-dimer levels compared with discontinuation. PMID:23714738

  7. Oxytocin in the medial prefrontal cortex regulates maternal care, maternal aggression and anxiety during the postpartum period

    PubMed Central

    Sabihi, Sara; Dong, Shirley M.; Durosko, Nicole E.; Leuner, Benedetta

    2014-01-01

    The neuropeptide oxytocin (OT) acts on a widespread network of brain regions to regulate numerous behavioral adaptations during the postpartum period including maternal care, maternal aggression, and anxiety. In the present study, we examined whether this network also includes the medial prefrontal cortex (mPFC). We found that bilateral infusion of a highly specific oxytocin receptor antagonist (OTR-A) into the prelimbic (PL) region of the mPFC increased anxiety-like behavior in postpartum, but not virgin, females. In addition, OTR blockade in the postpartum mPFC impaired maternal care behaviors and enhanced maternal aggression. Overall, these results suggest that OT in the mPFC modulates maternal care and aggression, as well as anxiety-like behavior, during the postpartum period. Although the relationship among these behaviors is complicated and further investigation is required to refine our understanding of OT actions in the maternal mPFC, these data nonetheless provide new insights into neural circuitry of OT-mediated postpartum behaviors. PMID:25147513

  8. Obsessive-compulsive disorder in pregnancy and the postpartum period: course of illness and obstetrical outcome.

    PubMed

    House, Samuel J; Tripathi, Shanti P; Knight, Bettina T; Morris, Natalie; Newport, D Jeffrey; Stowe, Zachary N

    2016-02-01

    The study aimed to examine the course of obsessive-compulsive disorder (OCD) across pregnancy and its impact on obstetric and neonatal outcomes. Women enrolled prior to 20-week gestation in a prospective, observational study. The Structured Clinical Interview for DSM-IV was completed to obtain lifetime Axis I diagnoses. A total of 56 women with OCD were followed at 1 to 3-month intervals through 52weeks postpartum. Each visit, the Yale-Brown Obsessive Compulsive Scale (YBOCS), clinical assessment, and medication/exposure tracking were performed. Obstetric and neonatal data were abstracted from the medical record. In subjects with OCD, associations between perinatal obsessive-compulsive symptoms (OCSs) and outcomes were examined. Additionally, outcomes were compared to 156 matched psychiatric patients without OCD. Maternal age inversely correlated with the YBOCS scores across the study period (??=?-0.5161, p?=?.0378). Cesarean section was associated with increased OCSs in the postpartum period compared to vaginal delivery (??=?5.3632, p?=?0.043). No associations were found between severity of perinatal obsessions or compulsions and any specific obstetric or neonatal complications. Subjects without OCD had higher frequency of fetal loss compared to mothers with OCD (? (2)?=?4.03, p?=?0.043). These novel prospective data fail to identify an association of OCSs with adverse outcomes. In contrast, there is an association of delivery method and younger maternal age with increased postnatal symptoms of OCD. Psychiatric subjects without OCD may have a higher risk of miscarriage and intrauterine fetal demise compared to subjects with OCD. PMID:26173597

  9. Postpartum contraception.

    PubMed

    Sober, Stephanie; Schreiber, Courtney A

    2014-12-01

    As birth spacing has demonstrated health benefits for a woman and her children, contraception after childbirth is recognized as an important health issue. The potential risk of pregnancy soon after delivery underscores the importance of initiating postpartum contraception in a timely manner. The contraceptive method initiated in the postpartum period depends upon a number of factors including medical history, anatomic and hormonal factors, patient preference, and whether or not the woman is breastfeeding. When electing a contraceptive method, informed choice is paramount. The availability of long-acting reversible contraceptive methods immediately postpartum provides a strategy to achieve reductions in unintended pregnancy. PMID:25264698

  10. Efficacy of Enhanced HIV Counseling for Risk Reduction during Pregnancy and in the Postpartum Period: A Randomized Controlled Trial

    PubMed Central

    Maman, Suzanne; Moodley, Dhayendre; McNaughton-Reyes, Heathe Luz; Groves, Allison K.; Kagee, Ashraf; Moodley, Prashini

    2014-01-01

    Introduction Pregnancy and the postpartum period present important intervention opportunities. Counseling can leverage the motivation women have during this time to change behaviors that may negatively affect their health and the heath of their infants. Methods Pregnant women attending an antenatal clinic in South Africa were randomly allocated to treatment (n?=?733) and control arms (n?=?747). Treatment arm participants received enhanced HIV pre- and post-test counseling, legal support and access to support groups at baseline, which occurred at the first antenatal visit, and then six and ten weeks postpartum. Control arm participants received standard HIV testing and counseling (HTC) and two postpartum attention control sessions. Outcomes were incidence of sexually transmitted infection (STI) by 14 weeks postpartum and past 30-day inconsistent condom use at 14 weeks and 9 months postpartum. Results There were no intervention effects on incident STIs for either HIV-negative (adjusted risk ratio (aRR) 1.01, 95% CI 0.711.44) or HIV-positive participants (aRR 0.86, 95% CI 0.611.23). The intervention was associated with a 28% decrease in risk of past 30-day inconsistent condom use at nine-months among HIV-negative women (aRR 0.72,95% CI 0.590.88), but did not affect inconsistent condom use among HIV-positive women (aRR1.08; 95% CI 0.671.75). Discussion An enhanced counseling intervention during pregnancy and the postpartum period can lead to reductions in inconsistent condom use among HIV-negative women. Results underscore the importance of the counseling that accompanies HIV HTC. More work is needed to understand how to promote and sustain risk reduction among HIV-positive women. Trial Registration ClinicalTrials.gov NCT01683461 PMID:24824050

  11. Depressive and anxiety disorders in the postpartum period: how prevalent are they and can we improve their detection?

    PubMed

    Austin, Marie-Paule V; Hadzi-Pavlovic, Dusan; Priest, Susan R; Reilly, Nicole; Wilhelm, Kay; Saint, Karen; Parker, Gordon

    2010-10-01

    The objectives of this study were: (1) to examine Composite International Diagnostic Interview (CIDI) period prevalence and comorbidity for depression and anxiety disorder in a cohort of women assessed during the first 6-8 months postpartum and (2) to examine the benefits of combining the Edinburgh Postnatal Depression Scale (EPDS) with a simple "interval symptom" question to optimize screening postpartum. Women aged over 18 (N = 1,549) were assessed during late pregnancy and reviewed at approximately 2, 4, and 6-8 months postpartum using the EPDS and an "interval symptom" question. The latter asked about any depressive symptoms in the interval since the last EPDS. Women who scored >12 on the EPDS and/or positive on the "interval symptom" question were then administered the CIDI. A further 65 randomly selected women that screened negative were also administered the CIDI. Loss to postnatal follow-up was very significant, and returns rates were inconsistent across the three postnatal time points. Almost 25% of those who screened positive did not complete a CIDI. For screen-positive status, a total of 314 (24.4%) of those that returned questionnaires (N = 1,289) screened positive at least once across the 6- to 8-month interval. Of these, 79 were lost to follow-up; thus, 235 (74.8%) completed a CIDI. In this group, 34.7% had been positive both on the EPDS and the "interval" question, 15.9% on the EPDS alone, and 49.4% on the "interval" question alone. For the CIDI diagnosis and estimated 6- to 8-month period CIDI prevalence, among those 235 women who screened positive and completed a CIDI, 67.2% met the criteria for a CIDI diagnosis, as did 16.9% of those who screened negative. The breakdown in CIDI diagnoses in the 235 women was 32.8% major depression (± anxiety disorder); 26.4% minor depression alone; and 8.1% with a primary anxiety disorder (approximately half with minor depression). Put another way, 20.4% of these women had an anxiety disorder (approximately two thirds with comorbid depression) and 37.7% of women with a major depressive episode (MDE) had a comorbid anxiety disorder. The estimated 6- to 8-month prevalence rate for a CIDI diagnosis of anxiety or depression (major or minor) was 29.2% (95% CI 26.7%-31.7%). The use of the "interval symptom" question alone was 1.7 times more likely to identify positive CIDI cases than the EPDS alone. Almost 40% of postnatal women with a diagnosis of MDE have a comorbid diagnosis of anxiety disorder. The estimated 6- to 8-month period prevalence for CIDI cases of anxiety and depression was 29.2%. Screening for anxiety and depression using the EPDS alone was associated with a lesser capacity to identify CIDI caseness than a simple "interval symptom" question (for the 2 months prior) which almost doubled the yield. This paper demonstrates that combining the EPDS with the "interval symptom" question improves detection of CIDI caseness. PMID:20232218

  12. Serum 1,25-dihydroxyvitamin D and calcium intake affect rates of bone calcium deposition during pregnancy and the early postpartum period123

    PubMed Central

    O'Brien, Kimberly O; Donangelo, Carmen M; Ritchie, Lorrene D; Gildengorin, Ginny; Abrams, Steve

    2012-01-01

    Background: Factors affecting bone calcium deposition across pregnancy and lactation are not well characterized. Objective: The impact of maternal age, calcium intake, race-ethnicity, and vitamin D status on the rate of bone calcium deposition (VO+) was assessed across pregnancy and lactation. Design: Stable calcium isotopes were given to 46 women at pre- or early pregnancy (trimester 1), late pregnancy (trimester 3), and 310 wk postpartum. Three cohorts were included: 23 adolescents from Baltimore (MD), aged 16.5 1.4 y (mean SD; Baltimore cohort); 13 adults from California, aged 29.5 2.6 y (California cohort); and 10 adults from Brazil, aged 30.4 4.0 y (Brazil cohort). The total exchangeable calcium pool, VO+, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D [1,25(OH)2D], parathyroid hormone, and calcium intake were evaluated. Results: At trimester 3, inverse associations between 1,25(OH)2D and VO+ were evident in the Baltimore (P = 0.059) and Brazil (P = 0.008) cohorts and in the whole group (P = 0.029); calcium intake was not a significant determinant of VO+ in any group during pregnancy. At postpartum, a significant positive association was evident between VO+ and calcium intake (P ? 0.002) and between VO+ and African ethnicity (P ? 0.004) in the whole group and within the Baltimore and Brazil cohorts. Conclusions: Elevated 1,25(OH)2D was associated with decreased rates of bone calcium deposition during late pregnancy, a finding that was particularly evident in pregnant adolescents and adult women with low calcium intakes. Higher dietary calcium intakes and African ethnicity were associated with elevated rates of bone calcium deposition in the postpartum period. PMID:22648718

  13. Understanding and meeting the needs of women in the postpartum period: the Perinatal Maternal Health Promotion Model.

    PubMed

    Fahey, Jenifer O; Shenassa, Edmond

    2013-01-01

    A new model for the care of women in the postpartum focuses on the development of life skills that promote complete well-being. The year following childbirth is a time of significant transition for women. In addition to the physiologic changes associated with the postpartum period, a woman undergoes marked psychosocial changes as she transitions into a motherhood role, reestablishes relationships, and works to meet the physical and emotional needs of her infant and other family members. It is a time when women are vulnerable to health problems directly related to childbirth and to compromised self-care, which can manifest in the development or reestablishment of unhealthy behaviors such as smoking and a sedentary lifestyle. In addition to long-term implications for women, compromised maternal health in the postpartum period is associated with suboptimal health and developmental outcomes for infants. Maternal health experts have called for a change in how care is provided for women in the postpartum period. This article presents the rationale for a health promotion approach to meeting the needs of women in the postpartum period and introduces the Perinatal Maternal Health Promotion Model. This conceptual framework is built around a definition of maternal well-being that asserts that health goes beyond merely the absence of medical complications. In the model, the core elements of a healthy postpartum are identified and include not only physical recovery but also the ability to meet individual needs and successfully transition into motherhood. These goals can best be achieved by helping women develop or strengthen 4 key individual health-promoting skills: the ability to mobilize social support, self-efficacy, positive coping strategies, and realistic expectations. While the model focuses on the woman, the health promotion approach takes into account that maternal health in this critical period affects and is affected by her family, social network, and community. Clinical implications of the model are addressed, including specific health promotion strategies that clinicians can readily incorporate into antepartum and postpartum care. PMID:24320095

  14. Endogenous CNS Expression of Neurotensin and Neurotensin Receptors Is Altered during the Postpartum Period in Outbred Mice

    PubMed Central

    Driessen, Terri M.; Zhao, Changjiu; Whittlinger, Anna; Williams, Horecia; Gammie, Stephen C.

    2014-01-01

    Neurotensin (NT) is a neuropeptide identical in mice and humans that is produced and released in many CNS regions associated with maternal behavior. NT has been linked to aspects of maternal care and previous studies have indirectly suggested that endogenous NT signaling is altered in the postpartum period. In the present study, we directly examine whether NT and its receptors exhibit altered gene expression in maternal relative to virgin outbred mice using real time quantitative PCR (qPCR) across multiple brain regions. We also examine NT protein levels using anti-NT antibodies and immunohistochemistry in specific brain regions. In the medial preoptic area (MPOA), which is critical for maternal behaviors, mRNA of NT and NT receptor 3 (Sort1) were significantly up-regulated in postpartum mice compared to virgins. NT mRNA was also elevated in postpartum females in the bed nucleus of the stria terminalis dorsal. However, in the lateral septum, NT mRNA was down-regulated in postpartum females. In the paraventricular nucleus of the hypothalamus (PVN), Ntsr1 expression was down-regulated in postpartum females. Neurotensin receptor 2 (Ntsr2) expression was not altered in any brain region tested. In terms of protein expression, NT immunohistochemistry results indicated that NT labeling was elevated in the postpartum brain in the MPOA, lateral hypothalamus, and two subregions of PVN. Together, these findings indicate that endogenous changes occur in NT and its receptors across multiple brain regions, and these likely support the emergence of some maternal behaviors. PMID:24416154

  15. Acute Myocardial Infarction Due to Coronary Artery Dissection in the Postpartum Period

    PubMed Central

    Moussa, Hind N.; Movahedian, Malahat; Leon, Mateo G.; Sibai, Baha M.

    2015-01-01

    Background?Though rare, myocardial infarction secondary to coronary artery dissection is a life-threatening event. In reproductive age women, it commonly occurs during pregnancy or the postpartum period. Case?We present a case of pregnancy-related acute myocardial infarction due to spontaneous coronary artery dissection in a 37-year-old woman who presented to the emergency room with shortness of breath and sudden onset of retrosternal chest pain 8 days after delivery of premature twins. Coronary artery catheterization showed 75 to 90% stenosis in the left main coronary artery (LMCA), extending into the proximal and mid left anterior descending (LAD) branch. The LMCA appearance in the heart catheterization was consistent with vasospasm, but it was not responsive to medical management. Subsequently, she underwent a second coronary artery catheterization and was found to have dissection requiring emergent coronary artery bypass graft??3 in the LMCA, circumflex, and LAD that was followed by an uneventful recovery. Conclusion?Early diagnosis and management of myocardial infarction due to coronary artery dissection in the peripartum period is crucial. This condition should be suspected in young reproductive age women, even in the setting of minimal risk factors. Angiography is required for diagnosis. Management should be individualized as it may include both invasive and noninvasive measures. PMID:26495161

  16. Postpartum Depression

    MedlinePLUS

    ... Education & Events Advocacy For Patients About ACOG Postpartum Depression Home For Patients Search FAQs Postpartum Depression Page ... Postpartum Depression FAQ091, December 2013 PDF Format Postpartum Depression Labor, Delivery, and Postpartum Care What are the ...

  17. Decision making for depression treatment during pregnancy and the postpartum period

    PubMed Central

    Patel, Sapana R.; Wisner, Katherine L.

    2011-01-01

    Background To explore women's perspectives about the treatment decision making process for depression during pregnancy and after birth. Method One hundred pregnant and postpartum women completed an anonymous web-based surveys regarding treatment decision making for depression. Results Survey data reveal that most women in this sample prefer an active collaborative role in treatment decision making for. Sixty-five percent of the sample made a decision for treatment of their MDD, including a decision for no treatment, and 34% reported not having made a decision or feeling unsure about their decision. More than half of the sample preferred combination treatment with medications and counseling (55%) followed by counseling (22%), no treatment (8%), and medications (8%). Overall, respondents in this sample had low levels of decisional conflict (uncertainty) with younger women in the sample reporting higher levels of decisional conflict. Conclusions Treatment decision making for depression during the perinatal period is complex. Asking women about their preferences for participation in decision making, their treatment preferences and their decision making needs during the clinical encounter may lead to improved communication, decision making and quality of care. PMID:21681871

  18. Are symptom features of depression during pregnancy, the postpartum period and outside the peripartum period distinct? Results from a nationally representative sample using Item Response Theory (IRT)

    PubMed Central

    Hoertel, Nicolas; López, Saioa; Peyre, Hugo; Wall, Melanie M.; González-Pinto, Ana; Limosin, Frédéric; Blanco, Carlos

    2014-01-01

    Background Whether there are systematic differences in depression symptom expression during pregnancy, the postpartum period and outside these periods (i.e., outside the peripartum period) remains debated. The aim of this study was to use methods based on item response theory (IRT) to examine, after equating for depression severity, differences in the likelihood of reporting DSM-IV symptoms of major depressive episode (MDE) in women of childbearing age (i.e., aged 18-50) during pregnancy, the postpartum period and outside the peripartum period. Method We conducted these analyses using a large, nationally representative sample of women of childbearing age from the USA (n = 11,256) who participated in the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Results The overall 12-month prevalence of all depressive criteria (except for worthlessness/guilt) was significantly lower in pregnant women than in women of childbearing age outside the peripartum period, whereas the prevalence of all symptoms (except for “psychomotor symptoms”) were not significantly different between the postpartum and the non-peripartum group. There were no clinically significant differences in the endorsement rates of symptoms of MDE by pregnancy status when equating for levels of depression severity. Conclusions This study suggests that the clinical presentation of depressive symptoms in women of childbearing age does not differ during pregnancy, the postpartum period and outside the peripartum period. These findings do not provide psychometric support for the inclusion of the peripartum onset specifier for major depressive disorder in the DSM-5. PMID:25424539

  19. Effect of pregnancy and the postpartum period on adherence to antiretroviral therapy among HIV-infected women established on treatment.

    PubMed

    Henegar, Cassidy E; Westreich, Daniel J; Maskew, Mhairi; Miller, William C; Brookhart, M Alan; Van Rie, Annelies

    2015-04-01

    : Among women who become pregnant after initiating highly active antiretroviral therapy (HAART), few data describe the effect of pregnancy and postpartum on adherence. We conducted a retrospective clinical cohort study among therapy-naive women (age, 18-45 years) initiating HAART in Johannesburg, South Africa. Among 7510 women in our analysis, 896 experienced a pregnancy after starting HAART. Compared with nonpregnant periods of follow-up, there was an increased risk of nonadherence during the postpartum period (weighted risk ratio: 1.46, 95% confidence interval: 1.17 to 1.82) but not during pregnancy itself (weighted risk ratio: 0.95, 95% confidence interval: 0.78 to 1.17). PMID:25559590

  20. Late postpartum eclampsia complicated with posterior reversible encephalopathy syndrome: a case report and a literature review

    PubMed Central

    Zhang, Lihong; Wang, Yacong; Shi, Liang; Cao, Jianhui

    2015-01-01

    Posterior reversible encephalopathy syndrome (PRES) is a rare but serious clinical-neuroradiological entity characterized by headache, vomiting, visual disturbances, altered mental status, seizures, and unconsciousness associated with the characteristic imaging findings including sub-cortical vasogenic edema at the bilateral parietal and occipital lobes. We describe a case of 28-year-old PRES patient secondary to delayed maternal postpartum eclampsia. This patient was not initially diagnosed with pre-eclampsia and PRES. The diagnosis was established after magnetic resonance imaging. After treatment this patients PRES resolved. Early diagnosis and treatment are the keys to reverse PRES. A literature review for PRES is provided in this report. PMID:26807372

  1. CYP3A activity based on plasma 4?-hydroxycholesterol during the early postpartum period has an effect on the plasma disposition of amlodipine.

    PubMed

    Naito, Takafumi; Kubono, Naoko; Ishida, Takuya; Deguchi, Shuhei; Sugihara, Masahisa; Itoh, Hiroaki; Kanayama, Naohiro; Kawakami, Junichi

    2015-12-01

    This study aimed to evaluate plasma 4?-hydroxycholesterol as an endogenous marker of CYP3A4/5 activity in early postpartum women and its impact on the plasma disposition of amlodipine. Twenty-seven early postpartum women treated with amlodipine for pregnancy-induced hypertension were enrolled. The plasma concentration of 4?-hydroxycholesterol and its ratio to cholesterol in postpartum and in non-perinatal women were evaluated. The predose plasma concentration of amlodipine was determined at steady state. The medians of the plasma 4?-hydroxycholesterol concentration at day 0-3 and 8-21 after delivery were 146 and 161ng/mL, respectively. No significant difference was observed in the plasma concentration of 4?-hydroxycholesterol between the postpartum periods. The plasma concentration of 4?-hydroxycholesterol and its ratio to cholesterol in postpartum women were significantly higher than those in non-perinatal women. A large individual variability was observed in the dose-normalized plasma concentration of amlodipine in early postpartum women. A weak negative correlation was observed between the dose-normalized plasma concentration of amlodipine and the plasma concentration of 4?-hydroxycholesterol. In conclusion, early postpartum women possessed higher CYP3A activity based on plasma 4?-hydroxycholesterol and had a large pharmacokinetic variability in amlodipine. CYP3A activity during the early postpartum period had an effect on the plasma disposition of amlodipine. PMID:26654672

  2. A Content Analysis of Attributions for Resuming Smoking or Maintaining Abstinence in the Post-Partum Period

    PubMed Central

    Correa, John B.; Simmons, Vani N.; Sutton, Steven K.; Meltzer, Lauren R.; Brandon, Thomas H.

    2014-01-01

    Objectives A significant proportion of women who self-quit smoking during pregnancy subsequently relapse to smoking post-partum. This study examined free-text responses describing attributions of smoking relapse or maintained abstinence at 1, 8, and 12 months post-partum. Method This study reports secondary analyses from a randomized clinical trial (N = 504) for preventing post-partum smoking relapse. At each follow-up, one survey item asked the participant to describe why she resumed smoking or what helped her maintain abstinence. A thematic content analysis was conducted on responses from the 472 participants (94.0 % of the original sample) who returned at least 1 survey. Results Content analyses revealed several themes for participants’ reasons for relapse and abstinence. Stress was the most frequently cited reason for smoking relapse across all follow-ups. Health concerns for children and family was the most common reason provided for remaining abstinent. Chi-square analyses revealed differences in written responses related to income, age, and depressive symptoms. Conclusions Overall, these findings suggest that during the post-partum period, stress and familial health concerns are perceived contributors to smoking relapse and abstinence, respectively. These results confirmed key risk and protective factors that have been identified through other assessment modalities (e.g., quantitative surveys and focus groups). They also provide support for targeting these variables in the development, content, and delivery of future post-partum smoking relapse-prevention interventions. The high response rate to these open-ended attribution questions suggests that future studies would benefit from including these and similar items, to allow for additional insight into participant perspectives. PMID:24996953

  3. Relationship factors and trajectories of intimate partner violence among South African women during pregnancy and the postpartum period.

    PubMed

    Groves, Allison K; McNaughton-Reyes, H Luz; Foshee, Vangie A; Moodley, Dhayendre; Maman, Suzanne

    2014-01-01

    Intimate partner violence (IPV) is a significant public health problem in South Africa. However, there is limited research on whether and how IPV changes during pregnancy and the postpartum period and on the factors that might affect women's risk during this time. In this study, we describe the mean trajectories of physical and psychological IPV during pregnancy and the postpartum period and examine whether relationship power, partner social support, and relationship stress are associated with women's trajectories of IPV. Data come from a longitudinal study with 1,480 women recruited during pregnancy between May 2008 and June 2010 at a public clinic in Durban. Women completed behavioral assessments at their first antenatal visit, at fourteen weeks and at nine months postpartum. Women's experiences of IPV were measured at all three time points and relationship power, partner social support and relationship stress were each measured at the baseline assessment. We used multilevel random coefficients growth modeling to build our models. The mean trajectory for both types of IPV was flat which means that, on average, there was not significant change in levels of IPV over pregnancy and the postpartum period. However, there was significant individual variability in trajectories of IPV over the study period. Women who had higher relationship power had lower levels of physical and psychological IPV over time than women with lower relationship power. Additionally, women with higher relationship stress and lower partner support had higher levels of psychological IPV at pregnancy. Interventions that maximize women's relationship power and partner social support and minimize relationship stress during this transformative time are needed. PMID:25268363

  4. The Associations of Maternal Weight Change with Breastfeeding, Diet and Physical Activity During the Postpartum Period.

    PubMed

    López-Olmedo, Nancy; Hernández-Cordero, Sonia; Neufeld, Lynnette M; García-Guerra, Armando; Mejía-Rodríguez, Fabiola; Méndez Gómez-Humarán, Ignacio

    2016-02-01

    Objective To determine the association between breastfeeding practices, diet and physical activity and maternal postpartum weight. Methods This was a secondary data analysis of a randomized community trial on beneficiaries of the Programa de Desarrollo Humano Oportunidades, recently renamed Prospera (n = 314 pregnant women), without any diseases that could affect body weight. Generalized estimating equations were used to determine the association between postpartum weight change and changes in diet, physical activity and type of breastfeeding. Results The mean postpartum weight change from the first to the third month was 0.6 ± 2.2 kg. Women who breastfed exclusively for 3 months had a 4.1 (SE = 1.9) kg weight reduction in comparison with women who did not provide exclusive breastfeeding or who discontinued breastfeeding before 3 months (p = 0.04). There was no association between postpartum weight change and physical activity (p = 0.24) or energy intake (p = 0.06). Conclusions Exclusive breastfeeding was associated with maternal postpartum weight reduction. These results reinforce the World Health Organization recommendation of exclusive breastfeeding during the first 6 months of life in order to reduce the risk of weight retention or weight gain in postpartum women. It has been well established that exclusive breastfeeding is beneficial for both infants and mothers, but promoting breastfeeding as a strategy to promote postpartum weight loss is of paramount importance, especially in countries like Mexico where excessive weight in women of reproductive age is a public health problem. PMID:26525558

  5. Glutamate, GABA, and glutamine are synchronously upregulated in the mouse lateral septum during the postpartum period

    PubMed Central

    Zhao, Changjiu; Gammie, Stephen C.

    2014-01-01

    Dramatic structural and functional remodeling occurs in the postpartum brain for the establishment of maternal care, which is essential for the growth and development of young offspring. Glutamate and GABA signaling are critically important in modulating multiple behavioral performances. Large scale signaling changes occur in the postpartum brain, but it is still not clear to what extent the neurotransmitters glutamate and GABA change and whether the ratio of glutamate/GABA remains balanced. In this study, we examined the glutamate/GABA-glutamine cycle in the lateral septum (LS) of postpartum female mice. In postpartum females (relative to virgins), tissue levels of glutamate and GABA were elevated in LS and increased mRNA was found for the respective enzymes producing glutamate and GABA, glutaminase (Gls) and glutamate decarboxylase 1 and 2 (Gad1 and Gad2). The common precursor, glutamine, was elevated as was the enzyme that produces it, glutamate-ammonia ligase (Glul). Additionally, glutamate, GABA, and glutamine were positively correlated and the glutamate/GABA ratio was almost identical in the postpartum and virgin females. Collectively, these findings indicate that glutamate and GABA signaling are increased and that the ratio of glutamate/GABA is well balanced in the maternal LS. The postpartum brain may provide a useful model system for understanding how glutamate and GABA are linked despite large signaling changes. Given that some mental health disorders, including depression and schizophrenia display dysregulated glutamate/GABA ratio, and there is increased vulnerability to mental disorders in mothers, it is possible that these postpartum disorders emerge when glutamate and GABA changes are not properly coordinated. PMID:25451092

  6. Effect of Dietary Cation-Anion Difference during Prepartum and Postpartum Periods on Performance, Blood and Urine Minerals Status of Holstein Dairy Cow

    PubMed Central

    Razzaghi, A.; Aliarabi, H.; Tabatabaei, M. M.; Saki, A. A.; Valizadeh, R.; Zamani, P.

    2012-01-01

    Twenty four periparturient cows were used to determine the effects of DCAD on acid-base balance, plasma and urine mineral concentrations, health status, and subsequent lactation performance. Each group of 12 cows received either a diet containing ?100 DCAD or +100 DCAD for 21 d prepartum. Both anionic and cationic groups were divided into two groups, one received a +200 DCAD and the other +400 DCAD diet for 60 d postpartum. Prepartum reduction of DCAD decreased DMI, urinary and blood pH, urinary concentrations of Na or K and increased plasma and urinary Ca, Mg, Cl and S. Also cows fed ?100 DCAD diet consumed the most dry matter in the first 60 d after calving. Postpartum +400 DCAD increased milk fat and total solid percentages, urinary and blood pH and urinary Na and K concentrations, but urinary Ca, P, Cl and S contents decreased. Greater DMI, FCM yields were observed in cows fed a diet of +400 DCAD than +200 DCAD. No case of milk fever occurred for any diets but feeding with a negative DCAD diet reduced placenta expulsion time. In conclusion, feeding negative DCAD in late gestation period and high DCAD in early lactation improves performance and productivity of dairy cows. PMID:25049589

  7. Patient Management with Metallic Valve Prosthesis during Pregnancy and Postpartum Period.

    PubMed

    Garcez, Juliane Dantas Seabra; Rosa, Vitor Emer Egypto; Lopes, Antonio Sergio de Santis Andrade; Accorsi, Tarso Augusto Duenhas; Fernandes, Joo Ricardo Cordeiro; Pomerantzeff, Pablo Maria; Avila, Walkiria Samuel; Tarasoutchi, Flavio

    2015-10-01

    Prosthetic thrombosis is a rare complication, but it has high mortality and morbidity. Young women of childbearing age that have prosthetic heart valves are at increased risk of thrombosis during pregnancy due to changes in coagulation factors. Anticoagulation with adequate control and frequent follow-up if pregnancy occurs must be performed in order to prevent complications related to anticoagulant use. Surgery remains the treatment of choice for prosthetic heart valve thrombosis in most clinical conditions. Patients with metallic prosthetic valves have an estimated 5% risk of thrombosis during pregnancy and maternal mortality of 1.5% related to the event. Anticoagulation with vitamin K antagonists during pregnancy is related to varying degrees of complications at each stage of the pregnancy and postpartum periods. Warfarin sodium crosses the placental barrier and when used in the first trimester of pregnancy is a teratogenic agent, causing 1-3% of malformations characterized by fetal warfarin syndrome and also constitutes a major cause of miscarriage in 10-30% of cases. In the third trimester and at delivery, the use of warfarin is associated with maternal and neonatal bleeding in approximately 5 to 15% of cases, respectively. On the other hand, inadequate anticoagulation, including the suspension of the oral anticoagulants aiming at fetal protection, carries a maternal risk of about 25% of metallic prosthesis thrombosis, particularly in the mitral valve. This fact is also due to the state of maternal hypercoagulability with activation of coagulation factors V, VI, VII, IX, X, platelet activity and fibrinogen synthesis, and decrease in protein S levels. The Registry of Pregnancy and Cardiac Disease (ROPAC), assessing 212 pregnant women with metal prosthesis, showed that prosthesis thrombosis occurred in 10 (4.7%) patients and maternal hemorrhage in 23.1%, concluding that only 58% of patients with metallic prosthesis had a complication-free pregnancy. PMID:26559990

  8. HPV clearance in postpartum period of HIV-positive and negative women: a prospective follow-up study

    PubMed Central

    2013-01-01

    Background HPV persistence is a key determinant of cervical carcinogenesis. The influence of postpartum on HPV clearance has been debated. This study aimed to assess HPV clearance in later pregnancy and postpartum among HIV-positive and negative women. Methods We conducted a follow-up study with 151 HPV-positive women coinfected with HIV, in 20072010. After baseline assessment, all women were retested for HPV infection using PCR in later pregnancy and after delivery. Multivariable logistic regressions assessed the putative association of covariates with HPV status in between each one of the successive visits. Results Seventy-one women (47%) have eliminated HPV between the baseline visit and their second or third visits. HIV-positive women took a significantly longer time (7.0??3.8months) to clear HPV, compared to those not infected by HIV (5.9??3.0months). HPV clearance was significantly more likely to take place after delivery than during pregnancy (84.5% x 15.5%). Conclusions Both HIV-positive and negative women presented a significant reduction in HPV infection during the postpartum period. HIV-positive status was found to be associated with a longer period of time to clear HPV infection in pregnant women. PMID:24289532

  9. Maternal Health-Related Quality of Life and Its Predicting Factors in the Postpartum Period in Iran

    PubMed Central

    Rezaei, Nazanin; Zargousi, Razieh; Sadoughi, Zinab; Tavalaee, Zahra; Rezayati, Maryam

    2016-01-01

    Background/Purpose. Postpartum period is accompanied by many physical, emotional, and social changes in women's health. The aim of this study was to examine the mothers' quality of life in postpartum period. In addition, it also sought to recognize the variables that predict their quality of life. Methods. This cross-sectional, descriptive study was undertaken among 380 women in 10 urban health centers in Ilam province in west of Iran. They were selected using proportional random sampling method. The SF-36 questionnaire was used to identify women's health-related quality of life (HRQoL). Data were analyzed using SPSS version 15. Results. Women who were employed, aged less than 30 years, had college degree, have no history of disease in pregnancy, and had given birth more than 3 months ago had higher quality of life scores. Independent predictors for lower physical HRQoL were being with history of disease in pregnancy; being with high school diploma or lower education; and giving birth less than 3 months ago. Also, independent predictor for lower mental HRQoL was being housewife. Conclusion. According to study findings, greater attention must be paid to providing postpartum healthcare for housewife and less educated women as well as those with history of disease in pregnancy.

  10. Update to CDC's U.S. Medical Eligibility Criteria for Contraceptive Use, 2010: revised recommendations for the use of contraceptive methods during the postpartum period.

    PubMed

    2011-07-01

    Initiation of contraception during the postpartum period is important to prevent unintended pregnancy and short birth intervals, which can lead to negative health outcomes for mother and infant. In 2010, CDC published U.S. Medical Eligibility Criteria for Contraceptive Use, 2010 (US MEC), providing evidence-based guidance for choosing a contraceptive method based on the relative safety of contraceptive methods for women with certain characteristics or medical conditions, including women who are postpartum. Recently, CDC assessed evidence regarding the safety of combined hormonal contraceptive use during the postpartum period. This report summarizes that assessment and the resulting updated guidance. These updated recommendations state that postpartum women should not use combined hormonal contraceptives during the first 21 days after delivery because of the high risk for venous thromboembolism (VTE) during this period. During 21-42 days postpartum, women without risk factors for VTE generally can initiate combined hormonal contraceptives, but women with risk factors for VTE (e.g., previous VTE or recent cesarean delivery) generally should not use these methods. After 42 days postpartum, no restrictions on the use of combined hormonal contraceptives based on postpartum status apply. PMID:21734635

  11. Lithium prophylaxis during pregnancy and the postpartum period in women with lithium-responsive bipolar I disorder.

    PubMed

    Rosso, Gianluca; Albert, Umberto; Di Salvo, Gabriele; Scatà, Manuela; Todros, Tullia; Maina, Giuseppe

    2016-04-01

    The aim of this study was to evaluate the efficacy of lithium prophylaxis during the peripartum period in women with lithium-responsive bipolar I disorder. Seventeen lithium-treated patients were selected and underwent preconception counseling that included both a psychiatric and an obstetric evaluation. Treatment was continued with flexible-doses of lithium combined with supportive psychotherapy throughout the pregnancy and the postpartum period. The results support the prophylaxis efficacy of lithium in lithium-responder bipolar women who have a high risk of severe peripartum recurrences. PMID:26790685

  12. Food deprivation and restriction during late gestation affects the sexual behavior of postpartum female meadow voles, Microtus pennsylvanicus

    PubMed Central

    Sabau, Ramona M.; Ferkin, Michael H.

    2013-01-01

    In many species of small mammals, including meadow voles, Microtus pennsylvanicus, females come into postpartum estrus (PPE) within 12–24 h of giving birth, allowing them to mate and become pregnant while raising the current litter. PPE females show increases in attractivity, proceptivity, and receptivity, the three components of sexual behavior, relative to females not in PPE. Several studies have shown that food deprivation and restriction reduce attractivity, proceptivity, and receptivity of females not in PPE. We tested the hypothesis that food deprivation and restriction during late gestation causes deficits and decreases the attractivity, proceptivity, and receptivity of females when they enter PPE. Our data support the hypothesis. On day 1 of lactation, females that were food deprived and food restricted produced scent marks that were significantly less attractive as those produced by control PPE females. Food deprivation but not food restriction caused females to no longer display significant preferences for the scent marks of males over those of females (proceptivity). Food deprivation and food restriction were sufficient to induce females to become significantly less sexually receptive than control females. Eleven of 12 control PPE females mated, 4 of 12 food-restricted females mated, and 3 of 12 food-deprived females mated. Dams facing food deprivation or restriction during late gestation may have to balance the benefits of mating during PPE with the increased costs associated with getting pregnant while they are lactating. PMID:24415820

  13. Incidence and risk factors for intimate partner violence during the postpartum period

    PubMed Central

    Silva, Elisabete Pereira; Valongueiro, Sandra; de Araújo, Thália Velho Barreto; Ludermir, Ana Bernarda

    2015-01-01

    OBJECTIVE To estimate the incidence and identify risk factors for intimate partner violence during postpartum. METHODS This prospective cohort study was conducted with women, aged between 18-49 years, enrolled in the Brazilian Family Health Strategy in Recife, Northeastern Brazil, between 2005 and 2006. Of the 1.057 women interviewed during pregnancy and postpartum, 539 women, who did not report violence before or during pregnancy, were evaluated. A theoretical-conceptual framework was built with three levels of factors hierarchically ordered: women’s and partners’ sociodemografic and behavioral characteristics, and relationship dynamics. Incidence and risk factors of intimate partner violence were estimated by Poisson Regression. RESULTS The incidence of violence during postpartum was 9.3% (95%CI 7.0;12.0). Isolated psychological violence was the most common (4.3%; 95%CI 2.8;6.4). The overlapping of psychological with physical violence occurred at 3.3% (95%CI 2.0;5.3) and with physical and/or sexual in almost 2.0% (95%CI 0.8;3.0) of cases. The risk of partner violence during postpartum was increased for women with a low level of education (RR = 2.6; 95%CI 1.3;5.4), without own income (RR = 1.7; 95%CI 1.0;2.9) and those who perpetrated physical violence against their partner without being assaulted first (RR = 2.0; 95%CI 1.2;3.4), had a very controlling partner (RR = 2.5; 95%CI 1.1;5.8), and had frequent fights with their partner (RR = 1.7; 95%CI 1.0;2.9). CONCLUSIONS The high incidence of intimate partner violence during postpartum and its association with aspects of the relationship’s quality between the couple, demonstrated the need for public policies that promote conflict mediation and enable forms of empowerment for women to address the cycle of violence. PMID:26270012

  14. Incidence and risk factors for intimate partner violence during the postpartum period.

    PubMed

    Silva, Elisabete Pereira; Valongueiro, Sandra; de Arajo, Thlia Velho Barreto; Ludermir, Ana Bernarda

    2015-01-01

    OBJECTIVE To estimate the incidence and identify risk factors for intimate partner violence during postpartum. METHODS This prospective cohort study was conducted with women, aged between 18-49 years, enrolled in the Brazilian Family Health Strategy in Recife, Northeastern Brazil, between 2005 and 2006. Of the 1.057 women interviewed during pregnancy and postpartum, 539 women, who did not report violence before or during pregnancy, were evaluated. A theoretical-conceptual framework was built with three levels of factors hierarchically ordered: women's and partners' sociodemografic and behavioral characteristics, and relationship dynamics. Incidence and risk factors of intimate partner violence were estimated by Poisson Regression. RESULTS The incidence of violence during postpartum was 9.3% (95%CI 7.0;12.0). Isolated psychological violence was the most common (4.3%; 95%CI 2.8;6.4). The overlapping of psychological with physical violence occurred at 3.3% (95%CI 2.0;5.3) and with physical and/or sexual in almost 2.0% (95%CI 0.8;3.0) of cases. The risk of partner violence during postpartum was increased for women with a low level of education (RR = 2.6; 95%CI 1.3;5.4), without own income (RR = 1.7; 95%CI 1.0;2.9) and those who perpetrated physical violence against their partner without being assaulted first (RR = 2.0; 95%CI 1.2;3.4), had a very controlling partner (RR = 2.5; 95%CI 1.1;5.8), and had frequent fights with their partner (RR = 1.7; 95%CI 1.0;2.9). CONCLUSIONS The high incidence of intimate partner violence during postpartum and its association with aspects of the relationship's quality between the couple, demonstrated the need for public policies that promote conflict mediation and enable forms of empowerment for women to address the cycle of violence. PMID:26270012

  15. Language Acquisition in Late Critical Period: A Case Report

    ERIC Educational Resources Information Center

    Gheitury, Amer; Sahraee, Ahmad Hosein; Hoseini, Maryam

    2012-01-01

    Studies carried out to support the existence of a critical period for language acquisition have concentrated mainly on the case of being in total deprivation from language contact, and in particular deprivation from auditory input in the entire time span before puberty. While arguing for a useful distinction between early and late critical

  16. Headache and status epilepticus in the postpartum period; posterior reversible encephalopathy syndrome or cerebral venous thrombosis?

    PubMed

    Zis, Panagiotis; Tavernarakis, Antonios

    2013-01-01

    We report a case of a young woman, with a history of a miscarriage and a molar pregnancy, who developed headache and status epilepticus in postpartum day three. Posterior reversible encephalopathy syndrome (PRES) and cerebral venous and sinus thrombosis (CVST) can present with identical clinical picture; however, the imaging findings can help the clinician to make the correct diagnosis and initiate the appropriate treatment. Both PRES and CVST are medical emergencies and fully reversible entities especially when treatment initiation is immediate. PMID:23710378

  17. The vaginal microbiome during pregnancy and the postpartum period in a European population

    PubMed Central

    MacIntyre, David A.; Chandiramani, Manju; Lee, Yun S.; Kindinger, Lindsay; Smith, Ann; Angelopoulos, Nicos; Lehne, Benjamin; Arulkumaran, Shankari; Brown, Richard; Teoh, Tiong Ghee; Holmes, Elaine; Nicoholson, Jeremy K.; Marchesi, Julian R.; Bennett, Phillip R.

    2015-01-01

    The composition and structure of the pregnancy vaginal microbiome may influence susceptibility to adverse pregnancy outcomes. Studies on the pregnant vaginal microbiome have largely been limited to Northern American populations. Using MiSeq sequencing of 16S rRNA gene amplicons, we characterised the vaginal microbiota of a mixed British cohort of women (n = 42) who experienced uncomplicated term delivery and who were sampled longitudinally throughout pregnancy (8–12, 20–22, 28–30 and 34–36 weeks gestation) and 6 weeks postpartum. We show that vaginal microbiome composition dramatically changes postpartum to become less Lactobacillus spp. dominant with increased alpha-diversity irrespective of the community structure during pregnancy and independent of ethnicity. While the pregnancy vaginal microbiome was characteristically dominated by Lactobacillus spp. and low alpha-diversity, unlike Northern American populations, a significant number of pregnant women this British population had a L. jensenii-dominated microbiome characterised by low alpha-diversity. L. jensenii was predominantly observed in women of Asian and Caucasian ethnicity whereas L. gasseri was absent in samples from Black women. This study reveals new insights into biogeographical and ethnic effects upon the pregnancy and postpartum vaginal microbiome and has important implications for future studies exploring relationships between the vaginal microbiome, host health and pregnancy outcomes. PMID:25758319

  18. Placental Corticotropin-Releasing Hormone Mediates the Association Between Prenatal Social Support and Postpartum Depression.

    PubMed

    Hahn-Holbrook, Jennifer; Schetter, Christine Dunkel; Arora, Chander; Hobel, Calvin J

    2013-07-01

    Three decades of research point to both biological and psychological risk factors for postpartum depression, but very little research integrates the two. This study bridged this gap by testing whether prenatal social support predicted depressive symptoms at 8 weeks postpartum in a multiethnic sample of 210 women and whether the stress hormone placental corticotropin-releasing hormone (pCRH), measured at 19, 29, and 37 weeks' gestation, mediated this relationship. We found that prenatal family support predicted significantly fewer depressive symptoms postpartum and more gradual increases in pCRH from 29 to 37 weeks' gestation. Furthermore, steeper increases in pCRH during this same period predicted more depressive symptoms postpartum. Finally, these changes in pCRH in late pregnancy mediated the relationship between prenatal family support and postpartum depressive symptoms. These results suggest that social and biological risk factors for postpartum depressive symptoms are intertwined and move us closer to an integrated biopsychosocial understanding of postpartum depression. PMID:23997996

  19. Placental Corticotropin-Releasing Hormone Mediates the Association Between Prenatal Social Support and Postpartum Depression

    PubMed Central

    Hahn-Holbrook, Jennifer; Schetter, Christine Dunkel; Arora, Chander; Hobel, Calvin J.

    2013-01-01

    Three decades of research point to both biological and psychological risk factors for postpartum depression, but very little research integrates the two. This study bridged this gap by testing whether prenatal social support predicted depressive symptoms at 8 weeks postpartum in a multiethnic sample of 210 women and whether the stress hormone placental corticotropin-releasing hormone (pCRH), measured at 19, 29, and 37 weeks gestation, mediated this relationship. We found that prenatal family support predicted significantly fewer depressive symptoms postpartum and more gradual increases in pCRH from 29 to 37 weeks gestation. Furthermore, steeper increases in pCRH during this same period predicted more depressive symptoms postpartum. Finally, these changes in pCRH in late pregnancy mediated the relationship between prenatal family support and postpartum depressive symptoms. These results suggest that social and biological risk factors for postpartum depressive symptoms are intertwined and move us closer to an integrated biopsychosocial understanding of postpartum depression. PMID:23997996

  20. Late pregnancy progesterone treatment as a modulatory signal for postpartum behavior.

    PubMed

    Cruz, A M; Sukikara, M H; Felicio, L F

    2015-03-01

    Changes in plasma progesterone levels during late pregnancy are a determining factor in the expression of maternal behavior during lactation. Previous studies showed that mild opioidergic stimulation during late pregnancy makes lactating females more sensitive to opioidergic-induced inhibition of maternal behavior and more willing to display hunting behavior. Such previous behaviorally meaningful opioidergic stimulation also selectively increased serum progesterone levels. The present study tested whether progesterone treatment during late pregnancy interferes with the display of maternal behavior and behavioral selection during lactation. In Experiment 1, rats were treated with progesterone (400 and 500 ?g per day) from the 17th day to the 22nd day of pregnancy. The lowest progesterone dose did not interfere with pregnancy or parturition, and this dose was used in Experiments 2 and 3, in which the rats were treated with subcutaneous progesterone or peanut oil for 5 days beginning on pregnancy day 17. On day 5 of lactation, dams were challenged with subcutaneous morphine (1.5 mg/kg), or saline. The rats were then tested for maternal care (Experiment 2) or behavioral selection with pups and cockroaches (Experiment 3). Animals treated with progesterone during late pregnancy and challenged with morphine during lactation exhibited a significant decrease in maternal behavior in both Experiments 2 and 3. Predatory hunting was not modified by progesterone treatment. These results indicate that sensitivity to opioidergic-mediated inhibition of maternal behavior is enhanced by prepartum progesterone administration. Thus progesterone might be part of the opioid-triggered prepartum signaling leading to behavioral changes during lactation. PMID:25550156

  1. Glutamic acid decarboxylase 65 and 67 expression in the lateral septum is up-regulated in association with the postpartum period in mice

    PubMed Central

    Zhao, Changjiu; Driessen, Terri; Gammie, Stephen C.

    2013-01-01

    The postpartum period in mammals undergoes a variety of physiological adaptations, including metabolic, behavioral and neuroendocrine alterations. GABA signaling has been strongly linked to various emotional states, stress responses and offspring protection. However, whether GABA signaling may change in the lateral septum (LS), a core brain region for regulating behavioral, emotional and stress responses in postpartum mice has not previously been examined. In this study, we tested whether the expression of two isoforms of glutamic acid decarboxylase (GAD), GAD65 (GAD2) and GAD67 (GAD1), the rate-limiting enzyme for GABA synthesis, exhibits altered expression in postpartum mice relative to nonmaternal, virgin mice. Using microdissected septal tissue from virgin and age-matched postpartum females, quantitative real-time PCR and Western blotting were carried out to assess GAD mRNA and protein expression, respectively. We found both protein and mRNA expression of GAD67 in the whole septum was up-regulated in postpartum mice. By contrast, no significant difference in the whole septum was observed in GAD65 expression. We then conducted a finer level of analysis using smaller micro-dissections and found GAD67 to be significantly increased in rostral LS, but not in caudal LS or medial septum (MS). Further, GAD65 mRNA expression in rostral LS, but not in caudal LS or MS was also significantly elevated in postpartum mice. These findings suggest that an increased GABA production in rostral LS of the postpartum mice via elevated GAD65 and GAD67 expression may contribute to multiple alterations in behavioral and emotional states, and responses to stress that occur during the postpartum period. Given that rostral LS contains GABA neurons that are projection neurons or local interneurons, it still needs to be determined whether the function of elevated GABA is for local or distant action or both. PMID:22750123

  2. Postpartum Depression

    MedlinePLUS

    ... for Your Child All About Food Allergies Postpartum Depression KidsHealth > For Parents > Postpartum Depression Print A A ... the cause of your emotional lows. continue Postpartum Depression For some women, the feelings of sadness or ...

  3. Postpartum depression

    MedlinePLUS

    Depression - postpartum; Postnatal depression; Postpartum psychological reactions ... The exact causes of postpartum depression are unknown. Changes in hormone levels during and after pregnancy may affect a woman’s mood. Many non-hormonal factors may also ...

  4. Postpartum Exercise and Lactation.

    PubMed

    Bane, Susan M

    2015-12-01

    Many women who are breastfeeding also want to participate in exercise, but have concerns about the safety of their newborn. The following chapter reviews issues related to postpartum exercise and lactation. The goals of the chapter are to help clinicians understand the benefits of exercise, examine the impact of postpartum exercise on breastfeeding, and provide practical recommendations for exercise during the postpartum period in women who are breastfeeding. PMID:26398298

  5. Thyroid dysfunction during pregnancy and in postpartum period: treatment and latest recommendations.

    PubMed

    Vandana; Kumar, Amit; Khatuja, Ritu; Mehta, Sumita

    2014-05-01

    Thyroid dysfunction is the second most common endocrine disorder, only after diabetes mellitus, affecting females in reproductive age group. Pregnancy is associated with profound repercussions on the thyroid status of a lady. Thyroid dysfunctions such as hypothyroidism, thyrotoxicosis and thyroid nodules may develop during pregnancy leading to abortion, placental abruptions, pre-eclampsia, preterm delivery and reduced intellectual function in the offspring. Thus, maintenance of euthyroid state is of utmost important for maternal and fetal well being during pregnancy as well as after. The Endocrine Society has issued latest guidelines regarding the diagnosis and management of thyroid dysfunction related to pregnancy. All the clinicians should be well aware of the latest recommendations regarding management of thyroid dysfunction in pregnancy and in postpartum phase and practice them accordingly. PMID:24510157

  6. A complete insect from the Late Devonian period.

    PubMed

    Garrouste, Romain; Clément, Gaël; Nel, Patricia; Engel, Michael S; Grandcolas, Philippe; D'Haese, Cyrille; Lagebro, Linda; Denayer, Julien; Gueriau, Pierre; Lafaite, Patrick; Olive, Sébastien; Prestianni, Cyrille; Nel, André

    2012-08-01

    After terrestrialization, the diversification of arthropods and vertebrates is thought to have occurred in two distinct phases, the first between the Silurian and the Frasnian stages (Late Devonian period) (425-385 million years (Myr) ago), and the second characterized by the emergence of numerous new major taxa, during the Late Carboniferous period (after 345 Myr ago). These two diversification periods bracket the depauperate vertebrate Romer's gap (360-345 Myr ago) and arthropod gap (385-325 Myr ago), which could be due to preservational artefact. Although a recent molecular dating has given an age of 390 Myr for the Holometabola, the record of hexapods during the Early-Middle Devonian (411.5-391 Myr ago, Pragian to Givetian stages) is exceptionally sparse and based on fragmentary remains, which hinders the timing of this diversification. Indeed, although Devonian Archaeognatha are problematic, the Pragian of Scotland has given some Collembola and the incomplete insect Rhyniognatha, with its diagnostic dicondylic, metapterygotan mandibles. The oldest, definitively winged insects are from the Serpukhovian stage (latest Early Carboniferous period). Here we report the first complete Late Devonian insect, which was probably a terrestrial species. Its 'orthopteroid' mandibles are of an omnivorous type, clearly not modified for a solely carnivorous diet. This discovery narrows the 45-Myr gap in the fossil record of Hexapoda, and demonstrates further a first Devonian phase of diversification for the Hexapoda, as in vertebrates, and suggests that the Pterygota diversified before and during Romer's gap. PMID:22859205

  7. [Contribution to the history of pharmacology (the late antique period)].

    PubMed

    Tesa?ov, Drahomra

    2015-01-01

    Pharmacological literature in the Late Antique period followed the Roman tradition and widely used Scribonius Largus and excerpts from the writings of Pliny the Elder. Literature was created both in the western part of the Roman Empire and in North Africa in Carthage. Manuals have been written about medicinal plants (Herbarius of Pseudo-Apuleius, De herba vettonica of Pseudo-Musa), for drugs obtained from the animal kingdom (Liber medicinae of Sextus Placitus) or documents containing both (De medicina of Cassius Felix, De medicamentis of Marcellus Empiricus). The contribution of this literature is the mediation of ancient knowledge into the Middle Ages. PMID:25994825

  8. Non-invasive endocrine monitoring of ovarian and adrenal activity in chinchilla (Chinchilla lanigera) females during pregnancy, parturition and early post-partum period.

    PubMed

    Mastromonaco, Gabriela F; Cantarelli, Verónica I; Galeano, María G; Bourguignon, Nadia S; Gilman, Christine; Ponzio, Marina F

    2015-03-01

    The chinchilla is a rodent that bears one of the finest and most valuable pelts in the world. The wild counterpart is, however, almost extinct because of a drastic past and ongoing population decline. The present work was developed to increase our knowledge of the reproductive physiology of pregnancy and post-partum estrus in the chinchilla, characterizing the endocrine patterns of urinary progesterone, estradiol, LH and cortisol metabolites throughout gestation and post-partum estrus and estimating the ovulation timing at post-partum estrus. Longitudinal urine samples were collected once per week throughout pregnancy and analyzed for creatinine, cortisol, LH, estrogen and progesterone metabolite concentrations. To indirectly determine the ovulation timing at post-partum estrus, a second experiment was performed using pregnant females subjected to a post-partum in vivo fertilization scheme. Urinary progestagen metabolites increased above baseline levels in early pregnancy between weeks-8 and -11 respectively to parturition, and slightly declined at parturition time. Urinary estrogens showed rising levels throughout mid- and late pregnancy (weeks-9 to -6 and a further increase at week-5 to parturition) and decreased in a stepwise manner after parturition, returning to baseline levels two weeks thereafter. Cortisol metabolite levels were relatively constant throughout pregnancy with a tendency for higher levels in the last third of gestation and after the pups' birth. Parturition was associated with dramatic reductions in urinary concentrations of sex steroids (especially progestagens). Observations in breeding farms indicated that the females that resulted in a second pregnancy after mating, did so on the second day after parturition. These data were in agreement with an LH peak detected 24h after parturition. Urinary steroid hormone patterns of estrogen and progestagen metabolites provided valuable information on endocrine events during pregnancy and after parturition in the chinchilla. Results presented in this study enhance our understanding of natural reproductive dynamics in the chinchilla and support empirical observations of breeders that post-partum ovulation occurs ∼ 48 h after parturition. PMID:25712434

  9. Identifying intimate partner violence (IPV) during the postpartum period in a Greek sample.

    PubMed

    Vivilaki, Victoria G; Dafermos, Vassilis; Daglas, Maria; Antoniou, Evagelia; Tsopelas, Nicholas D; Theodorakis, Pavlos N; Brown, Judith B; Lionis, Christos

    2010-12-01

    Research has highlighted the wide impact of intimate partner violence (IPV) and the public health role of community health professionals in detection of victimized women. The purpose of this study was to identify postpartum emotional and physical abuse and to validate the Greek version of the Women Abuse Screening Tool (WAST) along with its sensitivity and specificity. Five hundred seventy-nine mothers within 12 weeks postpartum were recruited from the perinatal care registers of the Maternity Departments of two public hospitals in Athens, Greece. Participants were randomly selected by clinic or shift. The WAST and the Partner Violence Screen (PVS) surveys were administered in random order to the mothers from September 2007 to January 2008. The WAST was compared with the PVS as a criterion standard. Agreement between the screening instruments was examined. The psychometric measurements that were performed included: two independent sample t tests, reliability coefficients, explanatory factor analysis using a Varimax rotation, and Principal Components Method. Confirmatory analysis-also called structural equation modeling-of principal components was conducted by Linear Structural Relations. A receiver operating characteristic (ROC) analysis was carried out to evaluate the global functioning of the scale. Two hundred four (35.6%) of the mothers screened were identified as experiencing IPV. Scores on the WAST correlated well with those on the PVS; the internal consistency of the WAST Greek version-tested using Cronbach's alpha coefficient-was found to be 0.926 and that of Guttman's split-half coefficient was 0.924. Our findings confirm the multidimensionality of the WAST, demonstrating a two-factor structure. The area under ROC curve (AUC) was found to be 0.824, and the logistic estimate for the threshold score of 0/1 fitted the model sensitivity at 99.7% and model specificity at 64.4%. Our data confirm the validity of the Greek version of the WAST in identifying IPV. The validated Greek WAST scale could be used for screening purposes in both clinical practice and research. PMID:20306211

  10. [Inpatient postpartum nursing: evaluation of "holistic" and "traditional" nursing processes in the post partum period].

    PubMed

    Hasseler, Martina

    2002-10-01

    During the last years one could observe a change in the organisation of postpartum care at hospitals in Germany. Maternity hospitals implement new models of care which they call "holistic", "integrated" or "family centered" care. The reasons for the implementation are various. The desire for an optimal care has surely to be mentioned in the first place, but social changes and changes in health politics like the shortening of the lengths of hospital stay after a normal birth and the demand for quality assurance are also very important. But what does the "new model of care" mean for mothers, their children and their families and for the staff? What effects have the new models of care in comparison with the traditional ones? Will the goals be achieved? A formative programme evaluation was chosen in order to investigate these questions. To do justice to the research plan, to the complexity of the field of research and to produce valid results, three qualitative methods were applied: (keywords: triangulation: time triangulation, within-method-triangulation): participant observation, problem-oriented interview according to Witzel and document analysis. The evaluation of the data followed the method of qualitative content analysis developed by Mayring. As a whole, the results suggest that the new model of care has not produced the changes and not left the impression and effects on the mothers and the staff the hospital and the supporters had hoped for. PMID:12465362

  11. Mental Health of HIV-Seropositive Women During Pregnancy and Postpartum Period: A Comprehensive Literature Review

    PubMed Central

    Dass-Brailsford, Priscilla; Nora, Diana; Talisman, Nicholas

    2014-01-01

    With growing numbers of HIV-seropositive (HIV+) women of child-bearing age and increased access to effective clinical protocols for preventing mother-to-child transmission (MTCT) of HIV, mental health-related factors have become increasingly relevant due to their potential to affect the women’s quality of life, obstetric outcomes and risk of MTCT. This review synthesizes evidence from 53 peer-reviewed publications examining mental health-related variables in pregnant and postpartum HIV+ women. The presentation of results is organized by the level of socioeconomic resources in the countries where studies were conducted (i.e., high-, middle-, and low-income countries). It is concluded that psychiatric symptoms, particularly depression, and mental health vulnerabilities (e.g., inadequate coping skills) are widespread among pregnant HIV+ women globally and have a potential to affect psychological well-being, quality of life and salient clinical outcomes. The current body of evidence provides rationale for developing and evaluating clinical and structural interventions aimed at improving mental health outcomes and their clinical correlates in pregnant HIV+ women. PMID:24584458

  12. Emotion Reactivity Is Increased 4-6 Weeks Postpartum in Healthy Women: A Longitudinal fMRI Study

    PubMed Central

    Gingnell, Malin; Bannbers, Elin; Moes, Harmen; Engman, Jonas; Sylvn, Sara; Skalkidou, Alkistis; Kask, Kristiina; Wikstrm, Johan; Sundstrm-Poromaa, Inger

    2015-01-01

    Marked endocrine alterations occur after delivery. Most women cope well with these changes, but the postpartum period is associated with an increased risk of depressive episodes. Previous studies of emotion processing have focused on maternalinfant bonding or postpartum depression (PPD), and longitudinal studies of the neural correlates of emotion processing throughout the postpartum period in healthy women are lacking. In this study, 13 women, without signs of post partum depression, underwent fMRI with an emotional face matching task and completed the MADRS-S, STAI-S, and EPDS within 48 h (early postpartum) and 46 weeks after delivery (late postpartum). Also, data from a previous study including 15 naturally cycling controls assessed in the luteal and follicular phase of the menstrual cycle was used. Women had lower reactivity in insula, middle frontal gyrus (MFG), and inferior frontal gyrus (IFG) in the early as compared to the late postpartum assessment. Insular reactivity was positively correlated with anxiety in the early postpartum period and with depressive symptoms late postpartum. Reactivity in insula and IFG were greater in postpartum women than in non-pregnant control subjects. Brain reactivity was not correlated with serum estradiol or progesterone levels. Increased reactivity in the insula, IFG, and MFG may reflect normal postpartum adaptation, but correlation with self-rated symptoms of depression and anxiety in these otherwise healthy postpartum women, may also suggest that these changes place susceptible women at increased risk of PPD. These findings contribute to our understanding of the neurobiological aspects of the postpartum period, which might shed light on the mechanisms underlying affective puerperal disorders, such as PPD. PMID:26061879

  13. [How to manage a patient with chronic arterial hypertension during pregnancy and the postpartum period].

    PubMed

    Pourrat, O

    2015-03-01

    The management of chronic arterial hypertension during pregnancy and postpartum requires first to estimate the risk of the pregnancy, linked with the severity of hypertension, with cardiac and renal involvement, with its cause as well as with the background (obesity, diabetes, possible history of placental vascular pathology). On a very practical approach, antihypertensive drug has to be started or increased if systolic pressure reaches or exceeds 160 mmHg or if diastolic pressure reaches or exceeds 105 mmHg. Below this level, there are no evidence-based medicine data, but it seems reasonable to treat if pressure increases over 150/100 mmHg (140/90 mmHg in case of ambulatory monitoring). Excessive pressure figures control must be avoided as much as insufficient ones: in practice, it is necessary to decrease the treatment dose if figures are below 130/80 mmHg. Three antihypertensive drugs are consensually recommended today: alphametyldopa, calcium-channel blockers and labetalol. Monotherapy is most often sufficient; if needed, two of these drugs can easily be associated, and even three if necessary. Converting enzyme inhibitors and angiotensin receptor II antagonists should not be prescribed to pregnant women. Betablockers and diuretics are not recommended. Whatever is the antihypertensive drug used, it is necessary to detect the signs of bad placenta blood circulation with uterine Doppler ultrasound and regular controls of fetal growth, and to check for appearance of proteinuria, defining then over-imposed pre-eclampsia needing immediate admission to the maternity. After delivery, lacatation suppresion with bromocriptin should not be prescribed. PMID:24075628

  14. High HIV incidence in the postpartum period sustains vertical transmission in settings with generalized epidemics: a cohort study in Southern Mozambique

    PubMed Central

    De Schacht, Caroline; Mabunda, Nédio; Ferreira, Orlando C; Ismael, Nália; Calú, Nurbai; Santos, Iolanda; Hoffman, Heather J; Alons, Catharina; Guay, Laura; Jani, Ilesh V

    2014-01-01

    Introduction Acute infection with HIV in the postpartum period results in a high risk of vertical transmission through breastfeeding. A study was done to determine the HIV incidence rate and associated risk factors among postpartum women in Southern Mozambique, where HIV prevalence among pregnant women is 21%. Methods A prospective cohort study was conducted in six rural health facilities in Gaza and Maputo provinces from March 2008 to July 2011. A total of 1221 women who were HIV-negative on testing at delivery or within two months postpartum were recruited and followed until 18 months postpartum. HIV testing, collection of dried blood spot samples and administration of a structured questionnaire to women were performed every three months. Infant testing by DNA-PCR was done as soon as possible after identification of a new infection in women. HIV incidence was estimated, and potential risk factors at baseline were compared using Poisson regression. Results Data from 957 women were analyzed with follow-up after the enrolment visit, with a median follow-up of 18.2 months. The HIV incidence in postpartum women is estimated at 3.20/100 women-years (95% CI: 2.30–4.46), with the highest rate among 18- to 19-year-olds (4.92 per 100 women-years; 95% CI: 2.65–9.15). Of the new infections, 14 (34%) were identified during the first six months postpartum, 11 (27%) between 6 and 12 months and 16 (39%) between 12 and 18 months postpartum. Risk factors for incident HIV infection include young age, low number of children, higher education level of the woman's partner and having had sex with someone other than one's partner. The vertical transmission was 21% (95% CI: 5–36) among newly infected women. Conclusions Incidence of HIV is high among breastfeeding women in Southern Mozambique, contributing to increasing numbers of HIV-infected infants. Comprehensive primary prevention strategies targeting women of reproductive age, particularly pregnant and postpartum women and their partners, will be crucial for the elimination of paediatric AIDS in Africa. PMID:24629842

  15. The role of the parents’ perception of the postpartum period and knowledge of maternal mortality in uptake of postnatal care: a qualitative exploration in Malawi

    PubMed Central

    Zamawe, Collins F; Masache, Gibson C; Dube, Albert N

    2015-01-01

    Background Postpartum is the most risky period for both mothers and newborn babies. However, existing evidence suggests that utilization of postnatal care is relatively lower when compared to uptake of other similar health care services. Therefore, the aim of this study was to examine the perceptions of parents toward the postpartum period and postnatal care in order to deepen our understanding of the maternal care-seeking practices after childbirth. Methods A descriptive qualitative study, comprising four focus group discussions with 50 parents aged between 18 and 35 years, was conducted in Malawi between January and March 2014. Only young men and women who had either given birth or fathered a baby within 12 months prior to the study were eligible to participate in this study. This was to ensure that only participants who had recent first-hand postpartum experience were included. Local leaders purposively identified all parents who met the inclusion criteria and then simple random sampling was used to select participants from this pool of parents. Data analysis followed the six steps of thematic approach developed by Braun and Clarke, and NVivo software aided the process. Findings The parents interviewed described the various factors relating to pregnancy, childbirth, and postpartum periods that may possibly influence uptake of postnatal care. These factors were categorized into the following three themes: beliefs about the causes of maternal morbidity and mortality; risks associated with the pregnancy, childbirth and postpartum periods; and the importance of and barriers to postnatal care. Most participants perceived pregnancy and childbirth as the most risky periods to women, and their understanding of the causes of maternal death differed considerably from the existing evidence. In addition, segregation of mother and baby care in the clinics was identified as one of the potential barriers to postnatal care. Conclusion The study findings suggest that parents’ perception of the postpartum period and postnatal care as well as their knowledge of maternal morbidity and mortality play a vital role in the uptake of postnatal care. The study has also established that lack of knowledge of postnatal care, long waiting time for treatment, and separation of the mother and baby care in clinics are some of the key barriers to postnatal care. We recommend massive maternal health education programs as well as the integration of all postdelivery health care services provided in clinics, so that mothers and neonates receive health care together. PMID:26089704

  16. Postpartum Depression

    MedlinePLUS

    ... do not need treatment. The symptoms of postpartum depression last longer and are more severe. You may ... treatment right away, often in the hospital. Postpartum depression can begin anytime within the first year after ...

  17. Postpartum Thyroiditis

    MedlinePLUS

    ... high thyroid hormone levels in the blood) and hypothyroidism (low thyroid hormone levels in the blood). In postpartum thyroiditis, thyrotoxicosis occurs first followed by hypothyroidism. What causes postpartum thyroiditis? The exact cause is ...

  18. Postpartum Depression

    MedlinePLUS

    MENU Postpartum Depression Overview Are mood changes common after childbirth? Yes. After having a baby, many women have mood swings. ... away within 10 days after delivery. What is postpartum depression? Some womens have more severe symptoms of the ...

  19. Immediate Postpartum Intrauterine Contraception Insertion.

    PubMed

    Prager, Sarah W; McCoy, Erin E

    2015-12-01

    The immediate postpartum period is a favorable time for initiating contraception because women who have recently given birth are often highly motivated to use contraception, pregnancy is excluded, and the hospital setting offers convenience for patients and providers. This article addresses immediate postpartum intrauterine contraception (IUC) insertion for copper and levonorgestrel IUC. Immediate postpartum IUC is safe and effective, with a majority of IUC devices retained at 6 and 12months. There are increased rates of expulsion, compared with delayed postpartum insertion and interval insertion, which need to be weighed against the risk of patients not returning for postpartum follow-up. PMID:26598300

  20. An Examination of Dynamic Gene Expression Changes in the Mouse Brain During Pregnancy and the Postpartum Period

    PubMed Central

    Ray, Surjyendu; Tzeng, Ruei-Ying; DiCarlo, Lisa M.; Bundy, Joseph L.; Vied, Cynthia; Tyson, Gary; Nowakowski, Richard; Arbeitman, Michelle N.

    2015-01-01

    The developmental transition to motherhood requires gene expression changes that alter the brain to drive the female to perform maternal behaviors. We broadly examined the global transcriptional response in the mouse maternal brain, by examining four brain regions: hypothalamus, hippocampus, neocortex, and cerebellum, in virgin females, two pregnancy time points, and three postpartum time points. We find that overall there are hundreds of differentially expressed genes, but each brain region and time point shows a unique molecular signature, with only 49 genes differentially expressed in all four regions. Interestingly, a set of “early-response genes” is repressed in all brain regions during pregnancy and postpartum stages. Several genes previously implicated in underlying postpartum depression change expression. This study serves as an atlas of gene expression changes in the maternal brain, with the results demonstrating that pregnancy, parturition, and postpartum maternal experience substantially impact diverse brain regions. PMID:26596646

  1. An Examination of Dynamic Gene Expression Changes in the Mouse Brain During Pregnancy and the Postpartum Period.

    PubMed

    Ray, Surjyendu; Tzeng, Ruei-Ying; DiCarlo, Lisa M; Bundy, Joseph L; Vied, Cynthia; Tyson, Gary; Nowakowski, Richard; Arbeitman, Michelle N

    2015-01-01

    The developmental transition to motherhood requires gene expression changes that alter the brain to drive the female to perform maternal behaviors. We broadly examined the global transcriptional response in the mouse maternal brain, by examining four brain regions: hypothalamus, hippocampus, neocortex, and cerebellum, in virgin females, two pregnancy time points, and three postpartum time points. We find that overall there are hundreds of differentially expressed genes, but each brain region and time point shows a unique molecular signature, with only 49 genes differentially expressed in all four regions. Interestingly, a set of "early-response genes" is repressed in all brain regions during pregnancy and postpartum stages. Several genes previously implicated in underlying postpartum depression change expression. This study serves as an atlas of gene expression changes in the maternal brain, with the results demonstrating that pregnancy, parturition, and postpartum maternal experience substantially impact diverse brain regions. PMID:26596646

  2. Prevalence of vitamin D deficiency and associated factors in women and newborns in the immediate postpartum period

    PubMed Central

    do Prado, Mara Rbia Maciel Cardoso; Oliveira, Fabiana de Cssia Carvalho; Assis, Karine Franklin; Ribeiro, Sarah Aparecida Vieira; do Prado, Pedro Paulo; Sant'Ana, Luciana Ferreira da Rocha; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro

    2015-01-01

    Abstract Objective: To assess the prevalence of vitamin D deficiency and its associated factors in women and their newborns in the postpartum period. Methods: This cross-sectional study evaluated vitamin D deficiency/insufficiency in 226 women and their newborns in Viosa (Minas Gerais, BR) between December 2011 and November 2012. Cord blood and venous maternal blood were collected to evaluate the following biochemical parameters: vitamin D, alkaline phosphatase, calcium, phosphorus and parathyroid hormone. Poisson regression analysis, with a confidence interval of 95%, was applied to assess vitamin D deficiency and its associated factors. Multiple linear regression analysis was performed to identify factors associated with 25(OH)D deficiency in the newborns and women from the study. The criteria for variable inclusion in the multiple linear regression model was the association with the dependent variable in the simple linear regression analysis, considering p<0.20. Significance level was ? <5%. Results: From 226 women included, 200 (88.5%) were 20-44 years old; the median age was 28 years. Deficient/insufficient levels of vitamin D were found in 192 (85%) women and in 182 (80.5%) neonates. The maternal 25(OH)D and alkaline phosphatase levels were independently associated with vitamin D deficiency in infants. Conclusions: This study identified a high prevalence of vitamin D deficiency and insufficiency in women and newborns and the association between maternal nutritional status of vitamin D and their infants' vitamin D status. PMID:26100593

  3. Variation of Transaminases, HCV-RNA Levels and Th1/Th2 Cytokine Production during the Post-Partum Period in Pregnant Women with Chronic Hepatitis C

    PubMed Central

    Ruiz-Extremera, ngeles; Muoz-Gmez, Jos Antonio; Abril-Molina, Ana; Salmern-Ruiz, Mara Angustias; Muoz-de-Rueda, Paloma; Pavn-Castillero, Esther Jos; Quiles-Prez, Rosa; Carazo, ngel; Gila, Ana; Jimenez-Ruiz, Sergio Manuel; Casado, Jorge; Martn, Ana Beln; Sanjun-Nez, Laura; Ocete-Hita, Esther; Viota, Julin Lpez; Len, Josefa; Salmern, Javier

    2013-01-01

    This study analyses the evolution of liver disease in women with chronic hepatitis C during the third trimester of pregnancy and the post-partum period, as a natural model of immune modulation and reconstitution. Of the 122 mothers recruited to this study, 89 were HCV-RNA+ve/HIV-ve and 33 were HCV-RNA-ve/HIV-ve/HCVantibody+ve and all were tested during the third trimester of pregnancy, at delivery and post-delivery. The HCV-RNA+ve mothers were categorized as either Type-A (66%), with an increase in ALT levels in the post-partum period (>40 U/L; P<0.001) or as Type-B (34%), with no variation in ALT values. The Type-A mothers also presented a significant decrease in serum HCV-RNA levels in the post-delivery period (P<0.001) and this event was concomitant with an increase in Th1 cytokine levels (INF?, P?=?0.04; IL12, P?=?0.01 and IL2, P?=?0.01). On the other hand, the Type-B mothers and the HCV-RNA-ve women presented no variations in either of these parameters. However, they did present higher Th1 cytokine levels in the partum period (INF? and IL2, P<0.05) than both the Type-A and the HCV-RNA-ve women. Cytokine levels at the moment of delivery do not constitute a risk factor associated with HCV vertical transmission. It is concluded that differences in the ALT and HCV-RNA values observed in HCV-RNA+ve women in the postpartum period might be due to different ratios of Th1 cytokine production. In the Type-B women, the high partum levels of Th1 cytokines and the absence of post-partum variation in ALT and HCV-RNA levels may be related to permanent Th1 cytokine stimulation. PMID:24130726

  4. Effect of ?-carotene supply during close-up dry period on the onset of first postpartum luteal activity in dairy cows.

    PubMed

    Kawashima, C; Nagashima, S; Sawada, K; Schweigert, F J; Miyamoto, A; Kida, K

    2010-12-01

    The aim of this study was to examine the effect of ?-carotene supply during the close-up dry period on the onset of first postpartum luteal activity in dairy cows. Twelve cows were supplied with 2000?mg of ?-carotene (20?g Rovimix() ?-Carotene containing 10% ?-carotene; DSM Nutrition Japan K.K., Tokyo, Japan) by oral administration daily from day 21 before expected calving date to parturition. Fourteen cows (control) did not receive ?-carotene supplementation. Blood samples were obtained on days 21, 14 and 7 before expected calving date and on days 1, 7, 14, 21 postpartum. When the plasma progesterone concentration exceeded 1?ng/ml by day 21 postpartum, luteal activity was assumed to have been initiated. The result showed that serum ?-carotene concentrations in the ?-carotene cows were higher than in the control cows during the experimental period (p?postpartum was 9/12 in the ?-carotene cows and 4/14 in the control cows (p?period may support the onset of luteal activity during early lactation in dairy cows. PMID:20002607

  5. Postpartum psychiatric disorders: Early diagnosis and management.

    PubMed

    Rai, Shashi; Pathak, Abhishek; Sharma, Indira

    2015-07-01

    Postpartum period is demanding period characterized by overwhelming biological, physical, social, and emotional changes. It requires significant personal and interpersonal adaptation, especially in case of primigravida. Pregnant women and their families have lots of aspirations from the postpartum period, which is colored by the joyful arrival of a new baby. Unfortunately, women in the postpartum period can be vulnerable to a range of psychiatric disorders like postpartum blues, depression, and psychosis. Perinatal mental illness is largely under-diagnosed and can have far reaching ramifications for both the mother and the infant. Early screening, diagnosis, and management are very important and must be considered as mandatory part of postpartum care. PMID:26330638

  6. Postpartum psychiatric disorders: Early diagnosis and management

    PubMed Central

    Rai, Shashi; Pathak, Abhishek; Sharma, Indira

    2015-01-01

    Postpartum period is demanding period characterized by overwhelming biological, physical, social, and emotional changes. It requires significant personal and interpersonal adaptation, especially in case of primigravida. Pregnant women and their families have lots of aspirations from the postpartum period, which is colored by the joyful arrival of a new baby. Unfortunately, women in the postpartum period can be vulnerable to a range of psychiatric disorders like postpartum blues, depression, and psychosis. Perinatal mental illness is largely under-diagnosed and can have far reaching ramifications for both the mother and the infant. Early screening, diagnosis, and management are very important and must be considered as mandatory part of postpartum care. PMID:26330638

  7. Periods of activity cycles in late-type stars

    NASA Technical Reports Server (NTRS)

    Kliorin, N. I.; Ruzmaykin, A. A.; Sokolov, D. D.

    1983-01-01

    The mean magnetic field dynamo theory is utilized to obtain the qualitative dependence of the period of activity on the angular velocity of rotation for stars with sufficiently extensive convective shells. The dependence of the cycle period on the spectral class is also discussed.

  8. [The state of the adaptation system of women during the postpartum period under the influence of an industrial complex].

    PubMed

    Kulkybaev, G A; Diusembin, Kh D; Konkabaeva, A E

    2001-01-01

    The hormonal status was studied in the dynamics of postpartum stress in the puerperas who lived in the town of Balkhash under the influence of an industrial complex. The puerperas were found to show no pronounced adrenal cortical response to postpartum stress; there was monotony of changes in the content of dopa and dophamine and the levels of adrenaline and noradrenaline remained high on day 5 after delivery as compared with the controls. There were high levels of prolactin and cortisole, which suggests different stress levels in Balkhash females and in the controls. It can be assumed that chronic exposure to industrial noxious agents results in so-called cross resistance caused by one stressor (delivery) in relation to the effect of other-order (ecological) stressors rather than in depletion of the hormonal system. PMID:11519456

  9. Postpartum Coronary Vasospasm with Literature Review

    PubMed Central

    Koneru, Jayanth; Alattar, Fadi; Alqaqa, Ashraf; Virk, Hirtaj; Shamoon, Fayez; Bikkina, Mahesh

    2014-01-01

    Acute myocardial infarction during pregnancy or the postpartum period is rare. We report a case of a 39-year-old postpartum woman who developed non-ST-elevation myocardial infarction due to severe diffuse coronary vasospasm. To our knowledge, this is the first case of angiographically evidenced coronary vasospasm, in a postpartum woman, with resistance to intracoronary nitroglycerin. PMID:25105029

  10. [Postpartum psychiatric disorders].

    PubMed

    Mazaira, Silvina

    2014-01-01

    The postpartum period represents a very particular time in women's life, the beginning of a new bond, the maternity. As many times, beginnings are such turbulent, intense. In this period the women suffers deep changes in their hormonal status, with its body and changes and affective oscillations. Women are often so labile at this time, ranging from happiness to deep sadness. The vast majority suffers the blues, a benign form of mild depressive state. On the other hand, 20% may have a major depressive episode, and a much less percentage will suffer the most disruptive postpartum syndrome, the postpartum psychosis. In this paper it will be described the symptomatology of such cases, the most important treatment approaches and will focus on the clinical dilemma of using psychotropic medications during breastfeeding. PMID:25545081

  11. Postpartum Sterilization

    MedlinePLUS

    ... called minilaparotomy ). For women who have had a cesarean delivery , postpartum tubal ligation can be done through ... following delivery. For women who have had a cesarean delivery, it is done right after the baby ...

  12. Acute subdural haemorrhage in the postpartum period as a rare manifestation of possible HELLP (haemolysis, elevated liver enzymes, and low-platelet count) syndrome: a case report

    PubMed Central

    2014-01-01

    Background The HELLP syndrome (haemolysis, elevated liver enzymes, and low-platelet count) occurs in about 0.5 to 0.9% of all pregnancies. With occurrence of thrombocytopaenia, it signals for several potentially lethal conditions such as complete or partial HELLP syndrome, thrombotic thrombocytopaenic purpura and acute fatty liver of pregnancy. Case presentation A previously healthy 27-year-old, Sinhala ethnic primigravida with pregnancy-induced hypertension was admitted at 38weeks of gestation with lower abdominal pain and a blood pressure of 140/90mmHg. She underwent emergency Caesarian section due to faetal distress giving birth to a healthy baby girl. Since postpartum day one, she was having intermittent fever spikes. All the routine investigations were normal in the first three weeks. Platelet count started dropping from post-partum day-20 onwards. On day-23, she had developed a seizure and computed tomography scan brain showed a subdural haemorrhage. She had a platelet count of 22,000??109/liter and was managed conservatively. She also had elevated liver enzymes, lactate dehydrogenase and bilirubin levels. Blood picture on day-24 showed haemolytic anemia. On day- 36, patient again developed seizures and she was having intermittent fever with generalized headache and signs of meningism. Computed tomography scan revealed an acute on chronic subdural haemorrhage. Conclusions Hypertensive disorders in pregnancy should be managed as high-risk throughout the postpartum period. Development of thrombocytopaenia can be considered as an early warning sign for HELLP, thrombotic thrombocytopaenic purpura or acute fatty liver of pregnancy which are lethal conditions. Prompt recognition of intracranial haemorrhages and early neurosurgical intervention is lifesaving. PMID:24972626

  13. Modulation of post-partum reproductive performance in dairy cows through supplementation of long- or short-chain fatty acids during transition period.

    PubMed

    Ulfina, G G; Kimothi, S P; Oberoi, P S; Baithalu, R K; Kumaresan, A; Mohanty, T K; Imtiwati, P; Dang, A K

    2015-12-01

    Thirty-six cross-bred cows were used to study the effect of long-chain (flaxseed) or short-chain (butyric acid) fatty acid supplementation on metabolic status, ovarian function and reproduction performance during transition period. Control cows received a routine feed of transition diet, while the cows in two treatment groups were supplemented with either 750-g crushed flaxseed or 250 g butyric acid per cow per day. Ovarian activity was monitored by transrectal ultrasonography on 10th, 20th and 30th days post-partum. Blood samples were collected by jugular venipuncture into heparinized polystyrene tubes; plasma was prepared and stored under -20 °C until analysis. Results indicated that cows in flaxseed group were in positive energy balance as indicated by lower NEFA and Beta hydroxy Butyrate and higher glucose concentrations. Uterine involution was completed well within 30 days post-partum in all the cows in flaxseed fed group compared to 76.9% in butyric acid supplemented and 61.5% in control groups. The size of dominant follicle and corpus luteum was significantly higher (p < 0.05) for flaxseed group compared to control group, which in turn resulted in higher concentrations of plasma progesterone. Cows fed on diets supplemented with flaxseed exhibited post-partum heat earlier and bred sooner (p < 0.05) than control cows. It has been noticed that supplementation of flaxseed and butyric acid enhanced involution of uterus, early resumption of cyclicity and thereby early breeding. However, in view of the encouraging results obtained for flaxseed supplemented group, its organic nature and easier availability at farmer's gate, we concluded that flaxseed can be safely included in transition diet to modulate reproductive performance of dairy cattle. PMID:25879374

  14. Recommendations for the diagnosis and treatment of deep venous thrombosis and pulmonary embolism in pregnancy and the postpartum period.

    PubMed

    McLintock, Claire; Brighton, Tim; Chunilal, Sanjeev; Dekker, Gus; McDonnell, Nolan; McRae, Simon; Muller, Peter; Tran, Huyen; Walters, Barry N J; Young, Laura

    2012-02-01

    Venous thromboembolism (VTE) in pregnancy and the postpartum is an important cause of maternal morbidity and mortality; yet, there are few robust data from clinical trials to inform an approach to diagnosis and management. Failure to investigate symptoms suggestive of pulmonary embolism (PE) is a consistent finding in maternal death enquiries, and clinical symptoms should not be relied on to exclude or diagnose VTE. In this consensus statement, we present our recommendations for the diagnosis and management of acute deep venous thrombosis (DVT) and PE. All women with suspected DVT in pregnancy should be investigated with whole leg compression ultrasonography. If the scan is negative and significant clinical suspicion remains, then further imaging for iliofemoral DVT maybe required. Imaging should be undertaken in all women with suspected PE, as the fetal radiation exposure with both ventilation/perfusion scans and CT pulmonary angiography is within safe limits. Low-molecular-weight heparin (LMWH) is the preferred therapy for acute VTE that occur during pregnancy. In observational cohort studies, using once-daily regimens appears adequate, in particular with the LMWH tinzaparin; however, pharmacokinetic data support twice-daily therapy with other LMWH and is recommended, at least initially, for PE or iliofemoral DVT in pregnancy. Treatment should continue for a minimum duration of six months, and until at least six weeks postpartum. Induction of labour or planned caesarean section maybe required to allow an appropriate transition to unfractionated heparin to avoid delivery in women in therapeutic doses of anticoagulation. PMID:21972999

  15. Rotation Periods of Nearby, Mid-to-late M Dwarfs from the MEarth Project

    NASA Astrophysics Data System (ADS)

    Newton, Elisabeth R.; Irwin, Jonathan; Charbonneau, David; Berta-Thomspon, Zachary K.; West, Andrew A.

    2015-11-01

    Field stars provide important constraints for the late stages of stars' angular momentum evolution. We measured rotation periods ranging from 0.1 to 150 days for approximately 450 mid-to-late M dwarfs using photometry from the MEarth transiting planet survey. We use parallaxes, proper motions, and radial velocities to calculate galactic kinematics for these solar neighborhood M dwarfs. The velocity dispersions increase towards longer rotation periods, indicating that there is a relationship between rotation and age for these stars.

  16. Rotation Periods of Nearby, Mid-to-late M Dwarfs from the MEarth Project

    NASA Astrophysics Data System (ADS)

    Newton, Elisabeth R.; Irwin, Jonathan; Charbonneau, David; Berta-Thomspon, Zachary K.; West, Andrew A.

    2016-01-01

    Field stars provide important constraints for the late stages of stars' angular momentum evolution. We measured rotation periods ranging from 0.1 to 150 days for approximately 450 mid-to-late M dwarfs using photometry from the MEarth transiting planet survey. We use parallaxes, proper motions, and radial velocities to calculate galactic kinematics for these solar neighborhood M dwarfs. The velocity dispersions increase towards longer rotation periods, indicating that there is a relationship between rotation and age for these stars.

  17. Short term post-partum heat stress in dairy cows

    NASA Astrophysics Data System (ADS)

    Fuquay, J. W.; Chapin, L. T.; Brown, W. H.

    1980-06-01

    Since many dairy cows calve during late summer, the objective was to determine if heat stress immediately post-partum would (1) alter metabolism, thus, increasing susceptibility to metabolic disorders, (2) affect lactation and/or (3) affect reproduction. Forty four cows, calving during late summer, were paired with one member of each pair stressed (HS) for the first 10 post-partum days in a hot barn. Controls (CC) were kept in a cooled section of the barn. Plasma drawn weekly for 7 weeks was analyzed in an autoanalyzer for calcium, inor. phosphorus, protein, glucose and cholesterol and by radioimmunoassay for cortisol and progesterone. Ovaries and uteri were palpated weekly. Rectal temperatures were significant higher for HS during the first 10 post-partum days. No significant effects on plasma constituents were observed during the 10-day treatment period. For the 7-week period, glucose and cholesterol were lower in HS, as were cyclic peaks of progesterone and cortisol. Both calcium and inorganic phosphorus remained clinically low for the 7 weeks, but no treatment effects were seen. Uteri of HS involuted more rapidly than the CC. Treatment did not affect reproductive efficiency. Lactation milk yields did not differ, but milk fat percent was lower in HS. Heat stress immediately post-partum altered lipid metabolism, but the animal's compensatory mechanisms prevented reduction in milk production or reproductive efficiency.

  18. Views of women and clinicians on postpartum preparation and recovery.

    PubMed

    Martin, Anika; Horowitz, Carol; Balbierz, Amy; Howell, Elizabeth A

    2014-04-01

    To explore important domains of women's postpartum experiences as perceived by postpartum mothers and obstetricians/midwives, and to investigate how postpartum care could enhance patient preparation for the postpartum period. Qualitative research study was conducted to explore women's and clinicians' perceptions of the postpartum experience. Four focus groups of postpartum women (n = 45) and two focus groups of obstetric clinicians (n = 13) were held at a large urban teaching hospital in New York City. All focus groups were audio recorded, transcribed, and analyzed using grounded theory. Four main themes were identified: lack of women's knowledge about postpartum health and lack of preparation for the postpartum experience, lack of continuity of care and absence of maternal care during the early postpartum period, disconnect between providers and postpartum mothers, and suggestions for improvement. Mothers did not expect many of the symptoms they experienced after childbirth and were disappointed with the lack of support by providers during this critical time in their recovery. Differences existed in the major postpartum concerns of mothers and clinicians. However, both mothers and clinicians agreed that preparation during the antepartum period could be beneficial for postpartum recovery. Results from this study indicate that many mothers do not feel prepared for the postpartum experience. Study findings raise the hypothesis that capturing patient-centered domains that define the postpartum experience and integrating these domains into patient care may enhance patient preparation for postpartum recovery and improve postpartum outcomes. PMID:23775250

  19. Views of Women and Clinicians on Postpartum Preparation and Recovery

    PubMed Central

    Martin, Anika; Horowitz, Carol; Howell, Elizabeth A.

    2015-01-01

    To explore important domains of womens postpartum experiences as perceived by postpartum mothers and obstetricians/midwives, and to investigate how postpartum care could enhance patient preparation for the postpartum period. Qualitative research study was conducted to explore womens and clinicians perceptions of the postpartum experience. Four focus groups of postpartum women (n = 45) and two focus groups of obstetric clinicians (n = 13) were held at a large urban teaching hospital in New York City. All focus groups were audio recorded, transcribed, and analyzed using grounded theory. Four main themes were identified: lack of womens knowledge about postpartum health and lack of preparation for the postpartum experience, lack of continuity of care and absence of maternal care during the early postpartum period, disconnect between providers and postpartum mothers, and suggestions for improvement. Mothers did not expect many of the symptoms they experienced after childbirth and were disappointed with the lack of support by providers during this critical time in their recovery. Differences existed in the major postpartum concerns of mothers and clinicians. However, both mothers and clinicians agreed that preparation during the antepartum period could be beneficial for postpartum recovery. Results from this study indicate that many mothers do not feel prepared for the postpartum experience. Study findings raise the hypothesis that capturing patient-centered domains that define the postpartum experience and integrating these domains into patient care may enhance patient preparation for postpartum recovery and improve postpartum outcomes. PMID:23775250

  20. Sad dads: paternal postpartum depression.

    PubMed

    Kim, Pilyoung; Swain, James E

    2007-02-01

    The postpartum period is associated with many adjustments to fathers that pose risks for depression. Estimates of the prevalence of paternal postpartum depression (PPD) in the first two months postpartum vary in the postpartum period from 4 to 25 percent. Paternal PPD has high comorbidity with maternal PPD and might also be associated with other postpartum psychiatric disorders. Studies so far have only used diagnostic criteria for maternal PPD to investigate paternal PPD, so there is an urgent need to study the validity of these scales for men and develop accurate diagnostic tools for paternal PPD. Paternal PPD has negative impacts on family, including increasing emotional and behavioral problems among their children (either directly or through the mother) and increasing conflicts in the marital relationship. Changes in hormones, including testosterone, estrogen, cortisol, vasopressin, and prolactin, during the postpartum period in fathers may be biological risk factors in paternal PPD. Fathers who have ecological risk factors, such as excessive stress from becoming a parent, lack of social supports for parenting, and feeling excluded from mother-infant bonding, may be more likely to develop paternal PPD. Support from their partner, educational programs, policy for paid paternal leave, as well as consideration of psychiatric care may help fathers cope with stressful experiences during the postpartum period. PMID:20805898

  1. Postpartum changes in methadone maintenance dose.

    PubMed

    Pace, Christine A; Kaminetzky, Leah B; Winter, Michael; Cheng, Debbie M; Saia, Kelley; Samet, Jeffrey H; Walley, Alexander Y

    2014-09-01

    The optimal approach to postpartum dosing among women treated with methadone maintenance is unclear. We examined doses among 101 methadone-maintained pregnant women 2, 6 and 12 weeks postpartum, and compared the incidence of having doses held for oversedation during pregnancy and postpartum. The average dose at delivery was 83.3mg, and the mean change from delivery to 12 weeks postpartum was -3.7 mg (95% CI -6.3, -1.1). The incidence of oversedation events per 10,000 days was 2.8 among pregnant women and 5.6 for postpartum women (incidence rate ratio [IRR] 2.04, 95% CI 0.66, 6.28). After adjusting for benzodiazepine prescriptions, the IRR of an oversedation event among postpartum women compared to pregnant women was 1.74 (95% CI 0.56, 5.30). In conclusion, postpartum dose changes were small in a methadone clinic using clinical assessments to determine dose. Although the incidence of oversedation events remained low postpartum, the clinically important but not statistically significant increase in events among postpartum women and those prescribed benzodiazepines requires further research. While there are not yet adequate data to support pre-specified postpartum dose reductions, the findings suggest that more frequent clinical assessments continuing as late as 12 weeks postpartum may be warranted. PMID:24953167

  2. Saturated fat supplementation interacts with dietary forage neutral detergent fiber content during the immediate postpartum and carryover periods in Holstein cows: Production responses and digestibility of nutrients.

    PubMed

    Piantoni, P; Lock, A L; Allen, M S

    2015-05-01

    Forty-eight multiparous cows were used in a randomized complete block design experiment with a 22 factorial arrangement of treatments to determine the interaction between a highly saturated free FA supplement (SFFA) and dietary forage neutral detergent fiber (fNDF) content on production responses and nutrient digestibility of dairy cows in the postpartum period. Treatment diets were offered from 1 to 29d postpartum (postpartum period; PP) and contained 20 or 26% fNDF (50:50 corn silage:alfalfa silage and hay, dry matter basis) and 0 or 2% SFFA [Energy Booster 100 (Milk Specialties Global, Eden Prairie, MN); 96.1% FA: 46.2% C18:0 and 37.0% C16:0]. From 30 to 71d postpartum (carryover period), a common diet (~23% fNDF, 0% SFFA) was offered to all cows to evaluate carryover effects of the treatment diets early in lactation. During the PP, higher fNDF decreased dry matter intake (DMI) by 2.0 kg/d, whereas SFFA supplementation increased it by 1.4kg/d. In addition, high fNDF with 0% SFFA decreased DMI compared with the other diets and this difference increased throughout the PP. Treatments did not affect 3.5% fat-corrected milk yield during the PP but did during the carryover period when SFFA supplementation decreased 3.5% fat-corrected milk yield for the low-fNDF diet (51.1 vs. 58.7kg/d), but not for the high-fNDF diet (58.5 vs. 58.0kg/d). During the PP, lower fNDF and SFFA supplementation decreased body condition score loss. A tendency for an interaction between fNDF and SFFA indicated that low fNDF with 2% SFFA decreased body condition score loss compared with the other diets (-0.49 vs. -0.89). During the PP, lower fNDF and 2% SFFA supplementation decreased feed efficiency (3.5% fat-corrected milk/DMI) by 0.30 and 0.23 units, respectively. The low-fNDF diet with 2% SFFA decreased feed efficiency compared with other diets early in the PP, but this difference decreased over time. Supplementation of SFFA in the PP favored energy partitioning to body reserves and limited DMI depression for the high-fNDF diet, which might allow higher-fNDF diets to be fed to cows in the PP. However, SFFA supplemented in the low-fNDF diet during the PP affected production negatively in the carryover period. Dietary fNDF and SFFA interacted, affecting performance in the PP with carryover effects when cows were fed a common diet in early lactation. PMID:25726102

  3. Neutrophil Functions and Cytokines Expression Profile in Buffaloes with Impending Postpartum Reproductive Disorders

    PubMed Central

    Patra, Manas Kumar; Kumar, Harendra; Nandi, Sukdeb

    2013-01-01

    The study was conducted to correlate the periparturient immune status in terms of neutrophil functions and cytokine expression in peripheral blood mononuclear cell culture with impending postpartum reproductive disorders in buffaloes. Forty pregnant buffaloes were observed for occurrence of postpartum reproductive disorders (PRD), i.e., metritis, endometritis and delayed uterine involution etc., during one week prepartum to four weeks postpartum period. A representative number (n = 6) of buffaloes that did not develop any PRD were included in group I (healthy, control), while the animals which experienced PRD were assigned into group II (PRD, n = 8). The blood samples were collected at weekly interval from one week prepartum to four weeks postpartum period considering the day of calving as ‘d 0’. Differential leucocytes counts, superoxide and hydrogen peroxide production activity in isolated neutrophils and the mRNA expression profile of cytokines i.e., IL-2, IL-4 and IFN-γ in PBMC culture were studied in all the samples. A higher total leucocytes, neutrophil and band cells count along with impaired neutrophil functions i.e., lowered level of production of superoxide and hydrogen peroxide before parturition and during early postpartum period were observed in buffaloes developing PRD. Further, a lower expression of IL-2, IFN-γ and IL-4 mRNA in PBMC culture was observed at calving in buffaloes that subsequently developed PRD at later postpartum. Thus, suppression in neutrophil function and cytokine expression at prepartum to early postpartum period predisposes the buffaloes to develop postpartum reproductive disorders. Hence, monitoring of neutrophils function and cytokine expression profile would be effective to predict certain reproductive disorders at late pregnancy or immediately after parturition in buffaloes. In future, this may be a novel approach for determining suitable management and therapeutic decisions for prevention of commonly occurring reproductive disorders in farm animals. PMID:25049724

  4. The Association of Cytokines and Micronutrients with Hepatitis E Virus Infection During Pregnancy and the Postpartum Period in Rural Bangladesh.

    PubMed

    Kmush, Brittany L; Labrique, Alain; Li, Wei; Klein, Sabra L; Schulze, Kerry; Shaikh, Saijuddin; Ali, Hasmot; Engle, Ronald E; Wu, Lee; Purcell, Robert H; Mehra, Sucheta; Christian, Parul; West, Keith; Nelson, Kenrad

    2016-01-01

    Hepatitis E virus (HEV) infection is severe during pregnancy, with a pregnant case fatality rate around 30%. In Bangladesh, plasma samples from 1,100 women during the first trimester (TM) and third TM of pregnancy and 3 months postpartum (PP) were tested for anti-HEV IgG. During this time, 40 women developed antibody responses to HEV. These seroconverters are classified as the cases (incidence = 46 infections per 1,000 person-years). All except one seroconversion occurred between the third TM and 3 months PP. The cases and 40 matched non-seroconverters (controls) underwent analysis of a panel of 10 cytokines, 12 vitamins and minerals, and two markers of inflammation. Throughout pregnancy, seroconverting cases displayed higher concentrations of both pro- and anti-inflammatory cytokines compared with the non-seroconverting controls, even prior to infection. In the first TM, seroconverters had lower circulating zinc concentrations (P = 0.03), an increased prevalence of vitamin D deficiency (25-hydroxy vitamin D [25(OH)2D] < 50 nmol/L, P = 0.08), and anemia (hemoglobin < 110 g/L, P = 0.05) compared with controls. There were no differences in C-reactive protein or ?-1-acid glycoprotein. Antecedent micronutrient deficiencies may lead to dysregulated cytokine expression and immunologic compromise, increasing the risk of HEV infection, especially during pregnancy. This exploratory analysis reveals potential novel associations that deserve further study. PMID:26621563

  5. Rates of change and chronolgical problems during the late-glacial period

    SciTech Connect

    Lotter, A.F.; Sturm, M.; Ammann, B.

    1992-01-01

    Results of high-resolution AMS {sup 14}C dating of terrestrial plant macrofossils from late-glacial and early-Holocene lake deposits in Switzerland show three periods with constant radiocarbon ages. These plateaux of constant age occur at 12700, 10000, and 9500 y BP. A comparison of this radiocarbon chronology with a varve chronology documents discrepancies between the sidereal and the radiocarbon time-scale for the late-glacial period. The age-plateaux and the time-scale discrepancies have a significant impact on the estimation of rates of change during this period; estimates of rates of change can be very misleading if calculated on the basis of radiocarbon ages. This is illustrated by an example of estimated rates of late-glacial and early Holocene palynological change in Switzerland. 33 refs., 6 figs.

  6. ASSOCIATIONS AMONG CIRCULATING CONCENTRATIONS OF IGF-1 AND GH DURING THE POSTPARTUM PERIOD WITH RESUMPTION OF ESTRUS, CALF WEIGHTS, AND MILK PRODUCTION IN MATURE CROSSBRED COWS FED VARYING LEVELS OF ENERGY INTAKE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Circulating concentrations of IGF-1 and GH fluctuate in response to nutritional status. Objectives of this study were to evaluate usefulness of circulating profiles of IGF-1 and GH during the postpartum period as predictors of capacity to resume estrus and level of production (milk and calf growth)...

  7. Saturated fat supplementation interacts with dietary forage neutral detergent fiber content during the immediate postpartum period in Holstein cows: Energy balance and metabolism.

    PubMed

    Piantoni, P; Lock, A L; Allen, M S

    2015-05-01

    Forty-eight multiparous cows were used in a randomized complete block design experiment with a 22 factorial arrangement of treatments to determine the interaction between a highly saturated free FA supplement (SFFA) and dietary forage NDF (fNDF) content on energy balance and metabolic responses in postpartum cows. Treatment diets were offered from 1 to 29 d postpartum and contained 20 or 26% fNDF and 0 or 2% SFFA (Energy Booster 100; 96.1% FA: 46.2% C18:0, and 37.0% C16:0). Overall, low fNDF versus high fNDF and 2% SFFA versus 0% SFFA increased digestible energy intake (DEI; 67.5 vs. 62.2 Mcal/d and 68.1 vs. 61.6 Mcal/d, respectively). The low fNDF diet with SFFA increased energy balance compared with the other treatments early during the treatment period, but treatment differences diminished over time. Overall, low fNDF versus high fNDF diets and 2% SFFA versus 0% SFFA improved energy balance (-13.0 vs. -16.3 Mcal/d and -12.0 vs. -17.3, respectively) decreasing efficiency of utilization of DEI for milk (milk NEL/DEI; 0.575 vs. 0.634 and 0.565 vs. 0.643). Low fNDF diets increased plasma insulin (308 vs. 137g/mL) and glucose concentrations (50.5 vs. 45.7mg/dL) and decreased plasma nonesterified FA (606 vs. 917Eq/L) and ?-hydroxybutyrate (9.29 vs. 16.5mg/dL) concentrations and liver triglyceride content. Compared with 0% SFFA, 2% SFFA decreased plasma nonesterified FA concentration during the first week postpartum (706 vs. 943Eq/L) and tended to decrease plasma nonesterified FA overall throughout the treatment period, but did not affect liver triglyceride content. During a glucose tolerance test, 2% SFFA increased plasma insulin concentration more in the low fNDF diet (84.5 vs. 44.6IU/mL) than in the high fNDF diet (40.4 vs. 38.0IU/mL). After glucose infusion, 2% SFFA increased insulin area under the curve by 64% when included in the low fNDF diet, but only by 5.2% when included in the high fNDF diet. Even though 2% SFFA did not affect weekly plasma insulin concentration, it increased plasma insulin baseline concentration before the tolerance tests. Supplementation of 2% SFFA and low fNDF diets increased DEI and improved energy balance, but decreased apparent efficiency of utilization of DEI for milk production. Fat supplementation affected energy partitioning, increasing energy balance and decreasing body condition score loss, especially in the lower fNDF diet. The decrease in body condition score loss observed was likely related to an increase in plasma insulin concentration. Feeding SFFA in a low fNDF diet during the first 29 d postpartum might have primed the cows to limit fat mobilization at the expense of milk. PMID:25726097

  8. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain.

    PubMed

    Fernandes da Mota, Patrcia Gonalves; Pascoal, Augusto Gil Brites Andrade; Carita, Ana Isabel Andrade Dinis; B, Kari

    2015-02-01

    Diastasis recti abdominis (DRA) is an impairment characterized by a midline separation of the rectus abdominis muscles along the linea alba. It has its onset during pregnancy and the first weeks following childbirth. There is scant knowledge on both prevalence and risk factors for development of the condition. The aim of this study was to investigate the prevalence of DRA at gestational week 35 and three timepoints postpartum, possible risk factors, and the relationship between DRA and lumbo-pelvic pain. Ultrasound images of inter rectus distance (IRD) were recorded in 84 healthy primiparous women, at three locations on the linea alba. The IRD was measured at: gestational week 35 and 6-8, 12-14, and 24-26 weeks postpartum. Diagnosis of DRA was defined as 16 mm at 2 cm below the umbilicus. Independent sample t-test and binary logistic regression was used to assess differences and risk factors in women with and without DRA and women with and without lumbo-pelvic pain. P < 0.05 was considered statistically significant. The prevalence of DRA decreased from 100% at gestational week 35-39% at 6 months postpartum. No statistically significant differences were found in prepregnancy body mass index (BMI), weight gain, baby's birth weight or abdominal circumference between women with and without DRA at 6 months postpartum. Women with DRA at 6 months postpartum were not more likely to report lumbo-pelvic pain than women without DRA. DRA is prevalent at 6 months postpartum, but is not linked with lumbo-pelvic pain. PMID:25282439

  9. Blood Lead Changes during Pregnancy and Postpartum with Calcium Supplementation

    PubMed Central

    Gulson, Brian L.; Mizon, Karen J.; Palmer, Jacqueline M.; Korsch, Michael J.; Taylor, Alan J.; Mahaffey, Kathryn R.

    2004-01-01

    Pregnancy and lactation are times of physiologic stress during which bone turnover is accelerated. Previous studies have demonstrated that there is increased mobilization of lead from the maternal skeleton at this time and that calcium supplementation may have a protective effect. Ten immigrants to Australia were provided with either calcium carbonate or a complex calcium supplement (~ 1 g/day) during pregnancy and for 6 months postpartum. Two immigrant subjects who did not conceive acted as controls. Sampling involved monthly venous blood samples throughout pregnancy and every 2 months postpartum, and quarterly environmental samples and 6-day duplicate diets. The geometric mean blood lead at the time of first sampling was 2.4 ?g/dL (range, 1.46.5). Increases in blood lead during the third trimester, corrected for hematocrit, compared with the minimum value observed, varied from 10 to 50%, with a geometric mean of 25%. The increases generally occurred at 68 months gestation, in contrast with that found for a previous cohort, characterized by very low calcium intakes, where the increases occurred at 36 months. Large increases in blood lead concentration were found during the postpartum period compared with those during pregnancy; blood lead concentrations increased by between 30 and 95% (geometric mean 65%; n = 8) from the minimum value observed during late pregnancy. From late pregnancy through postpartum, there were significant increases in the lead isotopic ratios from the minimum value observed during late pregnancy for 3 of 8 subjects (p < 0.01). The observed changes are considered to reflect increases in mobilization of lead from the skeleton despite calcium supplementation. The identical isotopic ratios in maternal and cord blood provide further confirmation of placental transfer of lead. The extra flux released from bone during late pregnancy and postpartum varies from 50 to 380 ?g lead (geometric mean, 145 ?g lead) compared with 330 ?g lead in the previous cohort. For subjects replete in calcium, the delay in increase in blood lead and halving of the extra flux released from bone during late pregnancy and postpartum may provide less lead exposure to the developing fetus and newly born infant. Nevertheless, as shown in several other studies on calcium relationships with bone turnover, calcium supplementation appears to provide limited benefit for lead toxicity during lactation. PMID:15531434

  10. Postpartum Depression Facts

    MedlinePLUS

    ... Where can I find more information? Share Postpartum Depression Facts Download PDF Download ePub Download Mobi Order ... for herself or her family. What is postpartum depression? Postpartum depression is a mood disorder that can ...

  11. Assessing Postpartum Family Functioning

    PubMed Central

    Midmer, Deana; Talbot, Yves

    1988-01-01

    The birth of a child requires adaptation and reorganization within the family system in order to accommodate the new family member and to allow the family to continue in its psychosocial development. Knowledge of the normative and transitional changes required at this stage of family life will enhance family practitioners' understanding of some of the common concerns and complaints related to them by various family members during the postpartum period. The Family FIRO model represents a helpful conceptual framework to increase the family physician's understanding of the issues of inclusion, control, and intimacy that are highlighted during the transition to parenthood. The authors briefly present this model and discuss its application to postpartum adjustment and its implications for health-care professionals. PMID:21253238

  12. Postpartum hemorrhage.

    PubMed

    Su, Cindy W

    2012-03-01

    Postpartum hemorrhage (PPH) is a very common obstetric emergency with high morbidity and mortality rates worldwide. Understanding its etiology is fundamental to effectively managing PPH in an acute setting. Active management of the third stage of labor is also a key component in its prevention. Management strategies include conservative measures (medications, uterine tamponade, and arterial embolization) as well as surgical interventions (arterial ligations, compression sutures, and hysterectomy). Creating a standardized PPH protocol and running simulation-based drills with a multidisciplinary team may also help decrease maternal morbidity and improve perinatal outcomes, although further studies are needed. PMID:22309588

  13. Personality and risk for postpartum depressive symptoms.

    PubMed

    Iliadis, S I; Koulouris, P; Gingnell, M; Sylvén, S M; Sundström-Poromaa, I; Ekselius, L; Papadopoulos, F C; Skalkidou, A

    2015-06-01

    Postpartum depression (PPD) is a common childbirth complication, affecting 10-15 % of newly delivered mothers. This study aims to assess the association between personality factors and PPD. All pregnant women during the period September 2009 to September 2010, undergoing a routine ultrasound at Uppsala University Hospital, were invited to participate in the BASIC study, a prospective study designed to investigate maternal well-being. Depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) while the Depression Self-Rating Scale (DSRS) was used as a diagnostic tool for major depression. Personality traits were evaluated using the Swedish Universities Scale of Personality (SSP). One thousand thirty-seven non-depressed pregnant women were included in the study. Non-depressed women reporting high levels of neuroticism in late pregnancy were at high risk of developing postpartum depressive symptoms (PPDSs) at 6 weeks and 6 months after delivery, even after adjustment for confounders (adjusted odds ratio (aOR) = 3.4, 95 % confidence interval (CI) 1.8-6.5 and adjusted odds ratio (aOR) = 3.9, 95 % CI 1.9-7.9). The same was true for a DSRS-based diagnosis of major depression at 6 months postpartum. Somatic trait anxiety and psychic trait anxiety were associated with increased risk for PPDS at 6 weeks (aOR = 2.1, 95 % CI 1.2-3.5 and aOR = 1.9, 95 % CI 1.1-3.1), while high scores of mistrust were associated with a twofold increased risk for PPDS at 6 months postpartum (aOR 1.9, 95 % CI 1.1-3.4). Non-depressed pregnant women with high neuroticism scores have an almost fourfold increased risk to develop depressive symptoms postpartum, and the association remains robust even after controlling for most known confounders. Clinically, this could be of importance for health care professionals working with pregnant and newly delivered women. PMID:25369905

  14. Biological aspects of postpartum depression.

    PubMed

    Skalkidou, Alkistis; Hellgren, Charlotte; Comasco, Erika; Sylvén, Sara; Sundström Poromaa, Inger

    2012-11-01

    In comparison with the vast epidemiological literature on postpartum depression (PPD), relatively few studies have examined the biological aspects of the disorder. However, research into the biological mechanisms of PPD is a challenging task, as normal pregnancy and the postpartum period cause adaptive endocrine changes, which would otherwise be considered pathological in nonpregnant women. This review focuses on the adaptive changes of childbearing and nursing, which ultimately may put women at increased risk of PPD. In light of the normal physiology, the authors also attempt to describe the current evidence of the biological changes associated with the development of depression in the postpartum period, including ovarian steroids, the hypothalamic-pituitary-adrenal axis, the serotonergic neurotransmitter system, the thyroid system and inflammatory markers. In addition, current knowledge on candidate genes associated with PPD is reviewed. PMID:23181531

  15. Chronic gestational stress leads to depressive-like behavior and compromises medial prefrontal cortex structure and function during the postpartum period.

    PubMed

    Leuner, Benedetta; Fredericks, Peter J; Nealer, Connor; Albin-Brooks, Christopher

    2014-01-01

    Postpartum depression, which affects approximately 15% of new mothers, is associated with impaired mother-infant interactions and deficits in cognitive function. Exposure to stress during pregnancy is a major risk factor for postpartum depression. However, little is known about the neural consequences of gestational stress. The medial prefrontal cortex (mPFC) is a brain region that has been linked to stress, cognition, maternal care, and mood disorders including postpartum depression. Here we examined the effects of chronic gestational stress on mPFC function and whether these effects might be linked to structural modifications in the mPFC. We found that in postpartum rats, chronic gestational stress resulted in maternal care deficits, increased depressive-like behavior, and impaired performance on an attentional set shifting task that relies on the mPFC. Furthermore, exposure to chronic stress during pregnancy reduced dendritic spine density on mPFC pyramidal neurons and altered spine morphology. Taken together, these findings suggest that pregnancy stress may contribute to postpartum mental illness and its associated symptoms by compromising structural plasticity in the mPFC. PMID:24594708

  16. Influence of interpersonal violence on maternal anxiety, depression, stress and parenting morale in the early postpartum: a community based pregnancy cohort study

    PubMed Central

    2012-01-01

    Background Research has shown that exposure to interpersonal violence is associated with poorer mental health outcomes. Understanding the impact of interpersonal violence on mental health in the early postpartum period has important implications for parenting, child development, and delivery of health services. The objective of the present study was to determine the impact of interpersonal violence on depression, anxiety, stress, and parenting morale in the early postpartum. Methods Women participating in a community-based prospective cohort study (n?=?1319) completed questionnaires prior to 25 weeks gestation, between 3436 weeks gestation, and at 4 months postpartum. Women were asked about current and past abuse at the late pregnancy data collection time point. Postpartum depression, anxiety, stress, and parenting morale were assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale, the Spielberger State Anxiety Index, the Cohen Perceived Stress Scale, and the Parenting Morale Index, respectively. The relationship between interpersonal violence and postpartum psychosocial health status was examined using Chi-square analysis (p?postpartum, while both child maltreatment and intimate partner violence were associated with low parenting morale. Interpersonal violence did not have an independent effect on anxiety or stress in the postpartum. Conclusion The most robust relationships were seen for the influence of child maltreatment on postpartum depression and low parenting morale. By identifying women at risk for depression and low parenting morale, screening and treatment in the prenatal period could have far-reaching effects on postpartum mental health thus benefiting new mothers and their families in the long term. PMID:23241428

  17. Photometric and Period Investigation of the Late F-type Overcontact Binary II UMa

    NASA Astrophysics Data System (ADS)

    Zhou, X.; Qian, S.-B.; Zhang, J.; Zhang, B.; Kreiner, J.

    2016-03-01

    II UMa is a late F-type (F5) contact binary with a close-in tertiary and a distant visual companion. According to the four-color (B V RcIc) light curves’ solutions of II UMa, it is a high fill-out (f = 86.6%) and low-mass ratio (q = 0.172) contact binary system, which indicates that it is at the late evolutionary stage of late-type tidal-locked binary stars. The masses of the primary star and secondary star are calculated to be {M}1=1.99{M}ȯ and {M}2=0.34{M}ȯ . The primary star has evolved from the zero-age main sequence, but it still appeared before the terminal-age main sequence, and the secondary star is even more evolved. Considering the mass ratio ({M}3/{M}1=0.67) obtained by spectroscopic observations, the mass of the close-in tertiary is estimated to be {M}3=1.34{M}ȯ . The period variations of the binary system are investigated for the first time. According to the observed–calculated (O‑C) curve analysis, a continuous period increase at a rate of {dP}/{dt}=4.88× {10}-7 {day} {{yr}}-1 is determined. The parabolic variation in the O‑C curve may be part of a cyclic period of change, or the combined period of change of a parabolic variation and a cyclic one. More instances of minimum light are needed to confirm this. The presence of the tertiary component may play an important role in the formation and evolution of this binary system by drawing angular momentum from the central system during the pre-contact stage.

  18. Low Omega-3 Index in Pregnancy Is a Possible Biological Risk Factor for Postpartum Depression

    PubMed Central

    Markhus, Maria Wik; Skotheim, Siv; Graff, Ingvild Eide; Frøyland, Livar; Braarud, Hanne Cecilie; Stormark, Kjell Morten; Malde, Marian Kjellevold

    2013-01-01

    Background Depression is a common disorder affecting 10–15% women in the postpartum period. Postpartum depression can disrupt early mother-infant interaction, and constitutes a risk factor for early child development. Recently, attention has been drawn to the hypothesis that a low intake of seafood in pregnancy can be a risk factor for postpartum depression. Seafood is a unique dietary source of the marine omega-3 fatty acids and is a natural part of a healthy balanced diet that is especially important during pregnancy. Methods In a community based prospective cohort in a municipality in Western Norway, we investigated both nutritional and psychological risk factors for postpartum depression. The source population was all women who were pregnant within the period November 2009 - June 2011. The fatty acid status in red blood cells was assessed in the 28th gestation week and participants were screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) three months after delivery. The aim of the present study was to investigate if a low omega-3 index in pregnancy is a possible risk factor for postpartum depression. Results In a simple regression model, the omega-3 index was associated with the EPDS score in a nonlinear inverse manner with an R square of 19. Thus, the low omega-3 index explained 19% of the variance in the EPDS score. The DPA content, DHA content, omega-3 index, omega-3/omega-6 ratio, total HUFA score, and the omega-3 HUFA score were all inversely correlated with the EPDS score. The EPDS scores of participants in the lowest omega-3 index quartile were significantly different to the three other omega-3 index quartiles. Conclusion In this study population, a low omega-3 index in late pregnancy was associated with higher depression score three months postpartum. PMID:23844041

  19. Rotation periods for nearby, mid-to-late M dwarfs estimated from the MEarth Project

    NASA Astrophysics Data System (ADS)

    Newton, Elisabeth R.; Irwin, Jonathan; Charbonneau, David; Berta-Thompson, Zachory K.; Dittmann, Jason

    2015-01-01

    Knowledge of M dwarfs' rotation is essential to understanding the generation of their magnetic fields and the mechanism by which they lose angular momentum. It is also important for characterizing the environment of planets that might orbit them. The most direct way to infer rotation periods is from variations in stars' brightnesses as dark spots rotate in and out of view. Most rotation periods estimated prior to this decade are the result of dedicated photometric studies. If care is taken to preserve astrophysical variability and limit systematics, transiting planet surveys generate the high-cadence monitoring required to estimate stellar rotation periods. While targeted surveys of clusters have provided data at young ages, observations of field M dwarfs are required to constrain their late-term evolution. Rotation periods of the smallest stars are also needed: the Kepler mission produced exquisite light curves of several thousand cool dwarfs, but field stars below 0.3 solar masses are not well-represented in the sample. The MEarth Project is a transiting planet survey targeting mid-to-late M dwarfs within 33 parsecs; it provides a unique data set for exploring rotation in a large sample of fully convective stars. We present a catalog of rotation periods for these stars. Our measurements are particularly useful because many of the MEarth targets have parallaxes, multi-wavelength photometry, and optical and near-infrared spectra. We present our methods for estimating rotation periods and quantifying our uncertainties, and discuss our results in the context of other surveys.The MEarth project gratefully acknowledges funding from the David and Lucile Packard Fellowship for Science and Engineering, the National Science Foundation under grants AST-0807690, AST-1109468, and AST-1004488, and the John Templeton Foundation

  20. The epidemiology of postpartum malaria: a systematic review.

    PubMed

    Boel, Machteld E; Rijken, Marcus J; Brabin, Bernard J; Nosten, Franois; McGready, Rose

    2012-01-01

    Pregnant women are more susceptible to malaria than their non-pregnant counterparts. Less is known about the risk of malaria in the postpartum period. The epidemiology of postpartum malaria was systematically reviewed. Eleven articles fitted the inclusion criteria. Of the 10 studies that compared malaria data from the postpartum period with pregnancy data, nine studies suggested that the risk for malaria infection decreased after delivery. All three studies that compared postpartum data with non-pregnant non-postpartum women concluded that the risk did not return to pre-pregnancy levels immediately after delivery. The results of this review have to be carefully interpreted, as the majority of studies were not designed to study postpartum malaria, and there was large variability in study designs and reported outcomes. Current evidence suggests an effort should be made to detect and radically cure malaria during pregnancy so that women do not enter the postpartum period with residual parasites. PMID:22500576

  1. Equatorial late-afternoon periodic TEC fluctuations observed by multiple GPS receivers

    NASA Astrophysics Data System (ADS)

    Tsugawa, T.; Maruyama, T.; Saito, S.; Ishii, M.

    2009-12-01

    We report, for the first time, equatorial periodic total electron content (TEC) fluctuations observed in the late afternoon by multiple GPS receivers. As a part of Southeast Asia low-latitude ionospheric network (SEALION), GPS receivers at Chiang Mai and Chumphon, Thailand, have been operated since 2005. We found that periodic TEC fluctuations (PTF) with the periods of 15-30 minutes are often observed at these two sites in the spring (Apr-May) late afternoon. Further investigations using multiple GPS receivers in Southeast Asia revealed that the PTFs propagate at 150-200 m/s away from the equator and their amplitudes depend on the satellite azimuth angle. Statistical study of the PTF activity at different latitudes and longitudes clarified that the PTFs are not observed at mid-latitudes, and their seasonal variations are different at different longitudes and at geomagnetically conjugate regions. These observational results indicate that the PTFs are caused by the atmospheric gravity waves (AGW) which are generated in the equatorial lower atmosphere and propagate away from the equator. Simultaneous GPS-TEC and ionosonde observations at Chumphon revealed that the day-to-day variations of PTF activities are well correlated with those of the rate of TEC change index (ROTI) and the occurrence of equatorial spread F (ESF) after the sunset, indicating the PTFs may be related with the onset of the ESF and plasma bubbles.

  2. Maternal Stress Predicts Postpartum Weight Retention

    PubMed Central

    Whitaker, Kara; Vernon, Marlo; Wilcox, Sara

    2014-01-01

    Postpartum weight retention (PPWR) is a significant contributor to the development of overweight and obesity in women of childbearing age. Stress may be a key mechanism making it more difficult for mothers to lose weight in the year following delivery. The aim of this study was to assess whether specific aspects of parenting stress and life stress influence postpartum weight retention in new mothers. Women in late pregnancy or up to 2 months postpartum (n = 123) were enrolled in the study and followed through the first year postpartum. Linear regression models evaluated the associations of parenting stress (isolation, attachment and depressive symptoms) as well as overall life stress at 2, 6, and 12 months postpartum with PPWR at 6 and 12 months. During the first year postpartum, higher depression and life stress were significantly associated with greater PPWR. As the effect of depression diminished, the effect of life stress became significant. Contrary to hypothesized relationships, fewer problems with attachment and less social isolation were significantly associated with greater PPWR. Higher gestational weight gain and African American race were also significantly associated with greater PPWR at both 6 and 12 months. Different types of stress predict weight retention in first time mothers during the first year postpartum. Understanding the relationships between parenting stress, concurrent life stress and PPWR can enhance the development of future interventions that specifically target self-identified stressors, leading to improved weight related outcomes. PMID:24760321

  3. Use of postpartum care: predictors and barriers.

    PubMed

    DiBari, Jessica N; Yu, Stella M; Chao, Shin M; Lu, Michael C

    2014-01-01

    This study aimed to identify actual and perceived barriers to postpartum care among a probability sample of women who gave birth in Los Angeles County, California in 2007. Survey data from the 2007 Los Angeles Mommy and Baby (LAMB) study (N = 4,075) were used to identify predictors and barriers to postpartum care use. The LAMB study was a cross-sectional, population-based study that examined maternal and child health outcomes during the preconception, prenatal, and postpartum periods. Multivariable analyses identified low income, being separated/divorced and never married, trying hard to get pregnant or trying to prevent pregnancy, Medi-Cal insurance holders, and lack of prenatal care to be risk factors of postpartum care nonuse, while Hispanic ethnicity was protective. The most commonly reported barriers to postpartum care use were feeling fine, being too busy with the baby, having other things going on, and a lack of need. Findings from this study can inform the development of interventions targeting subgroups at risk for not obtaining postpartum care. Community education and improved access to care can further increase the acceptability of postpartum visits and contribute to improvements in women's health. Postpartum care can serve as a gateway to engage underserved populations in the continuum of women's health care. PMID:24693433

  4. Postpartum Depression Action Plan

    MedlinePLUS

    MENU Return to Web version Postpartum Depression | Postpartum Depression Action Plan Patient __________________________ Physician/NP/PA __________________ Clinic ____________________________ Phone Number ____________________ Choose one area and add other areas as you begin to ...

  5. Postpartum Depression: An Overview.

    ERIC Educational Resources Information Center

    Albright, Angela

    1993-01-01

    Occurring in about 12 percent of postpartum women, postpartum depression has been focus of considerable research. Variables that have been correlated with postpartum depression range from biological causes, to lack of social support, to relationship with husband, to attributional styles, to psychodynamic explanations. There is need for more

  6. [Postpartum infections].

    PubMed

    Guyard-boileau, B

    1995-01-01

    The unexpected occurrence of a fever higher than 38 degrees Celsius at least twice in 48 hours after childbirth is a common problem. A well-executed clinical examination of a patient with a high fever is necessary to determine the origin of the infection. It is necessary to remain vigilant because it could be a sign of severe infection threatening a mother's life. The fever can sometimes remain moderate while the infection progresses at lightning speed. This is especially the case in weak patients (e.g., those with tuberculosis, AIDS, or malnutrition); thus it will be necessary to keep an attentive eye on them. Major causes to be familiar with and to recognize include malaria (always to be considered), uterine infection (the most common postpartum infection), kidney infection, tender breasts, pneumonia, meningitis, or appendicitis. Things health workers should consider if they suspect uterine infection are birth history, endometritis, and the fact that, in the absence of treatment, the infection can spread to the Fallopian tubes and eventually to the general circulation (septicemia). Special cases include uterine infections accompanied by retention of placental debris or membranes, fever after abortion, and fever after cesarean section. Health workers must consider all cases of retention, even those without a fever, as a potential infection. They must administer antibiotic treatment within 5 days after emptying the uterus. The treatment of choice for fever following an abortion is 3 g ampicillin for 7 days. In cases of infection after an abortion, health workers should consider uterine perforation and retention. Fever usually occurs 4-5 days after a cesarean section. Antibiotic treatment is usually necessary. PMID:12346337

  7. Discovery of a short-necked sauropod dinosaur from the Late Jurassic period of Patagonia.

    PubMed

    Rauhut, Oliver W M; Remes, Kristian; Fechner, Regina; Cladera, Gerardo; Puerta, Pablo

    2005-06-01

    Sauropod dinosaurs are one of the most conspicuous groups of Mesozoic terrestrial vertebrates. They show general trends towards an overall increase in size and elongation of the neck, by means of considerable elongation of the length of individual vertebrae and a cervical vertebra count that, in some cases, increases to 19 (ref. 1). The long neck is a particular hallmark of sauropod dinosaurs and is usually regarded as a key feeding adaptation. Here we describe a new dicraeosaurid sauropod, from the latest Jurassic period of Patagonia, that has a particularly short neck. With a neck that is about 40% shorter than in other known dicraeosaurs, this taxon demonstrates a trend opposite to that seen in most sauropods and indicates that the ecology of dicraeosaurids might have differed considerably from that of other sauropods. The new taxon indicates that there was a rapid radiation and dispersal of dicraeosaurids in the Late Jurassic of the Southern Hemisphere, after the separation of Gondwana from the northern continents by the late Middle Jurassic. PMID:15931221

  8. Postpartum services for adolescent mothers.

    PubMed

    Cartoof, V G

    1978-12-01

    The Crittenton Hastings House of the Florence Crittenton League, located in Boston's Brighton area has been serving inner-city teenage pregnant women in a day program since early 1973. The program's 400 or so young women are characterized as typically Black; 16 year old; resident of an inner-city neighborhood of Boston; and a 10th-grade public high school student at time of conception. Most come from welfare families, and most confessed that the pregnancy was unintended. The program aims to reach the young woman who traditionally drops out of school upon learning of her pregnancy; does not seek medical care until late in pregnancy; and rarely receives social services during this critical and stressful period. Program financing comes from the Massachusetts Dept. of Public Welfare; from private foundations; contributions; income from investments; and endowment funds. Program findings show that almost 80% of the mothers return to school soon after delivery, and 67% plan to continue education in a career school or college. Academic goals tend to be higher following program participation. 69% of the girls report using birth control devices after delivery. However, almost half of the mothers drop out of school and experience 1 more unintended pregnancy after 2 years of program participation. These alarming figures support similar findings in research conducted across the country and suggest that the benefits of a service program that ends at delivery are short-lived. Thus, a followup project was designed to change the statistics on school dropout and repeat pregnancy by extending services well into the postpartum period. Details of the followup project are described. Although the followup project is less than a year old, statistical and narrative records show that such intervention works, and that services must be offered aggressively even before they are asked for by the young mothers. PMID:738141

  9. Direct and indirect climate impact on the lake ecosystem during Late Glacial Period.

    NASA Astrophysics Data System (ADS)

    Zawiska, Izabela; S?owi?ski, Micha?; Obremska, Milena; Woszczyk, Micha?; Milecka, Krystyna

    2013-04-01

    Climate was the main factor that influenced environment in Late Glacial. The general warming trend was interrupted by cooling periods. This fluctuations had a great impact on the lakes environment not only directly by the changing temperature and precipitation but also indirectly influencing, among others, vegetation cover changes and intensity of erosion which consecutively effected lake productivity. In this study we analyzed the sediments of Lake ?ukie located in East part of Poland in ??czna-W?odawa Lake District, beyond the reach of the last glaciation. In present time lake ?ukie is shallow, eutrophic lake and its area do not extend 140ha. The aim of this study was to find out how lake ecosystem changed in Late Glacial under the influence of the climate. In order to reconstruct those changes we did several analysis: subfossil Cladocera, macrofossil, pollen, chemical composition of the sediment (TOC, OC, IC, SiO2biog, SiO2ter). The chronology was based on palinology and correlated with the lake Perespilno chronology which was based on the laminated sediments and several 14C data (lake Perespilno is located 30 km east of ?ukie lake). Our results show that during Late Glacial lake ?ukie ecosystem changed dynamically. Its history started in Older Dryas, whan the lake was shallow with low biodiversity. The erosion played very important role in the sediment formation as the vegetation cover was sparse, dominated by shrubs and grasses. The Allerod warming caused the deepening of the lake and the increase of biodiversity and productivity. The pine - birch forests developed. At the end of this period fishes appeared in the lake. The Younger Dryas cooling marked very visibly in all the results but though the productivity decreased the biodiversity maintained high. The vegetation cover become more open, with high share of grasses, which caused the increase in the erosion of the catchment. At the end on YD sudden change in lake ecosystem happened, probably caused by the water level drop. This dramatic event was probably caused by the changes in the ground water circulation connected with the permafrost disappearance.

  10. Postpartum Substance Use and Depressive Symptoms: A Review

    PubMed Central

    Chapman, Shawna L. Carroll; Wu, Li-Tzy

    2013-01-01

    National survey data suggest that new mothers have high prevalences of alcohol and illicit drug use. Depression correlates with substance use, and new mothers with postpartum depression (PPD) may be at high risk for substance use. Understanding postpartum substance use and its relationship to PPD can inform future research and intervention. A literature search was conducted resulting in 12 studies published from 1999–2012 examining postpartum alcohol use, drug use, or combined postpartum depression and substance use. Postpartum alcohol (prevalence range 30.1%−49%) and drug use (4.5%–8.5%) were lower than use among not pregnant, not postpartum women (41.5%–57.5%; 7.6%–10.6%, respectively) but higher than use among pregnant women (5.4%–11.6%; 3.7%–4.3%, respectively). Correlates of postpartum problem drinking were being unemployed, unmarried, and a cigarette smoker. Prevalence of drug use was highest among white new mothers, followed by Blacks and Hispanics, but Black new mothers appeared at greater risk of drug use. No identified studies examined correlates of postpartum drug use beyond race/ethnicity. Postpartum depressive symptoms were prevalent among postpartum substance users and those with a substance use history (19.7%–46%). The postpartum period is a critical time. Prevalent substance use and the scarcity of studies warrant research to identify means to reduce maternal substance use. PMID:23879459

  11. Anxiety symptoms during pregnancy and postpartum.

    PubMed

    Breitkopf, Carmen Radecki; Primeau, Loree A; Levine, Ruth E; Olson, Gayle L; Wu, Z Helen; Berenson, Abbey B

    2006-09-01

    This cross-sectional study compared the distribution of anxiety symptoms among pregnant, non-pregnant, and postpartum women of lower socioeconomic status. Participants were 807 women who were pregnant (24-36 weeks), postpartum (2-8 weeks), or not pregnant. Anxiety and depressive symptoms were assessed by the state-trait anxiety index and the Beck depression inventory, respectively. English and Spanish versions of the instrument were available. Group differences in anxiety were evaluated using analysis of variance. Multivariate regression was performed to evaluate differences in anxiety while controlling for marital status, education, race/ethnicity, employment, cohabitation, income, parity, history of depression/anxiety, and depressive symptoms. Anxiety scores were lower among postpartum women relative to pregnant and non-pregnant women (both P < 0.001), who did not differ (P = 0.99). After controlling for depressive symptoms and patient characteristics, anxiety remained lowest among postpartum women. Additionally, history of depression/anxiety and depressive symptoms were significant predictors of anxiety in the multivariate analysis. Comparatively low anxiety and depressive symptoms were observed among women who were 2-8 weeks postpartum. Anxiety symptoms that occur postpartum may not appear until later in the postpartum period. PMID:17214450

  12. Development of a Postpartum Stressor Measure.

    PubMed

    Park, E R; Psaros, C; Traeger, L; Stagg, A; Jacquart, J; Willett, J; Alert, M D; LaRoche, K L; Ecker, J L

    2015-10-01

    To develop a brief self-report assessment of the type and magnitude of stressors during the postpartum period. A cross-sectional study of a convenience sample of 138 women at Massachusetts General Hospital in Boston, MA completed a measure of postpartum stressors at their 6-week postpartum visit. Item analyses were conducted; items were eliminated based on low relevance, low endorsement, and cross-loadings, resulting in a 9-item measure. Items were summed to create a total postpartum stressors score. To establish concurrent validity with perceived stress, the total postpartum stressors score was correlated with the 4-item Perceived Stress Scale (PSS-4). The stressors score was tested for bivariate associations with depression (Patient Health Questionnaire-2) and with social support (three items adapted from the MOS Social Support Scale). The 9-item measure, which was comprised of three factors (baby care, well-being, and work) demonstrated good reliability (Cronbach's ? = .74) and concurrent validity with the PSS-4 (r = .53; p < .001) in the current sample. The stressors total score was negatively associated with social support (p < .001) and was positively associated with depression symptoms (p < .001). The early psychometric results on this measure are promising and associated with postpartum social support and depressive symptoms. With additional research to enhance external validity, this measure could be used and tested in an intervention study at the 6-week postpartum visit to identify women at risk for distress. PMID:25682113

  13. Fossil embryos from the Middle and Late Cambrian period of Hunan, south China.

    PubMed

    Dong, Xi-Ping; Donoghue, Philip C J; Cheng, Hong; Liu, Jian-Bo

    2004-01-15

    Comparative embryology is integral to uncovering the pattern and process of metazoan phylogeny, but it relies on the assumption that life histories of living taxa are representative of their antecedents. Fossil embryos provide a crucial test of this assumption and, potentially, insight into the evolution of development, but because discoveries so far lack phylogenetic constraint, their significance is moot. Here we describe a collection of embryos from the Middle and Late Cambrian period (500 million years ago) of Hunan, south China, that preserves stages of development from cleavage to the pre-hatching embryo of a direct-developing animal comparable to living Scalidophora (phyla Priapulida, Kinorhyncha, Loricifera). The latest-stage embryos show affinity to the Lower Cambrian embryo Markuelia, whose life-history strategy contrasts both with the primitive condition inferred for metazoan phyla and with many proposed hypotheses of affinity, all of which prescribe indirect development. Phylogenetic tests based on these embryological data suggest a stem Scalidophora affinity. These discoveries corroborate, rather than contradict, the predictions of comparative embryology, providing direct historical support for the view that the life-history strategies of living taxa are representative of their stem lineages. PMID:14724636

  14. Sleep Disturbance and Neurobehavioral Performance among Postpartum Women

    PubMed Central

    Insana, Salvatore P.; Williams, Kayla B.; Montgomery-Downs, Hawley E.

    2013-01-01

    Study Objectives: Sleep disturbances cause neurobehavioral performance and daytime functioning impairments. Postpartum women experience high levels of sleep disturbance. Thus, the study objective was to describe and explore the relation between neurobehavioral performance and sleep among women during the early postpartum period. Design: Longitudinal field-based study. Participants: There were 70 primiparous women and nine nulliparous women in a control group. Interventions: None. Methods and Results: During their first 12 postpartum weeks, 70 primiparous women wore continuous wrist actigraphy to objectively monitor their sleep. Each morning they self-administered the psychomotor vigilance test (PVT) to index their neurobehavioral performance. Nine nulliparous women in a control group underwent the same protocol for 12 continuous weeks. Postpartum PVT mean reciprocal (1/RT) reaction time did not differ from that of women in the control group at postpartum week 2, but then worsened over time. Postpartum slowest 10% 1/RT PVT reaction time was significantly worse than that of women in the control group at all weeks. Despite improvements in postpartum sleep, neurobehavioral performance continued to worsen from week 2 through the end of the study. Across the first 12 postpartum weeks, PVT measures were more frequently associated with percent sleep compared with total sleep time, highlighting the deleterious consequences of sleep disruption on maternal daytime functioning throughout the early postpartum period. Conclusions: Worsened maternal neurobehavioral performance across the first 12 postpartum weeks may have been influenced by the cumulative effects of sleep disturbance. These results can inform future work to identify the particular sleep profiles that could be primary intervention targets to improve daytime functioning among postpartum women, and indicate need for further research on the effectiveness of family leave policies. The time when postpartum women return to control-level daytime functioning is unknown. Citation: Insana SP; Williams KB; Montgomery-Downs HE. Sleep disturbance and neurobehavioral performance among postpartum women. SLEEP 2013;36(1):7381. PMID:23288973

  15. Postpartum depression: a metasynthesis.

    PubMed

    Beck, Cheryl Tatano

    2002-04-01

    Postpartum depression has been described as a dangerous thief that robs mothers of the love and happiness they expected to feel toward their newborn babies. Even though the number of qualitative studies on postpartum depression is increasing, knowledge development will be impeded unless the rich understandings gleaned from these studies are synthesized. Using Noblit and Hare's 1988 approach, the author conducted a metasynthesis of 18 qualitative studies on postpartum depression. Four overarching themes emerged that reflected four perspectives involved in postpartum depression: (a) incongruity between expectations and the reality of motherhood, (b) spiraling downward, (c) pervasive loss, and (d) making gains. Implications for clinical practice and theory development are addressed. PMID:11939248

  16. Postpartum depression following normal vaginal delivery among Nigerian women.

    PubMed

    Fatoye, Femi O; Adeyemi, Adebanjo B; Oladimeji, Benedicta Y

    2004-06-01

    The study investigated postpartum depression among Nigerian women by comparing 83 mothers who had normal vaginal deliveries with 83 matched controls. Analysis of scores on the Zung Self-rating Depression Scale indicated that the mothers and the controls were not significantly different on depression during the immediate postpartum period. There were significant relationships between postpartum depression and education after birth, not having male children at after 6 wk., primiparity after birth, and puerperal complications. PMID:15362404

  17. Infectious mononucleosis presenting as postpartum fever.

    PubMed

    Tibbitts, G Michael; Vogt, H Bruce; Dimitrievich, Elizabeth

    2004-05-01

    Infectious Mononucleosis and pregnancy are common conditions seen by obstetricians and family physicians. However, infectious mononucleosis in the postpartum period has not been reported in the literature. A 20 year-old woman presented with a four-day history of fever of 40 degrees C, and chills at her six-week postpartum visit, which prompted an evaluation of the cause of the fever. The atypical presentation of mononucleosis in this patient delayed the eventual diagnosis. Although Infectious Mononucleosis has not been mentioned in the literature as a cause of postpartum fever, it is likely more common than realized. For that reason the evaluation of Infectious Mononucleosis and postpartum fever are discussed. PMID:15181861

  18. Management of Postpartum Depression

    PubMed Central

    Guille, Constance; Newman, Roger; Fryml, Leah D.; Lifton, Clay K.; Epperson, C. Neill

    2013-01-01

    Postpartum depression, now termed peripartum depression by the DSM-V, is one of the most common complications in the postpartum period and has potentially significant negative consequences for mothers and their families. This article highlights common clinical challenges in the treatment of peripartum depression and reviews the evidence for currently available treatment options. Psychotherapy is the first-line treatment options for women with mild-to-moderate peripartum depression. Antidepressant medication in combination with therapy is recommended for women with moderate-to-severe depression. While pooled case reports and small controlled studies have demonstrated undetectable infant serum levels and no short-term adverse events in infants of mothers breastfeeding while taking sertraline (Zoloft) and paroxetine (Paxil), further research is needed including larger samples and long-term follow-up of infants exposed to antidepressants via breastfeeding with control for maternal depression. Pharmacological treatment recommendations in women who are lactating must include discussion with the patient regarding the benefits of breastfeeding, risks of antidepressant use during lactation and risks of untreated illness. There is a growing evidence base for non-pharmacological interventions including repetitive Transcranial Magnetic Stimulation (rTMS) which may offer an attractive option for women who wish to continue to breastfeed and are concerned about exposure of medication to their infant. Among severe cases of peripartum depression with psychosis referral to a psychiatrist or psychiatric APRN is warranted. Suicidal or homicidal ideation with a desire, intent or plan to harm oneself or anyone one else, including the infant, is a psychiatric emergency, and an evaluation by a mental health professional should be conducted immediately. Peripartum depression treatment research is limited by small samples sizes and few controlled studies. Much work is still needed to better understand which treatments women prefer and are the most effective in ameliorating the symptoms and disease burden associated with peripartum depression. PMID:24131708

  19. Postpartum onset and subsequent relapse of eosinophilic granulomatosis with polyangiitis.

    PubMed

    Edwards, Mark Hiley; Curtis, Elizabeth Mary; Ledingham, Joanna Mary

    2015-01-01

    Eosinophilic granulomatosis with polyangiitis (EGPA) can affect women of childbearing age. However, reports of the disease in the postpartum period are limited. We present a case of postpartum-onset EGPA that went into clinical remission before relapsing in the subsequent postpartum period. Our patient presented with dyspnoea, arthralgia and rash, shown to be eosinophilic vasculitis, 3 days following the birth of her second child. CT of the thorax showed alveolar shadowing and mediastinal lymphadenopathy. She was treated successfully for EGPA with glucocorticoid therapy. She declined maintenance treatment during remission. Off treatment, she remained disease free throughout her next pregnancy. In the postpartum period she relapsed in an almost identical manner, requiring prolonged glucocorticoid therapy, cyclophosphamide and rituximab. This case highlights the importance of maintenance therapy around pregnancy in individuals with EGPA, and the need for careful monitoring of women with a history of EGPA in the postpartum period. PMID:26106182

  20. Effects of assisted reproductive technology and of women's quality of life on depressive symptoms in the early postpartum period: a prospective case-control study.

    PubMed

    Monti, Fiorella; Agostini, Francesca; Paterlini, Marcella; Andrei, Federica; De Pascalis, Leonardo; Palomba, Stefano; La Sala, Giovanni Battista

    2015-05-01

    This study explored the influence of both assisted reproductive technology (ART) and reduced quality of life (QoL) during pregnancy on postpartum blues (PPB). Sixty-three sub-fertile patients who conceived through ART and 72 women who naturally conceived were enrolled in this prospective study. At 22nd and 32nd gestational weeks, women completed the Edinburgh Postnatal Depression Scale (EPDS) and the Short-Form 36 (SF-36), to investigate depressive symptoms and QoL, respectively; EPDS was again used at 15 days after birth to assess PPB. At both time points, higher EPDS scores and lower mental well-being scores (SF-36) significantly predicted PPB. The number of previous ART cycles emerged as the strongest predictor, whereas no significant effect was observed for the conceiving method. The results suggest the usefulness of assessing QoL during pregnancy and considering previous ART failures in preventing PPB. PMID:25625377

  1. A Sensitive Period for Language in the Visual Cortex: Distinct Patterns of Plasticity in Congenitally versus Late Blind Adults

    ERIC Educational Resources Information Center

    Bedny, Marina; Pascual-Leone, Alvaro; Dravida, Swethasri; Saxe, Rebecca

    2012-01-01

    Recent evidence suggests that blindness enables visual circuits to contribute to language processing. We examined whether this dramatic functional plasticity has a sensitive period. BOLD fMRI signal was measured in congenitally blind, late blind (blindness onset 9-years-old or later) and sighted participants while they performed a sentence

  2. Beyond the Critical Period: Processing-Based Explanations for Poor Grammaticality Judgment Performance by Late Second Language Learners

    ERIC Educational Resources Information Center

    McDonald, Janet L.

    2006-01-01

    This research explores if poor grammaticality judgments of late (age of arrival greater than or equal to 12) second language learners often attributed to being beyond the critical period for language acquisition can be better explained by processing difficulties due to (1) low L2 working memory capacity, (2) poor L2 decoding, and/or (3) inadequate

  3. A Sensitive Period for Language in the Visual Cortex: Distinct Patterns of Plasticity in Congenitally versus Late Blind Adults

    ERIC Educational Resources Information Center

    Bedny, Marina; Pascual-Leone, Alvaro; Dravida, Swethasri; Saxe, Rebecca

    2012-01-01

    Recent evidence suggests that blindness enables visual circuits to contribute to language processing. We examined whether this dramatic functional plasticity has a sensitive period. BOLD fMRI signal was measured in congenitally blind, late blind (blindness onset 9-years-old or later) and sighted participants while they performed a sentence…

  4. Maternal Deworming Research Study (MADRES) protocol: a double-blind, placebo-controlled randomised trial to determine the effectiveness of deworming in the immediate postpartum period

    PubMed Central

    Mofid, Layla S; Casapía, Martín; Montresor, Antonio; Rahme, Elham; Fraser, William D; Marquis, Grace S; Vercruysse, Jozef; Allen, Lindsay H; Gyorkos, Theresa W

    2015-01-01

    Introduction Soil-transmitted helminth infections are endemic in 114 countries worldwide, and cause the highest burden of disease among all neglected tropical diseases. The WHO includes women of reproductive age as a high-risk group for infection. The primary consequence of infection in this population is anaemia. During lactation, anaemia may contribute to reduced quality and quantity of milk, decreasing the duration of exclusive breastfeeding and lowering the age at weaning. To date, no study has investigated the effects of maternal postpartum deworming on infant or maternal health outcomes. Methods and analysis A single-centre, parallel, double-blind, randomised, placebo-controlled trial will be carried out in Iquitos, Peru, to assess the effectiveness of integrating single-dose 400 mg albendazole into routine maternal postpartum care. A total of 1010 mother-infant pairs will be randomised to either the intervention or control arm, following inhospital delivery and prior to discharge. Participants will be visited in their homes at 1, 6, 12 and 24 months following delivery for outcome ascertainment. The primary outcome is infant mean weight gain between birth and 6 months of age. Secondary outcomes include other infant growth indicators and morbidity, maternal soil-transmitted helminth infection and intensity, anaemia, fatigue, and breastfeeding practices. All statistical analyses will be performed on an intention-to-treat basis. Ethics and dissemination Research ethics board approval has been obtained from the McGill University Health Centre (Canada), the Asociación Civil Impacta Salud y Educación (Peru) and the Instituto Nacional de Salud (Peru). A data safety and monitoring committee is in place to oversee study progression and evaluate adverse events. The results of the analyses will be published in peer-reviewed journals, and presented at national and international conferences. Trial registration number Clinicaltrials.gov: NCT01748929. PMID:26084556

  5. Depression During Pregnancy and Postpartum.

    PubMed

    Becker, Madeleine; Weinberger, Tal; Chandy, Ann; Schmukler, Sarah

    2016-03-01

    Depression is a common complication of pregnancy and the postpartum period. There are multiple risk factors for peripartum mood disorders, most important of which is a prior history of depression. Both depression and antidepressant medications confer risk upon the infant. Maternal depression has been associated with preterm birth, low birth weight, fetal growth restriction, and postnatal cognitive and emotional complications. Antidepressant exposure has been associated with preterm birth, reductions in birth weight, persistent pulmonary hypertension, and postnatal adaptation syndrome (PNAS) as well as a possible connection with autism spectrum disorder. Paroxetine has been associated with cardiac malformations. Most antidepressant medications are excreted in low levels in breast milk and are generally compatible with breastfeeding. The use of antidepressants during pregnancy and postpartum must be weighed against the risk of untreated depression in the mother. PMID:26879925

  6. Psychiatric consultation to the postpartum mother.

    PubMed

    Anderson, Eleanor A; Kim, Deborah R

    2015-04-01

    The immediate postpartum period is a time of acute vulnerability to mental illness, which presents unique challenges for the psychiatric consultant. Because the postpartum hospital stay is typically brief, the consultant must have a working knowledge of postpartum physiology and the myriad forms of mental illness that may emerge in this vulnerable time, in order to quickly make a diagnosis and formulate a treatment plan. This review aims to characterize the most common reasons for postpartum consultation, review postpartum physiology and psychiatric conditions, and propose an evidence-based, practical approach to treatment. A literature search using the terms "postpartum," "obstetric," "consultation," and "psychiatry" yielded six studies that identified reasons for psychiatric consultation to the obstetrics and gynecology services. These studies informed the structure of the article such that we review the most common reasons for consultation and how to approach each issue. The most common reason for consultation is past psychiatric history, often in the absence of current symptoms. For each clinical situation, including depression, adverse birth events, and psychosis, we present a differential diagnosis, as well as risk factors, clinical signs, and recommended treatment. PMID:25764006

  7. Antigen exposure in the late light period induces severe symptoms of food allergy in an OVA-allergic mouse model.

    PubMed

    Tanabe, Kana; Kitagawa, Eri; Wada, Misaki; Haraguchi, Atsushi; Orihara, Kanami; Tahara, Yu; Nakao, Atsuhito; Shibata, Shigenobu

    2015-01-01

    The mammalian circadian clock controls many physiological processes that include immune responses and allergic reactions. Several studies have investigated the circadian regulation of intestinal permeability and tight junctions known to be affected by cytokines. However, the contribution of circadian clock to food allergy symptoms remains unclear. Therefore, we investigated the role of the circadian clock in determining the severity of food allergies. We prepared an ovalbumin food allergy mouse model, and orally administered ovalbumin either late in the light or late in the dark period under light-dark cycle. The light period group showed higher allergic diarrhea and weight loss than the dark period group. The production of type 2 cytokines, IL-13 and IL-5, from the mesenteric lymph nodes and ovalbumin absorption was higher in the light period group than in the dark period group. Compared to the dark period group, the mRNA expression levels of the tight junction proteins were lower in the light period group. We have demonstrated that increased production of type 2 cytokines and intestinal permeability in the light period induced severe food allergy symptoms. Our results suggest that the time of food antigen intake might affect the determination of the severity of food allergy symptoms. PMID:26419283

  8. Antigen exposure in the late light period induces severe symptoms of food allergy in an OVA-allergic mouse model

    PubMed Central

    Tanabe, Kana; Kitagawa, Eri; Wada, Misaki; Haraguchi, Atsushi; Orihara, Kanami; Tahara, Yu; Nakao, Atsuhito; Shibata, Shigenobu

    2015-01-01

    The mammalian circadian clock controls many physiological processes that include immune responses and allergic reactions. Several studies have investigated the circadian regulation of intestinal permeability and tight junctions known to be affected by cytokines. However, the contribution of circadian clock to food allergy symptoms remains unclear. Therefore, we investigated the role of the circadian clock in determining the severity of food allergies. We prepared an ovalbumin food allergy mouse model, and orally administered ovalbumin either late in the light or late in the dark period under light-dark cycle. The light period group showed higher allergic diarrhea and weight loss than the dark period group. The production of type 2 cytokines, IL-13 and IL-5, from the mesenteric lymph nodes and ovalbumin absorption was higher in the light period group than in the dark period group. Compared to the dark period group, the mRNA expression levels of the tight junction proteins were lower in the light period group. We have demonstrated that increased production of type 2 cytokines and intestinal permeability in the light period induced severe food allergy symptoms. Our results suggest that the time of food antigen intake might affect the determination of the severity of food allergy symptoms. PMID:26419283

  9. Factors Influencing Physical Activity among Postpartum Iranian Women

    ERIC Educational Resources Information Center

    Roozbahani, Nasrin; Ghofranipour, Fazlollah; Eftekhar Ardabili, Hassan; Hajizadeh, Ebrahim

    2014-01-01

    Background: Postpartum women are a population at risk for sedentary living. Physical activity (PA) prior to pregnancy may be effective in predicting similar behaviour in the postpartum period. Objective: To test a composite version of the extended transtheoretical model (TTM) by adding "past behaviour" in order to predict PA behaviour

  10. Factors Influencing Physical Activity among Postpartum Iranian Women

    ERIC Educational Resources Information Center

    Roozbahani, Nasrin; Ghofranipour, Fazlollah; Eftekhar Ardabili, Hassan; Hajizadeh, Ebrahim

    2014-01-01

    Background: Postpartum women are a population at risk for sedentary living. Physical activity (PA) prior to pregnancy may be effective in predicting similar behaviour in the postpartum period. Objective: To test a composite version of the extended transtheoretical model (TTM) by adding "past behaviour" in order to predict PA behaviour…

  11. Postpartum Depression and Child Development.

    ERIC Educational Resources Information Center

    Murray, Lynne, Ed.; Cooper, Peter J., Ed.

    Only recently has the research on postpartum depression dealt with the disorder's effects on child development. This book explores the impact of postpartum depression on mother-infant interaction and child development, its treatment, and postpartum psychosis. The chapters are: (1) "The Nature of Postpartum Depressive Disorders" (Michael O'Hara);…

  12. Postpartum Depression and Child Development.

    ERIC Educational Resources Information Center

    Murray, Lynne, Ed.; Cooper, Peter J., Ed.

    Only recently has the research on postpartum depression dealt with the disorder's effects on child development. This book explores the impact of postpartum depression on mother-infant interaction and child development, its treatment, and postpartum psychosis. The chapters are: (1) "The Nature of Postpartum Depressive Disorders" (Michael O'Hara);

  13. Postpartum IUCD: Rediscovering a Languishing Innovation.

    PubMed

    Balsarkar, Geetha Dharmesh; Nayak, Arun

    2015-07-01

    The National Family Planning Programme of India, since its inception in 1951, has been able to successfully achieve significant reductions in maternal mortality and fertility. Over the past decade, the need for contraception has changed dramatically in India. Couples no longer desire sterilization, but prefer modern reversible long-term methods of contraception. The ideal time to discuss contraception is in the antenatal period when there is a good rapport between the doctor and the patient. The window period when the patient is admitted in the hospital during delivery can be used effectively to offer postpartum contraception. It has been found that the highest chance of unwanted pregnancy is in the first year after delivery, when women do not report to the doctor if this window period is missed. Postpartum intrauterine contraceptive devices are ideal for a country like India and it can be used to cover the unmet need of contraception if inserted immediately after delivery. There are two types of insertion: post placental, within 10min of delivery of placenta and postpartum, within 48h of delivery. Although there is a greater chance of expulsion in the postpartum insertions, it can be significantly reduced with proper training and user experience. Postpartum IUCD should be routinely offered to all patients delivering in institutions to provide complete care to a parturient and to achieve safe motherhood. PMID:26243985

  14. A sensitive period for language in the visual cortex: Distinct patterns of plasticity in congenitally versus late blind adults

    PubMed Central

    Bedny, Marina; Pascual-Leone, Alvaro; Dravida, Swethasri; Saxe, Rebecca

    2012-01-01

    Recent evidence suggests that blindness enables visual circuits to contribute to language processing. We examined whether this dramatic functional plasticity has a sensitive period. BOLD fMRI signal was measured in congenitally blind, late blind (blindness onset 9-years-old or later) and sighted participants while they performed a sentence comprehension task. In a control condition, participants listened to backwards speech and made match/non-match to sample judgments. In both, congenitally and late blind participants BOLD signal increased in bilateral foveal-pericalcarine cortex during response preparation, irrespective of whether the stimulus was a sentence or backwards speech. However, only in congenitally blind people left occipital areas (pericalcarine, extrastriate, fusiform and lateral) responded more to sentences than backwards speech. We conclude that age of blindness onset constrains the non-visual functions of occipital cortex: while plasticity is present in both congenitally and late blind individuals, recruitment of visual circuits for language depends on blindness during childhood. PMID:22154509

  15. Epidemiological characteristics and predictors of late presentation of HIV infection in Barcelona (Spain) during the period 2001-2009

    PubMed Central

    2011-01-01

    Background Early diagnosis of HIV infection can prevent morbidity and mortality as well as reduce HIV transmission. The aim of the present study was to assess prevalence, describe trends and identify factors associated with late presentation of HIV infection in Barcelona (Spain) during the period 2001-09. Methods Demographic and epidemiological characteristics of cases reported to the Barcelona HIV surveillance system were analysed. Late presentation was defined for individuals with a CD4 count below 350 cells/ml upon HIV diagnosis or diagnosis of AIDS within 3 months of HIV diagnosis. Multivariate logistic regression were used to identify predictors of late presentation. Results Of the 2,938 newly diagnosed HIV-infected individuals, 2,507 (85,3%) had either a CD4 cell count or an AIDS diagnosis available. A total of 1,139 (55.6%) of the 2,507 studied cases over these nine years were late presenters varying from 48% among men who have sex with men to 70% among heterosexual men. The proportion of late presentation was 62.7% in 2001-2003, 51.9% in 2004-2005, 52.6% in 2006-2007 and 52.1% in 2008-2009. A decrease over time only was observed between 2001-2003 and 2004-2005 (p = 0.001) but remained constant thereafter (p = 0.9). Independent risk factors for late presentation were older age at diagnosis (p < 0.0001), use of injected drugs by men (p < 0.0001), being a heterosexual men (p < 0.0001), and being born in South America (p < 0.0001) or sub-Saharan Africa (p = 0.002). Conclusion Late presentation of HIV is still too frequent in all transmission groups in spite of a strong commitment with HIV prevention in our city. It is necessary to develop interventions that increase HIV testing and facilitate earlier entry into HIV care. PMID:21729332

  16. Eclipses in the Middle East from the Late Medieval Islamic Period to the Early Modern Period. Part 1: The observation of six lunar eclipses from the Late Medieval Islamic Period

    NASA Astrophysics Data System (ADS)

    Mozaffari, S. Mohammad

    2013-11-01

    This paper deals with the analysis of data obtained from observations of two sets of three lunar eclipses in the Late Medieval Islamic Period. The first trio consists of the lunar eclipses of 7 March 1262, 7 April 1270 and 24 January 1274, observed by Muḥyī al-Dīn al-Maghribī; from the Maragha Observatory (in north-western Iran), and the second includes those of 2 June and 26 November 1406, and 22 May 1407, observed by Jamshīd Ghiyāth al-Dīn al-Kāshī from Kāshān (in central Iran). The results are that al-Maghribī's values for the magnitudes of these eclipses agree excellently with modern data, and his values for the times when the maximum phases occurred agree to within five minutes with modern values. Al-Kāshī's values for the times of the maximum phases show a rather larger divergence from modern data, varying from about ten minutes to about one hour. The errors in all six values both astronomers computed from their own solar parameters for the longitude of the Sun at the instant of the opposition of the Moon to the Sun in these eclipses remain below ten minutes of arc. The motivation for doing these observations was to measure the lunar epicycle radius r in the Ptolemaic model. Al-Maghribī achieved r = 5;12 and al-Kāshī r ∼ 5;17,1 in terms of the radius of an orbit of R = 60 arbitrary units. It is argued that comparing with modern theory, neither of these two medieval values can be considered an improvement on Ptolemy's value of r = 5;15.

  17. Adaptation of the inflammatory immune response across pregnancy and postpartum in Black and White women.

    PubMed

    Gillespie, Shannon L; Porter, Kyle; Christian, Lisa M

    2016-04-01

    Pregnancy is a period of considerable physiological adaption in neuroendocrine, cardiovascular, as well as immune function. Understanding of typical changes in inflammatory immune responses during healthy pregnancy is incomplete. In addition, despite considerable racial difference in adverse pregnancy outcomes, data are lacking on potential racial differences in such adaptation. This repeated measures prospective cohort study included 37 Black and 39 White women who provided blood samples during early, mid-, and late pregnancy and 8-10 weeks postpartum. Peripheral blood mononuclear cells were incubated with lipopolysaccharide (LPS) for 24h and supernatants assayed by electrochemiluminescence to quantify interleukin(IL)-6, tumor necrosis factor(TNF)-α, IL-1β, and IL-8 production. While no changes were observed in IL-8 production over time, significant increases in IL-6, TNF-α, and IL-1β production were observed from early to late pregnancy, with subsequent declines approaching early pregnancy values at postpartum (ps<0.05). Overall, inflammatory response patterns were highly similar among Black versus White women. However, Black women had greater TNF-α production during mid-pregnancy (p=0.002) and marginally lower IL-1β production at postpartum (p=0.054). These data show a clear trajectory of change in the inflammatory immune response across pregnancy and postpartum. In this cohort of generally healthy women, Black and White women exhibited minimal differences in LPS-stimulated cytokine production across the perinatal period. Future prospective studies in Black and White women with healthy versus adverse outcomes (e.g., preeclampsia, preterm birth) would inform our understanding of the potential role of immune dysregulation in pregnant women and in relation to racial disparities in perinatal health. PMID:26895093

  18. Postpartum and Post-Abortion Contraception: From Research to Programs.

    PubMed

    Shah, Iqbal H; Santhya, K G; Cleland, John

    2015-12-01

    Contraception following delivery or an induced abortion reduces the risk of an early unintended pregnancy and its associated adverse health consequences. Unmet need for contraception during the postpartum period and contraceptive counseling and services following abortion have been the focus of efforts for the last several decades. This article provides an introduction to the more focused contributions that follow in this special issue. We discuss the validity and measurement of the concept of unmet need for family planning during the postpartum period. We then present key findings on postpartum contraceptive protection, use dynamics, and method mix, followed by an assessment of interventions to improve postpartum family planning. The evidence on postabortion contraceptive uptake and continuation of use remains thin, although encouraging results are noted for implementation of comprehensive abortion care and for the impact of post-abortion contraceptive counseling and services. Drawing on these studies, we outline policy and program implications for improving postpartum and post-abortion contraceptive use. PMID:26643486

  19. Comparative Efficacy of the Generalized Anxiety Disorder 7-Item Scale and the Edinburgh Postnatal Depression Scale as Screening Tools for Generalized Anxiety Disorder in Pregnancy and the Postpartum Period

    PubMed Central

    Simpson, William; Glazer, Melanie; Michalski, Natalie; Steiner, Meir; Frey, Benicio N

    2014-01-01

    Objective: About 24.1% of pregnant women suffer from at least 1 anxiety disorder, 8.5% of whom suffer specifically from generalized anxiety disorder (GAD). GAD is often associated with major depressive disorder (MDD). During the perinatal period, the presence of physical and somatic symptoms often makes differentiation between depression and anxiety more challenging. To date, no screening tools have been developed to detect GAD in the perinatal population. We investigated the psychometric properties of the GAD 7-item Scale (GAD-7) as a screening tool for GAD in pregnant and postpartum women. Methods: Two hundred and forty perinatal women (n = 155 pregnant and n = 85 postpartum) referred for psychiatric consultation were enrolled. On the day of initial assessment, all women completed the GAD-7 and the Edinburgh Postnatal Depression Scale (EPDS). Diagnostic and Statistical Manual of Mental Disorders, Fourth Editionbased diagnoses were made by experienced psychiatrists. Scores from the GAD-7 and EPDS were compared with the clinical diagnoses to evaluate the psychometric properties of the GAD-7 and EPDS when used as a screening tool for GAD. Results: The GAD-7 yielded a sensitivity of 61.3% and specificity of 72.7% at an optimal cut-off score of 13. Compared with the EPDS and the EPDS-3A subscale, the GAD-7 displayed greater accuracy and specificity over a greater range of cut-off scores and more accurately identified GAD in patients with comorbid MDD. Conclusion: Our findings suggest that the GAD-7 represents a clinically useful scale for the detection of GAD in perinatal women. PMID:25161068

  20. The Wandering Indian Plate and Its Changing Biogeography During the Late Cretaceous-Early Tertiary Period

    NASA Astrophysics Data System (ADS)

    Chatterjee, Sankar; Scotese, Christopher

    Palaeobiogeographic analysis of Indian tetrapods during the Late Cretaceous-Early Tertiary time has recognized that both vicariance and geodispersal have played important roles in producing biogeographic congruence. The biogeographic patterns show oscillating cycles of geodispersal (Late Cretaceous), followed by congruent episodes of vicariance and geodispersal (Early Eocene), followed by another geodispersal event (Middle Eocene). New biogeographic synthesis suggests that the Late Cretaceous Indian tetrapod fauna is cosmopolitan with both Gondwanan and Laurasian elements. Throughout most of the Cretaceous, India was separated from the rest of Gondwana, but in the latest Cretaceous it reestablished contact with Africa through Kohistan-Dras (K-D) volcanic arc, and maintained biotic link with South America via Ninetyeast Ridge-Kerguelen-Antarctica corridor. These two geodispersal routes allowed exchanges of "pan-Gondwana" terrestrial tetrapods from Africa, South America, and Madagascar. During that time India also maintained biotic connections with Laurasia across the Neotethys via Kohistan-Dras Arc and Africa. During the Palaeocene, India, welded to the K-D Arc, rafted like a "Noah's Ark" as an island continent and underwent rapid cladogenesis because of allopatric speciation. Although the Palaeocene fossil record is blank, Early Eocene tetrapods contain both endemic and cosmopolitan elements, but Middle Eocene faunas have strong Asian character. India collided with Asia in Early and Middle Eocene time and established a new northeast corridor for faunal migration to facilitate the bidirectional "Great Asian Interchange" dispersals.

  1. Postpartum evaluation and long term implications.

    PubMed

    Firoz, Tabassum; Melnik, Tanya

    2011-08-01

    Hypertension, proteinuria and biochemical changes caused by pre-eclampsia may persist for several weeks and even months postpartum. Hypertension and pre-eclampsia may even develop for the first time postpartum. Care in the six weeks postpartum should include management of hypertension and screening for secondary causes of hypertension including renal disease if abnormalities persist beyond six weeks. Optimal postpartum monitoring for patients with preeclampsia has not been determined, and care needs to be individualized. The postpartum period also provides a window of opportunity for planning for the next pregnancy in addition to discussing long term implications of pre-eclampsia. Increased risk for the development of premature cardiovascular disease is the most significant long term implication of pre-eclampsia. Pre-eclampsia and cardiovascular disease share a common disease pathophysiology. Women who develop pre-eclampsia have pre-existing metabolic abnormalities or may develop them later in life. Women with early onset pre-eclampsia are at the highest risk of ischemic heart disease. Women with a history of pre-eclampsia should adopt a heart healthy lifestyle and should be screened and treated for traditional cardiovascular risk factors according to locally accepted guidelines. PMID:21536498

  2. Perceptions matter: barriers to treatment of postpartum hemorrhage.

    PubMed

    Thaddeus, Sereen; Nangalia, Rachna; Vivio, Donna

    2004-01-01

    Postpartum hemorrhage is the leading cause of maternal deaths in developing countries. This report highlights the social and cultural factors that influence the decision to seek care in cases of postpartum bleeding. Survey data on awareness of danger signs in the postpartum period and findings from the anthropologic literature describing beliefs about bleeding in childbirth and the postpartum period are presented. Findings point to a mismatch between actual and perceived risks of danger in the postpartum period. This may reflect a viewpoint that there are few risks remaining after the baby is born. This may, in turn, shape the perception that the postpartum period is one in which less vigilance is required compared with labor and birth. Such beliefs are important to consider, as they may influence timely seeking of emergency obstetric care. Efforts to reduce the incidence of postpartum hemorrhage as a major cause of maternal death must progress on two fronts: on the supply side to ensure the provision of skilled care and on the demand side to ensure that women and their families accept the view that bleeding after birth is dangerous and that skilled care is preferable to traditional care. PMID:15236708

  3. Quality of life outcomes in pregnancy and postpartum complicated by hypertensive disorders, gestational diabetes, and preterm birth.

    PubMed

    Mautner, Eva; Greimel, Eva; Trutnovsky, Gerda; Daghofer, Fedor; Egger, Josef W; Lang, Uwe

    2009-12-01

    Health problems can develop during a pregnancy, turning it into a high risk. The aim of this study was to explore the influence of hypertensive disorders, gestational diabetes, and preterm birth as risk factors for health-related quality of life (HRQL) and depressive symptoms during late pregnancy and postpartum. A prospective, longitudinal study was performed with three assessments. Ninety women were recruited in the study including 29 controls. HRQL was measured using the WHO-QOL-BREF questionnaire. Depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS). Statistical analyses were performed using ANOVA and the chi-square test to explore HRQL and depressive symptoms between three pregnancy risk groups and controls. Women of the preterm group had statistically significant higher depression scores and lower HRQL scores on the physical domain during pregnancy than those without complications. Women with hypertensive disorders showed the second most depressive symptoms. Physical and global HRQL improved and depressive symptoms decreased significantly from late pregnancy and early postpartum period to late postpartum. Pregnant specific health problems, especially the risk for preterm delivery is associated with more depressive symptoms and decreased HRQL in pregnancy. Guidance and communication for these women is important. The counseling should be multi professional to reduce childbirth burdens. PMID:19845493

  4. The relationship between restrictive state abortion laws and postpartum depression.

    PubMed

    Medoff, Marshall H

    2014-01-01

    Is there a relationship between restrictive state abortion laws and postpartum depression? Do states with restrictive abortion laws have higher rates of postpartum depression? If there is a relationship, does it differ by the type of restrictive state abortion law? Using the Centers for Disease Control's 2008 Pregnancy Risk Assessment Monitoring System state survey of the percentage of women who gave birth and suffered from postpartum depression, states with and without restrictive abortion laws were compared. The empirical results found that there were no significant differences in the incidence of postpartum depression between states with parental involvement laws, mandatory counseling laws, waiting period laws, two-visit laws, and states without these restrictive abortion laws. States that prohibit the Medicaid funding of abortions have significantly higher rates of postpartum depression than in those states that fund Medicaid abortions. PMID:25068613

  5. Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 20002013

    PubMed Central

    Oza, Shefali; Lawn, Joy E; Hogan, Daniel R; Mathers, Colin

    2015-01-01

    Abstract Objective To estimate cause-of-death distributions in the early (06days of age) and late (727 days of age) neonatal periods, for 194 countries between 2000 and 2013. Methods For 65 countries with high-quality vital registration, we used each countrys observed early and late neonatal proportional cause distributions. For the remaining 129 countries, we used multinomial logistic models to estimate these distributions. For countries with low child mortality we used vital registration data as inputs and for countries with high child mortality we used neonatal cause-of-death distribution data from studies in similar settings. We applied cause-specific proportions to neonatal death estimates from the United Nations Inter-agency Group for Child Mortality Estimation, by country and year, to estimate cause-specific risks and numbers of deaths. Findings Over time, neonatal deaths decreased for most causes. Of the 2.8 million neonatal deaths in 2013, 0.99 million deaths (uncertainty range: 0.701.31) were estimated to be caused by preterm birth complications, 0.64 million (uncertainty range: 0.460.84) by intrapartum complications and 0.43 million (uncertainty range: 0.220.66) by sepsis and other severe infections. Preterm birth (40.8%) and intrapartum complications (27.0%) accounted for most early neonatal deaths while infections caused nearly half of late neonatal deaths. Preterm birth complications were the leading cause of death in all regions of the world. Conclusion The neonatal cause-of-death distribution differs between the early and late periods and varies with neonatal mortality rate level. To reduce neonatal deaths, effective interventions to address these causes must be incorporated into policy decisions. PMID:25558104

  6. Periodicity in Sediments from the Baltic Sea and in Greenland Ice as Climate Signals for the Late Quaternary

    NASA Astrophysics Data System (ADS)

    Harff, J.; Endler, R.; Kotov, S.; Leipe, T.; Witkowski, A.

    2009-12-01

    Climatic records from Greenland ice and Baltic Sea provide as well information about global climate changes as about local basin peculiarities. Late Quaternary sediments have been accumulated in the Baltic Basin with high accumulation rates, qualifying them for the study of late Pleistocene to Holocene climate and environmental history in Northern Europe and the North Atlantic realm. Physical and geochemical properties have been successfully used as proxies for paleo-temperature, primary production, hydrographic circulation pattern. The variability of these sediment parameters mirror changing depositional conditions determined by climatically-driven sea level change and glacio-isostatic adjustment which controls the coupling of the Baltic Seas hydrographical regime with the world ocean. During the late Holocene when the Baltic basin was permanently connected with the Atlantic Ocean the dynamics of the atmospheric circulation of the North Atlantic, but also its modification due to the variation of Eurasian anticyclones is reflected in the facies of sediments in the Baltic Sea varying on the centennial scale. On the other hand, there are components within the sedimentary facies that express environmental parameters that are periodically changing at annual to decadal scales. Changes in the salinity of the depositional basin reconstructed by diatom analysis play an important role, here. Data records provided by the Greenland Ice Sheet Project Two serve as proxy measure of climate conditions during Holocene on the global scale. We have compared different sediment proxies from the Baltic Basin with climate relevant ice core data from Greenland. Refined with Singular Spectrum Analysis, all the records have been analyzed on periodicity via Fourier analysis. Time series analysis covering a time span of the last 11.000 years reveals different periods of climate proxy-parameters. Decomposed and noise-free signals demonstrate the obvious presence of global components with concordant periods of about 900, 500 and 400 years in both records. Particularly prominent is a 900 year period found in Baltic, North Atlantic, and Greenland proxy data seems to be of global relevance. This period, also present in late Quaternary sun activity reconstructions, explains not only the Late Glacial to Middle Holocene record, but also to the more recent climate variations from the Dark Ages to the Medieval Climate Optimum, the Little Ice Age, and the Modern Warm Period. According to our data analysis the current phase of anthropogenic global warming coincides with a phase of naturally increasing temperature of the atmosphere. Periodicity analysis allows the development of future projections (scenarios) of the development of climate parameters based on mathematical models of proxy-data variability from sediments and ice cores. According to results of these projections, our planet is now towards the end of an ascending temperature cycle within a global process with a 900 years period.

  7. Maternal Postpartum Role Collapse as a Theory of Postpartum Depression

    ERIC Educational Resources Information Center

    Amankwaa, Linda Clark

    2005-01-01

    The purpose of this paper is to discuss the development of a theory of maternal postpartum role collapse. The influences of traditional role theory and symbolic interactionism are presented. The development of the maternal postpartum role collapse theory emerged from the study of postpartum depression among African-American women (Amankwaa, 2000).

  8. The Use of Parenteral Iron Therapy for the Treatment of Postpartum Anemia.

    PubMed

    Nash, Christopher M; Allen, Victoria M

    2015-05-01

    Rates of postpartum hemorrhage have been increasing in Canada over the last 10 years, with postpartum iron deficiency anemia as the most common consequence. Postpartum anemia is treated with oral iron supplementation and/or blood transfusion. Recent studies have evaluated the use of parenteral iron as a better tolerated treatment modality. Compared with oral iron supplements, parenteral iron is associated with a more rapid rise in serum ferritin and hemoglobin and improved maternal fatigue scores in the postpartum period. It may also decrease rates of blood transfusion. Parenteral iron may be considered in select clinical situations for the treatment of postpartum anemia. PMID:26168105

  9. Major storm periods and climate forcing in the Western Mediterranean during the Late Holocene

    NASA Astrophysics Data System (ADS)

    Degeai, Jean-Philippe; Devillers, Benoît; Dezileau, Laurent; Oueslati, Hamza; Bony, Guénaëlle

    2015-12-01

    Big storm events represent a major risk for populations and infrastructures settled on coastal lowlands. In the Western Mediterranean, where human societies colonized and occupied the coastal areas since the Ancient times, the variability of storm activity for the past three millennia was investigated with a multi-proxy sedimentological and geochemical study from a lagoonal sequence. Mappings of the geochemistry and magnetic susceptibility of detrital sources in the watershed of the lagoon and from the coastal barriers were undertaken in order to track the terrestrial or coastal/marine origin of sediments deposited into the lagoon. The multi-proxy analysis shows that coarser material, low magnetic susceptibility, and high strontium content characterize the sedimentological signature of the paleostorm levels identified in the lagoonal sequence. A comparison with North Atlantic and Western Mediterranean paleoclimate proxies shows that the phases of high storm activity occurred during cold periods, suggesting a climatically-controlled mechanism for the occurrence of these storm periods. Besides, an in-phase storm activity pattern is found between the Western Mediterranean and Northern Europe. Spectral analyses performed on the Sr content revealed a new 270-year solar-driven pattern of storm cyclicity. For the last 3000 years, this 270-year cycle defines a succession of ten major storm periods (SP) with a mean duration of 96 ± 54 yr. Periods of higher storm activity are recorded from >680 to 560 cal yr BC (SP10, end of the Iron Age Cold Period), from 140 to 820 cal yr AD (SP7 to SP5) with a climax of storminess between 400 and 800 cal yr AD (Dark Ages Cold Period), and from 1230 to >1800 cal yr AD (SP3 to SP1, Little Ice Age). Periods of low storm activity occurred from 560 cal yr BC to 140 cal yr AD (SP9 and SP8, Roman Warm Period) and from 820 to 1230 cal yr AD (SP4, Medieval Warm Period).

  10. Postpartum sacral insufficiency fractures.

    PubMed

    Yan, Charles Xiao Bo; Vautour, Line; Martin, Marie-Hlne

    2016-03-01

    Postpartum sacral insufficiency fracture is an uncommon occurrence that is often under-diagnosed because its symptoms of low back, buttock and groin pains may initially be attributed to physiologic biomechanical changes caused by pregnancy or to intervertebral disc disease. We present a case of bilateral sacral insufficiency fractures in a 37-year-old postpartum woman with osteopenic bone mineral density confirmed by dual energy X-ray absorptiometry. The symptoms were initially suspected to be of discogenic cause, and the fractures were incidentally appreciated at the edge of a lumbar spine magnetic resonance image. Therefore, it is important to keep in mind this potential diagnosis when examining imaging studies of postpartum patients. For women who present other risk factors of osteoporosis, imaging of the entire sacrum should be part of the imaging studies. If sacral stress fractures are diagnosed, further evaluation for bone mineral density and underlying metabolic bone disease is recommended. PMID:26554948

  11. Late Devonian glacial deposits from the eastern United States signal an end of the mid-Paleozoic warm period

    USGS Publications Warehouse

    Brezinski, D.K.; Cecil, C.B.; Skema, V.W.; Stamm, R.

    2008-01-01

    A Late Devonian polymictic diamictite extends for more than 400??km from northeastern Pennsylvania across western Maryland and into east-central West Virginia. The matrix-supported, unbedded, locally sheared diamictite contains subangular to rounded clasts up to 2??m in diameter. The mostly rounded clasts are both locally derived and exotic; some exhibit striations, faceting, and polish. The diamictite commonly is overlain by laminated siltstone/mudstone facies associations (laminites). The laminites contain isolated clasts ranging in size from sand and pebbles to boulders, some of which are striated. The diamictite/laminite sequence is capped by massive, coarse-grained, pebbly sandstone that is trough cross-bedded. A stratigraphic change from red, calcic paleo-Vertisols in strata below the diamictite to non-calcic paleo-Spodosols and coal beds at and above the diamictite interval suggests that the climate became much wetter during deposition of the diamictite. The diamictite deposit is contemporaneous with regressive facies that reflect fluvial incision during the Late Devonian of the Appalachian basin. These deposits record a Late Devonian episode of climatic cooling so extreme that it produced glaciation in the Appalachian basin. Evidence for this episode of climatic cooling is preserved as the interpreted glacial deposits of diamictite, overlain by glaciolacustrine varves containing dropstones, and capped by sandstone interpreted as braided stream outwash. The Appalachian glacigenic deposits are contemporaneous with glacial deposits in South America, and suggest that Late Devonian climatic cooling was global. This period of dramatic global cooling may represent the end of the mid-Paleozoic warm interval that began in the Middle Silurian. ?? 2008 Elsevier B.V. All rights reserved.

  12. Is Shade Beneficial for Mediterranean Shrubs Experiencing Periods of Extreme Drought and Late-winter Frosts?

    PubMed Central

    Valladares, Fernando; Zaragoza-Castells, Joana; Sánchez-Gómez, David; Matesanz, Silvia; Alonso, Beatriz; Portsmuth, Angelika; Delgado, Antonio; Atkin, Owen K.

    2008-01-01

    Background and Aims Plants are naturally exposed to multiple, frequently interactive stress factors, most of which are becoming more severe due to global change. Established plants have been reported to facilitate the establishment of juvenile plants, but net effects of plant–plant interactions are difficult to assess due to complex interactions among environmental factors. An investigation was carried out in order to determine how two dominant evergreen shrubs (Quercus ilex and Arctostaphylos uva-ursi) co-occurring in continental, Mediterranean habitats respond to multiple abiotic stresses and whether the shaded understorey conditions ameliorate the negative effects of drought and winter frosts on the physiology of leaves. Methods Microclimate and ecophysiology of sun and shade plants were studied at a continental plateau in central Spain during 2004–2005, with 2005 being one of the driest and hottest years on record; several late-winter frosts also occurred in 2005. Key Results Daytime air temperature and vapour pressure deficit were lower in the shade than in the sun, but soil moisture was also lower in the shade during the spring and summer of 2005, and night-time temperatures were higher in the shade. Water potential, photochemical efficiency, light-saturated photosynthesis, stomatal conductance and leaf 13C composition differed between sun and shade individuals throughout the seasons, but differences were species specific. Shade was beneficial for leaf-level physiology in Q. ilex during winter, detrimental during spring for both species, and of little consequence in summer. Conclusions The results suggest that beneficial effects of shade can be eclipsed by reduced soil moisture during dry years, which are expected to be more frequent in the most likely climate change scenarios for the Mediterranean region. PMID:18819947

  13. Induction of ovulation with GnRH and PGF(2 alpha) at two different stages during the early postpartum period in dairy cows: ovarian response and changes in hormone concentrations.

    PubMed

    Amaya-Montoya, Carlos; Matsui, Motozumi; Kawashima, Chiho; Hayashi, Ken-Go; Matsuda, Go; Kaneko, Etsushi; Kida, Katsuya; Miyamoto, Akio; Miyake, Yoh-Ichi

    2007-08-01

    The aims of this study were 1) to determine whether dairy cows can be induced to ovulate by the treatment with gonadotropin releasing hormone (GnRH) followed by prostaglandin F(2 alpha) (PGF(2 alpha)) during the early postpartum period and 2) to describe their ovarian and hormonal responses according to ovarian status. Cows were divided in two groups and received 10 microg of buserelin followed by 500 microg of cloprostenol 7 days apart starting from 21 (GnRH21, n=7) or around 37 days postpartum (GnRH37, n=7). The groups were further classified according to presence (-CL) or absence (-NCL) of functional corpora lutea (CL) on the day of GnRH treatment (d 0): GnRH21-NCL (n=4), GnRH21-CL (n=3) and GnRH37-CL (n=7). Ovarian morphology was monitored and the concentrations of P(4), E(2), FSH and insulin-like growth factor 1 (IGF-1) were measured. All cows ovulated after administration of GnRH. The P(4) levels of the GnRH21-NCL group from d 0 to d 5 were lower than those of the GnRH21-CL (P<0.05) and GnRH37-CL groups (P<0.01). In contrast, the E(2) levels of the GnRH21-NCL group within d 2 to d 6 were higher (P<0.05) than those of the other groups. Compared with the GnRH37-CL group, the GnRH21-NCL group had more small follicles on d 2 (P<0.05), d 3 (P<0.01) and d 4 (P<0.01) and more large follicles on d 5 (P<0.05). The induced CL and new ovulatory follicles were larger in the GnRH21-NCL group compared with the GnRH21-CL (P<0.001 and P<0.01) and GnRH37-CL groups (P<0.001 and P<0.05). IGF-1 did not differ among the groups. The GnRH21-NCL group had higher FSH levels than the GnRH21-CL (P<0.01) and GnRH37-CL groups (P<0.001) on d 0. Low P(4) and high FSH levels may suggest higher gonadotropin support on the enhanced ovarian morphology of the GnRH21-NCL group. PGF(2 alpha) treatment induced CL regression and subsequent ovulation in 3/4 (75%), 3/3 (100%) and 7/7 (100%) cows in the GnRH21-NCL, GnRH21-CL and GnRH37-CL groups, respectively. In conclusion, a 7-day GnRH-PGF(2 alpha) synchronization protocol can effectively induce dairy cows to ovulate as early as 21 days postpartum, regardless of ovarian status. PMID:17510528

  14. [Effects of the periodical spread of rinderpest on famine, epidemic, and tiger disasters in the late 17th Century].

    PubMed

    Kim, Dong Jin; Yoo, Han Sang; Lee, Hang

    2014-04-01

    This study clarifies the causes of the repetitive occurrences of such phenomena as rinderpest, epidemic, famine, and tiger disasters recorded in the Joseon Dynasty Chronicle and the Seungjeongwon Journals in the period of great catastrophe, the late 17th century in which the great Gyeongsin famine (1670~1671) and the great Eulbyeong famine (1695~1696) occurred, from the perspective that they were biological exchanges caused by the new arrival of rinderpest in the early 17th century. It is an objection to the achievements by existing studies which suggest that the great catastrophes occurring in the late 17th century are evidence of phenomena in a little ice age. First of all, rinderpest has had influence on East Asia as it had been spread from certain areas in Machuria in May 1636 through Joseon, where it raged throughout the nation, and then to the west part of Japan. The new arrival of rinderpest was indigenized in Joseon, where it was localized and spread periodically while it was adjusted to changes in the population of cattle with immunity in accordance with their life spans and reproduction rates. As the new rinderpest, which showed high pathogenicity in the early 17th century, was indigenized with its high mortality and continued until the late 17th century, it broke out periodically in general. Contrastively, epidemics like smallpox and measles that were indigenized as routine ones had occurred constantly from far past times. As a result, the rinderpest, which tried a new indigenization, and the human epidemics, which had been already indigenized long ago, were unexpectedly overlapped in their breakout, and hence great changes were noticed in the aspects of the human casualty due to epidemics. The outbreak of rinderpest resulted in famine due to lack of farming cattle, and the famine caused epidemics among people. The casualty of the human population due to the epidemics in turn led to negligence of farming cattle, which constituted factors that triggered rage and epidemics of rinderpest. The more the number of sources of infection and hosts with low immunity increased, the more lost human resources and farming cattle were lost, which led to a great famine. The periodic outbreak of the rinderpester along with the routine prevalence of various epidemics in the 17thcentury also had influenced on domestic and wild animals. Due to these phenomenon, full-fledged famines occurred that were incomparable with earlier ones. The number of domestic animals that were neglected by people who, faced with famines, were not able to take care of them was increased, and this might have brought about the rage of epidemics like rinderpest in domestic animals like cattle. The great Gyeongsin and Eulbyeong famines due to reoccurrence of the rinderpest in the late 17th century linked rinderpester, epidemics and great famines so that they interacted with each other. Furthermore, the recurring cycle of epidemics-famines-rinderpest-great famines constituted a great cycle with synergy, which resulted in eco-economic-historical great catastrophes accompanied by large scale casualties. Therefore, the Gyeongsin and Eulbyeong famines occurring in the late 17th century can be treated as events caused by the repetition of various periodic disastrous factors generated in 1670~1671 and in 1695~1696 respectively, and particularly as phenomena caused by biological exchanges based on rinderpester., rather than as little ice age phenomena due to relatively long term temperature lowering. PMID:24804681

  15. Rainy Periods and Bottom Water Stagnation Initiating Brine Accumulation and Metal Concentrations: 1. The Late Quaternary

    NASA Astrophysics Data System (ADS)

    Rossignol-Strick, Martine

    1987-06-01

    A working hypothesis is proposed to account for the present accumulation of brines in isolated pockets of the ocean floor and for the formation of the underlying organic and metal-rich sediments. These are the Tyro and Bannock basins in the East Mediterranean, the Red Sea Deeps, and the Orca Basin in the northern Gulf of Mexico. Initiation of brine-derived deposition in the Red Sea Deeps and Orca Basin occurred between 12,000 and 8000 years B.P. This time bracket also encompasses the formation of the latest East Mediterranean sapropel and the wettest global climate since the last glacial maximum. This wet period first appeared in the tropics around 12,000 years B.P, then in the subtropical and middle latitudes. During the same period, the 23,000 year precession cycle brought the summer insolation of the northern hemisphere to its peak at 11,000 years B.P. with retreating northern hemisphere ice sheets. The Red Sea Deeps and the Orca Basin became anoxic during this humid period, and metal-rich sapropel deposition then began. In contrast, the Tyro and Bannock basins began accumulating a brine long before and persisted beyond this climatic stage. The hypothesis involves two propositions: (1) As in the Eastern Mediterranean Sea, marine anoxia was mainly the consequence of the large influx of continental runoff and local precipitation. Longer residence time of bottom waters, so-called "stagnation," in silled rimmed basins would have resulted from lower salinity at the sea surface in areas of deep water formation in the Eastern Mediterranean, the Red Sea, and the Gulf of Mexico and (2) Miocene or older evaporites underlie these basins or outcrop on their flanks. Leaching from these evaporites was an ongoing process before the quasi-stagnation phase, but the initial leachate, much less saline than the present brines, was continuously flushed by bottom circulation. The climate-induced quiescence of bottom waters in these basins enabled the leachate to accumulate. The feedback of stagnation by increased density progressively raised the salinity of entrapped bottom waters to the present brine concentration. The high density has resisted brine removal by bottom circulation until present time, long after cessation of the initiating wet period. The brines therefore are stagnant, fossil waters.

  16. Marine molluscs and late quaternary environmental studies with particular reference to the late-glacial period in Northwest Europe: A review

    NASA Astrophysics Data System (ADS)

    Peacock, J. D.

    Although it is now commonly thought that temperature is a minor factor in limiting the distribution of marine invertebrates, particularly on a local scale, there is evidence to suggest that some boreal molluscs, particularly those which occur in similar environments on both sides of the North Atlantic, are valuable as oceanic temperature indicators. This applies particularly to planktotrophic species whose northern limits of distribution are apparently controlled by summer surface temperature. The oceanography of the eastern North Atlantic is briefly considered in relation to zoogeographic subdivisions based on temperature and it is concluded that the latter are fairly crude and apply only to shelf seas. Most glaciomarine molluscan faunas are not specific to that environment, an exception being that dominated by the bivalve Portlandia arctica. The role of marine molluscs in palaeoenvironmental research at the local level for the 13-11 ka BP period is illustrated by a site at Inchinnan, Scotland; it is concluded that a shell bed at this locality consists partly of a little modified life assemblage and partly of shells which have been gently reworked under conditions of generally rapid deposition. During the same time interval, the changing composition of molluscan faunas on the NW European seaboard suggests that a weak drift of North Atlantic water replaced polar water at or a little later than 13 ka BP off Scotland and a few hundred years later off northern Norway. Evidence for relatively 'warm' intervals early and late in the 13-11 ka BP period has been found particulary on the Scottish coast and (to a lesser extent) more generally. The later 'warm' interval may be related to the southward movement of the polar front at the beginning of the Younger Dryas. The value of the bivalve shell itself in the determination of temperature, seasonality and calendar years is briefly discussed.

  17. Pregnancy and postpartum bowel changes: constipation and fecal incontinence.

    PubMed

    Shin, Grace Hewon; Toto, Erin Lucinda; Schey, Ron

    2015-04-01

    Pregnancy and the postpartum period are often associated with many gastrointestinal complaints, including nausea, vomiting, and heartburn; however, the most troublesome complaints in some women are defecatory disorders such as constipation and fecal incontinence, especially postpartum. These disorders are often multifactorial in etiology, and many studies have looked to see what risk factors lead to these complications. This review discusses the current knowledge of pelvic floor and anorectal physiology, especially during pregnancy, and reviews the current literature on causes and treatments of postpartum bowel symptoms of constipation and fecal incontinence. PMID:25803402

  18. Postpartum Bilateral Sacroiliitis caused by Brucella Infection

    PubMed Central

    Yavuz, Ferdi; Altun, Demet; Ulubay, Mustafa; Firatligil, Fahri Burin

    2015-01-01

    Early diagnosis of this septic sacroiliitis is difficult because symptoms are nonspecific during the postpartum period. In this case we dicscuss about a patient with bilateral buttock pain unresolved with painkillers and rest, after an induction delivery. A 31-year-old woman was presented to our clinic on the second week of postpartum period with bilateral buttock pain. She was subfebrile and had no apparent abnormality on her pelvic X-ray. The pain was so severe that she was unable to walk properly. Sacroiliac MRI during the acute episode of pain showed bone marrow oedema and fluid within the bilateral sacroiliac joint. She was found seropositive for brucellosis and the patient completely recovered with antibiotherapy treatment. We stopped our patient from breastfeeding when the Rose Bengal test turned out positive. Brucella sacroiliitis should be considered in puerperium period women when buttock pain and difficulty in walking are present and pain is unresponsive to analgesics. PMID:26675497

  19. Postpartum Bilateral Sacroiliitis caused by Brucella Infection.

    PubMed

    Ozturk, Mustafa; Yavuz, Ferdi; Altun, Demet; Ulubay, Mustafa; Firatligil, Fahri Burin

    2015-11-01

    Early diagnosis of this septic sacroiliitis is difficult because symptoms are nonspecific during the postpartum period. In this case we dicscuss about a patient with bilateral buttock pain unresolved with painkillers and rest, after an induction delivery. A 31-year-old woman was presented to our clinic on the second week of postpartum period with bilateral buttock pain. She was subfebrile and had no apparent abnormality on her pelvic X-ray. The pain was so severe that she was unable to walk properly. Sacroiliac MRI during the acute episode of pain showed bone marrow oedema and fluid within the bilateral sacroiliac joint. She was found seropositive for brucellosis and the patient completely recovered with antibiotherapy treatment. We stopped our patient from breastfeeding when the Rose Bengal test turned out positive. Brucella sacroiliitis should be considered in puerperium period women when buttock pain and difficulty in walking are present and pain is unresponsive to analgesics. PMID:26675497

  20. Assimilating continental mean temperatures to reconstruct the climate of the late pre-industrial period

    NASA Astrophysics Data System (ADS)

    Matsikaris, Anastasios; Widmann, Martin; Jungclaus, Johann

    2015-08-01

    An on-line, ensemble-based data assimilation (DA) method is performed to reconstruct the climate for 1750-1850 AD, and the performance is evaluated on large and small spatial scales. We use a low-resolution version of the Max Planck Institute for Meteorology MPI-ESM model and assimilate the PAGES 2K continental mean temperature reconstructions for the Northern Hemisphere (NH). The ensembles are generated sequentially for sub-periods based on the analysis of previous sub-periods. The assimilation has good skill for large-scale temperatures, but there is no agreement between the DA analysis and proxy-based reconstructions for small-scale temperature patterns within Europe or with reconstructions for the North Atlantic Oscillation (NAO) index. To explain the lack of added value in small spatial scales, a maximum covariance analysis (MCA) of links between NH temperature and sea level pressure is performed based on a control simulation with MPI-ESM. For annual values, winter and spring the Northern Annular Mode (NAM) is the pattern that is most closely linked to the NH continental temperatures, while for summer and autumn it is a wave-like pattern. This link is reproduced in the DA for winter, spring and annual means, providing potential for constraining the NAM/NAO phase and in turn regional temperature variability. It is shown that the lack of actual small-scale skill is likely due to the fact that the link might be too weak, as the NH continental mean temperatures are not the best predictors for large-scale circulation anomalies, or that the PAGES 2K temperatures include noise. Both factors can lead to circulation anomalies in the DA analysis that are substantially different from reality, leading to unrealistic representation of small-scale temperature variability. Moreover, we show that even if the true amplitudes of the leading MCA circulation patterns were known, there is still a large amount of unexplained local temperature variance. Based on these results, we argue that assimilating temperature reconstructions with a higher spatial resolution might improve the DA performance.

  1. Impact of forced separation policy on incarcerated postpartum mothers.

    PubMed

    Chambers, Angelina N

    2009-08-01

    The number of incarcerated women in the United States is steadily increasing with 9% giving birth while serving time. Mothers and babies are routinely separated immediately and during most of the postpartum period. This qualitative study examines the impact of this policy by exploring the nature and meaning of the mother-infant bonding experience when the mothers know separation is coming. Twelve incarcerated postpartum mothers were interviewed during the early postpartum period about their antepartum and postpartum relationships with their babies. Qualitative data analysis produced four relational themes: (a) "a love connection," (b) "everything was great until I birthed," (c) "feeling empty and missing a part of me," and (d) "I don't try to think too far in advance." Results of this qualitative study provide information to professionals exploring gender-sensitive prison policies for the growing female population. PMID:20022914

  2. A transitional snake from the Late Cretaceous period of North America.

    PubMed

    Longrich, Nicholas R; Bhullar, Bhart-Anjan S; Gauthier, Jacques A

    2012-08-01

    Snakes are the most diverse group of lizards, but their origins and early evolution remain poorly understood owing to a lack of transitional forms. Several major issues remain outstanding, such as whether snakes originated in a marine or terrestrial environment and how their unique feeding mechanism evolved. The Cretaceous Coniophis precedens was among the first Mesozoic snakes discovered, but until now only an isolated vertebra has been described and it has therefore been overlooked in discussions of snake evolution. Here we report on previously undescribed material from this ancient snake, including the maxilla, dentary and additional vertebrae. Coniophis is not an anilioid as previously thought a revised phylogenetic analysis of Ophidia shows that it instead represents the most primitive known snake. Accordingly, its morphology and ecology are critical to understanding snake evolution. Coniophis occurs in a continental floodplain environment, consistent with a terrestrial rather than a marine origin; furthermore, its small size and reduced neural spines indicate fossorial habits, suggesting that snakes evolved from burrowing lizards. The skull is intermediate between that of lizards and snakes. Hooked teeth and an intramandibular joint indicate that Coniophis fed on relatively large, soft-bodied prey. However, the maxilla is firmly united with the skull, indicating an akinetic rostrum. Coniophis therefore represents a transitional snake, combining a snake-like body and a lizard-like head. Subsequent to the evolution of a serpentine body and carnivory, snakes evolved a highly specialized, kinetic skull, which was followed by a major adaptive radiation in the Early Cretaceous period. This pattern suggests that the kinetic skull was a key innovation that permitted the diversification of snakes. PMID:22832579

  3. Effect of indigenous herbs on growth, blood metabolites and carcass characteristics in the late fattening period of hanwoo steers.

    PubMed

    Kim, D H; Kim, K H; Nam, I S; Lee, S S; Choi, C W; Kim, W Y; Kwon, E G; Lee, K Y; Lee, M J; Oh, Y K

    2013-11-01

    This study was conducted to evaluate the effects of indigenous herbal supplements on growth, blood metabolites and carcass characteristics in the late fattening period of Hanwoo steers. In a 6 month feeding trial, thirty Hanwoo steers (64732 kg) were allotted to one of 5 treatment groups, control (basal diet contained lasalocid), licorice, clove, turmeric and silymarin, with six steers per pen. All groups received ad libitum concentrate and 1 kg rice straw/animal/d throughout the feeding trial. Blood samples were collected at the beginning, middle, and the end of the experiment and the steers were slaughtered at the end. Blood glucose, triglyceride, total protein, and albumin concentrations were higher in the turmeric treatment compared with other treatments. Blood urea nitrogen and creatinine concentrations were highest (p<0.003 and p = 0.071, respectively) in steers treated with silymarin. Alanine aminotransferase activity was lower (p<0.06) for licorice and silymarin compared with the control group. There were no alterations in serum aspartate aminotransferase and gamma glutamyltransferase activities as a consequence of herb treatments (p = 0.203 and 0.135, respectively). Final body weight, body weight gain, average dairy gain and dry matter intake were not significantly different among treatments. Yield grade, marbling score and quality grade were higher for silymarin group than those of the control group (p<0.05). Therefore, the results suggest that silymarin can be used an effective dietary supplement as an alternative to antibiotic feed additive and a productivity enhancer, providing safe and more consumer acceptable alternative to synthetic compounds during the late fattening period of steers. PMID:25049742

  4. Effect of Indigenous Herbs on Growth, Blood Metabolites and Carcass Characteristics in the Late Fattening Period of Hanwoo Steers

    PubMed Central

    Kim, D. H.; Kim, K. H.; Nam, I. S.; Lee, S. S.; Choi, C. W.; Kim, W. Y.; Kwon, E. G.; Lee, K. Y.; Lee, M. J.; Oh, Y. K.

    2013-01-01

    This study was conducted to evaluate the effects of indigenous herbal supplements on growth, blood metabolites and carcass characteristics in the late fattening period of Hanwoo steers. In a 6 month feeding trial, thirty Hanwoo steers (64732 kg) were allotted to one of 5 treatment groups, control (basal diet contained lasalocid), licorice, clove, turmeric and silymarin, with six steers per pen. All groups received ad libitum concentrate and 1 kg rice straw/animal/d throughout the feeding trial. Blood samples were collected at the beginning, middle, and the end of the experiment and the steers were slaughtered at the end. Blood glucose, triglyceride, total protein, and albumin concentrations were higher in the turmeric treatment compared with other treatments. Blood urea nitrogen and creatinine concentrations were highest (p<0.003 and p = 0.071, respectively) in steers treated with silymarin. Alanine aminotransferase activity was lower (p<0.06) for licorice and silymarin compared with the control group. There were no alterations in serum aspartate aminotransferase and gamma glutamyltransferase activities as a consequence of herb treatments (p = 0.203 and 0.135, respectively). Final body weight, body weight gain, average dairy gain and dry matter intake were not significantly different among treatments. Yield grade, marbling score and quality grade were higher for silymarin group than those of the control group (p<0.05). Therefore, the results suggest that silymarin can be used an effective dietary supplement as an alternative to antibiotic feed additive and a productivity enhancer, providing safe and more consumer acceptable alternative to synthetic compounds during the late fattening period of steers. PMID:25049742

  5. The Knowledge of Third Trimester Pregnant Women about Postpartum and Newborn Infants Care

    ERIC Educational Resources Information Center

    Rahayuningsih, Faizah Betty

    2015-01-01

    Introduction: Postpartum period is a transition period but it is being neglected aspect from women health care. Mother's knowledge and education before childbirth is important to be prepared for postpartum. Misinformation about traditions/customs in society are considered irrational, causing confusion in puerperal women, especially for mothers who

  6. Heterogeneity of postpartum depression: a latent class analysis

    PubMed Central

    2016-01-01

    Summary Background Maternal depression in the postpartum period confers substantial morbidity and mortality, but the definition of postpartum depression remains controversial. We investigated the heterogeneity of symptoms with the aim of identifying clinical subtypes of postpartum depression. Methods Data were aggregated from the international perinatal psychiatry consortium Postpartum Depression: Action Towards Causes and Treatment, which represents 19 institutions in seven countries. 17 912 unique subject records with phenotypic data were submitted. We applied latent class analyses in a two-tiered approach to assess the validity of empirically defined subtypes of postpartum depression. Tier one assessed heterogeneity in women with complete data on the Edinburgh postnatal depression scale (EPDS) and tier two in those with postpartum depression case status. Findings 6556 individuals were assessed in tier one and 4245 in tier two. A final model with three latent classes was optimum for both tiers. The most striking characteristics associated with postpartum depression were severity, timing of onset, comorbid anxiety, and suicidal ideation. Women in class 1 had the least severe symptoms (mean EPDS score 10·5), followed by those in class 2 (mean EPDS score 14·8) and those in class 3 (mean EPDS score 20·1). The most severe symptoms of postpartum depression were significantly associated with poor mood (mean EPDS score 20·1), increased anxiety, onset of symptoms during pregnancy, obstetric complications, and suicidal ideation. In class 2, most women (62%) reported symptom onset within 4 weeks postpartum and had more pregnancy complications than in other two classes (69% vs 67% in class 1 and 29% in class 3). Interpretation PPD seems to have several distinct phenotypes. Further assessment of PPD heterogeneity to identify more precise phenotypes will be important for future biological and genetic investigations. Funding Sources of funding are listed at the end of the article. PMID:26359613

  7. Is the significance of postpartum fatigue being overlooked in the lives of women?

    PubMed

    Troy, Nancy Wieland

    2003-01-01

    The focus of this article is to draw the attention of nurses to the important role fatigue plays in the lives of postpartum women, and to the related roles nurses can play in practice, research, and healthcare policy formulation. Fatigue in the postpartum period has the capacity to adversely affect not only the woman's quality of life, but also that of her family. For two decades women have been ranking fatigue as a major concern during the postpartum period; we know that postpartum fatigue is a real problem and continues to be so for as long as 19 months after delivery. The antecedents of postpartum fatigue and measures to reduce it have barely been discussed in the literature, nor have they been empirically investigated. This article provides an overview of the concept of postpartum fatigue including its definition, significance, incidence, etiology, nature, and management. In addition, recommendations are made for nurses involved in practice, research, and healthcare policy. PMID:12840692

  8. Postpartum psychiatric disorders.

    PubMed

    Brockington, Ian

    2004-01-24

    This review summarises the psychiatry of the puerperium, in the light of publications during the past 5 years. A wide variety of disorders are seen. Recognition of disorders of the mother-infant relationship is important, because these have pernicious long-term effects but generally respond to treatment. Psychoses complicate about one in 1000 deliveries. The most common is related to manic depression, in which neuroleptic drugs should be used with caution. Post-traumatic stress disorder, obsessions of child harm, and a range of anxiety disorders all require specific psychological treatments. Postpartum depression necessitates thorough exploration. Cessation of breastfeeding is not necessary, because most antidepressant drugs seem not to affect the infant. Controlled trials have shown the benefit of involving the child's father in therapy and of interventions promoting interaction between mother and infant. Owing to its complexity, multidisciplinary specialist teams have an important place in postpartum psychiatry. PMID:14751705

  9. Rock-inhabiting fungi originated during periods of dry climate in the late Devonian and middle Triassic.

    PubMed

    Gueidan, Cécile; Ruibal, Constantino; de Hoog, G S; Schneider, Harald

    2011-10-01

    Non-lichenized rock-inhabiting fungi (RIF) are slow-growing melanized ascomycetes colonizing rock surfaces in arid environments. They possess adaptations, which allow them to tolerate extreme abiotic conditions, such as high UV radiations and extreme temperatures. They belong to two separate lineages, one consisting in the sister classes Dothideomycetes and Arthoniomycetes (Dothideomyceta), and the other consisting in the order Chaetothyriales (Eurotiomycetes). Because RIF often form early diverging groups in Chaetothyriales and Dothideomyceta, the ancestors of these two lineages were suggested to most likely be rock-inhabitants. The lineage of RIF related to the Chaetothyriales shows a much narrower phylogenetic spectrum than the lineage of RIF related to Dothideomyceta, suggesting a much more ancient origin for the latter. Our study aims at investigating the times of origin of RIF using a relaxed clock model and several fossil and secondary calibrations. Our results show that the RIF in Dothideomyceta evolved in the late Devonian, much earlier than the RIF in Chaetothyriales, which originated in the middle Triassic. The origin of the chaetothyrialean RIF correlates well with a period of recovery after the Permian-Triassic mass extinction and an expansion of arid landmasses. The period preceding the diversification of the RIF related to Dothideomyceta (Silurian--Devonian) is also characterized by large arid landmasses, but temperatures were much cooler than during the Triassic. The paleoclimate record provides a good explanation for the diversification of fungi subjected to abiotic stresses and adapted to life on rock surfaces in nutrient-poor habitats. PMID:21944211

  10. Orbital-scale glacio-eustasy during the transition between the Early Ordovician warm period (greenhouse) and the Late Ordovician cool period (icehouse)

    NASA Astrophysics Data System (ADS)

    Elrick, M.; Reardon, D.; Labor, W. A.

    2011-12-01

    Recent studies using oxygen isotopes from conodont apatite and carbonate clumped isotopes suggest that the transition from the Early Ordovician warm period (greenhouse) to the Latest Ordovician glacial period (icehouse) occurred in two stages- cooling during the Early and Middle Ordovician and another, more abrupt cooling in the Latest Ordovician (Hirnantian). These results come from samples collected at time intervals of >0.5 My; therefore, the data does not resolve orbital-scale climatic changes. This study utilizes oxygen isotopes from conodont apatite collected across multiple, orbital-scale carbonate cycles (or parasequences) in the early Late Ordovician to evaluate high-frequency paleoclimate changes. More specifically, we are addressing whether the observed carbonate cycles formed in response to orbital-scale, glacio-eustasy and to shed light on the dynamics of the Ordovician warm-to-cool climatic transition. The Upper Ordovician (early Katian) Lexington Limestone of Kentucky is characterized by cyclic carbonates and shales deposited in southern subtropical waters of the Laurentian craton. Orbital-scale (~15-130 ky) subtidal cycles (1-3 m) are composed of offshore limestone and shale, overlain by lower shoreface, then upper shoreface skeletal carbonates and show no evidence of subaerial exposure at cycle tops. ?18Oapatite values from multiple cycles range from ~18-19.5%. The majority of cycles record low isotopic values in the deepest water facies (during sea-level rise and highstand) and higher isotopic values in the shallowest water facies (during sea-level fall and lowstand). The magnitude of isotopic shift across individual cycles is up to ~1%. Estimated subtropical SSTs range from ~28-34C. If the intracycle isotopic shifts were due only to SST changes, then the temperatures fluctuated up to 4C during individual cycle formation; estimated thermo-eustatic changes given these SST changes are not sufficient in magnitude to generate the observed offshore to upper shoreface facies changes. We suggest that similar to the Pleistocene, the measured isotopic shifts were due to a combination of SST and ice-volume effects. If we assume Pleistocene relationships for partitioning of SST versus ice-volume effects, this suggests orbital-scale glacio-eustatic sea-level changes of many tens of meters along with SST changes of <2C. Such magnitudes of glacio-eustasy imply that high-latitude continental ice sheets were waxing and waning at orbital time scales at least 6 My before the peak Hirnantian glacial period and that orbital-scale, glacial-interglacial cycles were superimposed upon the long-term Ordovician cooling trend- a pattern similar to that observed during the more recent Cenozoic cooling trend.

  11. Obstetric Outcome in Early and Late Onset Gestational Diabetes Mellitus.

    PubMed

    Easmin, S; Chowdhury, T A; Islam, M R; Beg, A; Jahan, M K; Latif, T; Dhar, S; Alam, M N; Akhter, M

    2015-07-01

    Obstetric outcome in early onset and late onset GDM was compared in a prospective study conducted at the Department of Obstetrics & Gynecology in BIRDEM, Dhaka, Bangladesh. A total 120 pregnant women were recruited purposively for the study in which 60 were early onset GDM and 60 were late onset GDM during study period of January 2008 to December 2009. Patients were followed up in different periods of gestation, during delivery and early postpartum period & findings were compared between two groups. BMI & family history of diabetes were significantly higher in early GDM group (p<0.05). Evidence of increased glycaemia was observed in early GDM group & difference of glycaemic status was statistically significant (p<0.05). Insulin was needed in 85% of early onset GDM and 55% in late onset GDM. There was also significant difference (p<0.05). In this study, 23.3% of early onset GDM group developed pre-eclampsia while in late onset GDM it was 10% and was statistically significant (p<0.05). Regarding intrapartum & postpartum complications - perineal tear, PPH wound infection, puerperal sepsis were more in early onset than late onset GDM group with no significant difference. Regarding foetal outcome, 8.3% early GDM group delivered asphyxiated baby in comparison to 3.3% in late GDM group. Twenty percent (20%) of early onset GDM group had to admit their babies in neonatal unit while in late onset group it was 5%. There was significant difference between two groups (p<0.05). Neonatal hypoglycaemia was also statistically significantly (p<0.05) higher in early GDM group. Neonatal hyper-bilirubinaemia, RDS, perinatal death was more in early onset GDM subjects. Early onset GDM subjects are high risk subgroup & have significant deleterious effect on maternal and perinatal outcome than late GDM groups. PMID:26329938

  12. Periodization

    PubMed Central

    Lorenz, Daniel S.; Reiman, Michael P.; Walker, John C.

    2010-01-01

    Background: Clinicians are constantly faced with the challenge of designing training programs for injured and noninjured athletes that maximize healing and optimize performance. Periodization is a concept of systematic progressionthat is, resistance training programs that follow predictable patterns of change in training variables. The strength training literature is abundant with studies comparing periodization schemes on uninjured, trained, and untrained athletes. The rehabilitation literature, however, is scarce with information about how to optimally design resistance training programs based on periodization principles for injured athletes. The purpose of this review is to discuss relevant training variables and methods of periodization, as well as periodization program outcomes. A secondary purpose is to provide an anecdotal framework regarding implementation of periodization principles into rehabilitation programs. Evidence Acquisition: A Medline search from 1979 to 2009 was implemented with the keywords periodization, strength training, rehabilitation, endurance, power, hypertrophy, and resistance training with the Boolean term AND in all possible combinations in the English language. Each author also undertook independent hand searching of article references used in this review. Results: Based on the studies researched, periodized strength training regimens demonstrate improved outcomes as compared to nonperiodized programs. Conclusions: Despite the evidence in the strength training literature supporting periodization programs, there is a considerable lack of data in the rehabilitation literature about program design and successful implementation of periodization into rehabilitation programs. PMID:23015982

  13. Evaporative cooling in late-gestation Murrah buffaloes potentiates immunity around transition period and overcomes reproductive disorders.

    PubMed

    Aarif, Ovais; Aggarwal, Anjali

    2015-10-15

    The objective of the study was to observe the effect of evaporative cooling during late gestation on immunity around the transition period and the probable outcome on reproductive disorders in Murrah buffaloes. Sixteen pregnant dry Murrah buffaloes at 60 days prepartum were selected and divided into two groups of eight animals each. Group 1 buffaloes remained without the provision of cooling, whereas the second group of buffaloes was managed under fans and mist cooling during the dry period. After parturition, all the animals were managed under evaporative cooling. Dry matter intake was significantly (P < 0.05) higher in cooled relative to noncooled animals at -15, 0, and +20 days of parturition. Cortisol and prolactin levels were significantly (P < 0.05) higher in noncooled relative to cooled animals at -15 and 0 days of parturition. However, prolactin was significantly (P < 0.05) higher in cooled animals at +20 days. Messenger RNA expression of prolactin receptor gene (PRL-R) was upregulated and suppressor of cytokine signaling gene 1 (SOCS-1) was downregulated in cooled animals at -20, 0, and +20 days of parturition. Tumor necrosis factor ? and interleukin 4 levels remained significantly (P < 0.05) higher in cooled animals at -20, 0, and +20 days of parturition. Interleukin 6 was significantly (P < 0.05) lower in cooled animals at -20 and 0 days. Interferon ? levels were significantly higher at -20 and +20 days of parturition in cooled relative to noncooled animals. The reproductive disorders such as retention of placenta, metritis, and endometritis occurred at the rate of 37.25%, 25%, and 12.25% in the noncooled group, whereas only retention of placenta was observed in the cooled (12.5%) group. PMID:26211430

  14. New constraints on the variation of the geomagnetic field during the late Neolithic period: Archaeointensity results from Sichuan, southwestern China

    NASA Astrophysics Data System (ADS)

    Cai, Shuhui; Chen, Wei; Tauxe, Lisa; Deng, Chenglong; Qin, Huafeng; Pan, Yongxin; Yi, Liang; Zhu, Rixiang

    2015-04-01

    We have carried out an archaeomagnetic study on a late Neolithic locality (Liujiazhai) in Sichuan, southwestern China. We pull together various dating techniques, including radiocarbon analysis, optically stimulated luminescence dating, stratigraphic information as well as archaeological and archaeomagnetic estimations, to constrain the age of the studied samples. Rock magnetic results indicate thermally stable fine-grained magnetite or titanomagnetite as the dominant magnetic carriers. More than half of the specimens (141/246) in the paleointensity experiment pass the selection criteria and are considered to record robust intensity values. The virtual axial dipole moments range from approximately (2.8 to 7.8) 1022 Am2 with an average of 5.9 1022 Am2, indicating that the geomagnetic intensity around 3000 before the Common Era (B.C.E.) is overall lower than the present field intensity (9.8 1022 Am2) of this area. The new results from Liujiazhai are generally consistent with the published data of similar age but deviate from the only available model of CALS10k.1b at certain time periods, making them important for future improvements of the model. Those data are significant for constraining the variation of geomagnetic field intensity between ~3100 and 2600 B.C.E. and improving the regional model of eastern Asia.

  15. Reentrant ventricular arrhythmias in the late myocardial infarction period: 17. Correlation of activation patterns of sinus and reentrant ventricular tachycardia.

    PubMed

    Assadi, M; Restivo, M; Gough, W B; el-Sherif, N

    1990-05-01

    The relationship between myocardial sites with late activation during sinus rhythm and sites critical for the initiation and sustentation of reentrant ventricular tachycardia was systematically examined in the 4-day-old postinfarction canine heart. The critical sites for prevention of the initiation of reentry and for termination of sustained figure-of-8 reentrant tachycardia by cryothermal techniques were correlated with the last 20 msec isochrone during sinus rhythm. In 12 experiments, 20 critical sites were examined. The mean distance between sites critical for reentry and the latest isochrone during sinus rhythm was 26.7 +/- 13.3 mm. Only five sites (25%) were within a 12 mm distance, which corresponded to the diameter of the cryoprobe. Nine sites (45%) were within a 24 mm distance (twice the diameter of the cryoprobe), while 11 sites (55%) were separated by more than 24 mm. In three experiments the sites of latest activation during sinus rhythm represented areas showing Wenckebach period or 2:1 conduction block. These sites became dissociated and did not participate in the reentrant excitation induced by premature stimulation. Poor correlation was explained by the fact that sites critical for reentry were intimately related to the location and extent of the arcs of functional conduction block while sites of delayed activation during sinus rhythm were not. PMID:2330860

  16. Sleep duration, depression, and oxytocinergic genotype influence prepulse inhibition of the startle reflex in postpartum women.

    PubMed

    Comasco, Erika; Gulinello, Maria; Hellgren, Charlotte; Skalkidou, Alkistis; Sylven, Sara; Sundström-Poromaa, Inger

    2016-04-01

    The postpartum period is characterized by a post-withdrawal hormonal status, sleep deprivation, and susceptibility to affective disorders. Postpartum mothering involves automatic and attentional processes to screen out new external as well as internal stimuli. The present study investigated sensorimotor gating in relation to sleep duration, depression, as well as catecholaminergic and oxytocinergic genotypes in postpartum women. Prepulse inhibition (PPI) of the startle reflex and startle reactivity were assessed two months postpartum in 141 healthy and 29 depressed women. The catechol-O-methyltransferase (COMT) Val158Met, and oxytocin receptor (OXTR) rs237885 and rs53576 polymorphisms were genotyped, and data on sleep duration were collected. Short sleep duration (less than four hours in the preceding night) and postpartum depression were independently associated with lower PPI. Also, women with postpartum depression had higher startle reactivity in comparison with controls. The OXTR rs237885 genotype was related to PPI in an allele dose-dependent mode, with T/T healthy postpartum women carriers displaying the lowest PPI. Reduced sensorimotor gating was associated with sleep deprivation and depressive symptoms during the postpartum period. Individual neurophysiological vulnerability might be mediated by oxytocinergic genotype which relates to bonding and stress response. These findings implicate the putative relevance of lower PPI of the startle response as an objective physiological correlate of liability to postpartum depression. PMID:26857197

  17. A Cross-Sectional Analytic Study of Postpartum Health Care Service Utilization in the Philippines

    PubMed Central

    Yamashita, Tadashi; Suplido, Sherri Ann; Ladines-Llave, Cecilia; Tanaka, Yuko; Senba, Naomi; Matsuo, Hiroya

    2014-01-01

    Background The maternal mortality ratio in the Philippines remains high; thus, it will be difficult to achieve the Millennium Development Goals 5 by 2015. Approximately two-thirds of all maternal deaths occur during the postpartum period. Therefore, we conducted the present study to examine the current state of postpartum health care service utilization in the Philippines, and identify challenges to accessing postpartum care. Methods A questionnaire and knowledge test were distributed to postpartum women in the Philippines. The questionnaire collected demographical characteristics and information about their utilization of health care services during pregnancy and the postpartum period. The knowledge test consisted of 11 questions regarding 6 topics related to possible physical and mental symptoms after delivery. Sixty-four questionnaires and knowledge tests were analyzed. Results The mean time of first postpartum health care visit was 5.15.2 days after delivery. Postpartum utilization of health care services was significantly correlated with delivery location (P<0.01). Women who delivered at home had a lower rate of postpartum health care service utilization than women who delivered at medical facilities. The majority of participants scored low on the knowledge test. Conclusion We found inadequate postpartum health care service utilization, especially for women who delivered at home. Our results also suggest that postpartum women lack knowledge about postpartum health concerns. In the Philippines, Barangay health workers may play a role in educating postpartum women regarding health care service utilization to improve their knowledge of possible concerns and their overall utilization of health care services. PMID:24465626

  18. Ecosystem responses during Late Glacial period recorded in the sediments of Lake Łukie (East Poland)

    NASA Astrophysics Data System (ADS)

    Zawiska, Izabela; Słowiński, Michał; Correa-Metrio, Alex; Obremska, Milena; Luoto, Tomi; Nevalainen, Liisa; Woszczyk, Michał; Milecka, Krystyna

    2014-05-01

    The main objectives of this study was to reconstruct climate impact on the functioning of Lake Łukie and its catchment (Łęczna Włodawa Lake District, East European Plain) during Late Glacial period. In order to reconstruct climatic fluctuations and corresponding ecosystem responses, we analysed lake sediments for pollen, subfossil Cladocera, plant macrofossils and chemical composition of the sediment. Of these, plant macrofossils and Cladocera were used to infer minimum and mean July temperatures and ordination analysis was used to examine biotic community shifts. Multiproxy analyses of late-glacial sediments of Lake Łukie clearly show that the main driver of aquatic and terrestrial ecosystems as well as geomorphological processes in the catchment was climate variation. The history of the lake initiated during the Older Dryas. In that period, Łęczna Włodawa Lake District was covered by open habitats dominated by grasses (Poaceae), humid sites were occupied by tundra plant communities with less clubmoss (Selaginella selaginoides), dry sites by dominated by steppe-like vegetation with light-demanding species such as Helianthemum, Artemisia, Chenopodiaceae, and juniper bushes (Juniperus). Cold climate limited the growth and development of organisms in the lake, Cladocera community species composition was poor, with only few species present there all the time. During this time period, permafrost was still present in the ground limiting infiltration of rainwater and causing high erosion in the catchment area. Surface runoff is confirmed by the presence of sclerotia of Cenococcum geophilum and high terrigenous silica content. The warming of the early Allerød caused a remarkable change in the natural environment of this area. This is in accordance with the temperature rise reconstructed with the use of plant macrofossils though the Cladocera reconstruction did not recorded the rise than. This temperature increase resulted in turnover of vegetation in the catchment of Lake Łukie, pioneer birch-pine forests dominated, later replaced by pine-birch forests. Consequently this limited the erosion. The results of all proxy suggest the water-lever rise in lake Łukie. The Younger Dryas cooling in the region began about 12 630 14C years BP and recorded in significant drop in temperature reconstructed with plant macrofossils and Cladocera. The cooling resulted in a decline of forest communities and development of open habitats with grasses (Poaceae), Artemisia, and Chenopodiaceae), as well as juniper thickets (Juniperus) At the end of the Younger Dryas, plant communities changed, the non-arborescent pollen declined, while pollen of trees (especially Pinus) became more abundant. This change was more abruptly reflected in Cladocera and aquatic pollen results and is probably related to gradual climate warming. This study is a contribution to the Virtual Institute ICLEA (Integrated Climate and Landscape Evolution Analysis) funded by the Helmholtz Association, projects UMO-2011/01/B/ST10/07367 and N N306 036436 founded by National Science Center, Poland.

  19. Principals in Late Career: Toward a Conceptualization of Principals' Tasks and Experiences in the Pre-Retirement Period

    ERIC Educational Resources Information Center

    Oplatka, Izhar

    2010-01-01

    Purpose: To fill the gap in theoretical and empirical knowledge on late career in principalship, the aim of this study was to explore the career experiences, needs, and behaviors of principals at this stage. Research method: Life history and semistructured interviews were conducted with 20 late-career principals, 20 schoolteachers, and 10

  20. Postpartum pituitary apoplexy with isolated oculomotor nerve palsy: A rare medical emergency

    PubMed Central

    Raina, Sujeet; Jearth, Vaneet; Sharma, Ashish; Sharma, Rajesh; Mistry, Kewal

    2015-01-01

    Pituitary apoplexy is a clinical syndrome characterized by sudden onset headache, visual deficits, ophthalmoplegia, altered mental status, and hormonal dysfunction due to an expanding mass within the sella turcica resulting from hemorrhage or infarction of pituitary gland. We report a case of pituitary apoplexy that developed in postpartum period following postpartum hemorrhage and presented with isolated third cranial nerve palsy. PMID:26752912

  1. Postpartum pituitary apoplexy with isolated oculomotor nerve palsy: A rare medical emergency.

    PubMed

    Raina, Sujeet; Jearth, Vaneet; Sharma, Ashish; Sharma, Rajesh; Mistry, Kewal

    2015-01-01

    Pituitary apoplexy is a clinical syndrome characterized by sudden onset headache, visual deficits, ophthalmoplegia, altered mental status, and hormonal dysfunction due to an expanding mass within the sella turcica resulting from hemorrhage or infarction of pituitary gland. We report a case of pituitary apoplexy that developed in postpartum period following postpartum hemorrhage and presented with isolated third cranial nerve palsy. PMID:26752912

  2. Developmental Profile of Infants Born to Mothers with Postpartum Depression and Anxiety: A Comparative Study

    ERIC Educational Resources Information Center

    Kalita, Kamal Narayan

    2010-01-01

    Background: Postpartum period is associated with higher rates for depression, blues and psychosis. Anxiety is also significant. These disorders may have serious implications in the cognitive development of the infant. There is relative lack of data in this area. So we tried to estimate postpartum anxiety and depression in a group of women and…

  3. Predictors of the Longitudinal Course of Postpartum Depression Following Interpersonal Psychotherapy

    ERIC Educational Resources Information Center

    Nylen, Kimberly J.; O'Hara, Michael W.; Brock, Rebecca; Moel, Joy; Gorman, Laura; Stuart, Scott

    2010-01-01

    Objective: We examined the course and predictors of postpartum depression in the 18 months following interpersonal psychotherapy (IPT). Method: We enrolled 120 community women with major depression in a 12-week randomized trial of individual IPT during the postpartum period (O'Hara, Stuart, Gorman, & Wenzel, 2000). At 6, 12, and 18 months…

  4. Predictors of the Longitudinal Course of Postpartum Depression Following Interpersonal Psychotherapy

    ERIC Educational Resources Information Center

    Nylen, Kimberly J.; O'Hara, Michael W.; Brock, Rebecca; Moel, Joy; Gorman, Laura; Stuart, Scott

    2010-01-01

    Objective: We examined the course and predictors of postpartum depression in the 18 months following interpersonal psychotherapy (IPT). Method: We enrolled 120 community women with major depression in a 12-week randomized trial of individual IPT during the postpartum period (O'Hara, Stuart, Gorman, & Wenzel, 2000). At 6, 12, and 18 months

  5. The Critical Period for Second Language Pronunciation: Is There Such a Thing? Ten Case Studies of Late Starters who Attained a Native-like Hebrew Accent

    ERIC Educational Resources Information Center

    Abu-Rabia, Salim; Kehat, Simona

    2004-01-01

    This paper investigates the critical period hypothesis (CPH) for the acquisition of a second language sound system (phonology) in a naturalistic setting. Ten cases of successful late-starters with a native-like Hebrew pronunciation are presented in an effort to determine possible variables that may account for their exceptional accomplishment. The

  6. Women with postpartum depression: "my husband" stories

    PubMed Central

    Montgomery, Phyllis; Bailey, Pat; Purdon, Sheri Johnson; Snelling, Susan J; Kauppi, Carol

    2009-01-01

    Background The research on Postpartum Depression (PPD) to date suggests that there is a knowledge gap regarding women's perception of their partners' role as carer and care activities they perform. Therefore, the purpose of this study was to describe women's understanding of their partners' or husbands' involvement in the midst of PPD. Methods This study used interview data from a larger study of northern and rural Ontario women's stories of help-seeking for PPD. The interpretive description approach was used to illustrate the complexity of women's spousal connections in PPD. Data from a purposive community sample of 27 women who self-identified as having been diagnosed with PPD was used. From the verbatim transcribed interviews a number of data excerpts were identified and labeled as "my husband" stories. Narrative analysis was employed to examine these stories. Results During this time of vulnerability, the husbands' physical, emotional and cognitive availability positively contributed to the women's functioning and self-appraisals as wife and mother. Their representations of their husbands' 'doing for' and/or 'being with' promoted their well-being and ultimately protected the family. Conclusion Given that husbands are perceived to be central in mitigating women's suffering with PPD, the consistent implementation of a triad orientation, that includes woman, child and partner rather than a more traditional and convenient dyadic orientation, is warranted in comprehensive postpartum care. Finally, this study contributes a theoretical understanding of responsive as well as reactive connections between women and family members during the postpartum period. PMID:19732461

  7. Differential patterns of cortical reorganization following constraint-induced movement therapy during early and late period after stroke

    PubMed Central

    Sawaki, Lumy; Butler, Andrew J.; Leng, Xiaoyan; Wassenaar, Peter A.; Mohammad, Yousef; Blanton, Sarah; Sathian, K.; Nichols-Larsen, Deborah S.; Wolf, Steven L.; Good, David C.; Wittenberg, George F.

    2015-01-01

    OBJECTIVE Constraint-induced movement therapy (CIMT) leads to improvement in upper extremity movement and cortical reorganization after stroke. Direct comparison of the differential degree of cortical reorganization according to chronicity in stroke subjects receiving CIMT has not been performed and was the purpose of this study. We hypothesized that a higher degree of cortical reorganization would occur in the early (less than 9 months post-stroke) compared to the late group (more than 12 months post-stroke). METHODS 17 early and 9 late subjects were enrolled. Each subject was evaluated using transcranial magnetic stimulation (TMS) and the Wolf Motor Function Test (WMFT) and received CIMT for 2 weeks. RESULTS The early group showed greater improvement in WMFT compared with the late group. TMS motor maps showed persistent enlargement in both groups. The map shifted posteriorly in the late stroke group. CONCLUSION CIMT appears to lead to greater improvement in motor function in early phase after stroke. Greater cortical reorganization associated with shift in map position occurred in late group. SIGNIFICANCE The contrast between larger functional gains in the early group vs larger map expansion in the late group may indicate that cortical reorganization depends upon different neural substrates in the late stroke group. PMID:25227542

  8. Postpartum Healthcare After Gestational Diabetes and Hypertension

    PubMed Central

    Maiden, Kristin; Rogers, Stephanie; Ball, Amy

    2014-01-01

    Abstract Background: Gestational diabetes and hypertensive disorders of pregnancy identify women with an elevated lifetime risk of diabetes and cardiovascular disease. Methods: Prospective cohort of women recruited from the postpartum service of a large community-based academic obstetrical hospital after delivery of a pregnancy complicated by gestational diabetes (GDM) or a hypertensive disorder of pregnancy (HDP). Interviews were conducted, and validated surveys completed, before hospital discharge and again 3 months postpartum. Results: The study sample included 249 women: 111 with GDM, 127 with HDP, and 11 with both. Most, 230 (92.4%) had a PCP prior to pregnancy and 97 (39.0%) reported an office visit with their PCP during the prenatal period. Of the 176 (70.7%) participants who attended the 3-month study visit, 169 (96.0%) women with either diagnosis reported they had attended their 6-week postpartum visit. By the 3-month study visit, 51 (57.9%) women with GDM had completed follow-up glucose testing; 93 (97.9%) with HDP had follow-up blood pressure testing; and 101 (57.4%) with either diagnosis recalled ever having completed lipid screening. Women least likely to complete screening tests were those who had no college education, less than a high school level of health literacy, and who were not privately insured. Conclusion: There are important opportunities to improve postpartum testing for diabetes and CVD risk factor assessment. Most women were connected to primary care suggesting a hand-off to a primary care physician after pregnancy is feasible. More robust strategies may be needed to improve follow-up care for women with less education, lower health literacy, and those without private health insurance. PMID:25089915

  9. Helping postpartum rural adolescents visualize future goals.

    PubMed

    Walsh, S M; Corbett, R W

    1995-01-01

    An Art Future Image (AFI) intervention was initiated among postpartum adolescent mothers during the hospitalization period in North Carolina. The aim was to improve adolescents self-image and encourage educational goal setting as a means of changing the cycle of poverty. The hope was that mothers would consider alternatives to public assistance. Nursing students were engaged as teachers during their clinical rotation in the postpartum unit. The project involved 9 mothers (8 Black women and 1 White woman). Women ranged in age from 17 to 24 years. 8 women were single, and all had a low socioeconomic status. Each study participant completed a workbook, which reflected future images as a high school or college graduate, an accountant, and other occupations. The study women selected a future role and spoke about their dreams and plans and constraints to achievement of their goal. Instant photos were taken of the mother and the infant following the interview and the faces placed on personalized body images of their choice. Both students and participants were enthusiastic about the project. An evaluation found, however, that time constraints of staff nurses would prohibit the use of this intervention model. The suggestion was made for this module to be incorporated into two 30 minute classes as part of postpartum classes. Mothers wanted only one time slot. Suggestions were made to expand the AFI program at other postpartum check-up times or when counseling on family planning. Other members of the family unit could be included. The long-term impact of AFI needs to be evaluated. PMID:7476012

  10. An investigation into the effects of antenatal stressors on the postpartum neuroimmune profile and depressive-like behaviors.

    PubMed

    Posillico, Caitlin K; Schwarz, Jaclyn M

    2016-02-01

    Postpartum depression is a specific type of depression that affects approximately 10-15% of mothers [28]. While many have attributed the etiology of postpartum depression to the dramatic change in hormone levels that occurs immediately postpartum, the exact causes are not well-understood. It is well-known, however, that pregnancy induces a number of dramatic changes in the peripheral immune system that foster the development of the growing fetus. It is also well-known that changes in immune function, specifically within the brain, have been linked to several neuropsychiatric disorders including depression. Thus, we sought to determine whether pregnancy induces significant neuroimmune changes postpartum and whether stress or immune activation during pregnancy induce a unique neuroimmune profile that may be associated with depressive-like behaviors postpartum. We used late-gestation sub-chronic stress and late-gestation acute immune activation to examine the postpartum expression of depressive-like behaviors, microglial activation markers, and inflammatory cytokines within the medial prefrontal cortex (mPFC) and the hippocampus (HP). The expression of many immune molecules was significantly altered in the brain postpartum, and postpartum females also showed significant anhedonia, both independently of stress. Following late-gestation immune activation, we found a unique set of changes in neuroimmune gene expression immediately postpartum. Thus, our data indicate that even in the absence of additional stressors, postpartum females exhibit significant changes in the expression of cytokines within the brain that are associated with depressive-like behavior. Additionally, different forms of antenatal stress produce varying profiles of postpartum neuroimmune gene expression and associated depressive-like behaviors. PMID:26589802

  11. Postpartum acquired hemophilia: a rare cause of postpartum hemorrhage.

    PubMed

    Seethala, Srikanth; Gaur, Sumit; Enderton, Elizabeth; Corral, Javier

    2013-01-01

    A 36-year-old female started having postpartum vaginal bleeding after normal vaginal delivery. She underwent hysterectomy for persistent bleeding and was referred to our institution. An elevation of PTT and normal PT made us suspect postpartum acquired hemophilia (PAH), and it was confirmed by low factor VIII activity levels and an elevated factor VIII inhibitor. Hemostasis was achieved with recombinant factor VII concentrates and desmopressin, and factor eradication was achieved with cytoxan, methylprednisolone, and plasmapheresis. PMID:23533849

  12. Postpartum Acquired Hemophilia: A Rare Cause of Postpartum Hemorrhage

    PubMed Central

    Seethala, Srikanth; Enderton, Elizabeth; Corral, Javier

    2013-01-01

    A 36-year-old female started having postpartum vaginal bleeding after normal vaginal delivery. She underwent hysterectomy for persistent bleeding and was referred to our institution. An elevation of PTT and normal PT made us suspect postpartum acquired hemophilia (PAH), and it was confirmed by low factor VIII activity levels and an elevated factor VIII inhibitor. Hemostasis was achieved with recombinant factor VII concentrates and desmopressin, and factor eradication was achieved with cytoxan, methylprednisolone, and plasmapheresis. PMID:23533849

  13. Uranium and molybdenum isotope evidence for an episode of widespread ocean oxygenation during the late Ediacaran Period

    NASA Astrophysics Data System (ADS)

    Kendall, Brian; Komiya, Tsuyoshi; Lyons, Timothy W.; Bates, Steve M.; Gordon, Gwyneth W.; Romaniello, Stephen J.; Jiang, Ganqing; Creaser, Robert A.; Xiao, Shuhai; McFadden, Kathleen; Sawaki, Yusuke; Tahata, Miyuki; Shu, Degan; Han, Jian; Li, Yong; Chu, Xuelei; Anbar, Ariel D.

    2015-05-01

    To improve estimates of the extent of ocean oxygenation during the late Ediacaran Period, we measured the U and Mo isotope compositions of euxinic (anoxic and sulfidic) organic-rich mudrocks (ORM) of Member IV, upper Doushantuo Formation, South China. The average δ238U of most samples is 0.24 ± 0.16‰ (2SD; relative to standard CRM145), which is slightly higher than the average δ238U of 0.02 ± 0.12‰ for restricted Black Sea (deep-water Unit I) euxinic sediments and is similar to a modeled δ238U value of 0.2‰ for open ocean euxinic sediments in the modern well-oxygenated oceans. Because 238U is preferentially removed to euxinic sediments compared to 235U, expanded ocean anoxia will deplete seawater of 238U relative to 235U, ultimately leading to deposition of ORM with low δ238U. Hence, the high δ238U of Member IV ORM points to a common occurrence of extensive ocean oxygenation ca. 560 to 551 Myr ago. The Mo isotope composition of sediments deposited from strongly euxinic bottom waters ([H2S]aq >11 μM) either directly records the global seawater Mo isotope composition (if Mo removal from deep waters is quantitative) or represents a minimum value for seawater (if Mo removal is not quantitative). Near the top of Member IV, δ98Mo approaches the modern seawater value of 2.34 ± 0.10‰. High δ98Mo points to widespread ocean oxygenation because the preferential removal of isotopically light Mo to sediments occurs to a greater extent in O2-rich compared to O2-deficient marine environments. However, the δ98Mo value for most Member IV ORM is near 0‰ (relative to standard NIST SRM 3134 = 0.25‰), suggesting extensive anoxia. The low δ98Mo is at odds with the high Mo concentrations of Member IV ORM, which suggest a large seawater Mo inventory in well-oxygenated oceans, and the high δ238U. Hence, we propose that the low δ98Mo of most Member IV ORM was fractionated from contemporaneous seawater. Possible mechanisms driving this isotope fractionation include: (1) inadequate dissolved sulfide for quantitative thiomolybdate formation and capture of a seawater-like δ98Mo signature in sediments or (2) delivery of isotopically light Mo to sediments via a particulate Fe-Mn oxyhydroxide shuttle. A compilation of Mo isotope data from euxinic ORM suggests that there were transient episodes of extensive ocean oxygenation that break up intervals of less oxygenated oceans during late Neoproterozoic and early Paleozoic time. Hence, Member IV does not capture irreversible deep ocean oxygenation. Instead, complex ocean redox variations likely marked the transition from O2-deficient Proterozoic oceans to widely oxygenated later Phanerozoic oceans.

  14. Postabortal and postpartum contraception.

    PubMed

    Cameron, Sharon

    2014-08-01

    Healthcare providers often underestimate a woman' need for immediate effective contraception after an abortion or childbirth. Yet, these are times when women may be highly motivated to avoid or delay another pregnancy. In addition, starting the most effective long-acting reversible methods (i.e. the intrauterine device, intrauterine system or implants) at these times, is safe, with low risk of complications. Good evidence shows that women choosing long-acting reversible contraceptives at the time of an abortion are at significantly lower risk of another abortion, compared with counterparts choosing other methods. Uptake of long-acting reversible methods postpartum can also prevent short inter-pregnancy intervals, which have negative consequences for maternal and child health. It is important, therefore, that providers of abortion and maternity care are trained and funded to be able to provide these methods for women immediately after an abortion or childbirth. PMID:24951405

  15. Internet confessions of postpartum depression.

    PubMed

    Kantrowitz-Gordon, Ira

    2013-12-01

    Women with postpartum depression may suffer in silence due to the stigma of depression and failed motherhood. It is important to consider how mothers are able to talk about postpartum depression and what strategies they use. Foucault's idea that confession is a widespread technique for producing truth in Western societies was tested through discourse analysis of posts on an Internet forum for women with postpartum depression. The Internet forum showed women's use of confessionary language and self-judgments as well as their sense of disconnected mothering, shame, and disembodiment. Discourses of depression included the good mother, biomedical illness, and social dysfunction. Findings have implications for creating safe spaces for helping mothers with postpartum depression. PMID:24274243

  16. Postpartum Depression: An Interactional View.

    ERIC Educational Resources Information Center

    Kraus, Mary Ann; Redman, E. Scott

    1986-01-01

    Postpartum depression is conceptualized as a predictable developmental, family crisis, which occurs when the natural difficulties of childbirth are benignly mishandled. Tactics are illustrated for interdicting maladaptive interpersonal spirals, including normalizing conflicting complaints; reframing depression as positive but costly; regulating

  17. The interrelationships among acculturation, social support, and postpartum depression symptoms among marriage-based immigrant women in Taiwan: a cohort study.

    PubMed

    Chen, Hung-Hui; Hwang, Fang-Ming; Tai, Chen-Jei; Chien, Li-Yin

    2013-02-01

    This cohort study assessed the structural relationships among social support, acculturation, and postpartum depressive symptoms experienced by marriage-based immigrant mothers in Taiwan. Data were collected at 1 and 6 months postpartum from 203 immigrant mothers married to Taiwanese men in Taipei, Taiwan. The structural equation modeling results showed that social support and postpartum depression were directly and negatively related. Higher social support and lower depression at 1 month postpartum were related to a positive social attitude (i.e., accepting attitude toward mainstream society). Social attitude was a moderator of the relationship between depression at 1 month and social support at 6 months postpartum, where a positive social attitude decreased the negative effect of depression at 1 month on social support at 6 months. Social support in the early postpartum period not only directly decreased postpartum depression, but also indirectly decreased postpartum depression through improving social attitude. PMID:22865022

  18. Vitamin D Status during Pregnancy: A Longitudinal Study in Swedish Women from Early Pregnancy to Seven Months Postpartum

    PubMed Central

    Lundqvist, Anette; Sandström, Herbert; Stenlund, Hans; Johansson, Ingegerd; Hultdin, Johan

    2016-01-01

    Low vitamin D levels during pregnancy may have negative consequences for the health of both the mother and child. Cross-sectional studies in childbearing women suggest that vitamin D levels are low during pregnancy, but few studies have followed the same women during pregnancy and postpartum. The aims of this study were to longitudinally assess vitamin D status during pregnancy and postpartum and identify the factors associated with vitamin D status in pregnant women in northern Sweden. Between September 2006 and March 2009, 184 women were consecutively recruited at five antenatal primary care clinics. Blood was sampled, and dietary intake was estimated using a food frequency questionnaire with 66 food items/food aggregates and questions on the intake of vitamin supplements at gestational weeks 12, 21, and 35, as well as at 12 and 29 weeks after birth. Plasma 25(OH) vitamin D levels were analyzed using liquid chromatography tandem-mass spectrometry. At least one-third of the women had 25(OH) vitamin D levels <50 nmol/L on at least one sampling occasion. Plasma levels increased slightly over the gestation period and peaked in late pregnancy. The levels reverted to the baseline levels after birth. Multivariate analysis showed that gestational and postpartum week, season, dietary intake of vitamin D, and vitamin supplementation were significantly related to plasma levels. There was also an influence of season on the longitudinal concentration patterns. In conclusion, more than one-third of the women studied had low 25(OH) vitamin D levels, and gestational and postpartum week was related to 25(OH) vitamin D levels after adjustment for season and vitamin D intake. PMID:26938997

  19. Vitamin D Status during Pregnancy: A Longitudinal Study in Swedish Women from Early Pregnancy to Seven Months Postpartum.

    PubMed

    Lundqvist, Anette; Sandström, Herbert; Stenlund, Hans; Johansson, Ingegerd; Hultdin, Johan

    2016-01-01

    Low vitamin D levels during pregnancy may have negative consequences for the health of both the mother and child. Cross-sectional studies in childbearing women suggest that vitamin D levels are low during pregnancy, but few studies have followed the same women during pregnancy and postpartum. The aims of this study were to longitudinally assess vitamin D status during pregnancy and postpartum and identify the factors associated with vitamin D status in pregnant women in northern Sweden. Between September 2006 and March 2009, 184 women were consecutively recruited at five antenatal primary care clinics. Blood was sampled, and dietary intake was estimated using a food frequency questionnaire with 66 food items/food aggregates and questions on the intake of vitamin supplements at gestational weeks 12, 21, and 35, as well as at 12 and 29 weeks after birth. Plasma 25(OH) vitamin D levels were analyzed using liquid chromatography tandem-mass spectrometry. At least one-third of the women had 25(OH) vitamin D levels <50 nmol/L on at least one sampling occasion. Plasma levels increased slightly over the gestation period and peaked in late pregnancy. The levels reverted to the baseline levels after birth. Multivariate analysis showed that gestational and postpartum week, season, dietary intake of vitamin D, and vitamin supplementation were significantly related to plasma levels. There was also an influence of season on the longitudinal concentration patterns. In conclusion, more than one-third of the women studied had low 25(OH) vitamin D levels, and gestational and postpartum week was related to 25(OH) vitamin D levels after adjustment for season and vitamin D intake. PMID:26938997

  20. Changes in perceived health status, physical symptoms, and sleep satisfaction of postpartum women over time.

    PubMed

    Song, Ju-Eun; Chae, Hyun Ju; Kim, Chang Hee

    2014-09-01

    The aim of this study was to identify the changes of perceived health status, physical symptoms, and sleep satisfaction of postpartum women over time. A longitudinal design was used. Participants were 137 healthy postpartum women who had not been diagnosed with any medical diseases. Data were collected by a self-report questionnaire at three periods, the second day, 4-6 weeks, and 12-14 weeks postpartum. Women's perceived health status was lower at 4-6 weeks than on the second day after childbirth, physical symptoms were more frequent at 4-6 weeks than on the second day after childbirth, and sleep satisfaction was lower at 4-6 weeks than at 12-14 weeks postpartum. Tiredness or fatigue was the most frequent symptom experienced by postpartum women at all three periods. These results indicate that the period from 4 to 6 weeks postpartum is the most difficult time for mothers. Therefore, there is a need to develop nursing interventions to alleviate fatigue and other symptoms, and to help and support women during the period 4-6 weeks postpartum, a critical period for interventions. PMID:24372842

  1. Antiretroviral Adherence During Pregnancy and Postpartum in Latin America

    PubMed Central

    Harris, D. Robert; Kakehasi, Fabiana; Haberer, Jessica E.; Cahn, Pedro; Losso, Marcelo; Teles, Elizabete; Pilotto, Jose H.; Hofer, Cristina B.; Read, Jennifer S.

    2012-01-01

    Abstract Adherence to antiretrovirals by pregnant women (and postpartum women if breastfeeding) is crucial to effectively decrease maternal viral load and decrease the risk of mother-to-child transmission of HIV. Our objectives were to describe self-reported adherence to antiretrovirals during the antepartum (after 22 weeks of pregnancy) and postpartum periods (612 weeks and 6 months), and identify predictors of adherence among HIV-infected women enrolled and followed in a prospective cohort study from June 2008 to June 2010 at multiple sites in Latin America. Adherence was evaluated using the number of missed and expected doses during the 3 days before the study visit. At the pre-delivery visit, 340 of 376 women (90%) reported perfect adherence. This rate significantly decreased by 612 weeks (171/214 [80%]) and 6 months postpartum (163/199 [82%], p<0.01). The odds for less than perfect adherence at the pre-delivery visit was significantly higher for pregnant women with current tobacco use (odds ratio [OR]=2.9, 95% confidence interval [CI]: 1.466.14; p=0.0029). At 612 weeks postpartum, the probability of non-perfect adherence increased by 6% for each 1 year increase in age (OR=1.06, 95% CI: 1.001.12, p=0.0497). At 6 months postpartum, the odds of nonperfect adherence was higher for those who were currently using alcohol (OR=3.04, 95% CI: 1.346.90; p=0.0079). Although a self-report measure of adherence based on only 3 days may lead to overestimation of actual adherence over time, women with perfect adherence had lower viral loads and higher CD4 counts. Adherence to antiretrovirals decreased significantly postpartum. Interventions should target women at high risk for lower adherence during pregnancy and postpartum, including tobacco and alcohol users. PMID:22663185

  2. [Concept Analysis of Postpartum Depression].

    PubMed

    Lee, Pei-Jung; Liaw, Jen-Jiuan; Chen, Chin-Mi

    2015-06-01

    Postpartum depression (PPD) affects the health of women and is an important issue that impacts negatively on the happiness of affected families. Previous studies have demonstrated that PPD impairs the mother-child attachment, impacts the marital relationship, and may cause family dysfunction. Although PPD is a common phenomenon, the concept of PPD is easily confused with other similar concepts such as postpartum blues and postpartum psychosis, which may delay proper prevention and management. This paper identifies the definitions, characteristics, antecedents, and consequences of PPD as well as provides empirical screen measurements and examples of model, borderline, and contrary cases in order to differentiate between the concepts of PPD and other disorders using Walker and Avant's (2011) concept analysis methodology. Three defining characteristics of postpartum depression were identified. First, depression begins four to six weeks after delivery and continues for at least two weeks. Second, we benchmarked over 5 depressive symptoms. Third, postpartum depression may disrupt puerperal women's lives by making it difficult for them to care for their babies and to concentrate on daily tasks. We hope that this article enhances nurses' professional competences to detect PPD as early as possible and to promote the quality of care received by postpartum women and their family members. PMID:26073958

  3. Practices related to postpartum uterine involution in the Western Highlands of Guatemala

    PubMed Central

    Radoff, K.A.; Thompson, Lisa M.; Bly, KC; Romero, Carolina

    2013-01-01

    Background Guatemala has the third highest level of maternal mortality in Latin America. Postpartum haemorrhage is the main cause of maternal mortality. In rural Guatemala, most women rely on Traditional Birth Attendants (TBAs) during labour, delivery, and the postpartum period. Little is known about current postpartum practices that may contribute to uterine involution provided by Mam- and Spanish-speaking TBAs in the Western Highlands of Guatemala. Methods a qualitative study was conducted with 39 women who participated in five focus groups in the San Marcos Department of Guatemala. Questions regarding postpartum practices were discussed during four focus groups of TBAs and one group of auxiliary nurses. Results three postpartum practices believed to aid postpartum uterine involution were identified: use of the chuj (Mam) (Spanish, temazcal), a traditional wood-fired sauna-bath used by Mam-speaking women; herbal baths and teas; and administration of biomedicines. Conclusions TBAs provide the majority of care to women during childbirth and the postpartum period and have developed a set of practices to prevent and treat postpartum haemorrhage. Integration of these practices may prove an effective method to reduce maternal morbidity and mortality in the Western Highlands of Guatemala. PMID:22762787

  4. Treatment of postpartum depression: clinical, psychological and pharmacological options

    PubMed Central

    Fitelson, Elizabeth; Kim, Sarah; Baker, Allison Scott; Leight, Kristin

    2011-01-01

    Postpartum depression (PPD) is a common complication of childbearing, and has increasingly been identified as a major public health problem. Untreated maternal depression has multiple potential negative effects on maternal-infant attachment and child development. Screening for depression in the perinatal period is feasible in multiple primary care or obstetric settings, and can help identify depressed mothers earlier. However, there are multiple barriers to appropriate treatment, including concerns about medication effects in breastfeeding infants. This article reviews the literature and recommendations for the treatment of postpartum depression, with a focus on the range of pharmacological, psychotherapeutic, and other nonpharmacologic interventions. PMID:21339932

  5. Dosing adjustments in postpartum patients maintained on buprenorphine or methadone.

    PubMed

    Jones, Hendre E; Johnson, Rolley E; O'Grady, Kevin E; Jasinski, Donald R; Tuten, Michelle; Milio, Lorraine

    2008-06-01

    Scant scientific attention has been given to examining the need for agonist medication dose changes in the postpartum period. Study objectives were: 1) to determine the need for medication dose adjustments in participants stabilized on buprenorphine or methadone 3 weeks before and 4 weeks after delivery, and 2) to evaluate the need for methadone dose adjustments during the first 7 days in participants transferred from buprenorphine to methadone at 5 weeks postpartum. Participants were opioid-dependent pregnant women who had completed a randomized, double-blind, double-dummy, flexible dosing comparison of buprenorphine to methadone. Participants received a stable dose of methadone (N = 10) or buprenorphine (N = 8) before and 4 weeks after delivery. Buprenorphine-maintained participants were transferred to methadone at 5 weeks postpartum. There were no significant differences predelivery and/or postdelivery between the buprenorphine and methadone conditions in the mean ratings of dose adequacy, "liking," "hooked," and "craving" of heroin or cocaine. Patient response to the conversion from buprenorphine to methadone seems variable. Buprenorphine-maintained participants required dose changes postpartum only after they transferred to methadone. Regardless of type of medication, postpartum patients should be monitored for signs of overmedication. PMID:21768979

  6. Postpartum relapse to cigarette smoking in inner city women.

    PubMed Central

    Hymowitz, Norman; Schwab, Maria; McNerney, Christopher; Schwab, Joseph; Eckholdt, Haftan; Haddock, Keith

    2003-01-01

    Past studies suggest that African American women who quit smoking during pregnancy are more likely to relapse during the postpartum period than white women, although it is not intuitively clear why this should be the case. To shed further light on this issue, two studies were carried out to determine factors that influence smoking cessation during pregnancy and postpartum relapse to smoking in a predominantly low-income African American population. In Study 1, the women were asked to fill out a written survey, and in Study 2, women participated in a structured interview. The same variables that influence smoking cessation and postpartum relapse in the general population, such as nicotine addiction levels, smoking by other members of the household, lack of social support, stress, weight gain, behavioral intentions to quit temporarily, and quitting for others, as opposed to one's self, influenced the behavior of low-income inner city residents. These findings suggest that the difference in rates of postpartum relapse to smoking in African American women and the general population is a matter of degree, rather than kind. The implications of these findings for understanding postpartum relapse in general and assisting low-income women in particular were discussed. PMID:12856912

  7. Promoting Postpartum Exercise: An Opportune Time for Change.

    ERIC Educational Resources Information Center

    Ringdahl, Erika N.

    2002-01-01

    During the postpartum period clinicians can promote the importance of physical fitness, help patients incorporate exercise into lifestyle changes, and encourage them to overcome barriers to exercise. New responsibilities, physical changes, and time constraints may make exercise seem impossible. By emphasizing weight control, stress reduction, and…

  8. Postpartum Early and Extended Contact: Quality, Quantity or Both?

    ERIC Educational Resources Information Center

    Hopkins, John B.; Vietze, Peter M.

    This study examined the effects of early vs. extended mother-infant contact on infant, maternal and interactional outcomes in the lying-in period for 104 lower class mother-infant dyads. The early contact treatment consisted of placing the mother and neonate together for 10 to 45 minutes within the first 3 postpartum hours. The extended contact…

  9. Delineating the Association between Heavy Postpartum Haemorrhage and Postpartum Depression

    PubMed Central

    Eckerdal, Patricia; Kollia, Natasa; Löfblad, Johanna; Hellgren, Charlotte; Karlsson, Linnea; Högberg, Ulf; Wikström, Anna-Karin; Skalkidou, Alkistis

    2016-01-01

    Objectives To explore the association between postpartum haemorrhage (PPH) and postpartum depression (PPD), taking into account the role of postpartum anaemia, delivery experience and psychiatric history. Methods A nested cohort study (n = 446), based on two population-based cohorts in Uppsala, Sweden. Exposed individuals were defined as having a bleeding of ≥1000ml (n = 196) at delivery, and non-exposed individuals as having bleeding of <650ml (n = 250). Logistic regression models with PPD symptoms (Edinburgh Postnatal Depression scale (EPDS) score ≥ 12) as the outcome variable and PPH, anaemia, experience of delivery, mood during pregnancy and other confounders as exposure variables were undertaken. Path analysis using Structural Equation Modeling was also conducted. Results There was no association between PPH and PPD symptoms. A positive association was shown between anaemia at discharge from the maternity ward and the development of PPD symptoms, even after controlling for plausible confounders (OR = 2.29, 95%CI = 1.15–4.58). Path analysis revealed significant roles for anaemia at discharge, negative self-reported delivery experience, depressed mood during pregnancy and postpartum stressors in increasing the risk for PPD. Conclusion This study proposes important roles for postpartum anaemia, negative experience of delivery and mood during pregnancy in explaining the development of depressive symptoms after PPH. PMID:26807799

  10. Relic Late Pleistocene fluvial forms as geomorphic archives indicating periods of high climatic runoff over the East European Plain

    NASA Astrophysics Data System (ADS)

    Panin, Andrei; Belyaev, Yury; Eremenko, Ekaterina; Sidorchuk, Alexei

    2014-05-01

    In water balance estimations within palaeoenvironmental studies river runoff is estimated as the difference between precipitation and evapotranspiration. The other technique is numerical modeling using general circulation models. Both approaches fail to recognize epochs of extremely high surface runoff characteristic for the Pleistocene cold epochs and recorded in geomorphic outcomes of this runoff. We have studied two kinds of such archives that have wide spatial coverage over the East European Plain (EEP). 1. Post-LGM large palaeochannels (macromeanders) in river valleys with channel width and meander wavelength 5-15 times as great as that of modern rivers. Massive measurements of their parameters and application of specially constructed transfer function provided estimations of palaeo-runoff from large river basins: in the Black Sea and Caspian Sea catchments it carried from 2.2 (Kama River) to 3.1 (Don, Dnieper Rivers) times as great as modern runoff. High runoff lasted long enough to provide formation of 2-3 generations of macromeanders characteristic for many valleys. Macromeanders were radiocarbon dated at 6 sites over EEP in the range 13-19 cal ka BP, but it is not clear whether high runoff was characteristic for the entire period or it performed during short isolated epochs within this interval. Therefore, it is not clear to what exact time palaeohydrological estimations should be attributed. 2. Dendritic and parallel systems of gentle hollows clearly designated in vegetation-free areas south from 55-57ºN. Distinctive spatial patterns and full integration into water transportation through modern fluvial landscapes provides interpretation of these hollow systems as partially or totally buried networks of small dry valleys (balkas). It is supported by revelation of buried incisions up to 10 m deep by coring and trenching across hollows. Ancient erosion network demonstrates erosion density much higher and Horton's "belt of no erosion" much narrower and therefore exhibits much abundant surface runoff than those at present. Dating of buried balkas has until recent times been based either on pollen spectra from peat deposits (in central EEP), or on stratigraphy of paleosoils found in the bottom of paleoforms (in southern EEP). Both markers point at Eemian (MIS 5e) age of their stabilization and therefore pre-Eemian (late MIS 6?) age of incision. However first attempt of OSL dating gave the contradictory result of filling of a 6-m deep balka by slopewash sediments during 80-70 ka BP. Questionable is the >30-ka delay between the soil formation in the balka bottom and start of its filling. It may mean either post-Eemian age of the soil, which would be unfortunate for the regional soil stratigraphy, or insufficient sensitivity of local quartz at ages close to Eemian. The conclusion is that geomorphic evidences make unique palaeohydrological archives that document changes not recorded in other types of palaeoenvironmental data, but they suffer from uncertainties and low resolution of dating. This presentation contributes to RFBR Projects 14-05-00119 and 14-05-00146.

  11. Postpartum weight loss: weight struggles, eating, exercise, and breast-feeding.

    PubMed

    Montgomery, Kristen S; Best, Melissa; Aniello, Tracy B; Phillips, Jennifer D; Hatmaker-Flanigan, Elizabeth

    2013-06-01

    Twenty-four women with children 5 years old or younger were interviewed regarding their experiences in losing weight during the postpartum period. Phenomenological interviews were conducted according to Husserl's perspective. Women who participated in the study revealed the issues related to postpartum weight loss: weight struggles, exercise, breast-feeding, eating, and pregnancy contributions to weight gain. The overall theme that resulted from these in-depth interviews was that women struggle to balance their successes and setbacks in losing weight during the postpartum period. PMID:23175169

  12. Exsanguinated uterus after massive atonic postpartum haemorrhage

    PubMed Central

    Mahadik, Kalpana V; Swami, M B; Pandey, Neha; Pathak, Ashish

    2013-01-01

    This article addresses issues related to pregnancy anaemia and late referral by a village birth attendant in resource poor setting in a central state of India. A young anaemic woman had labour onset at her village, a birth attendant tried to deliver her but failed. When she came to our hospital, had established septicaemia and absolutely non-reassurable uterine tone leading to intractable atonic postpartum haemorrhage. She died after 5?days because of coagulopathy and multiorgan failure. Huge budgets are being spent for the promotion of institutional deliveries but still the maternal mortality ratio has not reduced. The epidemiology of childbirth, social awareness for safe labour and administrative lethargy towards implementation of government programmes have not changed. The tertiary careblood and componentsmultidisciplinary approach could not prevent the death of an anaemic woman. Unless there is a grassroot level change in the healthcare delivery system at the village level, the scenario might not change. PMID:23853190

  13. The effects of gestational stress and Selective Serotonin reuptake inhibitor antidepressant treatment on structural plasticity in the postpartum brain - A translational model for postpartum depression.

    PubMed

    Haim, Achikam; Albin-Brooks, Christopher; Sherer, Morgan; Mills, Emily; Leuner, Benedetta

    2016-01-01

    This article is part of a Special Issue "Parental Care". Postpartum depression (PPD) is a common complication following childbirth experienced by one in every five new mothers. Although the neural basis of PPD remains unknown, previous research in rats has shown that gestational stress, a risk factor for PPD, induces depressive-like behavior during the postpartum period. Moreover, the effect of gestational stress on postpartum mood is accompanied by structural modifications within the nucleus accumbens (NAc) and the medial prefrontal cortex (mPFC)-limbic regions that have been linked to PPD. Mothers diagnosed with PPD are often prescribed selective serotonin reuptake inhibitor (SSRI) antidepressant medications and yet little is known about their effects in models of PPD. Thus, here we investigated whether postpartum administration of Citalopram, an SSRI commonly used to treat PPD, would ameliorate the behavioral and morphological consequences of gestational stress. In addition, we examined the effects of gestational stress and postpartum administration of Citalopram on structural plasticity within the basolateral amygdala (BLA) which together with the mPFC and NAc forms a circuit that is sensitive to stress and is involved in mood regulation. Our results show that postpartum rats treated with Citalopram do not exhibit gestational stress-induced depressive-like behavior in the forced swim test. In addition, Citalopram was effective in reversing gestational stress-induced structural alterations in the postpartum NAc shell and mPFC. We also found that gestational stress increased spine density within the postpartum BLA, an effect which was not reversed by Citalopram treatment. Overall, these data highlight the usefulness of gestational stress as a valid and informative translational model for PPD. Furthermore, they suggest that structural alterations in the mPFC-NAc pathway may underlie stress-induced depressive-like behavior during the postpartum period and provide much needed information on how SSRIs may act in the maternal brain to treat PPD. PMID:25997412

  14. Postpartum Depression - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... Are Here: Home ? Multiple Languages ? All Health Topics ? Postpartum Depression URL of this page: https://www.nlm.nih. ... V W XYZ List of All Topics All Postpartum Depression - Multiple Languages To use the sharing features on ...

  15. Physiological Reduction in Left Ventricular Contractile Function in Healthy Postpartum Women: Potential Overlap with Peripartum Cardiomyopathy

    PubMed Central

    Khan, Sitara G.; Melikian, Narbeh; Mushemi-Blake, Sitali; Dennes, William; Jouhra, Fadi; Monaghan, Mark; Shah, Ajay M.

    2016-01-01

    Aims Peripartum cardiomyopathy is a potentially life-threatening cause of heart failure, commoner in Afro-Caribbean than Caucasian women. Its diagnosis can be challenging due to physiological changes in cardiac function that also occur in healthy women during the early postpartum period. This study aimed to (i) establish the overlap between normal cardiac physiology in the immediate postpartum period and pathological changes in peripartum cardiomyopathy ii) identify any ethnicity-specific changes in cardiac function and cardiac biomarkers in healthy postpartum women. Methods and Results We conducted a cross-sectional study of 58 healthy postpartum women within 48 hours of delivery and 18 matched non-pregnant controls. Participants underwent cardiac assessment by echocardiography and strain analysis, including 3D echocardiography in 40 postpartum women. Results were compared with 12 retrospectively studied peripartum cardiomyopathy patients. Healthy postpartum women had significantly higher left ventricular volumes and mass, and lower ejection fraction and global longitudinal strain than non-pregnant controls. These parameters were significantly more impaired in peripartum cardiomyopathy patients but with overlapping ranges of values. Healthy postpartum women had higher levels of adrenomedullin, placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt1) compared to controls. The postpartum state, adrenomedullin, sFlt1 and the sFlt1:PlGF ratio were independent predictors of LV remodelling and function in healthy postpartum women. Conclusion Healthy postpartum women demonstrate several echocardiographic indicators of left ventricular remodelling and reduced function, which are associated with altered levels of angiogenic and cardiac biomarkers. PMID:26859567

  16. Longitudinal expression of Toll-like receptors on dendritic cells in uncomplicated pregnancy and postpartum

    PubMed Central

    Young, Brett C.; Stanic, Aleksandar K.; Panda, Britta; Rueda, Bo R.; Panda, Alexander

    2014-01-01

    OBJECTIVE Toll-like receptors (TLRs) are integral parts of the innate immune system and have been implicated in complications of pregnancy. The longitudinal expression of TLRs on dendritic cells in the maternal circulation during uncomplicated pregnancies is unknown. The objective of this study was to prospectively evaluate TLRs 1-9 as expressed on dendritic cells in the maternal circulation at defined intervals throughout pregnancy and postpartum. STUDY DESIGN This was a prospective cohort of 30 pregnant women with uncomplicated pregnancies and 30 nonpregnant controls. TLRs and cytokine expression was measured in unstimulated dendritic cells at 4 defined intervals during pregnancy and postpartum. Basal expression of TLRs and cytokines was measured by multicolor flow cytometry. The percent-positive dendritic cells for each TLRs were compared with both nonpregnant and postpartum levels with multivariate linear regression. RESULTS TLRs 1, 7, and 9 were elevated compared with nonpregnant controls with persistent elevation of TLR 1 and interleukin-12 (IL-12) into the postpartum period. Concordantly, levels of IL-6, IL-12, interferon alpha, and tumor necrosis factor alpha increased during pregnancy and returned to levels similar to nonpregnant controls during the postpartum period. The elevated levels of TLR 1 and IL-12 were persistent postpartum, challenging notions that immunologic changes during pregnancy resolve after the prototypical postpartum period. CONCLUSION Normal pregnancy is associated with time-dependent changes in TLR expression compared with nonpregnant controls; these findings may help elucidate immunologic dysfunction in complicated pregnancies. PMID:24291497

  17. Postpartum and Depression Status are Associated With Lower [11C]raclopride BPND in Reproductive-Age Women

    PubMed Central

    Moses-Kolko, Eydie L; Price, Julie C; Wisner, Katherine L; Hanusa, Barbara H; Meltzer, Carolyn C; Berga, Sarah L; Grace, Anthony A; di Scalea, Teresa Lanza; Kaye, Walter H; Becker, Carl; Drevets, Wayne C

    2012-01-01

    The early postpartum period is associated with increased risk for affective and psychotic disorders. Because maternal dopaminergic reward system function is altered with perinatal status, dopaminergic system dysregulation may be an important mechanism of postpartum psychiatric disorders. Subjects included were non-postpartum healthy (n=13), postpartum healthy (n=13), non-postpartum unipolar depressed (n=10), non-postpartum bipolar depressed (n=7), postpartum unipolar (n=13), and postpartum bipolar depressed (n=7) women. Subjects underwent 60 min of [11C]raclopride–positron emission tomography imaging to determine the nondisplaceable striatal D2/3 receptor binding potential (BPND). Postpartum status and unipolar depression were associated with lower striatal D2/3 receptor BPND in the whole striatum (p=0.05 and p=0.02, respectively) that reached a maximum of 7–8% in anteroventral striatum for postpartum status (p=0.02). Unipolar depression showed a nonsignificant trend toward being associated with 5% lower BPND in dorsal striatum (p=0.06). D2/3 receptor BPND did not differ significantly between unipolar depressed and healthy postpartum women or between bipolar and healthy subjects; however, D2/3 receptor BPND was higher in dorsal striatal regions in bipolar relative to unipolar depressives (p=0.02). In conclusion, lower striatal D2/3 receptor BPND in postpartum and unipolar depressed women, primarily in ventral striatum, and higher dorsal striatal D2/3 receptor BPND in bipolar relative to unipolar depressives reveal a potential role for the dopamine (DA) system in the physiology of these states. Further studies delineating the mechanisms underlying these differences in D2/3 receptor BPND, including study of DA system responsivity to rewarding stimuli, and increasing power to assess unipolar vs bipolar-related differences, are needed to better understand the affective role of the DA system in postpartum and depressed women. PMID:22257897

  18. The palaeoclimatic significance of Eurasian Giant Salamanders (Cryptobranchidae: Zaissanurus, Andrias) - indications for elevated humidity in Central Asia during global warm periods (Eocene, late Oligocene warming, Miocene Climate Optimum)

    NASA Astrophysics Data System (ADS)

    Vasilyan, Davit; Böhme, Madelaine; Winklhofer, Michael

    2010-05-01

    Cryptobranchids represent a group of large sized (up to 1.8 m) tailed amphibians known since the Middle Jurassic (Gao & Shubin 2003). Two species are living today in eastern Eurasia: Andrias davidianus (China) and A. japonicus (Japan). Cenozoic Eurasian fossil giant salamanders are known with two genera and two or three species from over 30 localities, ranging from the Late Eocene to the Early Pliocene (Böhme & Ilg 2003). The Late Eocene species Zaissanurus beliajevae is restricted to the Central Asian Zaissan Basin (SE-Kazakhstan, 50°N, 85°E), whereas the Late Oligocene to Early Pliocene species Andrias scheuchzeri is distributed from Central Europe to the Zaissan Basin. In the latter basin the species occur during two periods; the latest Oligocene and the late Early to early Middle Miocene (Chkhikvadse 1982). Andrias scheuchzeri is osteological indistinguishable from both recent species, indicating a similar ecology (Westfahl 1958). To investigate the palaeoclimatic significance of giant salamanders we analyzed the climate within the present-day distribution area and at selected fossil localities with independent palaeoclimate record. Our results indicate that fossil and recent Andrias species occur in humid areas where the mean annual precipitation reach over 900 mm (900 - 1.300 mm). As a working hypothesis (assuming a similar ecology of Andrias and Zaissanurus) we interpret occurrences of both fossil Eurasian giant salamanders as indicative for humid palaeoclimatic conditions. Based on this assumption the Late Eocene, the latest Oligocene (late Oligocene warming) and the late Early to early Middle Miocene (Miocene Climatic Optimum) of Central Asia (Zaissan Basin) are periods of elevated humidity, suggesting a direct (positive) relationship between global climate and Central Asian humidity evolution. Böhme M., Ilg A. 2003: fosFARbase, www.wahre-staerke.com/ Chkhikvadze V.M. 1982. On the finding of fossil Cryptobranchidae in the USSR and Mongolia. Vertebrata Hungarica, 21: 63-67. Gao K.-Q., Shubin N.H. 2003. Earliest known crown-group Salamanders. Nature, 422: 424-428. Westphal F. 1958. Die Tertiären und rezenten Eurasiatischen Riesensalamander. Palaeontolographica Abt. A, 110: 20-92.

  19. Maternal postpartum depressive symptoms and infant externalizing and internalizing behaviors.

    PubMed

    Vafai, Yassaman; Steinberg, Julia R; Shenassa, Edmond D

    2016-02-01

    Maternal postpartum depression has been shown to be one of the main predictors of externalizing and internalizing behaviors in toddlers and adolescents. Research suggests that presence of such behaviors can be observed as early as infancy. The current study uses longitudinal data from 247 mothers to examine the relationship between postpartum depressive symptoms at 8 weeks and the infant's externalizing and internalizing behaviors at 12 months. In unadjusted linear regression models, there were associations between postpartum depressive symptoms and infant externalizing behaviors (?=0.082, SE=0.032, p=0.012) and internalizing behaviors (?=0.111, SE=0.037, p=0.003). After controlling for potential confounding factors, including maternal age, race, education, home ownership, smoking status in the postpartum period, marital status, parenting stress, and happiness from becoming a parent, the associations between postpartum depressive symptoms and infant externalizing (?=0.051, SE=0.034, p=0.138) and internalizing behaviors (?=0.077, SE=0.040, p=0.057) were reduced and became non-significant. Furthermore, in these models the total amount of variance explained was 17.2% (p<0.0001) for externalizing behaviors and 10.5% (p<0.01) for internalizing behaviors; the only significant predictor of externalizing behaviors was maternal age (?=-0.074, SE=0.030, p=0.014), and of internalizing behaviors was white non-Hispanic ethnicity (?=-1.33, SE=0.378, p=0.0005). A combined effect of the confounding factors seems to explain the finding of no significant independent association between postpartum depressive symptoms and infant externalizing and internalizing behaviors. PMID:26800212

  20. Postpartum depression: Etiology, treatment and consequences for maternal care.

    PubMed

    Brummelte, Susanne; Galea, Liisa A M

    2016-01-01

    This article is part of a Special Issue "Parental Care". Pregnancy and postpartum are associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10-15% of women and impairs mother-infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the "father of motherhood", Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother-infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring. PMID:26319224

  1. Periodicities in mid- to late-Holocene peatland hydrology identified from Swedish and Lithuanian tree-ring data

    NASA Astrophysics Data System (ADS)

    Edvardsson, Johannes; Adolphi, Florian; Linderholm, Hans W.; Corona, Christophe; Muscheler, Raimund; Stoffel, Markus

    2016-04-01

    Twenty-five tree-ring width (TRW) chronologies, developed from moisture sensitive peatland trees in Sweden and Lithuania, and representing eight periods during the mid-Holocene to present, were analysed regarding common periodicities (cycles). Periods of 13-15, 20-22, and 30-35 years were found in most chronologies, while 8-10, 18-19, and 60-65 year periodicities were observed as well, but less commonly. Similar periodicities, especially about 15 and 30 years in duration, were detected in both living and subfossil trees, indicating that the trees have responded to similar forcing mechanisms on those timescales through time. Some of the detected periods may be related to solar variability and lunar nodal tides, but most of the detected periodicities are more likely linked to hydrological changes in the peatlands associated to atmospheric patterns such as the North Atlantic Oscillation (NAO), or variations in sea surface temperatures (i.e. the Atlantic Multidecadal Oscillation, AMO). However, no significant relationships between tree growth, NAO and AMO could be formally established, possibly due to hydrological lag and feedback effects which are typical for peatlands but render in-depth assessments rather difficult.

  2. Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric Study

    PubMed Central

    Montufar-Rueda, Carlos; Rodriguez, Laritza; Jarquin, Jos Douglas; Barboza, Alejandra; Bustillo, Maura Carolina; Marin, Flor; Ortiz, Guillermo; Estrada, Francisco

    2013-01-01

    Objective. Postpartum hemorrhage (PPH) is an important cause of maternal mortality (MM) around the world. Seventy percent of the PPH corresponds to uterine atony. The objective of our study was to evaluate multicenter PPH cases during a 10-month period, and evaluate severe postpartum hemorrhage management. Study Design. The study population is a cohort of vaginal delivery and cesarean section patients with severe postpartum hemorrhage secondary to uterine atony. The study was designed as a descriptive, prospective, longitudinal, and multicenter study, during 10 months in 13 teaching hospitals. Results. Total live births during the study period were 124,019 with 218 patients (0.17%) with severe postpartum hemorrhage (SPHH). Total maternal deaths were 8, for mortality rate of 3.6% and a MM rate of 6.45/100,000 live births (LB). Maternal deaths were associated with inadequate transfusion therapy. Conclusions. In all patients with severe hemorrhage and subsequent hypovolemic shock, the most important therapy is intravascular volume resuscitation, to reduce the possibility of target organ damage and death. Similarly, the current proposals of transfusion therapy in severe or massive hemorrhage point to early transfusion of blood products and use of fresh frozen plasma, in addition to packed red blood cells, to prevent maternal deaths. PMID:24363935

  3. Haootia quadriformis n. gen., n. sp., interpreted as a muscular cnidarian impression from the Late Ediacaran period (approx. 560 Ma).

    PubMed

    Liu, Alexander G; Matthews, Jack J; Menon, Latha R; McIlroy, Duncan; Brasier, Martin D

    2014-10-22

    Muscle tissue is a fundamentally eumetazoan attribute. The oldest evidence for fossilized muscular tissue before the Early Cambrian has hitherto remained moot, being reliant upon indirect evidence in the form of Late Ediacaran ichnofossils. We here report a candidate muscle-bearing organism, Haootia quadriformis n. gen., n. sp., from approximately 560 Ma strata in Newfoundland, Canada. This taxon exhibits sediment moulds of twisted, superimposed fibrous bundles arranged quadrilaterally, extending into four prominent bifurcating corner branches. Haootia is distinct from all previously published contemporaneous Ediacaran macrofossils in its symmetrically fibrous, rather than frondose, architecture. Its bundled fibres, morphology, and taphonomy compare well with the muscle fibres of fossil and extant Cnidaria, particularly the benthic Staurozoa. Haootia quadriformis thus potentially provides the earliest body fossil evidence for both metazoan musculature, and for Eumetazoa, in the geological record. PMID:25165764

  4. Haootia quadriformis n. gen., n. sp., interpreted as a muscular cnidarian impression from the Late Ediacaran period (approx. 560 Ma)

    PubMed Central

    Liu, Alexander G.; Matthews, Jack J.; Menon, Latha R.; McIlroy, Duncan; Brasier, Martin D.

    2014-01-01

    Muscle tissue is a fundamentally eumetazoan attribute. The oldest evidence for fossilized muscular tissue before the Early Cambrian has hitherto remained moot, being reliant upon indirect evidence in the form of Late Ediacaran ichnofossils. We here report a candidate muscle-bearing organism, Haootia quadriformis n. gen., n. sp., from approximately 560 Ma strata in Newfoundland, Canada. This taxon exhibits sediment moulds of twisted, superimposed fibrous bundles arranged quadrilaterally, extending into four prominent bifurcating corner branches. Haootia is distinct from all previously published contemporaneous Ediacaran macrofossils in its symmetrically fibrous, rather than frondose, architecture. Its bundled fibres, morphology, and taphonomy compare well with the muscle fibres of fossil and extant Cnidaria, particularly the benthic Staurozoa. Haootia quadriformis thus potentially provides the earliest body fossil evidence for both metazoan musculature, and for Eumetazoa, in the geological record. PMID:25165764

  5. The introduction of postpartum intrauterine devices in the People's Republic of China.

    PubMed

    Wen, Z S; Lin, L; Laufe, L E; Dixon, B

    1983-04-01

    In China, which has a commitment to family planning and, in particular, to the one-child family, a postpartum IUD should be widely accepted and could have significant impact on the Chinese family planning program. This report presents the introduction of the Delta T and Delta Loop devices, with 200 immediate postpartum insertions. Fifty-two deliveries were by cesarean section. The 6-month expulsion rates were 13.3 and 17.2 for the Delta T and Delta Loop, respectively. There was one pregnancy reported. Analysis suggests that the two devices are suitable for use in the postpartum period for Chinese women. PMID:6136435

  6. High Serum Level of β2-Microglobulin in Late Posttransplant Period Predicts Subsequent Decline in Kidney Allograft Function: A Preliminary Study

    PubMed Central

    Trailin, Andriy V.; Pleten, Marina V.; Ostapenko, Tatiana I.; Iefimenko, Nadiia F.; Nikonenko, Olexander S.

    2015-01-01

    Background. Identification of patients at risk for kidney allograft (KAG) failure beyond the first posttransplant year is an unmet need. We aimed to determine whether serum beta-2-microglobulin (β2MG) in the late posttransplant period could predict a decline in KAG function. Methods. We assessed a value of single measurement of serum β2MG at one to seventeen years after transplantation in predicting the estimated glomerular filtration rate (eGFR) and the decline in eGFR over a period of two years in 79 recipients of KAG. Results. At baseline serum β2MG concentration was higher (P = 0.011) in patients with allograft dysfunction: 8.67 ± 2.48 µg/mL versus those with satisfactory graft function: 6.67 ± 2.13 µg/mL. Higher β2MG independently predicted the lower eGFR, the drop in eGFR by ≥25% after one and two years, and the value of negative eGFR slope. When combined with proteinuria and acute rejection, serum β2MG had excellent power in predicting certain drop in eGFR after one year (AUC = 0.910). In conjunction with posttransplant time serum β2MG had good accuracy in predicting certain eGFR drop after two years (AUC = 0.821). Conclusions. Elevated serum β2MG in the late posttransplant period is useful in identifying patients at risk for rapid loss of graft function. PMID:26633915

  7. Is Postpartum Depression a Distinct Disorder?

    PubMed

    Di Florio, Arianna; Meltzer-Brody, Samantha

    2015-10-01

    The nosology of postpartum depression (PPD) is controversial. We review the evidence and arguments for and against the recognition of PPD as a distinct disorder and discuss the etiopathogenic and diagnostic validity of PPD as a distinct disorder, including its utility and indications for further research. Although multiple epidemiological and clinical studies have found that depression is more common following childbirth than at other times in a woman's life, there is conflicting evidence for the validity of PPD as a distinct disorder. PPD is likely to be a complex phenotype, encompassing several disorders with different disease pathways. It is plausible that for a sub-group of vulnerable women, childbirth triggers episodes of depression. However, even within this group, the mechanisms underpinning the mood disturbances are likely complex and heterogeneous. The distinction between depression occurring in the perinatal period and depression at other times is important for both research and clinical practice. Research should differentiate between episodes that begin during pregnancy and postpartum, as the pathogenetic factors involved may differ and require specialized treatment. PMID:26267038

  8. Adolescent Motherhood and Postpartum Depression

    ERIC Educational Resources Information Center

    Birkeland, Robyn; Thompson, J. Kevin; Phares, Vicky

    2005-01-01

    Adolescent mothers undergo unique personal and social challenges that may contribute to postpartum functioning. In this exploratory investigation completed within a risk and resilience framework, 149 adolescent mothers, ages 15 to 19, who participated in school-based teen parents' programs, completed measures of parental stress (social isolation

  9. Postpartum Adjustment in Primiparous Parents.

    ERIC Educational Resources Information Center

    Atkinson, A. Kathleen; Rickel, Annette U.

    Within the framework of the social stress and behavioral theories of depression, this study investigated the hypothesis that postpartum depression is a function of disruption of parents' prepartum functioning by the subsequent demands of infant caretaking. Seventy-eight primiparous married couples (N=156, 78 men and 78 women) volunteered to

  10. Prenatal and Postpartum Evening Salivary Cortisol Levels in Association with Peripartum Depressive Symptoms

    PubMed Central

    Iliadis, Stavros I.; Comasco, Erika; Sylvén, Sara; Hellgren, Charlotte; Sundström Poromaa, Inger; Skalkidou, Alkistis

    2015-01-01

    Background The biology of peripartum depression remains unclear, with altered stress and the Hypothalamus-Pituitary-Adrenal axis response having been implicated in its pathophysiology. Methods The current study was undertaken as a part of the BASIC project (Biology, Affect, Stress, Imaging, Cognition), a population-based longitudinal study of psychological wellbeing during pregnancy and the postpartum period in Uppsala County, Sweden, in order to assess the association between evening salivary cortisol levels and depressive symptoms in the peripartum period. Three hundred and sixty-five pregnant women from the BASIC cohort were recruited at pregnancy week 18 and instructed to complete a Swedish validated version of the Edinburgh Postnatal Depression Scale at the 36th week of pregnancy as well as the sixth week after delivery. At both times, they were also asked to provide evening salivary samples for cortisol analysis. A comprehensive review of the relevant literature is also provided. Results Women with postpartum EPDS score ≥ 10 had higher salivary evening cortisol at six weeks postpartum compared to healthy controls (median cortisol 1.19 vs 0.89 nmol/L). A logistic regression model showed a positive association between cortisol levels and depressive symptoms postpartum (OR = 4.1; 95% CI 1.7–9.7). This association remained significant even after controlling for history of depression, use of tobacco, partner support, breastfeeding, stressful life events, and sleep problems, as possible confounders (aOR = 4.5; 95% CI 1.5–14.1). Additionally, women with postpartum depressive symptoms had higher postpartum cortisol levels compared to both women with depressive symptoms antenatally and controls (p = 0.019 and p = 0.004, respectively). Conclusions Women with depressive symptoms postpartum had higher postpartum cortisol levels, indicating an altered response of the HPA-axis in postpartum depression. PMID:26322643

  11. The Late K-type Binary V1104 Her Near the Short-period End of Contact Binaries

    NASA Astrophysics Data System (ADS)

    Liu, N.-P.; Qian, S.-B.; Soonthornthum, B.; Zhu, L.-Y.; Liao, W.-P.; Zhao, E.-G.; Zhou, X.

    2015-04-01

    V1104 Her is a newly discovered periodic variable with EW type variability. With an orbital period that is extremely short for a contact binary, it was found to have almost the latest K spectral type. To study its properties and nature, two new sets of multi-color light curves were analyzed with the Wilson-Devinney code. Photometric solutions reveal that the system is a W-type shallow contact binary with a mass ratio of 1/q={{M}1}/{{M}2}=0.63+/- 0.01 and a degree of contact of about f=15%+/- 2%. The real parameter uncertainties may be from three to five times larger, depending on the required confidence. Combining the newly determined times of minimum light, some of which were reprocessed from initial data, in conjunction with others published, the period variation is investigated in detail. Different methods of curve fitting were used, based on a weighted least-squares method. Finally, the orbital period of V1104 Her is found to be undergoing a long-term decrease at a rate of dP/dt=-2.9?ft( +/- 0.5 \\right) {{10}-8} days yr-1, as well as double cyclic oscillations with a period ratio ({{T}1}/{{T}2}) very close to 9:2. The light-travel time effect was found to be the best explanation for the cyclic variations. This indicates that the object is a possible quadruple system, which further implies that multiplicity may be a common phenomenon among close binaries.

  12. Effect of thermal environment and caloric intake on head growth of low birthweight infants during late neonatal period.

    PubMed Central

    Glass, L; Lala, R V; Jaiswal, V; Nigam, S K

    1975-01-01

    In order to assess the effects of ambient thermal conditions on postnatal head growth in low birth weight infants, 42 asymtomatic neonates were reared under 4 combinations of caloric intake and thermal environment after the first week of life. Exposure to a subthermoneutral temperature (abdominal skin temperature of 35 degrees C), together with a relatively low caloric intake (120 cal/kg per day), was associated with significant retardation of head growth over a 2-week study period. PMID:1167073

  13. Immigrant women's perspective on prenatal and postpartum care: systematic review.

    PubMed

    Santiago, Maria da Conceio F; Figueiredo, Maria Henriqueta

    2015-02-01

    Female migration represents a major public health challenge faced today because its heterogeneity and gender issues placing immigrant women among the most vulnerable and at-risk group. To identify and analyze studies dealing with immigrant women's perspectives with prenatal and postpartum health care. A systematic literature review was conducted to assess studies published between 2000 and 2010 using Cumulative Index to Nursing and Allied Health Literature, EMBASE, PubMed and Cochrane Database of Systematic Reviews. The studies explored the relation between socio-demographic characteristics of immigrant women participants and its impact on the main factors identified as influencing prenatal and postpartum care, characterizing the manifested knowledge and behaviors expressed and describing the women's experience with health care services and the incidence of postpartum depression symptoms. The less favorable socio-economic status of migrant women participants seems to have been influential in the quality of health service in prenatal and postpartum periods. The language barrier was the main negative factor interfering with communication between women and health professionals, followed by health care professionals' lack of cultural sensitivity, leading to women's reluctance in using health services. PMID:24052479

  14. Postpartum maternal morbidity requiring hospital admission in Lusaka, Zambia - a descriptive study.

    PubMed

    Vallely, Lisa; Ahmed, Yusuf; Murray, Susan F

    2005-02-01

    BACKGROUND: Information on the extent of postpartum maternal morbidity in developing countries is extremely limited. In many settings, data from hospital-based studies is hard to interpret because of the small proportion of women that have access to medical care. However, in those areas with good uptake of health care, the measurement of the type and incidence of complications severe enough to require hospitalisation may provide useful baseline information on the acute and severe morbidity that women experience in the early weeks following childbirth. An analysis of health services data from Lusaka, Zambia, is presented. METHODS: Six-month retrospective review of hospital registers and 4-week cross-sectional study with prospective identification of postpartum admissions. RESULTS: Both parts of the study identified puerperal sepsis and malaria as, respectively, the leading direct and indirect causes of postpartum morbidity requiring hospital admission. Puerperal sepsis accounted for 34.8% of 365 postpartum admissions in the 6-month period. Malaria and pneumonia together accounted for one-fifth of all postpartum admissions (14.5% & 6% respectively). At least 1.7% of the postpartum population in Lusaka will require hospital-level care for a maternal morbidity. CONCLUSIONS: In developing country urban settings with high public health care usage, meticulous review of hospital registers can provide baseline information on the burden of moderate-to-severe postpartum morbidity. PMID:15686592

  15. The Impact of Sleep, Stress, and Depression on Postpartum Weight Retention: A Systematic Review

    PubMed Central

    Xiao, Rui S.; Kroll-Desrosiers, Aimee R.; Goldberg, Robert J; Pagoto, Sherry L.; Person, Sharina D.; Waring, Molly E.

    2014-01-01

    Objective To review the impact of sleep, stress, and/or depression on postpartum weight retention. Methods We searched three electronic databases, PubMed, ISI Web of Science, and PsycInfo. Studies were included if they were published between January 1990 and September 2013 in English, measured sleep, stress, and/or depression in the postpartum period and assessed the association of these factors with postpartum weight retention. Two reviewers reviewed included articles and rated study quality using a modified version of the Downs and Black scale. Results Thirteen studies met our pre-defined eligibility criteria, reporting on 9 study samples. Two were cross-sectional studies and eleven were longitudinal studies. The study sample size ranged from 74 to 37,127. All four studies examining short sleep duration and postpartum weight retention reported a positive association. The four studies examining postpartum stress and weight retention reported non-significant associations only. Of 7 studies examining postpartum depression and weight retention, 3 reported non-significant associations, and 4 reported positive associations. Conclusion Research investigating the impact of postpartum sleep, stress, depression and weight retention is limited. Future longitudinal studies are needed. PMID:25306538

  16. Lower sexual interest in postpartum women: relationship to amygdala activation and intranasal oxytocin

    PubMed Central

    RUPP, HEATHER A.; JAMES, THOMAS W.; KETTERSON, ELLEN D.; SENGELAUB, DALE R.; DITZEN, BEATE; HEIMAN, JULIA R.

    2012-01-01

    During the postpartum period, women experience significant changes in their neuroendocrine profiles and social behavior compared to before pregnancy. A common experience with motherhood is a decrease in sexual desire. Although the lifestyle and peripheral physiological changes associated with parturition might decrease a woman’s sexual interest, we hypothesized that there are also hormone-mediated changes in women’s neural response to sexual and infant stimuli with altered reproductive priorities. We predicted that amygdala activation to sexually arousing stimuli would be suppressed in postpartum versus nulliparous women, and altered with intranasal oxytocin administration. To test this, we measured amygdala activation using fMRI in response to sexually arousing pictures, infant pictures, and neutral pictures in 29 postpartum and 30 nulliparous women. Half of the women received a dose of exogenous oxytocin before scanning. As predicted, nulliparous women subjectively rated sexual pictures to be more arousing, and infant pictures to be less arousing, than did postpartum women. However, nulliparous women receiving the nasal oxytocin spray rated the infant photos as arousing as did postpartum women. Right amygdala activation was lower in postpartum versus nulliparous women in response to sexual, infant, and neutral images, suggesting a generalized decrease in right amygdala responsiveness to arousing images with parturition. There was no difference in right amygdala activation with nasal spray application. Postpartum women therefore appear to experience a decrease in sexual interest possibly as a feature of a more generalized decrease in amygdala responsiveness to arousing stimuli. PMID:23085496

  17. Commitment to lysogeny is preceded by a prolonged period of sensitivity to the late lytic regulator Q in bacteriophage λ.

    PubMed

    Svenningsen, Sine Lo; Semsey, Szabolcs

    2014-10-01

    A key event in development is the irreversible commitment to a particular cell fate, which may be concurrent with or delayed with respect to the initial cell fate decision. In this work, we use the paradigmatic bacteriophage λ lysis-lysogeny decision circuit to study the timing of commitment. The lysis-lysogeny decision is made based on the expression trajectory of CII. The chosen developmental strategy is manifested by repression of the pR and pL promoters by CI (lysogeny) or by antitermination of late gene expression by Q (lysis). We found that expression of Q in trans from a plasmid at the time of infection resulted in a uniform lytic decision. Furthermore, expression of Q up to 50 min after infection results in lysis of the majority of cells which initially chose lysogenic development. In contrast, expression of Q in cells containing a single chromosomal prophage had no effect on cell growth, indicating commitment to lysogeny. Notably, if the prophage was present in 10 plasmid-borne copies, Q expression resulted in lytic development, suggesting that the cellular phage chromosome number is the critical determinant of the timing of lysogenic commitment. Based on our results, we conclude that (i) the lysogenic decision made by the CI-Cro switch soon after infection can be overruled by ectopic Q expression at least for a time equivalent to one phage life cycle, (ii) the presence of multiple λ chromosomes is a prerequisite for a successful Q-mediated switch from lysogenic to lytic development, and (iii) phage chromosomes within the same cell can reach different decisions. PMID:25092034

  18. Towards an Understanding of Change in Physical Activity from Pregnancy Through Postpartum

    PubMed Central

    Evenson, Kelly R.

    2010-01-01

    Objective The purpose of this paper was to describe the rationale, data collection, and proposed analyses for examination of mediators of change in physical activity from pregnancy to postpartum among a cohort of pregnant women. Method The Pregnancy Infection and Nutrition 3 (PIN3) Study enrolled 2006 pregnant women into the cohort from 2001 to 2005. All women lived in central North Carolina upon enrollment. Physical activity was assessed using a self-reported one week recall, measured twice during pregnancy and once each at 3- and 12-months postpartum. On a subset of women, one-week accelerometer measures were also collected during the two postpartum time periods. Potential mediators (intrapersonal, interpersonal, community) were collected during pregnancy and postpartum through interviews and take home questionnaires. Results To assess mediation of physical activity among our cohort, we will first describe change in physical activity and the mediators, as well as their associations, through pregnancy into the postpartum period. Following this, the product of coefficients approach will be applied to examine whether each measure had indirect effects on change in physical activity. Each individual level mediator will be examined one at a time and across the time points in which it was available. The Sobel standard error approximation formula will be used to test for significance of the mediation effect. Conclusions This study will provide evidence to develop appropriate interventions targeted at physical activity and will help focus efforts on the appropriate time periods between pregnancy and postpartum. PMID:21278835

  19. Probable hepatic capillariosis and hydatidosis in an adolescent from the late Roman period buried in Amiens (France)

    PubMed Central

    Mowlavi, Gholamreza; Kacki, Sacha; Dupouy-Camet, Jean; Mobedi, Iraj; Makki, Mahsasadat; Harandi, Majid Fasihi; Naddaf, Saied Reza

    2014-01-01

    Two calcified objects recovered from a 3rd to 4th-century grave of an adolescent in Amiens (Northern France) were identified as probable hydatid cysts. By using thin-section petrographic techniques, probable Calodium hepaticum (syn. Capillaria hepatica) eggs were identified in the wall of the cysts. Human hepatic capillariosis has not been reported from archaeological material so far, but could be expected given the poor level of environmental hygiene prevalent in this period. Identification of tissue-dwelling parasites such as C. hepaticum in archaeological remains is particularly dependent on preservation conditions and taphonomic changes and should be interpreted with caution due to morphological similarities with Trichuris sp. eggs. PMID:24572211

  20. Complicated Postpartum Type B Aortic Dissection and Endovascular Repair

    PubMed Central

    Rosenberger, Laura H.; Adams, Joshua D.; Kern, John A.; Tracci, Margaret C.; Angle, J. Fritz; Cherry, Kenneth J.

    2012-01-01

    BACKGROUND Fifty percent of aortic dissections in women younger than 40 years occur in association with pregnancy. Of these, half of type B dissections occur in the postpartum period. CASE A 30-year-old woman was status post spontaneous vaginal delivery at 30 weeks of gestation for fetal death, complicated by an eclamptic seizure. On post-partum day 4, she suffered an acute, complicated type B aortic dissection treated with endovascular stent graft placement. CONCLUSION Endovascular repair may be an attractive option for the treatment of complicated type B aortic dissections in pregnancy and the peripartum period, with reduced maternal and fetal mortality. This may allow the fetus to remain in situ and avoid the risks of surgery and possible cardiopulmonary bypass, with little radiation risk to the fetus. PMID:22270446

  1. Predictors of Mothers Postpartum Body Dissatisfaction

    PubMed Central

    Gjerdingen, Dwenda; Fontaine, Patricia; Crow, Scott; McGovern, Patricia; Center, Bruce; Miner, Michael

    2009-01-01

    Purpose To investigate changes in mothers body dissatisfaction from delivery to 9 months postpartum, and the relationship of postpartum body dissatisfaction to weight, other health, and social characteristics. Methods In this prospective longitudinal study, 506 mothers completed surveys at 0-1 and 9 months postpartum. Postpartum changes in body dissatisfaction and weight were evaluated by paired t-tests, and predictors of postpartum body dissatisfaction were identified by stepwise multiple regression analysis. Results Mothers body dissatisfaction increased significantly from 0-1 to 9 months postpartum (mean scores of 15.2 and 18.2, respectively, p < .001). Although women lost an average of 10.1 pounds (sd = 16.3) or 4.6 kg. (sd = 7.4) between 0-1 and 9 months postpartum (p < .001), their weight at 9 months postpartum remained an average of 5.4 pounds (sd = 15.6) or 2.5 kg (sd = 7.1) above their pre-pregnancy weights (p < .001). Body dissatisfaction at 9 months postpartum was associated with overeating or poor appetite, higher current weight, worse mental health (SF-36 Mental Health scale), race other than black, bottle-feeding (vs. breastfeeding), being single (vs. married), and having fewer children,. Conclusions Mothers body satisfaction worsened from 1 to 9 months postpartum, and 9-month body dissatisfaction was associated with eating/appetite abnormalities, greater weight, worse mental health, non-black race, non-breastfeeding status, and fewer immediate family relationships. Given these relationships, it is important to educate women about expected postpartum weight and body changes, and to find ways to enhance mothers postpartum self-esteem and body satisfaction. PMID:20013517

  2. Imaging of Postpartum Ovarian Vein Thrombosis

    PubMed Central

    Bilgin, Mehmet; Sevket, Osman; Yildiz, Seyma; Sharifov, Rasul; Kocakoc, Ercan

    2012-01-01

    Postpartum ovarian vein thrombosis (OVT) is a rare but serious complication. Clinical findings of OVT are nonspecific. Postpartum OVT, which is a clinically difficultly diagnosed entity, must be thought of in differential diagnosis in cases of postpartum acute abdomen. OVT can be accurately diagnosed by appropriate noninvasive radiologic modalities to start early therapy with anticoagulants and intravenous antibiotics. In this paper, we review the imaging findings of a case with postpartum ovarian vein thrombosis that had been followed up for 6 months by ultrasonography (US), color Doppler US, computed tomography (CT), and magnetic resonance imaging (MRI). PMID:23133765

  3. Postpartum coronary artery dissection.

    PubMed Central

    Shaver, P J; Carrig, T F; Baker, W P

    1978-01-01

    A 27-year-old woman experienced anterior myocardial infarction three weeks after the delivery of her second child. Coronary arteriography subsequently showed primary dissection of the left coronary artery. This patient is believed to be the second reported survivor of angiographically proven peripartal left coronary artery dissection and the only such patient to achieve and maintain asymptomatic status for a prolonged period without operative intervention. Images PMID:626669

  4. Sedimentary Evidence for Land Use Change in the Narragansett Bay Watershed: Late Woodland period (~500 AD) to the present

    NASA Astrophysics Data System (ADS)

    Salacup, J. M.; Altabet, M. A.; Herbert, T.; Prell, W. L.

    2012-12-01

    In the U.S., the last ~300 years have been a period of progressive and widespread resource exploitation, ecosystem degradation, and habitat destruction. In southern New England, the European Colonists thrived on the spread of slave-based plantation farming, which peaked ~1750 in RI. They produced commodities such as livestock, apples, onions, flax, and dairy. Trees felled to produce the necessary pasture- and farm-land were quickly used as lumber for boards, planks, timber, and barrels. In 1793, Slater Mill, located on the Blackstone River at the head of Narragansett Bay, was the first mill in the U.S to spin yarn using water power, making it the birthplace of the U.S Industrial Revolution. The ensuing urbanization drove the human population of the watershed up from ~50,000 in 1790 to more than 2 million by the year 2000. More recently, the Bay has experienced episodic hypoxic events [1]. These events correlate well with spatial and temporal patterns of nutrients and productivity [2] suggesting that human-induced increases in nutrient nitrogen and phosphorus are responsible for eutrophication-induced oxygen depletion [3]. However, these post-Colonial land use changes have yet to be characterized within the longer context of Native American land use practices, mainly due to the lack of historical records for the period. Additionally, the impact of this ecosystem disturbance on the Bay has not been fully described. Here we present results based on sedimentary profiles of biomarkers diagnostic for soil delivery to marine systems, branched glycerol dialykl glycerol tetraethers, and pollen for disturbance taxa, that suggest land use change began in the Bay's watershed 300 years before European contact. This contradicts long standing ideas regarding the land use practices of local tribes but agrees with new archaeological findings suggesting large semi-permanent settlements and widespread horticulture of maize may have been the norm at this time. We also show results of pollen, nitrogen isotopes, and foraminiferal abundance (proxies for land disturbance, nutrient sources, and ecosystem productivity, respectively) implying the large domestic animal population housed on the plantations were a new source of nitrogen to the Bay. This nutrient input may have led to an increase in the Bay's primary productivity, which may have decreased or stabilized as plantations became less important. Lastly, these same proxies show that the industrialization and urbanization of the Bay's watershed added additional nutrients, further stimulating the Bay's productivity. 1. Codiga, D.L., et al., Narragansett Bay Hypoxic Event Characteristics Based on Fixed-Site Monitoring Network Time Series: Intermittency, Geographic Distribution, Spatial Synchronicity, and Interannual Variablity. Estuaries and Coasts, 2009. 32: p. 621-641. 2. Oviatt, C.A., Impacts of Nutrients on Narragansett Bay Productivity: A Gradient Approach, in Science for Ecosystem-based Management, Narragansett Bay in the 21st Century, A. Desbonnet, Editor 2008, Springer: New York. p. 523-543. 3. Nixon, S.W., et al., Nitrogen and Phosphorus Inputs to Narragansett Bay: Past, Present, and Future, in Science for Ecosystem-based Management: Narragansett Bay in the 21st Century, A. Desbonnet and B.A. Costa-Pierce, Editors. 2008, Springer: New York, NY. p. 101-175.

  5. Differentially Expressed MicroRNAs in Postpartum Breast Cancer in Hispanic Women

    PubMed Central

    Futscher, Bernard W.; Hu, Chengcheng; Komenaka, Ian K.; Meza-Montenegro, Maria Mercedes; Gutierrez-Millan, Luis Enrique; Daneri-Navarro, Adrian; Thompson, Patricia A.; Martinez, Maria Elena

    2015-01-01

    The risk of breast cancer transiently increases immediately following pregnancy; peaking between 3-7 years. The biology that underlies this risk window and the effect on the natural history of the disease is unknown. MicroRNAs (miRNAs) are small non-coding RNAs that have been shown to be dysregulated in breast cancer. We conducted miRNA profiling of 56 tumors from a case series of multiparous Hispanic women and assessed the pattern of expression by time since last full-term pregnancy. A data-driven splitting analysis on the pattern of 355 miRNAs separated the case series into two groups: a) an early group representing women diagnosed with breast cancer ? 5.2 years postpartum (n = 12), and b) a late group representing women diagnosed with breast cancer ? 5.3 years postpartum (n = 44). We identified 15 miRNAs with significant differential expression between the early and late postpartum groups; 60% of these miRNAs are encoded on the X chromosome. Ten miRNAs had a two-fold or higher difference in expression with miR-138, miR-660, miR-31, miR-135b, miR-17, miR-454, and miR-934 overexpressed in the early versus the late group; while miR-892a, miR-199a-5p, and miR-542-5p were underexpressed in the early versus the late postpartum group. The DNA methylation of three out of five tested miRNAs (miR-31, miR-135b, and miR-138) was lower in the early versus late postpartum group, and negatively correlated with miRNA expression. Here we show that miRNAs are differentially expressed and differentially methylated between tumors of the early versus late postpartum, suggesting that potential differences in epigenetic dysfunction may be operative in postpartum breast cancers. PMID:25875827

  6. Differentially expressed microRNAs in postpartum breast cancer in Hispanic women.

    PubMed

    Muoz-Rodrguez, Jos L; Vrba, Lukas; Futscher, Bernard W; Hu, Chengcheng; Komenaka, Ian K; Meza-Montenegro, Maria Mercedes; Gutierrez-Millan, Luis Enrique; Daneri-Navarro, Adrian; Thompson, Patricia A; Martinez, Maria Elena

    2015-01-01

    The risk of breast cancer transiently increases immediately following pregnancy; peaking between 3-7 years. The biology that underlies this risk window and the effect on the natural history of the disease is unknown. MicroRNAs (miRNAs) are small non-coding RNAs that have been shown to be dysregulated in breast cancer. We conducted miRNA profiling of 56 tumors from a case series of multiparous Hispanic women and assessed the pattern of expression by time since last full-term pregnancy. A data-driven splitting analysis on the pattern of 355 miRNAs separated the case series into two groups: a) an early group representing women diagnosed with breast cancer ? 5.2 years postpartum (n = 12), and b) a late group representing women diagnosed with breast cancer ? 5.3 years postpartum (n = 44). We identified 15 miRNAs with significant differential expression between the early and late postpartum groups; 60% of these miRNAs are encoded on the X chromosome. Ten miRNAs had a two-fold or higher difference in expression with miR-138, miR-660, miR-31, miR-135b, miR-17, miR-454, and miR-934 overexpressed in the early versus the late group; while miR-892a, miR-199a-5p, and miR-542-5p were underexpressed in the early versus the late postpartum group. The DNA methylation of three out of five tested miRNAs (miR-31, miR-135b, and miR-138) was lower in the early versus late postpartum group, and negatively correlated with miRNA expression. Here we show that miRNAs are differentially expressed and differentially methylated between tumors of the early versus late postpartum, suggesting that potential differences in epigenetic dysfunction may be operative in postpartum breast cancers. PMID:25875827

  7. New insights into the role of perinatal HPA-axis dysregulation in postpartum depression.

    PubMed

    Glynn, Laura M; Davis, Elysia Poggi; Sandman, Curt A

    2013-12-01

    Postpartum depression affects 10-20% of women following birth and exerts persisting adverse consequences on both mother and child. An incomplete understanding of its etiology constitutes a barrier to early identification and treatment. It is likely that prenatal hormone trajectories represent both markers of risk and also causal factors in the development of postpartum depression. During pregnancy the maternal hypothalamic-pituitary-adrenal axis undergoes dramatic alterations, due in large part, to the introduction of the placenta, a transient endocrine organ of fetal origin. We suggest that prenatal placental and hypothalamic-pituitary-adrenal axis dysregulation is predictive of risk for postpartum depression. In this model the positive feedback loop involving the systems regulating the products of the HPA axis results in higher prenatal levels of cortisol and placental corticotropin-releasing hormone. Greater elevations in placental corticotropin-releasing hormone are related to a disturbance in the sensitivity of the anterior pituitary to cortisol and also perhaps to decreased central corticotropin-releasing hormone secretion. Secondary or tertiary adrenal insufficiencies of a more extreme nature, which emerge during the prenatal period, may be predictive of an extended or more pronounced postpartum hypothalamic-pituitary-adrenal refractory period, which in turn represents a risk factor for development of postpartum depression. In addition to reviewing the relevant existing literature, new data are presented in support of this model which link elevated placental corticotropin-releasing hormone with low levels of ACTH at 3-months postpartum. Future research will further elucidate the role of hypothalamic-pituitary-adrenal axis dysregulation in postpartum depression and also whether prenatal placental and hypothalamic-pituitary-adrenal profiles might prove useful in the early identification of mothers at risk for postpartum mood dysregulation. PMID:24210135

  8. Sociodemographic, Perinatal, Behavioral, and Psychosocial Predictors of Weight Retention at 3 and 12 months Postpartum

    PubMed Central

    Siega-Riz, Anna Maria; Herring, Amy H.; Carrier, Kathryn; Evenson, Kelly R.; Dole, Nancy; Deierlein, Andrea

    2010-01-01

    Postpartum weight retention plays an important role in the pathway leading to obesity among women of childbearing age. The objective of this study was to examine predictors of moderate (110 pounds) and high (>10 pounds) postpartum weight retention using data from a prospective pregnancy cohort that followed women into the postpartum period; n=688 and 550 women at 3 and 12 months, respectively. Analysis included descriptive statistics and predictive modeling using log-binomial techniques. The average weight retained at 3 and 12 months postpartum in this population was 9.4 lbs (SD=11.4) and 5.7 lbs (SD=13.2) respectively. At 3- months postpartum, prepregnancy weight, gestational weight gain, and hours slept during the night were associated with moderate or high weight retention while having an infant hospitalized after going home and scoring in the upper 75th percentile of the eating attitudes test were associated only with high weight retention. At 12- months postpartum, prepregnancy weight, gestational weight gain and maternal education were associated with moderate weight retention and gestational weight gain, maternal age, race, employment status, and having an infant hospitalized at birth were associated with high weight retention. The results of this study illustrate the importance of prepregnancy weight and gestational weight gain in predicting postpartum weight retention. Furthermore, given the lack of successful intervention studies that exist to date to help women lose weight in the postpartum period, the results of this study may help to inform future interventions that focus on such aspects as hours of sleep, dealing with stress associated with a hospitalized infant, and non-clinical eating disorder symptomatology. PMID:20035283

  9. Effect of Medicinal Plant By-products Supplementation to Total Mixed Ration on Growth Performance, Carcass Characteristics and Economic Efficacy in the Late Fattening Period of Hanwoo Steers.

    PubMed

    Lee, S J; Kim, D H; Guan, Le Luo; Ahn, S K; Cho, K W; Lee, Sung S

    2015-12-01

    This study was conducted to evaluate the effect of medicinal plant by-products (MPB) supplementation to a total mixed ration (TMR) on growth, carcass characteristics and economic efficacy in the late fattening period of Hanwoo steers. Twenty seven steers (body weight [BW], 57357 kg) were assigned to 3 treatment groups so that each treatment based on BW contained 9 animals. All groups received ad libitum TMR throughout the feeding trial until slaughter (from 24 to 30 months of age) and treatments were as follows: control, 1,000 g/kg TMR; treatment 1 (T1), 970 g/kg TMR and 30 g/kg MPB; treatment 2 (T2), 950 g/kg TMR and 50 g/kg MPB. Initial and final BW were not different among treatments. Resultant data were analyzed using general linear models of SAS. Average daily gain and feed efficiency were higher (p<0.05) for T1 than control, but there was no difference between control and T2. Plasma albumin showed low-, intermediate- and high-level (p<0.05) for control, T1 and T2, whereas non-esterified fatty acid was high-, intermediate- and high-level (p<0.05) for control, T1 and T2, respectively. Carcass weight, carcass rate, backfat thickness and rib eye muscle area were not affected by MPB supplementation, whereas quality and yield grades were highest (p<0.05) for T1 and T2, respectively. Daily feed costs were decreased by 0.5% and 0.8% and carcass prices were increased by 18.1% and 7.6% for T1 and T2 compared to control, resulting from substituting TMR with 30 and 50 g/kg MPB, respectively. In conclusion, the substituting TMR by 30 g/kg MPB may be a potential feed supplement approach to improve economic efficacy in the late fattening period of Hanwoo steers. PMID:26580440

  10. Effects of Chromium Methionine Supplementation on Blood Metabolites and Fatty Acid Profile of Beef during Late Fattening Period in Holstein Steers.

    PubMed

    Nejad, Jalil Ghassemi; Lee, Bae-Hun; Kim, Byong-Wan; Ohh, Sang-Jip; Sung, Kyung Il

    2016-03-01

    The objective of this study was to determine the effects of chromium methionine (Cr-Met) chelate supplementation on blood metabolites and fatty acid profile of beef from Holstein steers during late fattening period. Fifteen Holstein steers were allotted randomly into two groups including the control (non Cr-Met feeding, NCM, ave. body weight [BW] = 48325.7 kg) and the treatment (Cr-Met feeding for 4 months, 4CM, ave. BW = 48627.5 kg) group. The feeding amount of Cr-Met to animals was limited to 400 ppb/cow/d and was supplemented to total mixed ration. No difference in blood albumin, alkaline phosphatase, urea-nitrogen, calcium, creatine, glucose, total protein, triglyceride, and cholesterol were observed between the treatment groups (p>0.05). The level of high density lipoprotein was higher in the 4CM group than the NCM group, whereas low density lipoprotein was lower in the 4CM group (p<0.05). The fatty acid composition (caprate, laurate, myristate, pentadecanoate, palmitate, palmitoleate, margarate, cis-11 heptadodecanoate, stearate, oleate, trans-vaccenate, linoleate, cis-11 eicosenoate, docosa hexaenoic acid, and docosa pentaenoic acid) of the beef showed no difference between the two groups (p>0.05). The arachidonic acid level tended to be higher in the 4CM than the NCM group (p = 0.07). Cr-Met had no influence (p>0.05) on the ratio of saturated, unsaturated, unsaturated/saturated, monounsaturated/saturated and polyunsaturated/saturated fatty acids whereas the ratio of polyunsaturated fatty acids (PUFA) in the 4CM group was comparatively higher than the NCM group (p<0.05). This study concluded that feeding Cr-Met supplementation in 400 ppb/d to Holstein steers for 4 months during late fattening period can improve some blood metabolites and beef quality by increasing PUFA and gamma-linoleate compositions of beef. PMID:26950869

  11. Simulating the Antarctic ice sheet in the Late-Pliocene warm period: PLISMIP-ANT, an ice-sheet model intercomparison project

    NASA Astrophysics Data System (ADS)

    de Boer, Bas; Dolan, Aisling M.; Hill, Daniel J.; van de Wal, Roderik S. W.

    2014-05-01

    In the context of future climate change, understanding the nature and behaviour of ice sheets during warm intervals in Earth history is of fundamental importance. The Late-Pliocene Warm Period (also known as the PRISM interval: 3.29 to 2.97 million years before present) can serve as a potential analogue for projected future climates, with a global annual mean surface-air temperature warming of 1.76 C. Although Pliocene ice locations and surface extents are still poorly constrained, a significant contribution to sea-level rise should be expected from Greenland and West and, possibly, East Antarctica based on palaeo sea-level reconstructions. Here, we present results from simulations of the Antarctic ice sheet by means of an international Pliocene Ice Sheet Modeling Intercomparison Project (PLISMIP-ANT). We include an overview of the different ice-sheet models used and how specific model configurations influence the resulting Pliocene Antarctic ice sheet. For the experiments, ice-sheet models including the shallow ice and shelf approximations have been used to simulate the complete Antarctic domain (including grounded and floating ice). We compare the performance of the ice-sheet models in simulating modern control and Pliocene ice sheets by a suite of sensitivity experiments. Ice-sheet model forcing fields are taken from the PlioMIP results incorporating multiple coupled atmosphere-ocean general circulation models (GCM). We show that ice-sheet models simulate a present-day ice sheet which is comparable to the observations, and find no systematic biases introduced when using different GCM forcing relative to observational climate forcing. This project includes multiple ice-sheet models forced with multiple climate model output, from which a comprehensive assessment can be made as to the uncertainties of ice-sheet extent on Antarctica. These results may eventually serve as a new constraint on the extent of the Antarctic ice sheet during the Late-Pliocene Warm Period for use in climate modelling experiments.

  12. Effect of Medicinal Plant By-products Supplementation to Total Mixed Ration on Growth Performance, Carcass Characteristics and Economic Efficacy in the Late Fattening Period of Hanwoo Steers

    PubMed Central

    Lee, S. J.; Kim, D. H.; Guan, Le Luo; Ahn, S. K.; Cho, K. W.; Lee, Sung S.

    2015-01-01

    This study was conducted to evaluate the effect of medicinal plant by-products (MPB) supplementation to a total mixed ration (TMR) on growth, carcass characteristics and economic efficacy in the late fattening period of Hanwoo steers. Twenty seven steers (body weight [BW], 573±57 kg) were assigned to 3 treatment groups so that each treatment based on BW contained 9 animals. All groups received ad libitum TMR throughout the feeding trial until slaughter (from 24 to 30 months of age) and treatments were as follows: control, 1,000 g/kg TMR; treatment 1 (T1), 970 g/kg TMR and 30 g/kg MPB; treatment 2 (T2), 950 g/kg TMR and 50 g/kg MPB. Initial and final BW were not different among treatments. Resultant data were analyzed using general linear models of SAS. Average daily gain and feed efficiency were higher (p<0.05) for T1 than control, but there was no difference between control and T2. Plasma albumin showed low-, intermediate- and high-level (p<0.05) for control, T1 and T2, whereas non-esterified fatty acid was high-, intermediate- and high-level (p<0.05) for control, T1 and T2, respectively. Carcass weight, carcass rate, backfat thickness and rib eye muscle area were not affected by MPB supplementation, whereas quality and yield grades were highest (p<0.05) for T1 and T2, respectively. Daily feed costs were decreased by 0.5% and 0.8% and carcass prices were increased by 18.1% and 7.6% for T1 and T2 compared to control, resulting from substituting TMR with 30 and 50 g/kg MPB, respectively. In conclusion, the substituting TMR by 30 g/kg MPB may be a potential feed supplement approach to improve economic efficacy in the late fattening period of Hanwoo steers. PMID:26580440

  13. Update on adolescent motherhood and postpartum depression.

    PubMed

    McGuinness, Teena M; Medrano, Bonnie; Hodges, Ashley

    2013-02-01

    Adolescent motherhood is a common and costly phenomenon, with almost a half million American girls becoming mothers every year in the United States. Postpartum depression is also common, with an estimated 53% to 61% of teen mothers affected. Psychiatric nurses can intervene by recognizing the high rate of postpartum depression among teen girls, screening, and referring to treatment when necessary. PMID:23330798

  14. Postpartum hemorrhage: a continuing challenge.

    PubMed

    Lockhart, Evelyn

    2015-12-01

    Obstetric hemorrhage remains a leading cause of maternal morbidity and mortality worldwide. Many postpartum hemorrhages (PPHs) do not have identifiable risk factors; maternity units should therefore have obstetric hemorrhageprotocols in place for all parturients as every pregnancy has the potential to be complicated by hemorrhage. This review will examine the epidemiology of PPH as well as current recommendations for key elements in obstetric hemorrhage protocols. Recent advances in hematologic management of PPH will be also be reviewed, including: (1) recognition of hypofibrinogenemia as a risk factor for severe PPH, (2) use of antifibrinolytic therapy, and (3) strategies for fibrinogen replacement therapy. PMID:26637712

  15. Using animal models to study post-partum psychiatric disorders

    PubMed Central

    Perani, C V; Slattery, D A

    2014-01-01

    The post-partum period represents a time during which all maternal organisms undergo substantial plasticity in a wide variety of systems in order to ensure the well-being of the offspring. Although this time is generally associated with increased calmness and decreased stress responses, for a substantial subset of mothers, this period represents a time of particular risk for the onset of psychiatric disorders. Thus, post-partum anxiety, depression and, to a lesser extent, psychosis may develop, and not only affect the well-being of the mother but also place at risk the long-term health of the infant. Although the risk factors for these disorders, as well as normal peripartum-associated adaptations, are well known, the underlying aetiology of post-partum psychiatric disorders remains poorly understood. However, there have been a number of attempts to model these disorders in basic research, which aim to reveal their underlying mechanisms. In the following review, we first discuss known peripartum adaptations and then describe post-partum mood and anxiety disorders, including their risk factors, prevalence and symptoms. Thereafter, we discuss the animal models that have been designed in order to study them and what they have revealed about their aetiology to date. Overall, these studies show that it is feasible to study such complex disorders in animal models, but that more needs to be done in order to increase our knowledge of these severe and debilitating mood and anxiety disorders. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24527704

  16. The Physical and Social Environment of Sleep in Socioeconomically Disadvantaged Postpartum Women

    PubMed Central

    Doering, Jennifer

    2012-01-01

    Objective To describe the physical and social environment of sleep self-management in postpartum socioeconomically disadvantaged women. Design Descriptive, exploratory design. Setting Participants were recruited in the hospital after giving birth. Data were collected in participant homes after discharge. Participants Postpartum women on Medicaid with normal healthy infants. Methods Participants completed a survey about features within their physical and social sleep environment at 2 weeks postpartum. Participants then completed three days and nights of sleep diaries at both 4 and 8 weeks postpartum to document perceived awakenings, select sleep hygiene practices, bed sharing, and reasons for sleep disruption. Results The sleep environments of participants were dynamic from night to night. Bed sharing was common with nearly half of participants sharing with a partner, approximately 25 percent with the infant, and 20 percent with older children. Fifty-two percent of participants slept with the television on part (31%) or all (69%) of the night. Eight-five percent of participants drank caffeine and 24 percent smoked. Conclusions These results inform theory-driven postpartum sleep interventions. Modifications to the physical and social sleep environment that attend specifically to how sleep hygiene and environmental factors are manifested in the postpartum period have the potential to improve sleep for socioeconomically disadvantaged women. Future research is needed to articulate which changes can be effectively self-managed by mothers through nursing interventions. PMID:23181913

  17. Predictors of Recovery from Prenatal Depressive Symptoms from Pregnancy Through Postpartum

    PubMed Central

    Flynn, Heather A.; Lancaster, Christie; Marcus, Sheila M.; McDonough, Susan C.; Volling, Brenda L.; Lopez, Juan F.; Kaciroti, Niko; Vazquez, Delia M.

    2012-01-01

    Abstract Background Identifying predictors of the course of depressive symptoms from pregnancy through postpartum is important to inform clinical interventions. Methods This longitudinal study investigated predictors of recovery from prenatal elevated depressive symptoms in the postpartum period. Forty-one pregnant women completed demographic, interpersonal, and psychosocial self-report assessment measures at 32 weeks of gestation and again 12 weeks postpartum. Results Of those with elevated depressive symptoms, defined as a Beck Depression Inventory-II (BDI-II) score ?10, at the prenatal baseline, 39% (n=16) recovered to nonelevated symptom levels postpartum, whereas 61% (n=25) experienced sustained elevated symptoms. Women who recovered evidenced significantly lower baseline depression severity and more frequent engagement in physical activity and cohabitated with a romantic partner. In multiparous women (n=25), history of past postpartum depression (PPD) differentiated between those with transient and those with persisting symptoms, although history of lifetime depression did not. None of the additional demographic, interpersonal, or psychosocial variables investigated differentiated between groups. Logistic regression analysis showed prenatal depression severity and exercise frequency as predictors of recovery postpartum. Conclusions Results suggest most women will not experience spontaneous recovery. Women with prenatal heightened symptom severity and previous experiences with PPD are acutely vulnerable to experience sustained symptoms. In contrast, having a cohabitating partner and engagement in prenatal exercise predicted symptom improvement. Physical exercise may be an important clinical recommendation, as it may improve mood. Given the small sample size, these results are preliminary. Implications and future research recommendations are discussed. PMID:22060255

  18. Postpartum family planning and health needs of women of low income in Istanbul.

    PubMed

    Bulut, A; Turan, J M

    1995-01-01

    This study was designed to learn what types of postpartum health and family planning services are most appropriate for couples with low incomes living in Istanbul, Turkey. The methods used included focus groups, site visits, questionnaires for postpartum women, and a self-administered questionnaire for health-care providers. By five months postpartum, 86 percent of the women surveyed were using some method of family planning. Many couples used withdrawal, starting immediately upon resumption of intercourse after childbirth, intending to use a medical method after menses resumed. However, only 34 percent of users had begun to use a medical method by five months after childbirth. The health facilities visited provide little information and counseling about the postpartum period. Women said that they wanted information on infant care, breast-feeding, and family planning, either before becoming pregnant or while they are pregnant. Most women prefer that postpartum services address the needs of the whole family, not only those of the baby or the mother. Recommendations for the timing, mode, and content of postpartum health and family planning services are made based on the study's findings. PMID:7618198

  19. The role of body image in prenatal and postpartum depression: a critical review of the literature.

    PubMed

    Silveira, Marushka L; Ertel, Karen A; Dole, Nancy; Chasan-Taber, Lisa

    2015-06-01

    Maternal depression increases risk of adverse perinatal outcomes, and recent evidence suggests that body image may play an important role in depression. This systematic review identifies studies of body image and perinatal depression with the goal of elucidating the complex role that body image plays in prenatal and postpartum depression, improving measurement, and informing next steps in research. We conducted a literature search of the PubMed database (1996-2014) for English language studies of (1) depression, (2) body image, and (3) pregnancy or postpartum. In total, 19 studies matched these criteria. Cross-sectional studies consistently found a positive association between body image dissatisfaction and perinatal depression. Prospective cohort studies found that body image dissatisfaction predicted incident prenatal and postpartum depression; findings were consistent across different aspects of body image and various pregnancy and postpartum time periods. Prospective studies that examined the reverse association found that depression influenced the onset of some aspects of body image dissatisfaction during pregnancy, but few evaluated the postpartum onset of body image dissatisfaction. The majority of studies found that body image dissatisfaction is consistently but weakly associated with the onset of prenatal and postpartum depression. Findings were less consistent for the association between perinatal depression and subsequent body image dissatisfaction. While published studies provide a foundation for understanding these issues, methodologically rigorous studies that capture the perinatal variation in depression and body image via instruments validated in pregnant women, consistently adjust for important confounders, and include ethnically diverse populations will further elucidate this association. PMID:25895137

  20. Trajectories of depressive symptoms over two years postpartum among overweight or obese women

    PubMed Central

    Lee, Chien-Ti; Stroo, Marissa; Fuemmeler, Bernard; Malhotra, Rahul; Østbye, Truls

    2014-01-01

    Background Although depressive symptoms are common postpartum, few studies have followed women beyond 12 months postpartum to investigate changes in the number and severity of these symptoms over time, especially in overweight and obese women. Using two complementary analytical methods, this study aims to identify trajectories of depressive symptoms over two years postpartum among overweight or obese mothers, and assess the demographic, socio-economic , and health covariates for these trajectories. Methods Using longitudinal data from two behavioral intervention studies (KAN-DO and AMP; N = 844), we used latent growth modeling to identify the overall trajectory of depressive symptoms and how it was related to key covariates. Next, we used latent class growth analysis to assess the heterogeneity in the depressive symptom trajectories over time, and thereby, identify subgroups of women with distinct trajectories. Findings The overall trajectory of depressive symptoms over two years postpartum was relatively stable in our sample. However, the presence of three distinct latent class trajectories [stable-low (82.5%), decreasing symptoms (7.3%) and increasing symptoms (10.2%)], identified based on trajectory shape and mean depressive symptom score, supported heterogeneity in depressive symptom trajectories over time. Lower maternal education was related to a higher symptom score, and poorer subjective health status at baseline predicted inclusion in the increasing symptoms trajectory. Conclusions In some overweight or obese mothers postpartum depressive symptoms do not resolve quickly. Practitioners should be aware of this phenomenon and continue to screen for depression for longer periods of time postpartum. PMID:25213748

  1. The role of body image in prenatal and postpartum depression: a critical review of the literature

    PubMed Central

    Silveira, Marushka L.; Ertel, Karen A.; Dole, Nancy

    2016-01-01

    Maternal depression increases risk of adverse perinatal outcomes, and recent evidence suggests that body image may play an important role in depression. This systematic review identifies studies of body image and perinatal depression with the goal of elucidating the complex role that body image plays in prenatal and postpartum depression, improving measurement, and informing next steps in research. We conducted a literature search of the PubMed database (1996– 2014) for English language studies of (1) depression, (2) body image, and (3) pregnancy or postpartum. In total, 19 studies matched these criteria. Cross-sectional studies consistently found a positive association between body image dissatisfaction and perinatal depression. Prospective cohort studies found that body image dissatisfaction predicted incident prenatal and postpartum depression; findings were consistent across different aspects of body image and various pregnancy and postpartum time periods. Prospective studies that examined the reverse association found that depression influenced the onset of some aspects of body image dissatisfaction during pregnancy, but few evaluated the postpartum onset of body image dissatisfaction. The majority of studies found that body image dissatisfaction is consistently but weakly associated with the onset of prenatal and postpartum depression. Findings were less consistent for the association between perinatal depression and subsequent body image dissatisfaction. While published studies provide a foundation for understanding these issues, methodologically rigorous studies that capture the perinatal variation in depression and body image via instruments validated in pregnant women, consistently adjust for important confounders, and include ethnically diverse populations will further elucidate this association. PMID:25895137

  2. Single rice growth period was prolonged by cultivars shifts, but yield was damaged by climate change during 1981-2009 in China, and late rice was just opposite.

    PubMed

    Tao, Fulu; Zhang, Zhao; Shi, Wenjiao; Liu, Yujie; Xiao, Dengpan; Zhang, Shuai; Zhu, Zhu; Wang, Meng; Liu, Fengshan

    2013-10-01

    Based on the crop trial data during 1981-2009 at 57 agricultural experimental stations across the North Eastern China Plain (NECP) and the middle and lower reaches of Yangtze River (MLRYR), we investigated how major climate variables had changed and how the climate change had affected crop growth and yield in a setting in which agronomic management practices were taken based on actual weather. We found a significant warming trend during rice growing season, and a general decreasing trend in solar radiation (SRD) in the MLRYR during 1981-2009. Rice transplanting, heading, and maturity dates were generally advanced, but the heading and maturity dates of single rice in the MLRYR (YZ_SR) and NECP (NE_SR) were delayed. Climate warming had a negative impact on growth period lengths at about 80% of the investigated stations. Nevertheless, the actual growth period lengths of YZ_SR and NE_SR, as well as the actual length of reproductive growth period (RGP) of early rice in the MLRYR (YZ_ER), were generally prolonged due to adoption of cultivars with longer growth period to obtain higher yield. In contrast, the actual growth period length of late rice in the MLRYR (YZ_LR) was shortened by both climate warming and adoption of early mature cultivars to prevent cold damage and obtain higher yield. During 1981-2009, climate warming and decrease in SRD changed the yield of YZ_ER by -0.59 to 2.4%; climate warming during RGP increased the yield of YZ_LR by 8.38-9.56%; climate warming and decrease in SRD jointly reduced yield of YZ_SR by 7.14-9.68%; climate warming and increase in SRD jointly increased the yield of NE_SR by 1.01-3.29%. Our study suggests that rice production in China has been affected by climate change, yet at the same time changes in varieties continue to be the major factor driving yield and growing period trends. PMID:23661287

  3. Effects of lactation on bone mineral content in healthy postpartum women

    SciTech Connect

    Hayslip, C.C.; Klein, T.A.; Wray, H.L.; Duncan, W.E.

    1989-04-01

    Bone mineral contents were estimated by dual photon absorptiometry of the lumbar spine (L2-L4) and single photon absorptiometry of the mid- and distal radius in 19 healthy women on their second postpartum day and at 6 months postpartum. All bone mineral measurements were performed by one technician, and the single and dual photon absorptiometry results were read by one observer. Daily oral calcium intakes were estimated from dietary histories obtained by a dietitian. Twelve women who breast-fed exclusively throughout the first 6 months postpartum were compared with seven formula-feeding women who did not breast-feed or who breast-fed for less than 3 months postpartum. No differences were found in age, parity, height, weight, or daily calcium intake between the breast- and formula-feeding women. Breast-feeding women had a significant decrease (averaging 6.5%) in bone mineral of the lumbar spine at 6 months postpartum as compared with 2 days postpartum (1.14 +/- 0.03 versus 1.22 +/- 0.03 g/cm2, mean +/- SEM; P less than .001), whereas no significant change occurred in the formula-feeding women at 6 months (1.24 +/- 0.03 versus 1.26 +/- 0.04 g/cm2). At 6 months postpartum, the breast-feeding women had a significantly lower mean bone mineral content of the lumbar spine than did formula-feeding women (P less than .05). No significant changes were noted in bone mineral content of the mid- or distal radius in either group of women during the period of evaluation. We conclude that during the first 6 months postpartum, breast-feeding is associated with bone mineral loss from the lumbar spine, but not from the mid- or distal radius.

  4. Antidepressant-like effects of omega-3 fatty acids in postpartum model of depression in rats.

    PubMed

    Arbabi, Leila; Baharuldin, Mohamad Taufik Hidayat; Moklas, Mohamad Aris Mohamad; Fakurazi, Sharida; Muhammad, Sani Ismaila

    2014-09-01

    Postpartum depression (PPD) is a psychiatric disorder that occurs in 10-15% of childbearing women. It is hypothesized that omega-3 fatty acids, which are components of fish oil, may attenuate depression symptoms. In order to examine this hypothesis, the animal model of postpartum depression was established in the present study. Ovariectomized female rats underwent hormone-simulated pregnancy (HSP) regimen and received progesterone and estradiol benzoate or vehicle for 23 days, mimicking the actual rat's pregnancy. The days after hormone termination were considered as the postpartum period. Forced feeding of menhaden fish oil, as a source of omega-3, with three doses of 1, 3, and 9g/kg/d, fluoxetine 15mg/kg/d, and distilled water 2ml/d per rat started in five postpartum-induced and one vehicle group on postpartum day 1 and continued for 15 consecutive days. On postpartum day 15, all groups were tested in the forced swimming test (FST) and open field test (OFT), followed by a biochemical assay. Results showed that the postpartum-induced rats not treated with menhaden fish oil, exhibited an increase in immobility time seen in FST, hippocampal concentration of corticosterone and plasmatic level of corticosterone, and pro-inflammatory cytokines. These depression-related effects were attenuated by supplementation of menhaden fish oil with doses of 3 and 9g/kg. Moreover, results of rats supplemented with menhaden fish oil were comparable to rats treated with the clinically effective antidepressant, fluoxetine. Taken together, these results suggest that menhaden fish oil, rich in omega-3, exerts beneficial effect on postpartum depression and decreases the biomarkers related to depression such as corticosterone and pro-inflammatory cytokines. PMID:24867329

  5. Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

    PubMed Central

    Lee, Minsun; Wen, Kuang-Yi; Hui, Sui-kuen Azor; Roussi, Pagona; Hernandez, Enrique

    2015-01-01

    This study evaluated a theory-guided cognitive-behavioral counseling (CBC) intervention for smoking cessation during pregnancy and postpartum. It also explored the mediating role of cognitive-affective variables on the impact of CBC. Underserved inner city pregnant women (N = 277) were randomized to the CBC or a best practice (BP) condition, each of which consisted of two prenatal and two postpartum sessions. Assessments were obtained at baseline, late pregnancy, and 1- and 5-months postpartum. An intent-to-treat analysis found no differences between the two groups in 7-day point-prevalence abstinence. However, a respondents-only analysis revealed a significantly higher cessation rate in the CBC (37.3 %) versus the BP (19.0 %) condition at 5-months postpartum follow-up. This effect was mediated by higher quitting self-efficacy and lower cons of quitting. CBC, based on the Cognitive-Social Health Information Processing model, has the potential to increase postpartum smoking abstinence by assessing and addressing cognitive-affective barriers among women who adhere to the intervention. PMID:26335312

  6. Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women.

    PubMed

    Lee, Minsun; Miller, Suzanne M; Wen, Kuang-Yi; Hui, Sui-kuen Azor; Roussi, Pagona; Hernandez, Enrique

    2015-12-01

    This study evaluated a theory-guided cognitive-behavioral counseling (CBC) intervention for smoking cessation during pregnancy and postpartum. It also explored the mediating role of cognitive-affective variables on the impact of CBC. Underserved inner city pregnant women (N = 277) were randomized to the CBC or a best practice (BP) condition, each of which consisted of two prenatal and two postpartum sessions. Assessments were obtained at baseline, late pregnancy, and 1- and 5-months postpartum. An intent-to-treat analysis found no differences between the two groups in 7-day point-prevalence abstinence. However, a respondents-only analysis revealed a significantly higher cessation rate in the CBC (37.3 %) versus the BP (19.0 %) condition at 5-months postpartum follow-up. This effect was mediated by higher quitting self-efficacy and lower cons of quitting. CBC, based on the Cognitive-Social Health Information Processing model, has the potential to increase postpartum smoking abstinence by assessing and addressing cognitive-affective barriers among women who adhere to the intervention. PMID:26335312

  7. Maternal and paternal genetic diversity of ancient sheep in Estonia from the Late Bronze Age to the post-medieval period and comparison with other regions in Eurasia.

    PubMed

    Rannamäe, E; Lõugas, L; Niemi, M; Kantanen, J; Maldre, L; Kadõrova, N; Saarma, U

    2016-04-01

    Sheep were among the first domesticated animals to appear in Estonia in the late Neolithic and became one of the most widespread livestock species in the region from the Late Bronze Age onwards. However, the origin and historical expansion of local sheep populations in Estonia remain poorly understood. Here, we analysed fragments of the hypervariable D-loop of mitochondrial DNA (mtDNA; 213 bp) and the Y-chromosome SRY gene (130 bp) extracted from 31 archaeological sheep bones dated from approximately 800 BC to 1700 AD. The ancient DNA data of sheep from Estonia were compared with ancient sheep from Finland as well as a set of contemporary sheep breeds from across Eurasia in order to place them in a wider phylogeographical context. The analysis shows that: (i) 24 successfully amplified and analysed mtDNA sequences of ancient sheep cluster into two haplogroups, A and B, of which B is predominant; (ii) four of the ancient mtDNA haplotypes are novel; (iii) higher mtDNA haplotype diversity occurred during the Middle Ages as compared to other periods, a fact concordant with the historical context of expanding international trade during the Middle Ages; (iv) the proportion of rarer haplotypes declined during the expansion of sheep from the Near Eastern domestication centre to the northern European region; (v) three male samples showed the presence of the characteristic northern European haplotype, SNP G-oY1 of the Y-chromosome, and represent the earliest occurrence of this haplotype. Our results provide the first insight into the genetic diversity and phylogeographical background of ancient sheep in Estonia and provide basis for further studies on the temporal fluctuations of ancient sheep populations. PMID:26805771

  8. Intimate partner abuse before and during pregnancy as risk factors for postpartum mental health problems

    PubMed Central

    2014-01-01

    Background Although research has established the profound effects that intimate partner abuse can have on postpartum mental health, little is known regarding how this association may change as a function of the timing and type of abuse. This study examined associations of psychological, physical and sexual abuse experienced as adults before and during pregnancy with symptoms of postpartum mental health problems in a non-clinical sample of women. Methods English-speaking mothers aged 18 years and older in the metropolitan area of a large, Western Canadian city were recruited to participate in a study of women’s health after pregnancy. The study was advertised in hospitals, local newspapers, community venues, and relevant websites. One-hundred women completed standardized, self-report questionnaires during semi-structured interviews conducted by female research assistants at approximately 2 months postpartum. In addition to questions about their general health and well-being, participants answered questions about their experiences of intimate partner abuse and about their mental health during the postpartum period. Results Almost two-thirds (61.0%) of women reported postpartum mental health symptoms above normal levels, with 47.0% reporting symptoms at moderate or higher levels. The majority reported some form of intimate partner abuse before pregnancy (84.0%) and more than two-thirds (70.0%), during pregnancy; however, the abuse was typically minor in nature. Multivariate models revealed that women who experienced intimate partner abuse—whether before or during pregnancy—reported higher levels of postpartum mental health problems; however, associations differed as a function of the timing and type of abuse, as well as specific mental health symptoms. Multivariate models also showed that as the number of types of intimate partner abuse experienced increased, so did the negative effects on postpartum mental health. Conclusions Results of this study provide further evidence that intimate partner abuse is a risk factor for postpartum mental health problems. They also underscore the complex risks and needs associated with intimate partner abuse among postpartum women and support the use of integrated approaches to treating postpartum mental health problems. Future efforts should focus on the extent to which strategies designed to reduce intimate partner abuse also improve postpartum mental health and vice versus. PMID:24708777

  9. Comparing the estimation of postpartum hemorrhage using the weighting method and National Guideline with the postpartum hemorrhage estimation by midwives

    PubMed Central

    Golmakani, Nahid; Khaleghinezhad, Khosheh; Dadgar, Selmeh; Hashempor, Majid; Baharian, Nosrat

    2015-01-01

    Introduction: In developing countries, hemorrhage accounts for 30% of the maternal deaths. Postpartum hemorrhage has been defined as blood loss of around 500 ml or more, after completing the third phase of labor. Most cases of postpartum hemorrhage occur during the first hour after birth. The most common reason for bleeding in the early hours after childbirth is uterine atony. Bleeding during delivery is usually a visual estimate that is measured by the midwife. It has a high error rate. However, studies have shown that the use of a standard can improve the estimation. The aim of the research is to compare the estimation of postpartum hemorrhage using the weighting method and the National Guideline for postpartum hemorrhage estimation. Materials and Methods: This descriptive study was conducted on 112 females in the Omolbanin Maternity Department of Mashhad, for a six-month period, from November 2012 to May 2013. The accessible method was used for sampling. The data collection tools were case selection, observation and interview forms. For postpartum hemorrhage estimation, after the third section of labor was complete, the quantity of bleeding was estimated in the first and second hours after delivery, by the midwife in charge, using the National Guideline for vaginal delivery, provided by the Maternal Health Office. Also, after visual estimation by using the National Guideline, the sheets under parturient in first and second hours after delivery were exchanged and weighted. The data were analyzed using descriptive statistics and the t-test. Results: According to the results, a significant difference was found between the estimated blood loss based on the weighting methods and that using the National Guideline (weighting method 62.68 16.858 cc vs. National Guideline 45.31 13.484 cc in the first hour after delivery) (P = 0.000) and (weighting method 41.26 10.518 vs. National Guideline 30.24 8.439 in second hour after delivery) (P = 0.000). Conclusions: Natural child birth education by using the National Guideline can increase the accuracy of estimated blood loss. Therefore, training the personnel to use this guideline is recommended. However, It has less accuracy than 'sheet weighing. Consequently, usage of symptoms and the weighing method is recommended in cases of postpartum bleeding. PMID:26257803

  10. Weight Concerns, Mood, and Postpartum Smoking Relapse

    PubMed Central

    Levine, Michele D.; Marcus, Marsha D.; Kalarchian, Melissa A.; Houck, Patricia R.; Cheng, Yu

    2010-01-01

    Background The majority of women who quit smoking as a result of pregnancy will resume smoking during the first 6 months postpartum. Evidence suggests that changes in depressive symptoms, perceived stress, and concerns about weight may relate to postpartum smoking relapse. Purpose This study was designed to prospectively evaluate the relationship of mood and weight concerns to postpartum smoking among women who quit smoking during pregnancy. Methods Pregnant women who had quit smoking (N = 183) were recruited between February 2003 and November 2006. Women completed assessments of mood (depressive symptoms, perceived stress, positive and negative affect) and weight concerns during the third trimester of pregnancy, and at 6, 12, and 24 weeks postpartum. Self-reported smoking status was verified by expired-air carbon monoxide and salivary cotinine at each assessment. Cox regression analyses in which mood and weight concerns were treated as time dependent covariates were conducted in 2007 and 2009. Results By 24 weeks postpartum, 65% of women had resumed smoking. Smoking-related weight concerns increased risk of relapse, and positive affect and self-efficacy for weight management without smoking decreased risk of relapse postpartum. Moreover, after controlling for variables previously related to postpartum relapse, weight concerns remained significantly related to smoking relapse. Conclusions Smoking-related weight concerns and positive affect increase the likelihood that a woman will resume smoking postpartum. Moreover, weight concerns appear to be salient even in the context of other factors shown to affect postpartum smoking. This study suggests that interventions may need to address women’s weight concerns and mood to help sustain smoking abstinence after childbirth. PMID:20837285

  11. Risk factors associated with postpartum depression in the Saudi population

    PubMed Central

    Alharbi, Abeer A; Abdulghani, Hamza Mohammad

    2014-01-01

    Introduction Postpartum depression (PPD) is one of the major psychological disorders worldwide that affects both mother and child. The aim of this study was to correlate the risk of PPD with obstetric and demographic variables in Saudi females. Materials and methods Data were collected by interviewing females 8–12 weeks postpartum. PPD symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 10 or higher. Variables included in this study were age, education, occupation, parity, baby’s sex, pregnancy period, delivery type, hemoglobin level, anemia, and iron pills taken during pregnancy. Results Of the 352 postpartum females, the prevalence of PPD symptom risk was 117 (33.2%). Among the PPD symptomatic females, 66 (39.8%) had low hemoglobin levels, and 45 (40.5%) females were anemic during pregnancy (P≤0.05). These results suggest that early postpartum anemia, indicated by low hemoglobin level, is a significant risk factor for PPD (adjusted odds ratio 1.70, 95% confidence interval 1.05–2.74; P=0.03). Other variables, including age, parity, education, occupation, and delivery type, were not significantly correlated (P=0.15–0.95), but marginally indicative of the risk of depressive symptoms. Conclusion Low hemoglobin level and anemia during pregnancy were risk factors for PPD in Saudi females. Many other factors may be considered risk factors, such as age, occupation, and parity. Anemic women need more attention and to be checked regarding their PPD, and treated if necessary. PMID:24570584

  12. Postpartum care -- what's best for mother and baby.

    PubMed

    1997-01-01

    This special feature focuses on the care of mothers and infants during the postpartum period. Postpartum care should include prevention, early detection and treatment of complications and disease, and provision of advice. Most maternal mortality is due to postpartum hemorrhage within 4 hours of delivery, especially among anemic women. The uterus should be well contracted, and blood loss should be minimal. Sepsis, as indicated by fever, should be treated with antibiotics, but preventive measures include cleanliness and hygiene at delivery. Infections are more likely after cesarean section, prolonged labor, and early rupture of membranes. Handwashing prevents infection. Women should be encouraged to pass urine in the first 12 hours after delivery. Bathing frequently relieves painful episiotomy. 85% of neonatal deaths are due to preterm birth and low birth weight. Keeping the baby warm helps prevent low body temperature and infections. Parents need social support in adjusting to congenital defects. Infants with infections should be recognized on time, managed correctly, and referred to a district hospital. Breast feeding should start immediately or within the first hour of birth. Mothers need adequate rest and a nutritious diet. Breast tenderness is common during the first 4 days after delivery. Breast feeding on demand and proper hygiene helps to prevent infections and breast tenderness. Postpartum depression requires support from families and expert advice. Exclusive breast feeding inhibits ovulation until menstruation returns. Family planning may begin during lactation with a progestin-only pill, IUD, or diaphragm. HIV-positive mothers should discontinue breast feeding and take extreme care to mix formula with clean water. Mothers should be immunized with two doses of tetanus toxoid. Pregnant mothers need iodized oil and vitamin A supplements. Reproductive tract infections should be treated. PMID:12321360

  13. Late Holocene shoreline behavior in embayments of Lake Michigan: Influence of quasi-periodic lake-level variations and sediment supply

    SciTech Connect

    Thompson, T.A.; Baedke, S.J. . Indiana Geological Survey)

    1994-04-01

    Lake Michigan contains numerous former embayments into glacial deposits or bedrock. Many of the embayments contain dunes, spits, and captured lakes, but others contain arcuate strandplains of beach ridges. The strandplains are a geologic record of shoreline behavior and lake-level variation throughout the late Holocene. The larger strandplains show similar long-term patterns of beach-ridge development. The similar patterns are expected because variations in lake level are a primary control on shoreline behavior, and all embayments would have experienced relatively the same lake-level changes. Some variations in the long-term pattern of shoreline development do occur between strandplains. These dissimilarities are primarily a function of different rates of sediment supply to the shoreline of each embayment. Beach-ridge development within embayments can be represented on a rate of water level change versus rate of sediment supply diagram (Curray diagram) as three superimposed ovals on the positive rate of sediment supply side of the diagram. The three stacked ovals represent the three quasi-periodic lake-level variations defined by Thompson (1992) and show the position of the shoreline for a given time within the Curray diagram fields. For shorelines with a high rate of sediment supply, only the 30-year quasi-periodic variation would reach the aggradation line. For shorelines having significantly less sediment supply, rising lake level on the 150- and 600-year variations would force the 30-year oval across the aggradation line and well into the depositional and possibly the erosional transgression fields. Under these conditions erosion would occur that may remove, stack, or at least prevent one or more beach ridges from being developed.

  14. Postpartum Care and Contraception in Obese Women.

    PubMed

    Maclean, Courtney C; Thompson, Ivana S

    2016-03-01

    Postpartum obese women have an increased risk of breastfeeding difficulties and depression. Retaining the pregnancy weight at 6 months postpartum predicts long-term obesity. Risks for weight retention include excessive gestational weight gain, ethnicity, socioeconomic status, diet, exercise, depression, and duration of breastfeeding. Exercise and reducing total caloric intake promote postpartum weight loss. Intrauterine devices and contraceptive implants are the most effective contraceptives for obese women. Contraceptive pills, patches, and vaginal rings are effective options; however, obese women should be made aware of a potential increased risk of venous thromboembolism. Vasectomy and hysteroscopic sterilization carry the least surgical risk for obese women. PMID:26694498

  15. Relationship among insulin-like growth factor-I, blood metabolites and postpartum ovarian function in dairy cows.

    PubMed

    Zulu, Victor Chisha; Sawamukai, Yutaka; Nakada, Ken; Kida, Katsuya; Moriyoshi, Masaharu

    2002-10-01

    The relationship among nutritional status, systemic insulin-like growth factor-I (IGF-I) and ovarian function early postpartum were investigated. A total of 27 Holstein-Friesian cows, 10 that cycled normally within 20 days postpartum, 5 diagnosed with follicular cysts, 8 with persistent corpus luteum (CL) after the first ovulation postpartum and 4 with inactive ovaries were used for the study. Blood samples were collected 1-3 times per week, for 60 days pre- and postpartum, for IGF-I, progesterone, estradiol, free fatty acids (FFA), blood urea nitrogen (BUN), and aspartate aminotransferase (AST) determination. Inactive ovary and cystic cows had a higher body condition score before calving and lost more condition than normal or persistent CL cows. Immediately postpartum, IGF-I levels were higher and rose sharply in cows that cycled normally than in cystic, inactive ovary or persistent CL cows. At calving and early postpartum, FFA was higher in inactive ovary and cystic than in normal and persistent CL cows. There was a significant strong positive relationship between IGF-I and BUN, and strong negative relationships between IGF-I and FFA and AST in all groups. There was a positive relationship between serum IGF-I and estradiol in normal cystic and inactive ovary cows. This study found that overconditioned cows during the dry period or at calving, lost more body condition postpartum. These cows also had a deeper and longer period of negative energy balance (NEB), poor liver function and low circulating IGF-I concentrations early postpartum. Such cows were likely to have poor reproductive function as seen in development of cystic ovaries, persistent CL and inactive ovary. Changes in serum IGF-I early postpartum may help predict both nutritional and reproductive status in dairy cattle. PMID:12419863

  16. Spontaneous postpartum clearance of Plasmodium falciparum parasitemia in pregnant women, Benin.

    PubMed

    Bottero, Julie; Briand, Valrie; Agbowai, Carine; Doritchamou, Justin; Massougbodji, Achille; Cot, Michel

    2011-02-01

    The question of malaria in the postpartum period is controversial. Malaria was investigated during a randomized trial of intermittent preventive treatment in pregnancy in Benin. Women infected at delivery were tested for parasitemia in the early postpartum period; they had not received treatment unless they were symptomatic. Among the 35 of 1,346 infected women, parasitologic follow-up results could not be interpreted in 15 because they were treated for symptoms, 18 cleared parasitemia spontaneously within five days postpartum, and 2 had a strong decrease in parasitemia before being treated. Because the placenta is the privileged site for sequestration of parasites, it facilitates their persistence during pregnancy, and its elimination may rapidly induce their clearance. PMID:21292897

  17. Case Report: Postpartum hemorrhage associated with Dengue with warning signs in a term pregnancy and delivery

    PubMed Central

    Phi Hung, Le; Diem Nghi, Tran; Hoang Anh, Nguyen; Van Hieu, Mai; Thien Luan, Nguyen; Phuoc Long, Nguyen; Trong Thach, Than

    2015-01-01

    Background: Dengue infection during peripartum period, although rare in endemic regions, has challenged clinicians regarding its management, especially if a parturient woman experiences postpartum hemorrhage due to a classical risk factor of maternal bleeding. Case: A full-term pregnant Vietnamese woman was diagnosed with polyhydramnios and Dengue with warning signs (DWS). She was administered platelet transfusion prior to delivery and then gave birth to a healthy newborn. After active management of the third stage of labor, the patient suffered a postpartum hemorrhage which was caused by uterine atony and accompanied with thrombocytopenia. Therefore, we decided to administer uterotonic drugs and additionally transfuse platelets. Conclusion: We describe a case of postpartum hemorrhage caused by uterine atony and coinciding with Dengue infection during delivery period, which is a rare clinical entity. With timely detection and management, the patient was finally discharged without complications. PMID:26925224

  18. Changes in Experiences With Discrimination Across Pregnancy and Postpartum: Age Differences and Consequences for Mental Health

    PubMed Central

    Earnshaw, Valerie A.; Lewis, Tené T.; Reid, Allecia E.; Lewis, Jessica B.; Stasko, Emily C.; Tobin, Jonathan N.; Ickovics, Jeannette R.

    2015-01-01

    Objectives. We aimed to contribute to growing research and theory suggesting the importance of examining patterns of change over time and critical life periods to fully understand the effects of discrimination on health, with a focus on the period of pregnancy and postpartum and mental health outcomes. Methods. We used hierarchical linear modeling to examine changes across pregnancy and postpartum in everyday discrimination and the resulting consequences for mental health among predominantly Black and Latina, socioeconomically disadvantaged young women who were receiving prenatal care in New York City. Results. Patterns of change in experiences with discrimination varied according to age. Among the youngest participants, discrimination increased from the second to third trimesters and then decreased to lower than the baseline level by 1 year postpartum; among the oldest participants, discrimination decreased from the second trimester to 6 months postpartum and then returned to the baseline level by 1 year postpartum. Within-subjects changes in discrimination over time predicted changes in depressive and anxiety symptoms at subsequent points. Discrimination more strongly predicted anxiety symptoms among participants reporting food insecurity. Conclusions. Our results support a life course approach to understanding the impact of experiences with discrimination on health and when to intervene. PMID:24922166

  19. Antenatal psychosocial risk factors associated with adverse postpartum family outcomes.

    PubMed Central

    Wilson, L M; Reid, A J; Midmer, D K; Biringer, A; Carroll, J C; Stewart, D E

    1996-01-01

    OBJECTIVE: To determine the strength of the association between antenatal psychosocial risk factors and adverse postpartum outcomes in the family, such as assault of women by their partner, child abuse, postpartum depression, marital dysfunction and physical illness. DATA SOURCES: MEDLINE, Cinahl, Famli, Psych Abstracts and the Oxford Database of Perinatal Trials were searched from relevant articles published from Jan. 1, 1980, to Dec. 31, 1993, with the use of MeSH terms "depression, involutional," "child abuse," "child neglect," "domestic violence," "family," "marital adjustment," "family health," "newborn health," "child health," "physical illness," "social support," "psychosocial risk," "prediction," "risk factors," "obstetrics" and "prenatal care." Further articles were identified from bibliographies. STUDY SELECTION: Of the 370 articles identified through the search, 118 were included for review. Studies were included if they examined the association between psychosocial risk factors and the outcomes of interest. Articles were excluded if they were reviews of poor quality or they had one or more of the following features: insufficient description of the sample, a high attrition rate, a lack of standardized outcome measures, outcomes other than the ones of interest or results that had already been reported in a previous study. DATA EXTRACTION: The strength of evidence of each study was evaluated. On the basis of the evidence, each risk factor was assigned a rating of the strength of its association with each of the postpartum outcomes. The ratings were class A (good evidence of association), class B (fair evidence) and class C (no clear evidence). Of the 129 antenatal psychosocial risk factors studied, 15 were found to have a class A association with at least one of the postpartum outcomes. DATA SYNTHESIS: Child abuse and abuse of the mother by her partner were most strongly correlated (class A evidence) with a history of lack of social support, recent life stressors, psychiatric disturbance in the mother and an unwanted pregnancy. Child abuse was also strongly associated with a history of childhood violence in the mother or her partner, previous child abuse by the mother's partner, a poor relationship between the mother and her parents, low self-esteem in the mother and lack of attendance at prenatal classes. Postpartum abuse of the mother was also associated with a history of abuse of the mother, prenatal care not started until the third trimester and alcohol or drug abuse by the mother or her partner (class A evidence). Child abuse had a fair (class B) association with poor marital adjustment or satisfaction, current or past abuse of the mother and alcohol or drug abuse by the mother or her partner. There was class B evidence supporting an association between abuse of the mother and poor marital adjustment, traditional sex-role expectations, a history of childhood violence in the mother or her partner and low self-esteem in the mother. Postpartum depression was most strongly associated with poor marital adjustment, recent life stressors, antepartum depression (class A evidence), but was also associated with lack of social support, abuse of the mother and a history of psychiatric disorder in the mother (class B evidence). Marital dysfunction was associated with poor marital adjustment before the birth and traditional sex-role expectations (class A evidence), and physical illness was correlated with recent life stressors (class B evidence). CONCLUSIONS: Psychosocial risk factors during the antenatal period may herald postpartum morbidity. Research is required to determine whether detection of these risk factors may lead to interventions that improve postpartum family outcomes. PMID:8634957

  20. Postpartum Care - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... List of All Topics All Postpartum Care - Multiple Languages To use the sharing features on this page, please enable JavaScript. Bosnian (Bosanski) Chinese - Traditional (????) Hindi (??????) Japanese (???) Korean (???) Portuguese (portugus) Somali (af Soomaali) Spanish (espaol) ...

  1. Traditions and plant use during pregnancy, childbirth and postpartum recovery by the Kry ethnic group in Lao PDR

    PubMed Central

    2011-01-01

    Background Activities and diet during the postpartum period are culturally dictated in many Southeast Asian cultures, and a period of confinement is observed. Plants play an important role in recovery during the postpartum period in diet and traditional medicine. Little is known of the Kry, a small ethnic group whose language was recently described, concerning its traditions and use of plants during pregnancy, parturition, postpartum recovery and infant healthcare. This research aims to study those traditions and identify medicinal plant use. Methods Data were collected in the 3 different Kry villages in Khammouane province, Lao PDR, through group and individual interviews with women by female interviewers. Results A total of 49 different plant species are used in women's healthcare. Plant use is culturally different from the neighboring Brou and Saek ethnic groups. Menstruation, delivery and postpartum recovery take place in separate, purpose-built, huts and a complex system of spatial restrictions is observed. Conclusions Traditions surrounding childbirth are diverse and have been strictly observed, but are undergoing a shift towards those from neighboring ethnic groups, the Brou and Saek. Medicinal plant use to facilitate childbirth, alleviate menstruation problems, assist recovery after miscarriage, mitigate postpartum haemorrhage, aid postpartum recovery, and for use in infant care, is more common than previously reported (49 species instead of 14). The wealth of novel insights into plant use and preparation will help to understand culturally important practices such as traditional delivery, spatial taboos, confinement and dietary restrictions, and their potential in modern healthcare. PMID:21569234

  2. Further studies of post-partum ovulation timing in mice.

    PubMed

    Bingel, A S

    1982-07-01

    The times at which post-partum ovulation occurred relative to the times of parturition, were similar for CD-1 mice exposed either to 18L:6D of 10L:14D and comparable to the times reported previously for mice of the same strain kept under 14L:10D. When parturition took place close to 'lights off', ovulation tended to occur 13--14 h after littering (i.e. during the last part of the same dark period and the early part of the next light period). Conversely, when parturition took place closer to 'lights on', ovulation tended to be delayed by the equivalent number of hours so that it occurred during the last part of the next dark period and early part of the subsequent light period. This confirmation and extension of earlier work suggests that mice of this strain would be useful for investigating hormonal events associated with the timing of post-partum ovulation in the mouse. PMID:7201517

  3. Postpartum depression: psychoneuroimmunological underpinnings and treatment

    PubMed Central

    Anderson, George; Maes, Michael

    2013-01-01

    Postpartum depression (PPD) is common, occurring in 10%15% of women. Due to concerns about teratogenicity of medications in the suckling infant, the treatment of PPD has often been restricted to psychotherapy. We review here the biological underpinnings to PPD, suggesting a powerful role for the tryptophan catabolites, indoleamine 2,3-dixoygenase, serotonin, and autoimmunity in mediating the consequences of immuno-inflammation and oxidative and nitrosative stress. It is suggested that the increased inflammatory potential, the decreases in endogenous anti-inflammatory compounds together with decreased omega-3 poly-unsaturated fatty acids, in the postnatal period cause an inflammatory environment. The latter may result in the utilization of peripheral inflammatory products, especially kynurenine, in driving the central processes producing postnatal depression. The pharmacological treatment of PPD is placed in this context, and recommendations for more refined and safer treatments are made, including the better utilization of the antidepressant, and the anti-inflammatory and antioxidant effects of melatonin. PMID:23459664

  4. Maternal postpartum morbidity in Marrakech: what women feel what doctors diagnose?

    PubMed Central

    2013-01-01

    Background Information about postpartum maternal morbidity in developing countries is limited and often based on information obtained from hospitals. As a result, the reports do not usually reflect the true magnitude of obstetric complications and poor management at delivery. In Morocco, little is known about obstetric maternal morbidity. Our aim was to measure and identify the causes of postpartum morbidity 6 weeks after delivery and to compare women’s perception of their health during this period to their medical diagnoses. Methods We did a cross-sectional study of all women, independent of place of delivery, in Al Massira district, Marrakech, from December 2010 to March 2012. All women were clinically examined 6 to 8 weeks postpartum for delivery-related morbidities. We coupled a clinical examination with a questionnaire and laboratory tests (hemoglobin). Results During postpartum consultation, 44% of women expressed at least one complaint. Complaints related to mental health were most often reported (10%), followed by genital infections (8%). Only 9% of women sought treatment for their symptoms before the postpartum visit. Women who were aged ≥30 years, employed, belonged to highest socioeconomic class, and had obstetric complications during birth or delivered in a private facility or at home were more likely to report a complaint. Overall, 60% of women received a medical diagnosis related to their complaint, most of which were related to gynecological problems (22%), followed by laboratory-confirmed anemia (19%). Problems related to mental health represented only 5% of the diagnoses. The comparative analysis between perceived and diagnosed morbidity highlighted discrepancies between complaints that women expressed during their postpartum consultation and those they received from a physician. Conclusions A better understanding of postpartum complaints is one of the de facto essential elements to ensuring quality of care for women. Sensitizing and training clinicians in mental health services is important to respond to women’s needs and improve the quality of maternal care. PMID:24314155

  5. Effects of an energy-dense diet and nicotinic acid supplementation on production and metabolic variables of primiparous or multiparous cows in periparturient period.

    PubMed

    Tienken, Reka; Kersten, Susanne; Frahm, Jana; Meyer, Ulrich; Locher, Lena; Rehage, Jrgen; Huber, Korinna; Kenz, kos; Sauerwein, Helga; Mielenz, Manfred; Dnicke, Sven

    2015-01-01

    It is well observed that feeding energy-dense diets in dairy cows during the dry period can cause metabolic imbalances after parturition. Especially dairy cows with high body condition score (BCS) and fed an energy-dense diet were prone to develop production diseases due to metabolic disturbances postpartum. An experiment was conducted to determine the effects of an energy-dense diet and nicotinic acid (NA) on production and metabolic variables of primiparous and multiparous cows in late pregnancy and early lactation which were not pre-selected for high BCS. Thirty-six multiparous and 20 primiparous German Holstein cows with equal body conditions were fed with energy-dense (60% concentrate/40% roughage mixture; HC group) or adequate (30% concentrate/70% roughage mixture; LC group) diets prepartum. After parturition, concentrate proportion was dropped to 30% for all HC and LC groups and was increased to 50% within 16days for LC and within 24days for HC cows. In addition, half of the cows per group received 24g NA supplement per day and cow aimed to attenuate the lipid mobilisation postpartum. Feeding energy-dense diets to late-pregnant dairy cows elevated the dry matter (p<0.001) and energy intake (p<0.001) as well as the energy balance (p<0.001) without affecting the BCS (p=0.265) during this period. However, this did not result in any metabolic deviation postpartum as the effects of prepartum concentrate feeding were not carried over into postpartum period. Multiparous cows responded more profoundly to energy-dense feeding prepartum compared with primiparous cows, and parity-related differences in the transition from late pregnancy to lactation were obvious pre- and postpartum. The supplementation with 24g NA did not reveal any effect on energy metabolism. This study clearly showed that energy-dense feeding prepartum did not result in metabolic imbalances postpartum in multiparous and primiparous cows not selected for high BCS. A genetic predisposition for an anabolic metabolic status as indicated by high BCS may be crucial for developing production diseases at the onset of lactation. PMID:26305382

  6. Isotopic evidence for divergent diets and mobility patterns in the Atacama Desert, northern Chile, during the Late Intermediate Period (AD 900-1450).

    PubMed

    Santana-Sagredo, Francisca; Lee-Thorp, Julia A; Schulting, Rick; Uribe, Mauricio

    2015-03-01

    The decline of the Tiwanaku state saw the emergence of two new cultures-Pica-Tarapacá and Atacama-during the Late Intermediate Period in northern Chile. Archeological evidence suggests that both groups practised maize agriculture and pastoralism, but that their interaction zones differed significantly. Marine resources are common at Pica-Tarapacá sites, even those far from coast, while Atacama sites in the desert oases and precordilleran area seem to have directed their networks towards the highlands. Here we apply stable carbon, nitrogen, and oxygen isotope analysis on human bone and enamel to test dietary patterns and residential mobility at two sites, Pica 8 and Quitor 6, representing the Pica-Tarapacá and Atacama cultures, respectively. Our results show that diet at the two sites indeed differed: significant but variable consumption of marine resources and maize is indicated at Pica 8, despite being an inland site, while diet at Quitor 6 was based mainly on terrestrial resources. The use of seabird guano and llama dung as fertilizers and extreme aridity may have contributed to the high nitrogen isotope values observed in Pica 8 humans. The δ(18) O values in Pica 8 individuals are generally lower than for Quitor in spite of its greater distance from the Andes. All three isotopes suggest the presence of at least five nonlocals in the 30 measured at Pica 8. This evidence for human mobility is consistent with the high levels of trade and interaction observed in the archeological record, and begins to quantify the degree of movement of specific individuals. PMID:25385676

  7. Simulating the Antarctic ice sheet in the late-Pliocene warm period: PLISMIP-ANT, an ice-sheet model intercomparison project

    NASA Astrophysics Data System (ADS)

    de Boer, B.; Dolan, A. M.; Bernales, J.; Gasson, E.; Goelzer, H.; Golledge, N. R.; Sutter, J.; Huybrechts, P.; Lohmann, G.; Rogozhina, I.; Abe-Ouchi, A.; Saito, F.; van de Wal, R. S. W.

    2015-05-01

    In the context of future climate change, understanding the nature and behaviour of ice sheets during warm intervals in Earth history is of fundamental importance. The late Pliocene warm period (also known as the PRISM interval: 3.264 to 3.025 million years before present) can serve as a potential analogue for projected future climates. Although Pliocene ice locations and extents are still poorly constrained, a significant contribution to sea-level rise should be expected from both the Greenland ice sheet and the West and East Antarctic ice sheets based on palaeo sea-level reconstructions. Here, we present results from simulations of the Antarctic ice sheet by means of an international Pliocene Ice Sheet Modeling Intercomparison Project (PLISMIP-ANT). For the experiments, ice-sheet models including the shallow ice and shelf approximations have been used to simulate the complete Antarctic domain (including grounded and floating ice). We compare the performance of six existing numerical ice-sheet models in simulating modern control and Pliocene ice sheets by a suite of five sensitivity experiments. We include an overview of the different ice-sheet models used and how specific model configurations influence the resulting Pliocene Antarctic ice sheet. The six ice-sheet models simulate a comparable present-day ice sheet, considering the models are set up with their own parameter settings. For the Pliocene, the results demonstrate the difficulty of all six models used here to simulate a significant retreat or re-advance of the East Antarctic ice grounding line, which is thought to have happened during the Pliocene for the Wilkes and Aurora basins. The specific sea-level contribution of the Antarctic ice sheet at this point cannot be conclusively determined, whereas improved grounding line physics could be essential for a correct representation of the migration of the grounding-line of the Antarctic ice sheet during the Pliocene.

  8. How do memory and attention change with pregnancy and childbirth? A controlled longitudinal examination of neuropsychological functioning in pregnant and postpartum women.

    PubMed

    Logan, Dustin M; Hill, Kyle R; Jones, Rochelle; Holt-Lunstad, Julianne; Larson, Michael J

    2014-01-01

    Current literature on cognitive functioning in pregnancy and postpartum is mixed, with most research showing deficits in memory and attention during pregnancy or no difference between pregnant participants and controls with little emphasis on the postpartum period. In the current study, we used a longitudinal controlled design and 42 primarily not depressed participants to compare pregnant women in the third trimester and approximately three months postpartum with matched controls over the same time period on neuropsychological domains including memory, attention, learning, visuospatial, and executive functioning. We also evaluated the role of mood and quality of life as potential moderators of cognitive functioning in pregnancy/postpartum. Results indicated no differences between controls and pregnant/postpartum women on neuropsychological measures at any time points. Self-reported memory difficulties, however, were higher in the pregnant/postpartum women. Pregnant and postpartum women had worse self-reported mood and quality of life than controls. Mood and quality of life slightly moderated specific measures of attention and verbal fluency; however, neither mood nor quality of life moderated overall neuropsychological functioning in either group. Number of previous pregnancies had no effect on the study findings. Results suggest differences in subjective memory complaints, but no differences in objective neuropsychological test results between controls and pregnant/postpartum women who are primarily not diagnosed with depression. PMID:24820853

  9. Effect of propylene glycol on adipose tissue mobilization in postpartum over-conditioned Holstein cows.

    PubMed

    Bjerre-Harpøth, V; Storm, A C; Eslamizad, M; Kuhla, B; Larsen, M

    2015-12-01

    Our objective was to investigate the quantitative and qualitative effects of propylene glycol (PG) allocation on postpartum adipose tissue mobilization in over-conditioned Holstein cows. Nine ruminally cannulated and arterially catheterized cows were, at parturition, randomly assigned to a ruminal pulse dose of either 500g of tap water (n=4) or 500g of PG (n=5) once a day. The PG was given with the morning feeding for 4 wk postpartum (treatment period), followed by a 4-wk follow-up period. All cows were fed the same prepartum and postpartum diets. At -16 (±3), 4 (±0), 15 (±1) and 29 (±2) days in milk (DIM), body composition was determined using the deuterium oxide dilution technique, liver and subcutaneous adipose tissue biopsies were collected, and mammary gland nutrient uptake was measured. Weekly blood samples were obtained during the experiment and daily blood samples were taken from -7 to 7 DIM. Postpartum feed intake and milk yield was not affected by PG allocation. The body content of lipid was not affected by treatment, but tended to decrease from 4 to 29 DIM with both treatments. Except for the first week postpartum, no difference in plasma nonesterified fatty acids concentration was noted between treatments in the treatment period. Yet, PG allocation resulted in decreased plasma concentrations of β-hydroxybutyrate (BHB) and increased plasma concentrations of glucose. In the follow-up period, plasma concentrations of nonesterified fatty acids, glucose, and BHB did not differ between treatments. Additionally, the change in abundance of proteins in adipose tissue biopsies from prepartum to 4 DIM was not affected by treatment. In conclusion, the different variables to assess body fat mobilization were concurrent and showed that a 4-wk postpartum PG allocation had limited effect on adipose tissue mobilization. The main effect was an enhanced glucogenic status with PG. No carry-over effect of PG allocation was recorded for production or plasma metabolites, and, hence, a new period of metabolic adaption to lactation seemed to occur with PG treatment after ceasing PG allocation. Thus, PG seemed to induce a 2-step adaption to lactation, reducing the immediate postpartum nadir and peak of plasma concentration of glucose and BHB, respectively; which is beneficial for postpartum cows at high risk of lipid-related metabolic diseases. PMID:26454303

  10. Impact of antenatal depression on perinatal outcomes and postpartum depression in Korean women

    PubMed Central

    Choi, Sae Kyung; Park, Yong Gyu; Park, In Yang; Ko, Hyun Sun; Shin, Jong Chul

    2014-01-01

    Background: Maternal prenatal mental health has been shown to be associated with adverse consequences for the mother and the child. However, studies considering the effect of prenatal depressive symptoms are lacking. The aim of this study was to examine the influence of antenatal depressive symptoms on obstetric outcomes and to determine associations between antenatal and postpartum depressions. Materials and Methods: This was a prospective cohort study. The Edinburgh postnatal depression scale (EPDS) questionnaire was completed by pregnant women receiving obstetrical care at Seoul St. Mary's hospital in the third trimester of gestation. The electronic medical records were reviewed after delivery and perinatal outcomes were evaluated. The association between antenatal and postpartum depression was analyzed using the EPDS questionnaire, which was completed by the same women within 2 months of delivery. Results: Of the 467 participants, 26.34% (n = 123) had antenatal depressive symptoms, with EPDS scores of ≥10. There were no significant perinatal outcomes associated with antenatal depressive symptoms. During the postpartum period, 192 of the women in the initial study cohort were given the EPDS again as a follow-up. Of the 192 participants, 56 (29.17%) scored >10. Spearman correlation coefficient between the antenatal and postpartum EPDS scores was 0.604, which was statistically significant (P < 0.001). Conclusion: Antenatal depression does not lead to unfavorable perinatal outcomes. However, screening for antenatal depression may be helpful to identify women at risk of postpartum depression. PMID:25535492

  11. Postpartum Exercise among Nigerian Women: Issues Relating to Exercise Performance and Self-Efficacy

    PubMed Central

    Adeniyi, A. F.; Ogwumike, O. O.; Bamikefa, T. R.

    2013-01-01

    Physical exercise during postpartum period is beneficial to mothers, and the health gains are abundantly reported. This study characterises the postpartum exercise profile of a group of Nigerian women and reports how their exercise self-efficacies are influenced by sociodemographic characteristics. Participants were women attending the two largest postnatal clinics in Ibadan, south-western Nigeria. A self-developed questionnaire assessed the socio-demographic and exercise profile of participants, while the Exercise Self-Efficacy Scale assessed their exercise self-efficacy. About two-third (61.0%) of the participants were not aware that they could undertake physical exercise to enhance postpartum health, and 109 (47.8%) were not engaged in any exercise. Those who exercised did so for less than three days/week, and 89% of the women did not belong to any exercise support group. Exercise self-efficacy was significantly (P < 0.05) associated with being in an exercise programme, age, employment, work hours/week, monthly income, and number of pregnancies. Most of the women were not aware they could engage in postpartum exercise, and about half were not undertaking it. More women with high compared to moderate exercise self-efficacy undertook the exercise. Efforts at increasing awareness, improving exercise self-efficacy and adoption of postpartum exercise are desirable among the Nigerian women. PMID:23844290

  12. The prevalence of early postpartum psychiatric morbidity in Dubai: a transcultural perspective.

    PubMed

    Abou-Saleh, M T; Ghubash, R

    1997-05-01

    There have been numerous studies of the prevalence of postpartum psychiatric illness and its putative risk factors in Western Europe and North America, but very few studies have been undertaken in developing countries, including the Arab world. A total of 95 women admitted to the New Dubai Hospital in Dubai, United Arab Emirates, for childbirth were studied. All subjects were assessed in the postpartum period using clinical and socio-cultural instruments, namely the Self-Reporting Questionnaire (SRQ) on day 2 and the Edinburgh Postnatal Depression Scale (EPDS) on day 7 after delivery. The prevalence of psychiatric morbidity was 24% according to the SRQ and 18% according to the EPDS. A number of psychosocial factors emerged as putative risk factors for postpartum psychiatric disturbance, including depressive illness. It is concluded that the prevalence of postpartum psychiatric morbidity and its risk factors in this Arab culture are similar to the results obtained in numerous previous studies conducted in industrialized countries. These findings have implications for the early detection and care of women at risk for postpartum psychiatric illness. PMID:9197909

  13. Urban minority womens perceptions of and preferences for postpartum contraceptive counseling

    PubMed Central

    Yee, Lynn; Simon, Melissa

    2011-01-01

    Objective Focused antenatal contraceptive counseling about postpartum contraception may reduce the risk of contraceptive nonuse and misuse, although the optimal timing, content, and communication style of such counseling remain controversial. This study used an in-depth qualitative approach in a population of young, postpartum, urban minority women in order to examine womens perspectives toward the optimal provision of comprehensive contraceptive counseling. Methods Brief surveys and semi-structured interviews were conducted with 30 consenting postpartum women. In-person one-on-one interviews were then reviewed for themes, using an iterative process. Qualitative analysis techniques identifying emergent themes were applied to interview data. Results In this cohort of African American (63%) and Hispanic (37%) women (median age 26), 73% had unplanned pregnancies. Women preferred frequent, short sessions of provider-initiated comprehensive contraceptive counseling throughout the antepartum period with reinforcement of decisions while postpartum. Participants valued patient-centered counseling that is inclusive of all appropriate methods and personalized to individual needs. Conclusion We recommend that frequent, provider-initiated, multiple-modality discussions of appropriate postpartum contraceptive options should take place throughout pregnancy in an open, individualized manner. Further work should address the long-term effects of improved patient-centered antenatal contraceptive counseling on rates of unintended pregnancy. PMID:21323851

  14. Use of prostaglandin F2 alpha as a postpartum reproductive management tool for lactating dairy cows.

    PubMed

    Pankowski, J W; Galton, D M; Erb, H N; Guard, C L; Grhn, Y T

    1995-07-01

    This study compared three programs for reproductive management of the postpartum period for reproductive performance and net economic benefit within three dairy herds (n = 1624 cows). Cows on one program received PGF alpha injection at 25 to 32 d postpartum for reproductive therapy, and cows on a second program received additional PGF2 alpha at 39 to 46 d postpartum for synchronization of estrus. These programs were compared with a postpartum program of rectal palpation based on veterinary intervention. Survival analysis indicated that cows receiving PGF2 alpha for reproductive therapy and synchronization of estrus had an 11% higher rate of first AI and 10% higher rate of pregnancy than did cows receiving the rectal palpation. No differences existed between the cows receiving rectal palpation and those receiving the PGF2 alpha. Because overall conception rates and conception rates at first AI did not differ among programs, the improved reproductive performance of cows receiving PGF2 alpha for both therapy and synchronization may be attributed to greater synchronization of estrus, which resulted in improved estrus detection. A partial budget indicated that the PGF2 alpha programs were less expensive than the rectal palpation program. When PGF2 alpha was used for postpartum reproductive therapy and synchronization of estrus, reproductive performance and net economic benefit were increased compared with those of the other programs. PMID:7593841

  15. Maternity leave duration and postpartum mental and physical health: implications for leave policies.

    PubMed

    Dagher, Rada K; McGovern, Patricia M; Dowd, Bryan E

    2014-04-01

    This study examines the association of leave duration with depressive symptoms, mental health, physical health, and maternal symptoms in the first postpartum year, using a prospective cohort design. Eligible employed women, eighteen years or older, were interviewed in person at three Minnesota hospitals while hospitalized for childbirth in 2001. Telephone interviews were conducted at six weeks (N = 716), twelve weeks (N = 661), six months (N = 625), and twelve months (N = 575) after delivery. Depressive symptoms (Edinburgh Postnatal Depression Scale), mental and physical health (SF-12 Health Survey), and maternal childbirth-related symptoms were measured at each time period. Two-stage least squares analysis showed that the relationship between leave duration and postpartum depressive symptoms is U-shaped, with a minimum at six months. In the first postpartum year, an increase in leave duration is associated with a decrease in depressive symptoms until six months postpartum. Moreover, ordinary least squares analysis showed a marginally significant linear positive association between leave duration and physical health. Taking leave from work provides time for mothers to rest and recover from pregnancy and childbirth. Findings indicate that the current leave duration provided by the Family and Medical Leave Act, twelve weeks, may not be sufficient for mothers at risk for or experiencing postpartum depression. PMID:24305845

  16. Assessment of psychometric properties of the Postpartum Bonding Questionnaire (PBQ) in Spanish mothers.

    PubMed

    Garcia-Esteve, Lluïsa; Torres, Anna; Lasheras, Gracia; Palacios-Hernández, Bruma; Farré-Sender, Borja; Subirà, Susana; Valdés, Manuel; Brockington, Ian Fraser

    2016-04-01

    The Postpartum Bonding Questionnaire (PBQ) was developed to assess mother-infant bonding disturbances in the postpartum period. The aim of this study was to examine the psychometric properties of the Spanish version of the PBQ in a sample of Spanish postpartum women. Eight hundred forty mothers were recruited in the postpartum visit (4-6 weeks after delivery): 513 from a gynecology unit (forming the general population sample) and 327 mothers from a perinatal psychiatry program (forming the clinical sample). All women were assessed by means of the Edinburgh Postnatal Depression Scale (EPDS) and the PBQ. Neither the original four-factor structure nor alternative structures (Reck et al. 2006; Wittkowski et al. 2010) were replicated by the confirmatory factor analyses. An exploratory factor analysis showed a four-factor solution. The Schmid-Leiman transformation found a general factor that accounted for 61 % of the variance of the PBQ. Bonding impairment showed higher associations with depressive symptomatology in both samples. The Spanish version of the PBQ showed adequate psychometric properties for use with clinical and general populations of Spanish postpartum women. The results suggest that the PBQ could be summarized by a general factor and confirm the utility of the use of the total score for detecting bonding impairment. PMID:26608303

  17. Association of Postpartum Maternal Morbidities with Children's Mental, Psychomotor and Language Development in Rural Bangladesh

    PubMed Central

    Tofail, F.; Hilaly, A.; Mehrin, F.; Shiraji, S.; Banu, S.; Huda, S.N.

    2012-01-01

    Little is known from developing countries about the effects of maternal morbidities diagnosed in the postpartum period on children's development. The study aimed to document the relationships of such morbidities with care-giving practices by mothers, children's developmental milestones and their language, mental and psychomotor development. Maternal morbidities were identified through physical examination at 6-9 weeks postpartum (n=488). Maternal care-giving practices and postnatal depression were assessed also at 6-9 weeks postpartum. Children's milestones of development were measured at six months, and their mental (MDI) and psychomotor (PDI) development, language comprehension and expression, and quality of psychosocial stimulation at home were assessed at 12 months. Several approaches were used for identifying the relationships among different maternal morbidities, diagnosed by physicians, with children's development. After controlling for the potential confounders, maternal anaemia diagnosed postpartum showed a small but significantly negative effect on children's language expression while the effects on language comprehension did not reach the significance level (p=0.085). Children's development at 12 months was related to psychosocial stimulation at home, nutritional status, education of parents, socioeconomic status, and care-giving practices of mothers at six weeks of age. Only a few mothers experienced each specific morbidity, and with the exception of anaemia, the sample-size was insufficient to make a conclusion regarding each specific morbidity. Further research with a sufficient sample-size of individual morbidities is required to determine the association of postpartum maternal morbidities with children's development. PMID:22838161

  18. An Intervention to Extend Breastfeeding Among Black and Latina Postpartum Mothers

    PubMed Central

    Howell, Elizabeth A.; Bodnar-Deren, Susan; Balbierz, Amy; Parides, Michael; Bickell, Nina

    2014-01-01

    OBJECTIVE To compare breastfeeding duration in postpartum mothers randomized to a behavioral educational intervention versus enhanced usual care. STUDY DESIGN Randomized trial. Self-identified black and Latina early postpartum mothers were randomized to receive a behavioral educational intervention or enhanced usual care. The two-step intervention aimed to prepare and educate mothers about postpartum symptoms and experiences (including tips on breastfeeding and breast/nipple pain), bolster social support and self-management skills. Enhanced usual care participants received a list of community resources and received a 2-week control call. Intention-to-treat analyses examined breastfeeding duration (measured in weeks) for up to six-months of follow-up. This study is registered with clinicaltrial.gov (NCT01312883). RESULTS Five hundred forty mothers were randomized to the intervention (n=270) versus controls (n=270). Mean age was 28 (range 1846); 62% were Latina and 38% were black. Baseline sociodemographic, clinical, psycho-social, and breastfeeding characteristics were similar among intervention versus controls. Mothers in the intervention arm breastfed for longer duration than controls (median of 12.0 weeks versus 6.5 weeks, respectively, p =.02) Mothers in the intervention arm were less likely to quit breastfeeding over the first six-months postpartum (hazard ratio of 0.79; 95% CI 0.650.97). CONCLUSION A behavioral educational intervention increased breastfeeding duration among low-income, self-identified black and Latina mothers during the six-month postpartum period. PMID:24262719

  19. Economic stress and cortisol among postpartum low-income Mexican American women: buffering influence of family support

    PubMed Central

    Jewell, Shannon L.; Luecken, Linda J.; Gress-Smith, Jenna; Crnic, Keith A.; Gonzales, Nancy A.

    2016-01-01

    Low-income Mexican American women experience significant health disparities during the postpartum period. Contextual stressors, such as economic stress, are theorized to affect health via dysregulated cortisol output. However, cultural protective factors including strong family support may buffer the impact of stress. In a sample of 322 low-income Mexican American women (mother age 1842; 84% Spanish-speaking; modal family income $10,000$15,000), we examined the interactive influence of economic stress and family support at 6 weeks postpartum on maternal cortisol output (AUCg) during a mildly challenging mother-infant interaction task at 12 weeks postpartum, controlling for 6 week maternal cortisol and depressive symptoms. The interaction significantly predicted cortisol output such that higher economic stress predicted higher cortisol only among women reporting low family support. These results suggest that family support is an important protective resource for postpartum Mexican American women experiencing elevated economic stress. PMID:26332931

  20. Evidence of proviral clearance following postpartum transmission of an ovine lentivirus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Lentiviral transmission by transfer of infected colostrum and/or milk is considered to be highly efficient. In this study, postpartum transmission of ovine progressive pneumonia virus (OPPV) from 10 naturally infected ewes to their 23 lambs was followed from the perinatal period throughout a four y...

  1. Postpartum Postural Orthostatic Tachycardia Syndrome in a Patient with the Joint Hypermobility Syndrome

    PubMed Central

    Kanjwal, Khalil; Karabin, Beverly; Kanjwal, Yousuf; Grubb, Blair P.

    2009-01-01

    Postural orthostatic tachycardia syndrome (POTS) commonly affects women of childbearing age. We report on a 37-year-old woman who developed symptoms of recurrent syncope in the postpartum period. Her head up tilt test and clinical presentation was consistent with POTS. PMID:19946638

  2. Postpartum Treatment With Immunoglobulin Does Not Prevent Relapses of Multiple Sclerosis in the Mother.

    PubMed

    Fragoso, Yara Dadalti; Adoni, Tarso; Alves-Leon, Soniza Vieira; Azambuja, Nerio Dutra; Barreira, Amilton Antunes; Brooks, Joseph Bruno Bidin; Carneiro, Denise Sisteroli Diniz; Carvalho, Margarete J; Claudino, Rinaldo; Comini-Frota, Elizabeth Regina; Domingues, Renan Barros; Finkelsztejn, Alessandro; Gama, Paulo Diniz; Giacomo, Maria Cristina Brandao; Gomes, Sidney; Goncalves, Marcus Vinicius Magno; Grzesiuk, Anderson Kuntz; Kaimen-Maciel, Damacio Ramon; Mendes, Maria Fernanda; Morales, Nivea Macedo Oliveira; Morales, Rogerio Rizo; Muniz, Andre; Papais-Alvarenga, Regina Maria; Parolin, Monica Koncke Fiuza; Ribeiro, Sonia Beatriz Felix; Ruocco, Heloisa Helena; Salgado, Pedro Rippel; Siquineli, Fabio; Souza, Doralina Brum; Tosta, Elza Dias; Vasconcelos, Claudia Cristina Ferreira; Almeida, Sandra Maria Garcia; Bernardes, Daniella Freire Ribeiro; Castro, Simone Nascimento; Gama, Rodrigo Assad Diniz; Gomide, Fabrizio Antonio Resende; Finkelzstejn, Juliana; Lopes, Josiane; Lourenco, Fabiani Honorato de Barros; Lourenco, Gisele A; Oliveira, Celso Luis Silva; Oliveira, Francisco Tomaz Meneses; Oliveira, Lucas Felix; Patroclo, Cristiane Borges; Pereira, Wildea Lice de Carvalho Jennings; Safanelli, Juliana; Sahdo, Alinne Martiniano; Saldanha, Patricia Correa de Oliveira; Shinzato, Yves Fumio; Souza, Jorge Murilo Barbosa; Zani, Denis Evandro

    2015-01-01

    Multiple sclerosis (MS) is a chronic, neurological, immune-mediated disease that can worsen in the postpartum period. There is no consensus on the use of immunoglobulin for prevention of disease relapses after delivery. We have shown that the controversial beneficial effect of immunoglobulin given immediately after birth could not be observed in patients with MS. PMID:25187102

  3. Postpartum Depression Effects on Early Interactions, Parenting, and Safety Practices: A Review

    PubMed Central

    Field, Tiffany

    2009-01-01

    In this paper studies are reviewed from the last decade on postpartum depression effects on early interactions, parenting, safety practices and on early interventions. The interaction disturbances of depressed mothers and their infants appear to be universal, across different cultures and socioeconomic status groups and, include less sensitivity of the mothers and responsivity of the infants. Several caregiving activities also appear to be compromised by postpartum depression including feeding practices, most especially breastfeeding, sleep routines and well-child visits, vaccinations and safety practices. These data highlight the need for universal screening of maternal and paternal depression during the postpartum period. Early interventions reviewed here include psychotherapy and interaction coaching for the mothers, and infant massage for their infants. PMID:19962196

  4. Effects of Space Flight on Ovarian-Hypophyseal Function in Postpartum Rats

    NASA Technical Reports Server (NTRS)

    Burden, H. W.; Zary, J.; Lawrence, I. E.; Jonnalagadda, P.; Davis, M.; Hodson, C. A.

    1997-01-01

    The effect of space flight in a National Aeronautics and Space Administration (NASA) shuttle was studied in pregnant rats. Rats were launched on day 9 of gestation and recovered on day 20 of gestation. On day 20 of gestation, rats were unilaterally hysterectomized and subsequently allowed to go to term and deliver vaginally. There was no effect of space flight on pituitary and ovary mass postpartum. In addition, space flight did not alter healthy and atretic ovarian antral follicle populations, fetal wastage in utero, plasma concentrations of progesterone and luteinizing hormone (LH) or pituitary content of follicle stimulating hormone (FSH). Space flight significantly increased plasma concentrations of FSH and decreased pituitary content of LH at the postpartum sampling time. Collectively, these data show that space flight, initiated during the postimplantation period of pregnancy, and concluded before parturition, is compatible with maintenance of pregnancy and has minimal effects on postpartum hypophyseal parameters; however, none of the ovarian parameters examined was altered by space flight.

  5. Social Support, Postpartum Depression, and Professional Assistance: A Survey of Mothers in the Midwestern United States

    PubMed Central

    Corrigan, Catherine P.; Kwasky, Andrea N.; Groh, Carla J.

    2015-01-01

    ABSTRACT Transition into motherhood is generally a joyful life event; for some women, however, it is marked by emotional turmoil. Lack of support can be associated with postpartum depression and can compromise both the mother and infant. A descriptive, cross-sectional study (N = 61) was conducted to explore the relationship between social support and postpartum depression and to determine whether mothers overwhelmed with childcare, or overwhelmed with life in general since becoming a mother, sought professional help. The results revealed that screening for depression alone may not be sufficient, that mothers are willing to contact a professional for help in the postpartum period, and that assessments after birth should include a broader assessment of life’s difficulties rather than focusing on childcare responsibilities alone.

  6. Maternal anxiety from pregnancy to 2years postpartum: transactional patterns of maternal early adversity and child temperament.

    PubMed

    Agrati, Daniella; Browne, Dillon; Jonas, Wibke; Meaney, Michael; Atkinson, Leslie; Steiner, Meir; Fleming, Alison S

    2015-10-01

    The aims of this study were to examine the anxiety trajectories of women from pregnancy to 2years postpartum and to assess the influence of their early life experiences and the temperament of the child on these trajectories. We evaluated state anxiety (State-Trait Anxiety Inventory) at pregnancy and 3, 6, 12, 18, and 24months postpartum and determined its course as a function of self-reported early adverse experiences (Childhood Trauma Questionnaire) and the temperament of the child at 18months (Early Child Behavior Questionnaire). Based on growth curve modeling, we found that anxiety followed a general U-shape pattern from gestation to 2years postpartum, which was modified by early life experience of women. Greater early adversity was associated with higher gestational anxiety, followed by a marked decrease once the baby was born, and subsequent increase during the later postpartum period. The temperament of the child also modulated anxiety trajectories. Thus, mothers of children high in negative affectivity andwho also experienced greater early adversity had elevated and flat anxiety trajectories, while child extraversion was associated with increasing anxiety courses approaching 2years postpartum. These results show that maternal anxiety dynamically changes through the postpartum period with a course that is affected by previous and current experiences. PMID:25627018

  7. Chronic Cocaine Exposure During Pregnancy Increases Postpartum Neuroendocrine Stress Responses

    PubMed Central

    Williams, Sarah K.; Barber, John S.; Jamieson-Drake, Abigail W.; Enns, Jordan A.; Townsend, Leah B.; Walker, Cheryl H.; Johns, Josephine M.

    2012-01-01

    The cycle of chronic cocaine (CC) use and withdrawal results in increased anxiety, depression and disrupted stress-responsiveness. Oxytocin and corticosterone (CORT) interact to mediate hormonal stress responses and can be altered by cocaine use. These neuroendocrine signals play important regulatory roles in a variety of social behaviours, specifically during the postpartum period, and are sensitive to disruption by CC exposure in both clinical settings and preclinical models. To determine whether CC exposure during pregnancy affected behavioural and hormonal stress response in the early postpartum period in a rodent model, Sprague-Dawley rats were administered cocaine daily (30 mg/kg) throughout gestation (days 120). Open field test (OFT) and forced swim test (FST) behaviours were measured on postpartum day 5. Plasma CORT concentrations were measured prior to and following testing throughout the test day, while plasma and brain oxytocin concentrations were measured post-testing only. Results indicated increased CORT response following the OFT in CC-treated dams (p? 0.05). CC-treated dams also exhibited altered FST behaviour (p? 0.05), suggesting abnormal stress responsiveness. Peripheral, but not central, oxytocin levels were increased by cocaine treatment (p? 0.05). Peripheral oxytocin and CORT increased following the FST regardless of treatment condition (p? 0.05). Changes in stress-responsiveness, both behaviourally and hormonally may underlie some deficits in maternal behaviour, thus a clearer understanding of CCs effect on the stress response system may potentially lead to treatment interventions which could be relevant to clinical populations. Additionally, these results indicate that CC treatment can have long-lasting effects on peripheral oxytocin regulation in rats, similar to changes observed in persistent social behaviour and stress-response deficits in clinical populations. PMID:22309318

  8. Chronic cocaine exposure during pregnancy increases postpartum neuroendocrine stress responses.

    PubMed

    Williams, S K; Barber, J S; Jamieson-Drake, A W; Enns, J A; Townsend, L B; Walker, C H; Johns, J M

    2012-04-01

    The cycle of chronic cocaine (CC) use and withdrawal results in increased anxiety, depression and disrupted stress-responsiveness. Oxytocin and corticosterone (CORT) interact to mediate hormonal stress responses and can be altered by cocaine use. These neuroendocrine signals play important regulatory roles in a variety of social behaviours, specifically during the postpartum period, and are sensitive to disruption by CC exposure in both clinical settings and preclinical models. To determine whether CC exposure during pregnancy affected behavioural and hormonal stress response in the early postpartum period in a rodent model, Sprague-Dawley rats were administered cocaine daily (30 mg/kg) throughout gestation (days 1-20). Open field test (OFT) and forced swim test (FST) behaviours were measured on postpartum day 5. Plasma CORT concentrations were measured before and after testing throughout the test day, whereas plasma and brain oxytocin concentrations were measured post-testing only. The results obtained indicated increased CORT response after the OFT in CC-treated dams (P ≤ 0.05). CC-treated dams also exhibited altered FST behaviour (P ≤ 0.05), suggesting abnormal stress responsiveness. Peripheral, but not central, oxytocin levels were increased by cocaine treatment (P ≤ 0.05). Peripheral oxytocin and CORT increased after the FST, regardless of treatment condition (P ≤ 0.05). Changes in stress-responsiveness, both behaviourally and hormonally, may underlie some deficits in maternal behaviour; thus, a clearer understanding of the effect of CC on the stress response system may potentially lead to treatment interventions that could be relevant to clinical populations. Additionally, these results indicate that CC treatment can have long-lasting effects on peripheral oxytocin regulation in rats, similar to changes observed in persistent social behaviour and stress-response deficits in clinical populations. PMID:22309318

  9. Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period

    PubMed Central

    Tomfohr, Lianne M.; Buliga, Elena; Letourneau, Nicole L.; Campbell, Tavis S.; Giesbrecht, Gerald F.

    2015-01-01

    Objective: The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories. Design, Setting, and Participants: Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1; < 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period. Results: Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period. Conclusions: Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period. Citation: Tomfohr LM, Buliga E, Letourneau NL, Campbell TS, Giesbrecht GF. Trajectories of sleep quality and associations with mood during the perinatal period. SLEEP 2015;38(8):1237–1245. PMID:25845691

  10. Simulating the Antarctic ice sheet in the Late-Pliocene warm period: PLISMIP-ANT, an ice-sheet model intercomparison project

    NASA Astrophysics Data System (ADS)

    de Boer, Bas; Dolan, Aisling; Bernales, Jorge; Gasson, Edward; Goelzer, Heiko; Golledge, Nick; Sutter, Johannes; Huybrechts, Phillipe; Lohmann, Gerrit; Rogozhina, Irina; Abe-Ouchi, Ayako; Saito, Fuyuki; van de Wal, Roderik

    2015-04-01

    In the context of future climate change, understanding the nature and behaviour of ice sheets during warm intervals in Earth history is of fundamental importance. The Late-Pliocene warm period (also known as the PRISM interval: 3.264 to 3.025 million years before present) can serve as a potential analogue for projected future climates. Although Pliocene ice locations and extents are still poorly constrained, a significant contribution to sea-level rise should be expected from both the Greenland ice sheet and the West and East Antarctic ice sheets based on palaeo sea-level reconstructions. Here, we present results from simulations of the Antarctic ice sheet by means of an international Pliocene Ice Sheet Modeling Intercomparison Project (PLISMIP-ANT). For the experiments, ice-sheet models including the shallow ice and shelf approximations have been used to simulate the complete Antarctic domain (including grounded and floating ice). We compare the performance of six existing numerical ice-sheet models in simulating modern control and Pliocene ice sheets by a suite of four sensitivity experiments. Ice-sheet model forcing fields are taken from the HadCM3 atmosphere-ocean climate model runs for the pre-industrial and the Pliocene. We include an overview of the different ice-sheet models used and how specific model configurations influence the resulting Pliocene Antarctic ice sheet. The six ice-sheet models simulate a comparable present-day ice sheet, although the models are setup with their own parameter settings. For the Pliocene simulations using the Bedmap1 bedrock topography, some models show a small retreat of the East Antarctic ice sheet, which is thought to have happened during the Pliocene for the Wilkes and Aurora basins. This can be ascribed to either the surface mass balance, as the HadCM3 Pliocene climate shows a significant increase over the Wilkes and Aurora basin, or the initial bedrock topography. For the latter, our simulations with the recently published Bedmap2 bedrock topography indicate a significantly larger contribution to Pliocene sea-level rise from the East Antarctic ice sheet for all six models relative to the simulations with Bedmap1. Such multi-model comparison efforts will assist in providing potential model uncertainty when comparing reconstructions of the Antarctic ice sheet with available proxy data.

  11. Simulating the Antarctic ice sheet in the Late-Pliocene warm period: PLISMIP-ANT, an ice-sheet model intercomparison project

    NASA Astrophysics Data System (ADS)

    de Boer, B.; Dolan, A. M.; Bernales, J.; Gasson, E.; Goelzer, H.; Golledge, N. R.; Sutter, J.; Huybrechts, P.; Lohmann, G.; Rogozhina, I.; Abe-Ouchi, A.; Saito, F.; van de Wal, R. S. W.

    2014-11-01

    In the context of future climate change, understanding the nature and behaviour of ice sheets during warm intervals in Earth history is of fundamental importance. The Late-Pliocene warm period (also known as the PRISM interval: 3.264 to 3.025 million years before present) can serve as a potential analogue for projected future climates. Although Pliocene ice locations and extents are still poorly constrained, a significant contribution to sea-level rise should be expected from both the Greenland ice sheet and the West and East Antarctic ice sheets based on palaeo sea-level reconstructions. Here, we present results from simulations of the Antarctic ice sheet by means of an international Pliocene Ice Sheet Modeling Intercomparison Project (PLISMIP-ANT). For the experiments, ice-sheet models including the shallow ice and shelf approximations have been used to simulate the complete Antarctic domain (including grounded and floating ice). We compare the performance of six existing numerical ice-sheet models in simulating modern control and Pliocene ice sheets by a suite of four sensitivity experiments. Ice-sheet model forcing fields are taken from the HadCM3 atmosphere-ocean climate model runs for the pre-industrial and the Pliocene. We include an overview of the different ice-sheet models used and how specific model configurations influence the resulting Pliocene Antarctic ice sheet. The six ice-sheet models simulate a comparable present-day ice sheet, although the models are setup with their own parameter settings. For the Pliocene simulations using the Bedmap1 bedrock topography, some models show a small retreat of the East Antarctic ice sheet, which is thought to have happened during the Pliocene for the Wilkes and Aurora basins. This can be ascribed to either the surface mass balance, as the HadCM3 Pliocene climate shows a significant increase over the Wilkes and Aurora basin, or the initial bedrock topography. For the latter, our simulations with the recently published Bedmap2 bedrock topography indicate a significantly larger contribution to Pliocene sea-level rise from the East Antarctic ice sheet for all six models relative to the simulations with Bedmap1.

  12. An improved atmosphere-surface model in Africa reveals the importance of vegetation and lakes in the Late Quaternary and Green Sahara periods

    NASA Astrophysics Data System (ADS)

    Farrow, A.; Singarayer, J. S.; Valdes, P. J.; B. R. I. D. G. E

    2011-12-01

    Paleoclimate records from Late Quaternary Africa imply high amplitude variability between wet and dry conditions. In this work, we use asynchronously coupled atmosphere and land surface models to investigate the mechanisms and feedbacks responsible for Northern Africa moisture fluctuations and find that model simulations are altered dramatically by the inclusion of land surface effects. During the last de-glaciation large amplitude perturbations of the African climate occurred linked to orbitaly forced changes in monsoon strength. Furthermore during the Holocene an abrupt and widespread greening of the Sahara is recorded in numerous paleoclimate archives. This greening represents the largest anomaly in the atmosphere-biosphere system in the last 12,000 years but is consistently misrepresented by modeling studies. Northern African climates are thought to highly sensitive to land surface feedbacks and it has been suggested that better representation of the land surface may improve model simulations. We investigate how the role of surface feedbacks in the climate system change over a uniquely extensive suite of time slice simulations from the last glacial maximum to the present. The Hadley Centre's atmosphere-only GCM, HadAM3 is asynchronously coupled with the equilibrium vegetation model BIOME (Prentice et al 1992) and surface hydrology feedbacks are considered using the surface water scheme HYDRA (Coe 1998). Equilibrium time slices are run at 3000 year intervals from the pre-industrial to 24 kyr B.P. This enables us to dissect the relative importance of orbital, vegetation and hydrologic systems in controlling the climate of Northern Africa across a complete spectrum of de-glacial to present climates. Although over millennial and longer time scales African water balance is steered by orbital configuration we show that the system is also affected by fluxes working across the land surface-atmosphere interface. Changes in the land surface cover seen by a GCM have a significant local and regional impact on the atmosphere. As such, our simulations provide extensive new data on African Holocene and de-glacial climates. They further quantify the relative contribution of climate forcings and feedbacks during the Green Sahara period and include significant simulated greening of the mid-Holocene Sahel.

  13. Depression Screening Should Include All Pregnant, Postpartum Women: Panel

    MedlinePLUS

    ... nlm.nih.gov/medlineplus/news/fullstory_156904.html Depression Screening Should Include All Pregnant, Postpartum Women: Panel ... pregnant and postpartum women, should be screened for depression by their family doctor, the nation's leading preventive ...

  14. A Prospective Longitudinal Study of Perceived Infant Outcomes at 18–24 Months: Neural and Psychological Correlates of Parental Thoughts and Actions Assessed during the First Month Postpartum

    PubMed Central

    Kim, Pilyoung; Rigo, Paola; Leckman, James F.; Mayes, Linda C.; Cole, Pamela M.; Feldman, Ruth; Swain, James E.

    2015-01-01

    The first postpartum months constitute a critical period for parents to establish an emotional bond with their infants. Neural responses to infant-related stimuli have been associated with parental sensitivity. However, the associations among these neural responses, parenting, and later infant outcomes for mothers and fathers are unknown. In the current longitudinal study, we investigated the relationships between parental thoughts/actions and neural activation in mothers and fathers in the neonatal period with infant outcomes at the toddler stage. At the first month postpartum, mothers (n = 21) and fathers (n = 19) underwent a neuroimaging session during which they listened to their own and unfamiliar baby’s cry. Parenting-related thoughts/behaviors were assessed by interview twice at the first month and 3–4 months postpartum and infants’ socioemotional outcomes were reported by mothers and fathers at 18–24 months postpartum. In mothers, higher levels of anxious thoughts/actions about parenting at the first month postpartum, but not at 3–4 months postpartum, were associated with infant’s low socioemotional competencies at 18–24 months. Anxious thoughts/actions were also associated with heightened responses in the motor cortex and reduced responses in the substantia nigra to own infant cry sounds. On the other hand, in fathers, higher levels of positive perception of being a parent at the first month postpartum, but not at 3–4 months postpartum, were associated with higher infant socioemotional competencies at 18–24 months. Positive thoughts were associated with heightened responses in the auditory cortex and caudate to own infant cry sounds. The current study provides evidence that parental thoughts are related to concurrent neural responses to their infants at the first month postpartum as well as their infant’s future socioemotional outcome at 18–24 months. Parent differences suggest that anxious thoughts in mothers and positive thoughts in fathers may be the targets for parenting-focused interventions very early postpartum. PMID:26635679

  15. Incident HIV during Pregnancy and Postpartum and Risk of Mother-to-Child HIV Transmission: A Systematic Review and Meta-Analysis

    PubMed Central

    Drake, Alison L.; Wagner, Anjuli; Richardson, Barbra; John-Stewart, Grace

    2014-01-01

    Background Women may have persistent risk of HIV acquisition during pregnancy and postpartum. Estimating risk of HIV during these periods is important to inform optimal prevention approaches. We performed a systematic review and meta-analysis to estimate maternal HIV incidence during pregnancy/postpartum and to compare mother-to-child HIV transmission (MTCT) risk among women with incident versus chronic infection. Methods and Findings We searched PubMed, Embase, and AIDS-related conference abstracts between January 1, 1980, and October 31, 2013, for articles and abstracts describing HIV acquisition during pregnancy/postpartum. The inclusion criterion was studies with data on recent HIV during pregnancy/postpartum. Random effects models were constructed to pool HIV incidence rates, cumulative HIV incidence, hazard ratios (HRs), or odds ratios (ORs) summarizing the association between pregnancy/postpartum status and HIV incidence, and MTCT risk and rates. Overall, 1,176 studies met the search criteria, of which 78 met the inclusion criterion, and 47 contributed data. Using data from 19 cohorts representing 22,803 total person-years, the pooled HIV incidence rate during pregnancy/postpartum was 3.8/100 person-years (95% CI 3.0–4.6): 4.7/100 person-years during pregnancy and 2.9/100 person-years postpartum (p = 0.18). Pooled cumulative HIV incidence was significantly higher in African than non-African countries (3.6% versus 0.3%, respectively; p<0.001). Risk of HIV was not significantly higher among pregnant (HR 1.3, 95% CI 0.5–2.1) or postpartum women (HR 1.1, 95% CI 0.6–1.6) than among non-pregnant/non-postpartum women in five studies with available data. In African cohorts, MTCT risk was significantly higher among women with incident versus chronic HIV infection in the postpartum period (OR 2.9, 95% CI 2.2–3.9) or in pregnancy/postpartum periods combined (OR 2.3, 95% CI 1.2–4.4). However, the small number of studies limited power to detect associations and sources of heterogeneity. Conclusions Pregnancy and the postpartum period are times of persistent HIV risk, at rates similar to “high risk” cohorts. MTCT risk was elevated among women with incident infections. Detection and prevention of incident HIV in pregnancy/postpartum should be prioritized, and is critical to decrease MTCT. Please see later in the article for the Editors' Summary PMID:24586123

  16. Brief daily postpartum separations from the litter alter dam response to psychostimulants and to stress

    PubMed Central

    Silveira, P.P.; Benetti, C. da Silva; Portella, A.K.; Diehl, L.A.; Molle, R. Dalle; Lucion, A.B.; Dalmaz, C.

    2013-01-01

    Neonatal handling induces several behavioral and neurochemical alterations in pups, including decreased responses to stress and reduced fear in new environments. However, there are few reports in the literature concerning the behavioral effects of this neonatal intervention on the dams during the postpartum period. Therefore, the aim of the current study was to determine if brief postpartum separation from pups has a persistent impact on the dam's stress response and behavior. Litters were divided into two neonatal groups: 1) non-handled and 2) handled [10?min/day, from postnatal day (PND) 1 to 10]. Weaning occurred at PND 21 when behavioral tasks started to be applied to the dams, including sweet food ingestion (PND 21), forced swimming test (PND 28), and locomotor response to a psychostimulant (PND 28). On postpartum day 40, plasma was collected at baseline for leptin assays and after 1?h of restraint for corticosterone assay. Regarding sweet food consumption, behavior during the forced swimming test or plasma leptin levels did not differ between dams briefly separated and non-separated from their pups during the postpartum period. On the other hand, both increased locomotion in response to diethylpropion and increased corticosterone secretion in response to acute stress were detected in dams briefly separated from their pups during the first 10 postnatal days. Taken together, these findings suggest that brief, repeated separations from the pups during the neonatal period persistently impact the behavior and induce signs of dopaminergic sensitization in the dam. PMID:23739746

  17. Plants used during pregnancy, childbirth and postpartum healthcare in Lao PDR: A comparative study of the Brou, Saek and Kry ethnic groups

    PubMed Central

    de Boer, Hugo; Lamxay, Vichith

    2009-01-01

    Background In many Southeast Asian cultures the activities and diet during the postpartum period are culturally dictated and a period of confinement is observed. Plants play an important role in recovery during the postpartum period in diet, traditional medicine, steam bath and mother roasting (where mother and child placed on a bed above a brazier with charcoal embers on which aromatic plants are laid). This research focuses on the use of plants during pregnancy, parturition, postpartum recovery and infant healthcare among three ethnic groups, the Brou, Saek and Kry. It aims to identify culturally important traditions that may facilitate implementation of culturally appropriate healthcare. Methods Data were collected in 10 different villages in Khammouane province, Lao PDR, through group and individual interviews with women by female interviewers. Results A total of 55 different plant species are used in women's healthcare, of which over 90% are used in postpartum recovery. Consensus Analysis rejects the hypothesis that the three ethnic groups belong to a single culture for postpartum plant use, and multidimensional scaling reveals non-overlapping clusters per ethnic group. Conclusion Medicinal plant use is common among the Brou, Saek and Kry to facilitate childbirth, alleviate menstruation problems, assist recovery after miscarriage, mitigate postpartum haemorrhage, aid postpartum recovery, and for use in infant care. The wealth of novel insights into plant use and preparation will help to understand culturally important practices such as confinement, dietary restrictions, mother roasting and herbal steam baths and their incorporation into modern healthcare. PMID:19737413

  18. COMMON PROBLEMS OF BREASTFEEDING IN THE POSTPARTUM PERIOD

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Breastfeeding a healthy infant is often accompanied by challenges. Some may be predictable, while others are unexpected. These problems may accompany the normal anxiety of first-time parents, who rarely appreciate the intensity of care infants require. Reassurance and guidance often will enable moth...

  19. Return to work, economic hardship, and women's postpartum health.

    PubMed

    Tucker, Jenna N; Grzywacz, Joseph G; Leng, Iris; Clinch, C Randall; Arcury, Thomas A

    2010-10-01

    This study followed a sample of 217 new mothers in a North Carolina county as they returned to work full-time, measuring their mental and physical health-related quality of life through 16 months postpartum. In general, working mothers of infants had mental health scores that were comparable to the general population of U.S. women, and physical health that was slightly better than women in general. Using ANCOVA and controlling for important demographic characteristics, health-related quality of life was compared between mothers experiencing low and high levels of economic hardship. Across the study period, women with high economic hardship, who constituted 30.7% of the sample, had levels of mental and physical health below those of women with low economic hardship. Mothers with high economic hardship also had less stable health trajectories than mothers with low economic hardship. The findings highlight the importance of reconsidering the traditionally accepted postpartum recovery period of six weeks and extending benefits, such as paid maternity and sick leave, as well as stable yet flexible work schedules. PMID:21104566

  20. History of childhood sexual abuse and risk of prenatal and postpartum depression or depressive symptoms: an epidemiologic review.

    PubMed

    Wosu, Adaeze C; Gelaye, Bizu; Williams, Michelle A

    2015-10-01

    The objective of this review is to summarize the literature (and to the extent possible, report the magnitude and direction of the association) concerning history of childhood sexual abuse (CSA) and depression or depressive symptoms among pregnant and postpartum women. Publications were identified through literature searches of seven databases (PubMed, EMBASE, PyscINFO, CINAHL, Web of Science, BIOSIS, and Science Direct) using keywords including "child abuse," "depression," "pregnancy," "prenatal," "pregnancy," and "postpartum." The literature search yielded seven eligible studies on the prenatal period and another seven studies on the postpartum period. All but one prenatal study observed statistically significant positive associations of CSA with depression or depressive symptoms during pregnancy. Findings on the association of CSA with postpartum depression or depressive symptoms were inconsistent; pooled unadjusted and adjusted odds ratios were 1.82 (95 % confidence interval (CI) 0.92, 3.60) and 1.20 (95 % CI 0.81, 1.76). In sum, findings suggest a positive association of history of CSA with depression and depressive symptoms in the prenatal period. Findings on the postpartum period were inconsistent. Clinical and public health implications of evidence from the available literature are discussed, as are desirable study design characteristics of future research. PMID:25956589

  1. Idiopathic intracranial hypertension presenting as postpartum headache.

    PubMed

    Mathew, Mariam; Salahuddin, Ayesha; Mathew, Namitha R; Nandhagopal, Ramachandiran

    2016-01-01

    Postpartum headache is described as headache and neck or shoulder pain during the first 6 weeks after delivery. Common causes of headache in the puerperium are migraine headache and tension headache; other causes include pre-eclampsia/eclampsia, post-dural puncture headache, cortical vein thrombosis, subarachnoid hemorrhage, posterior reversible leukoencephalopathy syndrome, brain tumor, cerebral ischemia, meningitis, and so forth. Idiopathic intracranial hypertension (IIH) is a rare cause of postpartum headache. It is usually associated with papilledema, headache, and elevated intracranial pressure without any focal neurologic abnormality in an otherwise healthy person. It is more commonly seen in obese women of reproductive age group, but rare during pregnancy and postpartum. We present a case of IIH who presented to us 18 days after cesarean section with severe headache and was successfully managed. PMID:26818168

  2. Advance distribution of misoprostol for prevention of postpartum hemorrhage (PPH) at home births in two districts of Liberia

    PubMed Central

    2014-01-01

    Background A postpartum hemorrhage prevention program to increase uterotonic coverage for home and facility births was introduced in two districts of Liberia. Advance distribution of misoprostol was offered during antenatal care (ANC) and home visits. Feasibility, acceptability, effectiveness of distribution mechanisms and uterotonic coverage were evaluated. Methods Eight facilities were strengthened to provide PPH prevention with oxytocin, PPH management and advance distribution of misoprostol during ANC. Trained traditional midwives (TTMs) as volunteer community health workers (CHWs) provided education to pregnant women, and district reproductive health supervisors (DRHSs) distributed misoprostol during home visits. Data were collected through facility and DRHS registers. Postpartum interviews were conducted with a sample of 550 women who received advance distribution of misoprostol on place of delivery, knowledge, misoprostol use, and satisfaction. Results There were 1826 estimated deliveries during the seven-month implementation period. A total of 980 women (53.7%) were enrolled and provided misoprostol, primarily through ANC (78.2%). Uterotonic coverage rate of all deliveries was 53.5%, based on 97.7% oxytocin use at recorded facility vaginal births and 24.9% misoprostol use at home births. Among 550 women interviewed postpartum, 87.7% of those who received misoprostol and had a home birth took the drug. Sixty-three percent (63.0%) took it at the correct time, and 54.0% experienced at least one minor side effect. No serious adverse events reported among enrolled women. Facility-based deliveries appeared to increase during the program. Conclusions The program was moderately effective at achieving high uterotonic coverage of all births. Coverage of home births was low despite the use of two channels of advance distribution of misoprostol. Although ANC reached a greater proportion of women in late pregnancy than home visits, 46.3% of expected deliveries did not receive education or advance distribution of misoprostol. A revised community-based strategy is needed to increase advance distribution rates and misoprostol coverage rates for home births. Misoprostol for PPH prevention appears acceptable to women in Liberia. Correct timing of misoprostol self-administration needs improved emphasis during counseling and education. PMID:24894566

  3. The Role of Reproductive Hormones in Postpartum Depression

    PubMed Central

    Schiller, Crystal Edler; Meltzer-Brody, Samantha; Rubinow, David R.

    2014-01-01

    Despite decades of research aimed at identifying the causes of postpartum depression (PPD), PPD remains common, and the causes are poorly understood. Many have attributed the onset of PPD to the rapid perinatal change in reproductive hormones. Although a number of human and non-human animal studies support the role of reproductive hormones in PPD, several studies have failed to detect an association between hormone concentrations and PPD. The purpose of this review is to examine the hypothesis that fluctuations in reproductive hormone levels during pregnancy and the postpartum period trigger PPD in susceptible women. We discuss and integrate the literature on animal models of PPD and human studies of reproductive hormones and PPD. We also discuss alternative biological models of PPD to demonstrate the potential for multiple PPD phenotypes and to describe the complex interplay of changing reproductive hormones and alterations in thyroid function, immune function, HPA axis function, lactogenic hormones, and genetic expression that may contribute to affective dysfunction. There are three primary lines of inquiry that have addressed the role of reproductive hormones in PPD: non-human animal studies, correlational studies of postpartum hormone levels and mood symptoms, and hormone manipulation studies. Reproductive hormones influence virtually every biological system implicated in PPD, and a subgroup of women seem to be particularly sensitive to the effects of perinatal changes in hormone levels. We propose that these women constitute a “hormone-sensitive” PPD phenotype, which should be studied independent of other PPD phenotypes to identify underlying pathophysiology and develop novel treatment targets. PMID:25263255

  4. Timing and characteristics of Late Pleistocene and Holocene wetter periods in the Eastern Desert and Sinai of Egypt, based on 14C dating and stable isotope analysis of spring tufa deposits

    NASA Astrophysics Data System (ADS)

    Hamdan, Mohamed A.; Brook, George A.

    2015-12-01

    There is very little dated evidence on wet periods in the Eastern Desert and Sinai Peninsula of Egypt during the Late Pleistocene and Holocene. To obtain such information, we have studied the petrography, isotope geochemistry and AMS radiocarbon ages of mostly relict tufas deposited by springs draining perched ground water bodies in metamorphic and volcanic rocks. The tufas unconformably overly Precambrian basic igneous rocks (basalt, diabase and gabbro). As the ages of tufa carbonate are frequently older than the true ages of the deposits because of the incorporation of old, 14C-dead carbon, we have dated both the carbonate matrix and insoluble organic material of the tufas. These ages show that the tufas were largely formed during two broad time periods, the most recent from 12,058 to 6678 cal yr BP (African Humid Period), and the other from ∼31,200-22,500 cal yr BP, with preferential growth during the coldest times of this period namely during Heinrich Events 2 and 3 (H2 and H3) and the Last Glacial Maximum (LGM). The time span between 19,000-9000 cal yr BP, including the YD and H1, appears to have been relatively more arid than the earlier LGM or H2 periods or the later Holocene. The Late Pleistocene tufas are depleted in 18O relative to the Holocene tufas and were deposited at a lower temperature (∼14.0°-20.8 °C vs. 18.4°-23.4 °C). We believe that the Holocene tufas in the Sinai were formed by rainfall from the Mediterranean and those in the southern part of the Eastern Desert by African monsoon rainfall derived from the Red Sea-Gulf of Aden and Indian Ocean. In contrast, the moisture that fed the Late Pleistocene tufas, which are depleted in 18O relative to Holocene deposits, and progressively depleted from north to south, was probably brought by the Westerlies from the Atlantic-Mediterranean Sea when the Westerly circulation was pushed southwards during the coldest periods of the Late Pleistocene. Periods of tufa deposition correlate with major documented paleoclimatic events in North Africa during the late Pleistocene and Holocene; such as the Nile floods, high sea level and the formation of sapropels in the Mediterranean.

  5. The association between diabetes and postpartum depression.

    PubMed

    Miller, Emily S; Peri, Marisa R; Gossett, Dana R

    2016-02-01

    This study aims to estimate if diabetic women were more likely to experience postpartum depression symptoms than women without diabetes. This was a prospective cohort of women who received prenatal care at a hospital-affiliated prenatal clinic serving low-income women in Chicago, Illinois. For the primary analysis, women were divided by diabetes status (i.e., no diabetes or either gestational diabetes or pre-pregnancy diabetes). Postpartum depression was defined as a positive screen on the Patient Health Questionnaire-9. Rates of postpartum depression were compared, stratified by diabetic status. A multivariable logistic regression was performed to control for potential confounders. A planned secondary analysis compared women with pre-pregnancy diabetes to those without pre-pre-pregnancy diabetes. Three hundred and five women consented to participate of whom 100 (30.5%) had gestational diabetes mellitus (GDM) and 33 (10.8%) had pre-pregnancy diabetes. Compared to women without any diabetes, women with diabetes (either GDM or pre-pregnancy diabetes) had similar rates of antenatal [(OR) 0.69, 95% CI) 0.44-1.08] and postpartum depression (OR 0.74, 95% CI 0.33-1.66). However, postpartum depression was more common among women with pre-pregnancy diabetes (34.8%) compared to non-diabetic women (16.7%) (OR 2.67, 95% CI 1.05-6.78). This association persisted even after adjusting for potential confounders (aOR 2.67, 95% CI 1.05-9.79). Gestational diabetes was not associated with increased rates of depression. However, women with pre-pregnancy diabetes are more likely to experience postpartum depression compared to women without pre-pregnancy diabetes, even after adjusting for related comorbidities. PMID:26184833

  6. Effects of rumen-protected methionine on plasma amino acid concentrations during a period of weight loss for late gestating beef heifers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study determined changes in plasma amino acid concentration in late-gestating (beginning 58 1.02 d prior to calving), primiparous, winter-grazing range heifers receiving wheat middling based supplement without (CON) or with rumen-protected methionine (MET) to provide 15 g DL- MET each day. Pl...

  7. Low rates of postpartum glucose screening among indigenous and non-indigenous women in Australia with gestational diabetes.

    PubMed

    Chamberlain, Catherine; McLean, Anna; Oats, Jeremy; Oldenburg, Brian; Eades, Sandra; Sinha, Ashim; Wolfe, Rory

    2015-03-01

    Women with gestational diabetes have a high risk of type 2 diabetes postpartum, with Indigenous women particularly affected. This study reports postpartum diabetes screening rates among Indigenous and non-Indigenous women with gestational diabetes, in Far North Queensland, Australia. Retrospective study including 1,012 women with gestational diabetes giving birth at a regional hospital from 1/1/2004 to 31/12/2010. Data were linked between hospital records, midwives perinatal data, and laboratory results, then analysed using survival analysis and logistic regression. Indigenous women had significantly longer times to first oral glucose tolerance test (OGTT) [hazards ratio (HR) 0.62, 95 % confidence interval (CI) 0.48-0.79, p < 0.0001) and 'any' postpartum glucose test (HR 0.81, 95 % CI 0.67-0.98, p = 0.03], compared to non-Indigenous women. Postpartum screening rates among all women were low. However, early OGTT screening rates (<6 months) were significantly lower among Indigenous women (13.6 vs. 28.3 %, p < 0.0001), leading to a persistent gap in cumulative postpartum screening rates. By 3 years postpartum, cumulative rates of receiving an OGTT, were 24.6 % (95 % CI 19.9-30.2 %) and 34.1 % (95 % CI 30.6-38.0 %) among Indigenous and non-Indigenous women, respectively. Excluding OGTTs in previous periods, few women received OGTTs at 6-24 months (7.8 vs. 6.7 %) or 2-4 years (5.2 vs. 6.5 %), among Indigenous and non-Indigenous women, respectively. Low rates of postpartum diabetes screening demonstrate that essential 'ongoing management' and 'equity' criteria for population-based screening for gestational diabetes are not being met; particularly among Indigenous women, for whom recent guideline changes have specific implications. Strategies to improve postpartum screening after gestational diabetes are urgently needed. PMID:24981736

  8. Prevalence of serious psychological distress and mental health treatment in a national sample of pregnant and postpartum women.

    PubMed

    Glasheen, Cristie; Colpe, Lisa; Hoffman, Valerie; Warren, Lauren Klein

    2015-01-01

    This study examines the prevalence and correlates of past month serious psychological distress (SPD) and past year mental health treatment (MHT) across pregnancy and the postpartum. Data are from the 2008 to 2012 National Surveys on Drug Use and Health. Prevalence estimates of SPD as well as MHT among women with SPD were generated for each trimester and across the postpartum period. Correlates of SPD and MHT were examined among pregnant and postpartum women. The prevalence of past month SPD was 6.4 % in first trimester women and 3.9 % in third trimester women. In postpartum women, SPD prevalence ranged from 4.6 % (0-2 months) to 6.9 % (3-5 months). Correlates of SPD among pregnant and postpartum women included being younger; non-Hispanic black; unmarried; making under $20,000 annually; having past month cigarette use; or having a past year alcohol or illicit drug use disorder. Only 38.5 % of pregnant and 49.5 % of postpartum women with past month SPD reported past year MHT. Those who received MHT were more likely to be white; widowed, divorced, or separated; have insurance; and have a history of depression or anxiety than their counterparts with no MHT. Pregnant women with SPD were less likely to report past year MHT than postpartum women, even after adjusting for potential confounders. Over half of pregnant and postpartum women with past month SPD are not receiving MHT. Increased contact with health care professionals during this time may be an opportunity for screening, identification, and referral to MHT. PMID:24802262

  9. Prenatal depression leading to postpartum psychosis.

    PubMed

    Ebeid, E; Nassif, N; Sinha, P

    2010-01-01

    Postpartum psychosis is a mood disorder occurring up to 3 months after delivery. Incidence is one to two women every 1,000 live births. If not detected and appropriately treated in time, it may have detrimental effects on both the mother and her baby. We report a case of puerperal psychosis in a patient with a history of depression. We have also reviewed the relevant literature discussing prediction, management and differential diagnosis of postpartum psychosis. We emphasise the importance of early detection and provision of care to all women at risk of mental illness by multidisciplinary team, including GPs, obstetricians, midwives and perinatal mental health professionals. PMID:20604641

  10. Patterns and trends of postpartum family planning in Ethiopia, Malawi, and Nigeria: evidence of missed opportunities for integration

    PubMed Central

    Hounton, Sennen; Winfrey, William; Barros, Aluisio J. D.; Askew, Ian

    2015-01-01

    Background The first 12 months following childbirth are a period when a subsequent pregnancy holds the greatest risk for mother and baby, but also when there are numerous contacts with the healthcare system for postnatal care for mother and baby (immunisation, nutrition, etc.). The benefits and importance of postpartum family planning are well documented. They include a reduction in risk of miscarriage, as well as mitigation of (or protection against) low birth weight, neonatal and maternal death, preterm birth, and anaemia. Objectives The objectives of this paper are to assess patterns and trends in the use of postpartum family planning at the country level, to determine whether postpartum family planning is associated with birth interval and parity, and to identify the health services most closely associated with postpartum family planning after adjusting for socio-economic characteristics. Design Data were used from Demographic and Health Surveys that contain a reproductive calendar, carried out within the last 10 years, from Ethiopia, Malawi, and Nigeria. All women for whom the calendar was completed and who gave birth between 57 and 60 months prior to data collection were included in the analysis. For each of the births, we merged the reproductive calendar with the birth record into a survey for each country reflecting the previous 60 months. The definition of the postpartum period in this paper is based on a period of 3 months postpartum. We used this definition to assess early adoption of postpartum family planning. We assessed variations in postpartum family planning according to demographic and socio-economic variables, as well as its association with various contact opportunities with the health system [antenatal care (ANC), childbirth in facilities, immunisation, etc.]. We did simple descriptive analysis with tabular, graphic, and equiplot displays and a logistic regression controlling for important background characteristics. Results Overall, variation in postpartum use of modern contraception was not affected over the years by age or marital status. One contrast to this is in Ethiopia, where the data show a significant increase in uptake of postpartum contraception among adolescents from 2005 to 2011. There are systematic and pervasive equity issues in the use of modern postpartum family planning by education level, place of residence, and wealth quintile, especially in Ethiopia where the gaps are very large. Disaggregation of data also point to significant sub-national variations. After adjusting for socio-economic variables, the most consistent health sector services associated with modern postpartum contraception are institutional childbirth and child immunisation. ANC is less likely to be associated with the use of modern postpartum family planning. Conclusion Postpartum use of modern family planning has remained very low over the years, including for childbearing adolescents. Our results indicate that improving postpartum family planning requires policies and strategies to address the inequalities caused by socio-economic factors and the integration of family planning with maternal and newborn health services, particularly with childbirth in facilities and child immunisation. Scaling up systematic screening, training of providers, and generation of demand are some possible ways forward. PMID:26562144

  11. Prepartum and Postpartum Rumen Fluid Microbiomes: Characterization and Correlation with Production Traits in Dairy Cows

    PubMed Central

    Lima, Fabio S.; Oikonomou, Georgios; Lima, Svetlana F.; Bicalho, Marcela L. S.; Ganda, Erika K.; de Oliveira Filho, Jose C.; Lorenzo, Gustavo; Trojacanec, Plamen

    2014-01-01

    Microbes present in the rumen of dairy cows are essential for degradation of cellulosic and nonstructural carbohydrates of plant origin. The prepartum and postpartum diets of high-producing dairy cows are substantially different, but in what ways the rumen microbiome changes in response and how those changes may influence production traits are not well elucidated. Here, we sequenced the 16S and 18S rRNA genes using the MiSeq platform to characterize the prepartum and postpartum rumen fluid microbiomes in 115 high-producing dairy cows, including both primiparous and multiparous animals. Discriminant analysis identified differences between the microbiomes of prepartum and postpartum samples and between primiparous and multiparous cows. 18S rRNA sequencing revealed an overwhelming dominance of the protozoan class Litostomatea, with over 90% of the eukaryotic microbial population belonging to that group. Additionally, fungi were relatively more prevalent and Litostomatea relatively less prevalent in prepartum samples than in postpartum ones. The core rumen microbiome (common to all samples) consisted of 64 bacterial taxa, of which members of the genus Prevotella were the most prevalent. The Chao1 richness index was greater for prepartum multiparous cows than for postpartum multiparous cows. Multivariable models identified bacterial taxa associated with increased or reduced milk production, and general linear models revealed that a metagenomically based prediction of productivity is highly associated with production of actual milk and milk components. In conclusion, the structure of the rumen fluid microbiome shifts between the prepartum and first-week postpartum periods, and its profile within the context of this study could be used to accurately predict production traits. PMID:25501481

  12. The relationship between breastfeeding and postpartum weight change--a systematic review and critical evaluation.

    PubMed

    Neville, C E; McKinley, M C; Holmes, V A; Spence, D; Woodside, J V

    2014-04-01

    Pregnancy and the postpartum period is a time of increased vulnerability for retention of excess body fat in women. Breastfeeding (BF) has been shown to have many health benefits for both mother and baby; however, its role in postpartum weight management is unclear. Our aim was to systematically review and critically appraise the literature published to date in relation to the impact of BF on postpartum weight change, weight retention and maternal body composition. Electronic literature searches were carried out using MEDLINE, EMBASE, PubMed, Web of Science, BIOSIS, CINAHL and British Nursing Index. The search covered publications up to 12 June 2012 and included observational studies (prospective and retrospective) carried out in BF mothers (either exclusively or as a subgroup), who were ≤ 2 years postpartum and with a body mass index (BMI) >18.5 kg m(-2), with an outcome measure of change in weight (including weight retention) and/or body composition. Thirty-seven prospective studies and eight retrospective studies were identified that met the selection criteria; studies were stratified according to study design and outcome measure. Overall, studies were heterogeneous, particularly in relation to sample size, measurement time points and in the classification of BF and postpartum weight change. The majority of studies reported little or no association between BF and weight change (n=27, 63%) or change in body composition (n=16, 89%), although this seemed to depend on the measurement time points and BF intensity. However, of the five studies that were considered to be of high methodological quality, four studies demonstrated a positive association between BF and weight change. This systematic review highlights the difficulties of examining the association between BF and weight management in observational research. Although the available evidence challenges the widely held belief that BF promotes weight loss, more robust studies are needed to reliably assess the impact of BF on postpartum weight management. PMID:23892523

  13. Greater nutrition knowledge is associated with lower 1-year postpartum weight retention in low-income women.

    PubMed

    Nuss, Henry; Freeland-Graves, Jeanne; Clarke, Kristine; Klohe-Lehman, Deborah; Milani, Tracey J

    2007-10-01

    The purpose of this study was to assess nutrition knowledge during early and late postpartum in a sample of low-income and minority women, and to determine if that knowledge had any relationship to weight retention at 1-year postpartum. A questionnaire was developed and validated in a sample of 151 low-income new mothers. This instrument was then administered to a separate sample of mothers (n=140) of similar demographics to assess nutrition knowledge at 0 to 1 days and 12 months postpartum. In addition, a survey of nutrition information sources was administered at both time points. Nutrition knowledge was compared with 12-month postpartum weight retention and demographic variables. Women who retained less than 5% of weight gained during pregnancy had greater knowledge of nutrition at 0 months (53% vs 49%, P<0.05) and 12 months (55% vs 51%, P<0.05) than those who retained 5% or more of weight gained during pregnancy. Whites had higher nutrition knowledge scores than non-Hispanic blacks and Hispanics. Women who lactated 6 months or more had more knowledge than those who lactated less than 6 months. Higher knowledge test scores were observed among women who used the Internet and books/magazines as their source for information. These results indicate that assessment of nutrition knowledge in early postpartum can identify women at risk for significant weight retention. PMID:17904941

  14. Postpartum fever in the presence of a fibroid: Sphingomonas paucimobilis sepsis associated with pyomyoma

    PubMed Central

    2013-01-01

    Background Pyomyoma is a life-threatening complication of uterine leiomyoma. It may occur in post- menopausal women, during pregnancy and in the postpartum period. Fever may be the only manifestation during the early stages of the disease. We detail the first reported case of postpartum pyomyoma-related sepsis due to Sphingomonas paucimobilis, a Gram-negative bacillus that is gaining recognition as an important human pathogen. Case presentation A woman presented with an asymptomatic uterine fibroid and a two-week history of fever during the postpartum period. Suppurative uterine leiomyoma was diagnosed, and blood cultures grew Sphingomonas paucimobilis. The myoma was surgically removed from the uterus without hysterectomy. Intravenous antimicrobial therapy was given for fifteen days, and the patient was discharged from hospital in good condition. Conclusion Pyomyoma should be considered in broad differential diagnosis of postpartum fever. This case highlights a unique disease manifestation of S. paucimobilis, an emerging opportunistic pathogen with increasing significance in the nosocomial setting. PMID:24308831

  15. Endocrine substrates of cognitive and affective changes during pregnancy and postpartum.

    PubMed

    Workman, Joanna L; Barha, Cindy K; Galea, Liisa A M

    2012-02-01

    Pregnancy and motherhood constitute periods of tremendous hormonal variation that orchestrate parturition, lactation, maternal care, maternal aggression, and recognition of offspring, among other functions. Cognitive processing also varies during pregnancy and motherhood and may serve an adaptive function in preparation for parturition and rearing. Additionally, maternal experience may have enduring consequences for the brain, behavior, and cognition long after offspring are mature. However, the early postpartum period also renders women psychologically vulnerable as approximately 15% of women experience postpartum depression, with estimates of 50-80% reporting a milder form of depression termed "maternal blues." This review will present literature on pregnancy- and parity-related changes in both cognition and affect and how these changes likely involve plastic changes within the hippocampus, a region that is sensitive to reproductive hormones. Further, this review will discuss steroid and peptide hormones that may contribute to affective and cognitive disruptions during pregnancy and postpartum. Research in this area may reveal insight into how pregnancy and motherhood alter the likelihood of developing postpartum depression and related disorders. PMID:21967374

  16. Poor Pre-Pregnancy and Antepartum Mental Health Predicts Postpartum Mental Health Problems among US Women: A Nationally Representative Population-Based Study

    PubMed Central

    Witt, Whitney P.; Wisk, Lauren E.; Cheng, Erika R.; Hampton, John M.; Creswell, Paul; Hagen, Erika W.; Spear, Hilary A.; Maddox, Torsheika; DeLeire, Thomas

    2011-01-01

    Purpose Mental health problems disproportionately affect women, particularly during childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. Methods We examined data on 1,863 mothers from eleven panels of the 1996-2006 Medical Expenditure Panel Survey (MEPS). Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of “fair” or “poor.” Results 9.5% of women reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor pre-pregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between pre-pregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. Conclusions While poor antepartum mental health is the strongest predictor of postpartum mental health problems, pre-pregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health, as they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond. PMID:21349740

  17. Lying behavior and postpartum health status in grazing dairy cows.

    PubMed

    Seplveda-Varas, P; Weary, D M; von Keyserlingk, M A G

    2014-10-01

    Many cows have difficulty making the transition from pregnancy to lactation, as evidenced by the high incidence of disease that occurs in the weeks after calving. Changes in lying behavior can be used as an indicator of illness, yet no work to date has evaluated this relationship in dairy cows on pasture. The objectives of this study were to describe the lying behavior of grazing dairy cows during the first 3 wk after calving and determine the relationships between transition diseases and lying behavior. Our convenience sample included 227 multiparous and 47 primiparous Holstein cows from 6 commercial farms. Cows were recruited as they calved during the spring calving period. Electronic data loggers (Hobo Pendant G Acceleration, Onset Computer Corp., Pocasset, MA) recorded lying behavior at 1-min intervals. Diseases were recorded up to 21 d in milk, and cows were subsequently categorized into 3 health categories: (1) healthy, not lame and had no other signs of clinical (retained placenta, milk fever, metritis, mastitis) or subclinical (ketosis, hypocalcemia) postpartum diseases; (2) lame, identified as being clinically or severely lame with no other signs of clinical or subclinical postpartum disease; and (3) sick, diagnosed as having one or more clinical postpartum diseases (with or without a subclinical disease) but not lame. This last group was further divided into 2 groups: those that were diagnosed with a single clinical health event and those diagnosed with more than one clinical event. Lying behavior differed between primiparous and multiparous cows; primiparous cows divided their lying time into more bouts than did multiparous cows (9.7 0.54 vs. 8.4 0.26 bouts/d) and spent less time lying down than multiparous cows (7.5 0.38 h/d vs. 8.5 0.19 h/d). Lying behavior was also affected by illness; primiparous cows that developed more than one clinical disease, excluding lameness, spent more time lying, and tended to have longer lying bouts in the days following calving compared with healthy cows; multiparous severely lame cows spent more time lying down (1.7 h longer per day) compared with multiparous cows that were nonlame. Clinically lame cows had fewer lying bouts per day and these bouts were of longer duration than healthy nonlame cows. In summary, changes in lying behavior after calving were associated with postpartum health status in grazing dairy cows. PMID:25151885

  18. Feeding infants directly at the breast during the postpartum hospital stay is associated with increased breastfeeding at 6?months postpartum: a prospective cohort study

    PubMed Central

    Forster, Della A; Johns, Helene M; McLachlan, Helen L; Moorhead, Anita M; McEgan, Kerri M; Amir, Lisa H

    2015-01-01

    Objective To explore whether feeding only directly from the breast in the first 2448?h of life increases the proportion of infants receiving any breast milk at 6?months. Design A prospective cohort study. Setting Three maternity hospitals in Melbourne, Australia. Participants 1003 postpartum English-speaking women with a healthy singleton term infant, who intended to breast feed, were recruited between 2009 and 2011. Women were excluded if they or their infant were seriously ill. 92% (n=924) were followed up at 6?months postpartum. Primary and secondary outcome measures Main exposure variable type of infant feeding in hospital up to time of study recruitment (2448?h postpartum), categorised as fed directly at the breast only or received at least some expressed breast milk (EBM) or infant formula. Primary outcomeproportion of infants receiving any breast milk feeding at 6?months postpartum. Secondary outcomesproportion of infants receiving only breast milk feeding at 6?months; breast milk feeding duration; and maternal characteristics associated with giving any breast milk at 6?months. Results Infants who had fed only at the breast prior to recruitment were more likely to be continuing to have any breast milk at 6?months than those who had received any EBM and/or infant formula (76% vs 59%; adjusted OR 1.76, 95% CI 1.24 to2.48 (adjusted for parity, type of birth, breastfeeding intention, breastfeeding problems at recruitment, public/private status, epidural for labour or birth, maternal body mass index and education)). Conclusions Healthy term infants that fed only directly at the breast 2448?h after birth were more likely to be continuing to breast feed at 6?months than those who received any EBM and/or formula in the early postpartum period. Support and encouragement to initiate breastfeeding directly at the breast is important. PMID:25953728

  19. Postpartum contraceptive use and unmet need for family planning in five low-income countries

    PubMed Central

    2015-01-01

    Background During the post-partum period, most women wish to delay or prevent future pregnancies. Despite this, the unmet need for family planning up to a year after delivery is higher than at any other time. This study aims to assess fertility intention, contraceptive usage and unmet need for family planning amongst women who are six weeks postpartum, as well as to identify those at greatest risk of having an unmet need for family planning during this period. Methods Using the NICHD Global Network for Womens and Childrens Health Researchs multi-site, prospective, ongoing, active surveillance system to track pregnancies and births in 100 rural geographic clusters in 5 countries (India, Pakistan, Zambia, Kenya and Guatemala), we assessed fertility intention and contraceptive usage at day 42 post-partum. Results We gathered data on 36,687 women in the post-partum period. Less than 5% of these women wished to have another pregnancy within the year. Despite this, rates of modern contraceptive usage varied widely and unmet need ranged from 25% to 96%. Even amongst users of modern contraceptives, the uptake of the most effective long-acting reversible contraceptives (intrauterine devices) was low. Women of age less than 20 years, parity of two or less, limited education and those who deliver at home were at highest risk for having unmet need. Conclusions Six weeks postpartum, almost all women wish to delay or prevent a future pregnancy. Even in sites where early contraceptive adoption is common, there is substantial unmet need for family planning. This is consistently highest amongst women below the age of 20 years. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed in the majority of sites in order to reduce unmet need and to improve both maternal and infant outcomes, especially amongst young women. Study registration Clinicaltrials.gov (ID# NCT01073475) PMID:26063346

  20. Postpartum and contraception in women after gestational diabetes.

    PubMed

    Kerlan, V

    2010-12-01

    Women who have had gestational diabetes mellitus must be monitored in the immediate postpartum period to ensure that blood glucose levels return to normal without further treatment. In the few studies performed specifically in these women, those that breastfed did not have a different metabolic profile, at least during the period of breastfeeding; the metabolic profiles of children born to women that had gestational diabetes and that breastfed also did not differ from those that were not breastfed. The choice of contraception must mainly take into consideration the associated risk factors. The studies, even if few have specifically focused on women with a history of gestational diabetes, have not demonstrated a significant disturbance of glucose metabolism while using hormonal contraception, whether combined oral oestrogen/progestogen or progestogen-only contraception. However, the presence of obesity, hypertension, or dyslipidaemia must direct the choice of contraception towards one without cardiovascular consequences. In these cases, the intrauterine device is an excellent choice. PMID:21163421

  1. Risk/benefit ratio of changing late obstetrical strategies in the management of insulin-dependent diabetic pregnancies. A comparison between 1971-1977 and 1978-1985 periods in 389 pregnancies.

    PubMed

    Tchobroutsky, C; Vray, M M; Altman, J J

    1991-01-01

    We compared the results of 166 pregestational insulin dependent diabetic pregnancies in the period 1971-1977 to those of 223 in the period of 1978-1985, after the introduction of self monitoring of blood glucose. During this second study period late obstetrical strategies changed to prolongation of pregnancy up to term, avoidance of final hospitalization and decrease of the rate of cesarean section. Maternal blood glucose control was less optimal in the second period resulting in a higher incidence of fetal macrosomia. Despite this, unexplained stillbirth disappeared, neonatal morbidity did not change significantly and the overall benefit was a reduction of preterm birth and a better quality of life for our patients. We conclude that the final hospitalization from week 32 onward in insulin dependent diabetic pregnancies is no more mandatory. PMID:1864436

  2. Perception of Partner Sleep and Mood: Postpartum Couples' Relationship Satisfaction

    PubMed Central

    Insana, Salvatore P.; Costello, Chelsea R.; Montgomery-Downs, Hawley E.

    2011-01-01

    Separate research areas indicate that sleep quality, mood, and relationship satisfaction decline among couples during the postpartum period. Furthermore, accurate partner perceptions are associated with positive relationship qualities. Twenty-one first-time postpartum mother-father dyads, contributed one week of continuous wrist actigraphy along with concurrent subjective Palm Pilot monitoring to provide both objective and subjective sleep measures. Parents also reported on their own as well as their perception of their partners’ sleep, mood, and relationship satisfaction. Greater objectively measured total sleep time was associated with greater relationship satisfaction. Mothers underestimated fathers’ self-reported frequency of nocturnal awakenings and relationship satisfaction, and overestimated fathers’ self-reported sleep quality. Fathers underestimated mothers’ self-reported duration of wake at night and sleep quality, and overestimated mothers’ self-reported mood disturbance. Preventative measures that target sleep and improvement in perception of partner’s experiences could be used to buffer against decreases in relationship satisfaction among new parents. PMID:21961447

  3. Tips for Postpartum Dads and Partners

    MedlinePLUS

    ... if you stick to a plan of healthcare, support, and communication. Call our “Dads Chat with an Expert” on the first Monday of every month for a free, facilitated phone call with one of our experts in pregnancy and postpartum mental health and family support. Learn more about the Chat for Dads here. ...

  4. Uterine artery embolization for primary postpartum hemorrhage

    PubMed Central

    Kim, Tae-Hee; Lee, Hae-Hyeog; Kim, Jun-Mo; Ryu, Ae-Li; Chung, Soo-Ho; Seok Lee, Woo

    2013-01-01

    Background: Postpartum hemorrhage is the leading cause of severe maternal morbidity and death. A prompt management of uterine artery embolization (UAE) is important for a good outcome. UAE is generally accepted to be a safe and reliable procedure. Objective: To estimate critical patient characteristics influencing the success of UAE for the treatment of emergent primary postpartum hemorrhage. Materials and Methods: This was a cross sectional study that reviewed 121 patients who were diagnosed primary postpartum hemorrhage between February 2002 and December 2009 at a tertiary treatment center among 4,022 deliveries. We evaluated patient clinical characteristics associated with a successful surgical outcome of UAE. Results: The success rate for UAE was 96%. For two cases, UAE complication was associated with fever (>38.5oC). Five patients had problems that required admission to the intensive care unit (ICU). Conclusion: To increase the surgical success rate and lower the number of ICU admissions, the decision to treat primary postpartum hemorrhage using UAE should be based on individual patient clinical findings under the direction of obstetrics staff and an interventional radiologist. PMID:24639786

  5. Postpartum depression among women with unintended pregnancy

    PubMed Central

    Brito, Cynthia Nunes de Oliveira; Alves, Sandra Valongueiro; Ludermir, Ana Bernarda; de Araújo, Thália Velho Barreto

    2015-01-01

    OBJECTIVE To analyze the association between unintended pregnancy and postpartum depression. METHODS This is a prospective cohort study conducted with 1,121 pregnant aged 18 to 49 years, who attended the prenatal program devised by the Brazilian Family Health Strategy, Recife, PE, Northeastern Brazil, between July 2005 and December 2006. We interviewed 1,121 women during pregnancy and 1,057 after childbirth. Unintended pregnancy was evaluated during the first interview and postpartum depression symptoms were assessed using the Edinburgh Postnatal Depression Screening Scale. The crude and adjusted odds ratios for the studied association were estimated using logistic regression analysis. RESULTS The frequency for unintended pregnancy was 60.2%; 25.9% presented postpartum depression symptoms. Those who had unintended pregnancies had a higher likelihood of presenting this symptoms, even after adjusting for confounding variables (OR = 1.48; 95%CI 1.09;2.01). When the Self Reporting Questionnaire (SRQ-20) variable was included, the association decreased, however, remained statistically significant (OR = 1.42; 95%CI 1.03;1.97). CONCLUSIONS Unintended pregnancy showed association with subsequent postpartum depressive symptoms. This suggests that high values in Edinburgh Postnatal Depression Screening Scale may result from unintended pregnancy. PMID:26083941

  6. Anthropogenic changes and environmental degradation in pre-Hispanic and post-Colonial periods: soil erosion modelled with WEPP during Late Holocene in Teotihuacn Valley (central Mexico)

    NASA Astrophysics Data System (ADS)

    Lourdes Gonzlez-Arqueros, M.; Mendoza Cant, Manuel E.

    2015-04-01

    Land use changes and support practices are a worldwide significant issue in soil erosion and subsequently, land degradation. Anthropogenic changes, along different periods of the history in the last 2000 years in the Valley of Teotihuacan (central Mexico), highlight that soil erosion varies depending on how the management and the intensity of soil use is handled, considering the soils as a main resource. As a part of a broader effort to reconstruct the erosion dynamics in the Teotihuacn Valley through geoarchaeological approaches, this study apply a process-based watershed hydrology and upland erosion model, Water Erosion Prediction Project (WEPP). This research aims to contribute with insights through modelling and to recreate soil erosion and sedimentation dynamics in several historical periods with different environmental and anthropogenic scenarios. The Geo-spatial interface for WEPP (GeoWEPP) was used to characterize location of detachment, depositions and erosion predicted on the profile through time, based on current and hypothetical reconstructed conditions in the watershed. Climate, topography, soil and land use were used as inputs for the WEPP model to estimate runoff fluxes, soil loss rates, and sediment delivery ratio (SDR) for three historical scenarios: current period, reconstructed Teotihuacn period (AD 1-650), and reconstructed Aztec period (AD 1325-1520). Over a simulated and stablished timeframe for those social periods, the runoff, soil loss rate and SDR were estimated to be greater during the Aztec period. We assume that in general the climate conditions for this period were wetter, compared with present, in agreement with several authors that proposed climate reconstructions for the center of Mexico. It is also highlighted that support practices were more effective in this period. The next period with higher values is the current one, and fewer rates are estimated for the Teotihuacn period. This comparison release new arguments in the scientific debate about the antiquity and causes on ancient erosion in central Mexico and information for the social-cultural transition of periods. Therefore, it increases the knowledge for great periods in the Mesoamerica history through interdisciplinary approach. Nucleation of settlements, due to the Colonial policy for the nucleation and, abandonment by fall in population agree with a change in the soil use. Results show how changes in land use are one of the foremost reasons in the soil erosion, not only in nowadays conditions, but also in ancient periods.

  7. NEUROENDOCRINE FUNCTIONS OF PUERPERAE WITH POSTPARTUM DEPRESSION AGGRAVATED BY STRESSFUL CHILDBIRTH-RELATED EVENTS.

    PubMed

    Song, W; Yu, S

    2015-01-01

    In the period of gestation, delivery and post-delivery, fear and tension produced in puerperae are likely to evolve into depression as they worry too much about delivery pain. In recent years, it has been noted that stressful events during this period aggravate postpartum depression. To discuss the effect of these childbirth-related stressful events on neuroendocrine functions of patients with postpartum depression, 300 full-term puerperae who had been admitted to the Beijing Obstetrics and Gynecology Hospital, Capital Medical University between October, 2011 and October, 2013 and who had suffered from stressful childbirth-related events were enrolled as a study group. This group was divided into six subgroups, i.e., A, B, C, D, E and F, based on the number of stressful events they had suffered which were labeled by numbers 1 to 6. Additionally, 100 puerperae from the same hospital who had not suffered from childbirth-related stressful events were taken as controls. Relevant clinical indexes, including serum adrenocorticotropic hormone (ACTH), plasma 5-hydroxytryptamine (5-HT), noradrenaline ELISA (NE), dopamine (DA) and cortisol level were measured and compared. It was found that incidence probability of postpartum depression was significantly different between the study group (13.67%, 41/300) and the control group (7%, 7/100). Moreover, the incidence probability of postpartum depression of puerperae suffering from no less than 4 childbirth-related stressful events was higher than those suffering from no more than 3, and the difference was statistically significant (P<0.05). Thus, stress disorders caused by these events are one of the important pathogenic factors of postpartum depression. PMID:26403408

  8. Plasticity and constraint in response to early-life stressors among late/final Jomon period foragers from Japan: evidence for life history trade-offs from incremental microstructures of enamel.

    PubMed

    Temple, Daniel H

    2014-12-01

    This study evaluates two hypotheses that address how Late/Final Jomon period people responded to early-life stress using linear enamel hypoplasia (LEH) and incremental microstructures of enamel. The first hypothesis predicts that Jomon people who experienced early-life stressors had greater physiological competence in responding to future stress events (predictive adaptive response). The second hypothesis predicts that Jomon people traded-off in future growth and maintenance when early investment in growth and survival was required (plasticity/constraint). High resolution tooth impressions were collected from intact, anterior teeth and studied under an engineer's measuring microscope. LEH were identified based on accentuated perikymata and depressions in the enamel surface profile. Age of formation for each LEH was estimated by summing counts of perikymata and constants associated with crown initiation and cuspal enamel formation times. The relationship between age-at-first-defect formation, number of LEH, periodicity between LEH, and mortality was evaluated using multiple regression and hazards analysis. A significant, positive relationship was found between age-at-death relative to age-at-first-defect formation and a significant, negative relationship was found between number of LEH relative to age-at-first-defect formation. Individuals with earlier forming defects were at a significantly greater risk of forming defects at later stages of development and dying at younger ages. These results suggest that Late/Final Jomon period foragers responded to early-life stressors in a manner consistent with the plasticity/constraint hypothesis of human life history. Late/Final Jomon period individuals were able to survive early-life stressors, but this investment weakened responses to future stress events and exacerbated mortality schedules. PMID:25156299

  9. Late pregnancy thyroid-binding globulin predicts perinatal depression.

    PubMed

    Pedersen, Cort; Leserman, Jane; Garcia, Nacire; Stansbury, Melissa; Meltzer-Brody, Samantha; Johnson, Jacqueline

    2016-03-01

    Previously we found that late pregnancy total and free thyroxine (TT4, FT4) concentrations were negatively related to greater pre and/or postpartum depressive symptoms. In a much larger cohort, the current study examined whether these thyroid indices measured earlier in the third trimester (31-33 weeks) predict subsequent perinatal depression and anxiety ratings as well as syndromal depression. Thyroid-binding globulin (TBG) concentrations increase markedly during pregnancy and may be an index of sensitivity to elevated estrogen levels. TBG was examined in this study because prior findings suggest that postpartum depression is related to sensitivity to mood destabilization by elevated sex hormone concentrations during pregnancy. Our cohort was 199 euthyroid women recruited from a public health obstetrics clinic (63.8% Hispanic, 21.6% Black). After screening and blood draws for hormone measures at pregnancy weeks 31-33, subjects were evaluated during home visits at pregnancy weeks 35-36 as well as postpartum weeks 6 and 12. Evaluations included psychiatric interviews for current and life-time DSM-IV psychiatric history (M.I.N.I.-Plus), subject self-ratings and interviewer ratings for depression and anxiety (Edinburgh Postnatal Depression Scale, Montgomery-?sberg Depression Rating Scale; Spielberger State-Trait Anxiety Inventory, Hamilton Anxiety Inventory), as well as a standardized interview to obtain life-time trauma history. Numerous covariates were included in all regression analyses. Trauma and major depression history were robustly significant predictors of depression and anxiety ratings over the study period when these variables were analyzed individually or in a combined model including FT4 or TBG (p<.001). When analyzed alone, FT4 levels were a less strong but still significant predictor of all depression and anxiety ratings (p<.05) while TBG levels was a significant or nearly significant predictor of most ratings. FT4, TBG and trauma history, but not major depression history, were significant individual predictors of syndromal depression during the study period (p<.05) in single predictor models. In models combining each with trauma and major depression history, FT4 and TBG generally were not significantly predictive of depression or anxiety ratings, and FT4 was also not a significant predictor of syndromal depression: however, in the combined model TBG was a particularly strong predictor of perinatal syndromal depression (p=.005) and trauma history was also significant (p=.016). Further study of the interactions among TBG, FT4, sex hormones, trauma history and perinatal depression may provide insights into the pathophysiological basis of individual variance in vulnerability to mood destabilization by the hormone conditions of pregnancy. PMID:26731573

  10. Obstetric Characteristics and Management of Patients with Postpartum Psychosis in a Tertiary Hospital Setting

    PubMed Central

    Shehu, C. E.; Yunusa, M. A.

    2015-01-01

    Background. Postpartum psychosis is the most severe and uncommon form of postnatal affective illness. It constitutes a medical emergency. Acute management emphasizes hospitalization to ensure safety, antipsychotic medication adherence, and treatment of the underlying disorder. Objective. The aim of the study was to determine the obstetric characteristics and management of patients with postpartum psychosis in a tertiary centre in North-Western Nigeria. Methodology. This was a 10-year retrospective study. Records of the patients diagnosed with postpartum psychosis from January 1st, 2002, to December 31st, 2011, were retrieved and relevant data extracted and analyzed using the SPSS for Windows version 16.0. Results. There were 29 cases of postpartum psychosis giving an incidence of 1.1 per 1000 deliveries. The mean age of the patients was 20.6 ± 4 years. Twelve (55%) were primiparae, 16 (72.7%) were unbooked, and 13 (59%) delivered at home. All had vaginal deliveries at term. There were 12 (52.2%) live births, and 11 (47.8%) perinatal deaths and the fetal sex ratio was equal. The most common presentation was talking irrationally. Conclusion. There is need for risk factor evaluation for puerperal psychosis during the antenatal period especially in primigravidae and more advocacies to encourage women to book for antenatal care in our environment. PMID:26089908

  11. Meta-analysis of the role of delivery mode in postpartum depression (Iran 1997-2011)

    PubMed Central

    Bahadoran, Parvin; Oreizi, Hamid Reza; Safari, Saeideh

    2014-01-01

    Background: Postpartum period is the riskiest time for mood disorders and psychosis. Postpartum depression is the most important mood disorder after delivery, which can be accompanied by mother-child and family relationship disorders. Meta-analysis with the integration of research results demonstrates to investigate the association between the mode of delivery and postpartum depression. Materials and Methods: This meta-analysis uses the Rosenthal and Robin approach. For this purpose, 18 studies which were acceptable in terms of methodology were selected and meta-analysis was conducted on them. Research instrument was a checklist of meta-analysis. After summarizing the results of the studies, effect sizes were calculated manually and combined based on meta-analysis method. Results: The findings showed that the amount of effect size (in term of Cohen d) of delivery mode on postpartum depression was 0/30 (P < 0.001). Conclusion: Delivery mode on maternal mental health is assessed medium. Meta analysis also indicates moderator variables role, and researcher must focus in these variables. PMID:25540791

  12. Prepartum peripherally-induced hyposmia does not reduce postpartum anoestrus duration in nursing goats.

    PubMed

    Hernandez, Horacio; Delgadillo, J Alberto; Serafn, Norma; Rodrguez, Alma D; Poindron, Pascal

    2004-01-01

    Parturient goats rapidly develop exclusive nursing of their own litter that relies on olfactory recognition of the young. They also show a period of postpartum anoestrus whose duration depends on the presence of the kid. In cattle, maternal selectivity is one of the factors that delays the recovery of sexual activity. To investigate the possible influence of maternal selectivity on the duration of postpartum anoestrus in goats, we compared the recovery of estrus behavior by daily estrus detection with an active buck in intact and selective nursing goats (n = 24) with that of dams rendered non-selective by peripheral hyposmia with ZnSO4 (n = 18). Postpartum anoestrus duration was shorter in intact (68+/-7 days) than in hyposmic mothers (93+/-7 days; P < 0.05). However, the cycles of normal duration were less frequent in intact goats (P = 0.03). We conclude that in nursing goats, preventing the establishment of selective nursing by prepartum peripheral hyposmia does not reduce postpartum anoestrus duration. Our results suggest that daily exposure to the buck may result in an earlier recovery of ovarian activity in intact mothers. PMID:15460164

  13. Long-term postpartum adherence to antiretroviral drugs among women in Latin America.

    PubMed

    Kreitchmann, Regis; Coelho, Debora Fernandes; Kakehasi, Fabiana Maria; Hofer, Cristina Barroso; Read, Jennifer S; Losso, Marcelo; Haberer, Jessica E; Siberry, George K; Harris, D Robert; Yu, Qilu

    2016-04-01

    Antiretroviral adherence in the postpartum period is crucial for maternal health and decreasing the risk of mother-to-child HIV transmission and transmission to sexual partners. Self-reported antiretroviral adherence was examined between 6- to 12-weeks and 30 months postpartum among 270 HIV-infected women enrolled in a prospective cohort study from 2008 to 2010 at multiple sites in Latin America. Adherence data were collected at each study visit to quantify the proportion of prescribed antiretrovirals taken during the previous three days, assess the timing of the last missed dose, and identify predictors of adherence. Mean adherence rates were 89.5% at 6-12 weeks and 92.4% at 30 months; the proportions with perfect adherence were 80.3% and 83.6%, respectively. The overall trend for perfect adherence was not significant (p = 0.71). In adjusted regression modelling, younger age was associated with an increased probability of non-perfect adherence at 18 and 24 months postpartum. Other factors associated with increased probability of non-perfect adherence were higher parity, current use of alcohol and tobacco, and more advanced HIV disease. Women with perfect adherence had lower viral loads. Interventions for alcohol and tobacco use cessation, and support for young women and those with advanced HIV disease should be considered to improve postpartum adherence. PMID:25931238

  14. Preventing urinary incontinence during pregnancy and postpartum: a review.

    PubMed

    Wesnes, Stian Langeland; Lose, Gunnar

    2013-06-01

    Urinary incontinence (UI) is a common condition in association with pregnancy. Incident UI in pregnancy or postpartum are significant risk factors for UI later in life. Epidemiological studies on UI during pregnancy and postpartum list numerous variables associated with UI. For women, the main focus is on pelvic floor muscle training to prevent UI. However, several other modifiable risk factors are likely to contribute to prevention of UI during pregnancy and postpartum. This review investigated modifiable risk factors for UI during pregnancy and postpartum and also reviewed randomized controlled trials on prevention of UI in association with pregnancy. Systematic searches for publications until September 2012 on prevention of UI during pregnancy and postpartum were performed. Based on available evidence, the following recommendations to prevent UI during pregnancy and postpartum were made: women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations are addressed in association with pregnancy, incidence of UI during pregnancy and postpartum is likely to decrease. PMID:23436034

  15. The control of short-term feed intake by metabolic oxidation in late-pregnant and early lactating dairy cows exposed to high ambient temperatures.

    PubMed

    Eslamizad, Mehdi; Lamp, Ole; Derno, Michael; Kuhla, Bjrn

    2015-06-01

    The objective of the present study was to integrate the dynamics of feed intake and metabolic oxidation in late pregnant and early lactating Holstein cows under heat stress conditions. On day 21 before parturition and again on day 20 after parturition, seven Holstein cows were kept for 7days at thermoneutral (TN) conditions (15C; temperature-humidity-index (THI)=60) followed by a 7day heat stress (HS) period at 28C (THI=76). On the last day of each temperature condition, gas exchange, feed intake and water intake were recorded every 6min in a respiration chamber. Pre- and post-partum cows responded to HS by decreasing feed intake. The reduction in feed intake in pre-partum cows was achieved through decreased meal size, meal duration, eating rate and daily eating time with no change in meal frequency, while post-partum cows kept under HS conditions showed variable responses in feeding behavior. In both pre- and post-partum cows exposed to heat stress, daily and resting metabolic heat production decreased while the periprandial respiratory quotient (RQ) increased. The prolonged time between meal and the postprandial minimum in fat oxidation and the postprandial RQ maximum, respectively, revealed that HS as compared to TN early-lactating cows have slower postprandial fat oxidation, longer feed digestion, and thereby showing a shift from fat to glucose utilization. PMID:25839094

  16. Nighttime Breastfeeding Behavior Is Associated with More Nocturnal Sleep among First-Time Mothers at One Month Postpartum

    PubMed Central

    Doan, Therese; Gay, Caryl L.; Kennedy, Holly P.; Newman, Jack; Lee, Kathryn A.

    2014-01-01

    Study Objective: To describe sleep duration and quality in the first month postpartum and compare the sleep of women who exclusively breastfed at night to those who used formula. Methods: We conducted a longitudinal study in a predominantly low-income and ethnically diverse sample of 120 first-time mothers. Both objective and subjective measures of sleep were obtained using actigraphy, diary, and self-report data. Measures were collected in the last month of pregnancy and at one month postpartum. Infant feeding diaries were used to group mothers by nighttime breastfeeding behavior. Results: Mothers who used at least some formula at night (n = 54) and those who breastfed exclusively (n = 66) had similar sleep patterns in late pregnancy. However, there was a significant group difference in nocturnal sleep at one month postpartum as measured by actigraphy. Total nighttime sleep was 386 66 minutes for the exclusive breastfeeding group and 356 67 minutes for the formula group. The groups did not differ with respect to daytime sleep, wake after sleep onset (sleep fragmentation), or subjective sleep disturbance at one month postpartum. Conclusion: Women who breastfed exclusively averaged 30 minutes more nocturnal sleep than women who used formula at night, but measures of sleep fragmentation did not differ. New mothers should be encouraged to breastfeed exclusively since breastfeeding may promote sleep during postpartum recovery. Further research is needed to better understand how infant feeding method affects maternal sleep duration and fragmentation. Citation: Doan T; Gay CL; Kennedy HP; Newman J; Lee KA. Nighttime breastfeeding behavior is associated with more nocturnal sleep among first-time mothers at one month postpartum. J Clin Sleep Med 2014;10(3):313-319. PMID:24634630

  17. Malaria and immunity during pregnancy and postpartum: a tale of two species.

    PubMed

    McLean, A R D; Ataide, R; Simpson, J A; Beeson, J G; Fowkes, F J I

    2015-07-01

    It is well established that pregnant women are at an increased risk of Plasmodium falciparum infection when compared to non-pregnant individuals and limited epidemiological data suggest Plasmodium vivax risk also increases with pregnancy. The risk of P. falciparum declines with successive pregnancies due to the acquisition of immunity to pregnancy-specific P. falciparum variants. However, despite similar declines in P. vivax risk with successive pregnancies, there is a paucity of evidence P. vivax-specific immunity. Cross-species immunity, as well as immunological and physiological changes that occur during pregnancy may influence the susceptibility to both P. vivax and P. falciparum. The period following delivery, the postpartum period, is relatively understudied and available epidemiological data suggests that it may also be a period of increased risk of infection to Plasmodium spp. Here we review the literature and directly compare and contrast the epidemiology, clinical pathogenesis and immunological features of P. vivax and P. falciparum in pregnancy, with a particular focus on studies performed in areas co-endemic for both species. Furthermore, we review the intriguing epidemiology literature of both P. falciparum and P. vivax postpartum and relate observations to the growing literature pertaining to malaria immunology in the postpartum period. PMID:25731914

  18. Maternal bonding in mothers with postpartum anxiety disorder: the crucial role of subclinical depressive symptoms and maternal avoidance behaviour.

    PubMed

    Tietz, A; Zietlow, A-L; Reck, C

    2014-10-01

    Hardly any research has examined the link between postpartum anxiety disorder and maternal bonding. This study examined if postpartum anxiety disorder and maternal bonding are related in the postpartum period. Thereby, subclinical depressive symptoms and specific aspects of an anxious symptomatology were also taken into consideration. The German sample of N = 78 mother-infant dyads is composed of n = 30 mothers with postpartum anxiety disorders but without major or minor depression according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) and n = 48 healthy mothers. Subjects were interviewed with the Structured Clinical Interview for DSM-IV Disorders at an average infant age of M = 4.1 months. Moreover, mothers filled out the Postpartum Bonding Questionnaire-16. The Anxiety Cognitions Questionnaire, the Body Sensations Questionnaire and the Mobility Inventory were chosen to assess different aspects of anxious symptomatology. To control for concurrent subclinical depressive symptoms, we used the German Edinburgh-Postnatal-Depression Scale. Mothers with postpartum anxiety disorder reported significantly lower bonding than healthy mothers. However, in a linear regression analysis, concurrent subclinical depressive symptoms and avoidance of anxiety-related situations in company explained 27 % of the overall variance in maternal bonding. The perceived lower bonding of mothers with anxiety disorder could be due to aspects of a concurrent subclinical depressive symptomatology. This notion emphasizes the need to target even mild depressive symptoms in the treatment of postpartum anxiety disorders. The outcomes also underline that the severity of anxious symptomatology, reflected by avoidance behaviour in company, puts the mother-infant bond at risk. PMID:24687168

  19. Postpartum Sacral Stress Fracture: An Atypical Case Report.

    PubMed

    Speziali, Andrea; Tei, Matteo Maria; Placella, Giacomo; Chillemi, Marco; Cerulli, Giuliano

    2015-01-01

    Sacral stress fractures are common in elderly people. However, sacral stress fracture should be always screened in the differential diagnoses of low back pain during the postpartum period. We present a case of sacral fracture in a thirty-six-year-old woman with low back pain and severe right buttock pain two days after cesarean section delivery of a 3.9?Kg baby. The diagnosis was confirmed by MRI and CT scan, while X-ray was unable to detect the fracture. Contribution of mechanical factors during the cesarean section is not a reasonable cause of sacral fracture. Pregnancy and lactation could be risk factors for sacral stress fracture even in atraumatic delivery such as cesarean section. Our patient had no risk factors for osteoporosis except for pregnancy and lactation. Transient or focal osteoporosis is challenging to assess and it cannot be ruled out even if serum test and mineral density are within the normal range. PMID:26246926

  20. Visual acuity changes during pregnancy and postpartum: a cross-sectional study in Iran.

    PubMed

    Mehdizadehkashi, Khashayar; Chaichian, Shahla; Mehdizadehkashi, Abolfazl; Jafarzadepour, Ebrahim; Tamannaie, Zeinab; Moazzami, Bahram; Pishgahroudsari, Mohaddeseh

    2014-01-01

    In this research, we represent the changes in visual acuity during pregnancy and after delivery. Changes as myopic shift start during second trimester and will be stopped after delivery; however it is obtained that women will have the same refractive error as what they had in the first trimester, after postpartum. So, any change in their spectacle prescription during this period is forbidden. As a result, not only changing in hormones can cause myopic shift in vision, but also overweight has its retributive role. What we are trying to do is to notify gynecologists and optometrists to be aware of these changes, so as to leave spectacle prescription writing to the session after postpartum period. PMID:25328705

  1. [Use of Bakri Balloon in postpartum hemorrhage].

    PubMed

    Poreba, Ryszard; Nowosielski, Krzysztof; Belowska, Anna; Poreba, Aneta

    2010-03-01

    Postpartum hemorrhage (PPH) is one of the leading causes of maternal death and one of the major causes of mortality in women in developing countries. According to the Central Statistical Office, in 2006, in Poland 540 maternal peripartum deaths were noted, 34.7% of which due to PPH. Therefore, active postpartum management should be the main goal in contemporary obstetrics. Some PPH management algorithms have been proposed by the World Health Organization, the American College of Obstetricians and Gynecologists and Polish Gynecological Society. In the event of unsuccessful conventional management of PPH (uterotonics, curettage, etc.) a new technique, intrauterine Bakri balloon tamponade, has been recently proposed. The current paper presents two case reports where this method has been successfully applied. PMID:20486546

  2. The relationship between ovarian steroids and uterine estrogen receptors during late pregnancy

    SciTech Connect

    Cathey, T.M.; Chung, Kyung W. )

    1991-01-01

    Although a direct interdependence exists between the ovarian steroids, estrogen and progesterone, the exact role of these two hormones during pregnancy, especially late pregnancy, is not completely understood. Investigations have been conducted to determine whether the circulating levels of progesterone and estrogen or changes in the ratio of progesterone/estrogen in relation to the concentration of uterine estrogen receptors are associated with triggering parturition. Ninety-day old female rats were sacrificed at gestation days 14, 16, 18, 20 and two days post-partum. The plasma levels of estradiol and progesterone were measured by solid-phase radioimmunoassay. Uterine cytosol was subjected to a charcoal binding assay to determine the concentration of estrogen receptors. Our findings demonstrate that there is a significant drop in both plasma progesterone and estradiol during late pregnancy. Also indicated is a significant increase in uterine estrogen receptors throughout late pregnancy. Finally, during this period there is a direct correlation between the shift in the progesterone/estrogen ratio and the increase in the concentration of uterine estrogen receptors in late pregnancy.

  3. Direct-fed microbial supplementation on ruminal digestion, health, and performance of pre- and postpartum dairy cattle.

    PubMed

    Nocek, J E; Kautz, W P

    2006-01-01

    Effects of supplementing direct-fed microbial agents (DFM) to dairy cows during the transition period were evaluated. Forty-four Holstein cows were fed close-up and lactating diets that did or did not contain 2 g of DFM/cow per d. The direct-fed microbial (DFM) supplement was fed at a rate of 2 109 viable yeast cells and 5 109 cfu of bacteria per cow per day [corrected].Supplemented cows were fed the DFM 21 d prior to expected calving date through 10 wk postpartum. Cows supplemented with DFM had higher estimated ruminally available dry matter (DM) for both corn silage and haylage than did control cows. Supplemented cows consumed more DM during both the pre- and postpartum periods. In addition, those supplemented with DFM produced 2.3 kg more milk/cow per d than did nonsupplemented cows. There was no difference in 3.5% fat-corrected milk. Milk fat percentage was lower, but not depressed (4.76 vs. 4.44%) for cows receiving DFM. There were no differences in milk fat yield or milk protein percentage and yield. Cows consuming DFM had higher blood glucose postpartum, as well as lower beta-hydroxybutyrate levels both prepartum and on d 1 postpartum. Plasma nonesterified fatty acid concentration was not statistically affected by DFM, but was numerically lower prepartum and higher postpartum for supplemented cows. This study demonstrated that targeted DFM supplementation enhanced ruminal digestion of forage DM. Early lactation cows receiving supplemental DFM produced more milk and consumed more DM during the pre- and postpartum periods. Cows consuming DFM, however, experienced a lower, but not depressed, fat percentage compared with nonsupplemented cows. PMID:16357289

  4. Periodic isolation of the southern coastal plain of South Africa and the evolution of modern humans over late Quaternary glacial to interglacial cycles

    NASA Astrophysics Data System (ADS)

    Compton, J. S.

    2012-04-01

    Humans evolved in Africa, but where in Africa and by what mechanisms remain unclear. The evolution of modern humans over the last million years is associated with the onset of major global climate fluctuations, glacial to interglacial cycles, related to the build up and melting of large ice sheets in the Northern Hemisphere. During interglacial periods, such as today, warm and wet climates favored human expansion but during cold and dry glacial periods conditions were harsh and habitats fragmented. These large climate fluctuations periodically expanded and contracted African ecosystems and led to human migrations to more hospitable glacial refugia. Periodic isolation of relatively small numbers of humans may have allowed for their rapid evolutionary divergence from the rest of Africa. During climate transitions these divergent groups may have then dispersed and interbred with other groups (hybridization). Two areas at the opposite ends of Africa stand out as regions that were periodically isolated from the rest of Africa: North Africa (the Maghreb) and the southern coastal plain (SCP) of South Africa. The Maghreb is isolated by the Sahara Desert which periodically greens and is reconnected to the rest of Africa during the transition from glacial to interglacial periods. The SCP of South Africa is isolated from the rest of Africa by the rugged mountains of the Cape Fold Belt associated with inedible vegetation and dry climates to the north. The SCP is periodically opened when sea level falls by up to 130 m during glacial maxima to expose the present day submerged inner continental shelf. A five-fold expansion of the SCP receiving more rainfall in glacial periods may have served as a refuge to humans and large migratory herds. The expansive glacial SCP habitat abruptly contracts, by as much as one-third in 300 yr, during the rapid rise in sea level associated with glacial terminations. Rapid flooding may have increased population density and competition on the SCP to select for humans who expanded their diet to include marine resources or hunted large animals. Modest expansion of the coastal plain off Morocco and more extensive expansion off Tunisia would have similarly provided potential refugia for human groups during glacial periods. Other refugia in the African interior included the Ethiopian Highlands and the East African lakes; however, most of these regions probably had more diffuse barriers connected by river valley corridors. The earliest yet reported occurrence of symbolic artifacts from both North Africa and the SCP coastal caves of South Africa suggest that human populations in these areas were under shared selection pressures to adapt to increasing population densities associated with the transition from Marine Isotope Stage (MIS) 6 to 5, 135 to 130 thousand years ago. The hypothesis that periodic expansion and contraction of the coastal plains of South Africa and North Africa contributed to the stepwise origin of our species over the last 800 thousand years is evaluated by comparing the archeological, DNA and sea-level records.

  5. Fordyce happiness program and postpartum depression

    PubMed Central

    Rabiei, Leili; Mazaheri, Maryam Amidi; Masoudi, Reza; Hasheminia, Sayed Ali Mohammad

    2014-01-01

    Background: Postpartum depression is endangering the health of mothers and has negative impacts on the evolution of social communication and newborns evolution. This study was conducted to determine the effects of Fordyce Happiness program on the postpartum depression. Materials and Methods: This quasi-experimental intervention carried out on postpartum mothers that referred to 4 health centers in Isfahan. A total of 133 mothers were selected by convenient sampling and then randomly allocated in two groups (63 and 70 mothers for intervention and control respectively). Maternal depression 3 times before, immediate and 1 months after intervention in both groups was evaluated with Beck Depression Inventory-II-Persian standardized questionnaires. Educational sessions based on the Fordyce happiness program were conducted for intervention group. Data was analyzed in SPSS17 (SPSS Inc, Chicago, Illinois) descriptive and analytic statistical tests at significance level of 0.05. Results: No significant differences in demographic variables between the two groups (P ? 0.05). No significant differences in depression scores in the two groups before training. However after 2 months a significant difference in depression score was observed between two groups (control group: 19.38 3.94; intervention group: 16.24 4.8; P < 0.001). Furthermore in intervention group showed significant differences in depression scores before and after intervention (19.15 3.41 and 16.24 4.83; P < 0.001). However in the control group had not any significant change. Conclusion: Fordyce happiness program was effective in reducing postpartum depression in our study. With attention to the effectiveness and low cost of this program, it is recommended that this program might be considered for all mothers after childbirth in health centers or other community-based settings. PMID:24949034

  6. Postpartum Ovarian Vein and Inferior Vena Cava Thrombosis

    PubMed Central

    Ada, Sibel; elik, Sebahattin; Topta?, Tayfur

    2014-01-01

    Postpartum ovarian vein thrombosis (POVT), which generally occurs 215 days postpartum, is a rare complication. It can be confused with acute appendicitis, pelvic infection, ovarian torsion, tubo-ovarian abscess, and pyelonephritis. It is associated with morbidity and mortality. Here, we present a patient with postpartum OVT and IVC diagnosed by US and CT findings. She was treated successfully with no further need for any interventional procedures. PMID:25114685

  7. Effects of rumen-protected methionine on plasma amino acid concentrations during a period of weight loss for late gestating beef heifers.

    PubMed

    Waterman, Richard C; Ujazdowski, Valerie L; Petersen, Mark K

    2012-11-01

    This study determined changes in plasma amino acid concentration in late-gestating (beginning 58 ± 1.02 days prior to calving), primiparous, winter-grazing range heifers receiving wheat middling-based supplement without (CON) or with rumen-protected methionine (MET) to provide 15 g DL-MET each day. Plasma was collected on days -2 and 0 (start of MET supplementation just prior to individually receiving supplement at 0700 hours). Plasma was sampled again on days 40, 42 and 44 prior to supplementation at 0700 and 1100 hours (4 h after receiving daily supplement). Data were analyzed with cow as the experimental unit. Continuous variables were analyzed by the main effects of treatment, date, or time and their interaction when appropriate. Comparable BW (P = 0.32) and BCS (P = 0.83) over the 44-day metabolism trial were found between both CON- and MET-fed heifers. MET-supplemented heifers had greater (P < 0.01) plasma concentrations of methionine indicating that the rumen-protection technology successfully delivered methionine to the small intestine. Supplementation with rumen-protected DL-MET caused a significant supplement × date interaction for glutamine (P = 0.03), glycine (P = 0.02), methionine (P < 0.01), and serine (P = 0.05). In addition, trends for supplement × date interactions were detected for leucine (P = 0.07), threonine (P = 0.09), valine (P = 0.08), total amino acids (TAA; P = 0.08), non essential amino acids (NEAA; P = 0.08), branched chain amino acids (BCAA; P = 0.08), and glucogenic amino acids (GLUCO; P = 0.08). These results suggest that the BCAA (leucine and valine) were utilized more efficiently with MET supplemented heifers compared to CON supplemented heifers. Plasma AA concentrations for glutamic acid (P < 0.01), histidine (P = 0.01), tyrosine (P < 0.01), and EAA (P < 0.01), all decreased throughout the study. These results further confirm methionine is a limiting amino acid in forage fed late-gestating heifers and further suggests the limitation when grazing dormant range forages as shown by improved utilization of other plasma amino acids when supplemental methionine was provided. PMID:22555648

  8. Postpartum Contraception: a Comparative Study of Berlin Women with and without Immigration Background

    PubMed Central

    David, M.; Brenne, S.; Breckenkamp, J.; Razum, O.; Borde, T.

    2015-01-01

    Research Questions: Are there differences in postpartum contraceptive use between women with and without immigration background? Do women more commonly use contraception following a high-risk pregnancy or caesarean section? What role does current breastfeeding play and, amongst immigrants, what is the effect of acculturation level on the frequency of contraceptive use? Study Population and Methods: Data collection was carried out as part of a larger study in three Berlin delivery units using standardised interviews (questionnaires covering e.g. sociodemographics, immigration history/acculturation and use of antenatal care); telephone interviews comprising 6 questions on postpartum contraception, breastfeeding and postpartum complications were conducted on a sample of the study population six months after delivery. Results: 247 women with, and 358 women without a background of immigration were included in the study (total study population n = 605, response rate 81.1 %). 68 % of 1st generation immigrants, 87 % of 2nd/3rd generation women and 73 % of women without immigration background (non-immigrants) used contraception. In the logistical regression analysis 1st generation immigrants were less likely than non-immigrants to be using contraception six months postpartum, and 1st generation immigrants with low acculturation level were significantly less likely to use contraception than 2nd/3rd generation women with low acculturation level. Conclusion: In the extended postpartum period there was no major difference in contraceptive use between immigrants in general and non-immigrants. It remains unclear whether the differing contraceptive behaviour of 1st generation immigrants is the result of less access to information, sociocultural factors or differing contraceptive requirements and further targeted, qualitative study is required. PMID:26500367

  9. Postpartum Maternal and Neonatal Hospitalizations Among Women with HIV: A Population-Based Study

    PubMed Central

    Macdonald, Erin M.; Ng, Ryan; Yudin, Mark H.; Bayoumi, Ahmed M.; Loutfy, Mona; Raboud, Janet; Masinde, Khatundi-Irene; Tharao, Wangari E.; Brophy, Jason; Glazier, Richard H.

    2015-01-01

    Abstract Postpartum maternal and neonatal readmissions in the period shortly following birth are indicators of serious morbidity. We compared the risk of postpartum maternal and neonatal hospitalizations in women living with and without HIV in Ontario, Canada. We conducted a population-based study of pregnancies in Ontario between April 1, 2002 and March 31, 2011 using Ontario's administrative health care databases. Generalized estimating equations were used to derive adjusted odds ratios (aORs) and 95% confidence intervals (CI) for the association of HIV infection with postpartum maternal hospitalizations within 30 days of hospital discharge and neonatal hospitalizations within 30 and 60 days of hospital discharge. Between 2002/2003 and 2010/2011, 1,133,505 pregnancies were available for analysis, of which 634 (0.06%) were to women living with HIV. The proportion of postpartum maternal hospitalizations (2.8% versus 1.1%; odds ratio 2.53; 95% CI 1.57 to 4.07) was higher among women with HIV. The multivariable adjusted odds ratio was 1.54 (95% CI 0.93 to 2.55). The proportions of neonates hospitalized within 30 (2.6% versus 3.7%; aOR 0.68, 95% CI 0.42 to 1.10) and 60 days (4.9% versus 4.9%; aOR 0.86, 95% CI 0.60 to 1.24) of discharge were similar among infants born to women with and without HIV. Women living with HIV are at a higher risk of postpartum maternal hospitalizations than women not living with HIV. The effect of HIV infection was attenuated by multivariable adjustment, suggesting that sociodemographic or health care factors are responsible for much of the difference in outcomes. PMID:26132654

  10. Postpartum women's use of medicines and breastfeeding practices: a systematic review.

    PubMed

    Saha, Moni R; Ryan, Kath; Amir, Lisa H

    2015-01-01

    The objectives of this article are to systematically review i) the extent of medicine use in postpartum women, and ii) the impact of maternal medicine use (excluding contraceptives and galactogogues) on breastfeeding outcomes (initiation and/or duration). PubMed, Medline (Ovid), Scopus (Elsevier), Cinahl (EBSCO), PsycINFO (Ovid), Embase (Ovid) and Web of Science (ISI) databases were searched to find original studies on medicine use in women after the birth. Additional studies were identified by searching Google Scholar, Wiley Online Library, Springer Link, selected journals and from the reference list of retrieved articles. Observational studies with information about postpartum women's use of any type of medicine either for chronic or acute illnesses with or without breastfeeding information were included. The majority of relevant studies suggest that more than 50 % of postpartum women (breastfeeding or not) required at least one medicine. Due to the lack of uniform medication use reporting system and differences in study designs, settings and samples, the proportion of medicine use by postpartum women varies widely, from 34 to 100 %. Regarding the impact of postpartum women's medicine use on breastfeeding, a few studies suggest that women's use of certain medicines (e.g. antiepileptics, propylthiouracil, antibiotics) during lactation can reduce initiation and/ or duration of breastfeeding. These studies are limited by small sample size, and with one exception, all were conducted in Canada more than a decade ago. Large scale studies are required to establish the relationship between maternal medicine use and breastfeeding, considering type of illness, period of use and total duration of medicine use. PMID:26516340

  11. Clinical guidelines for postpartum women and infants in primary carea systematic review

    PubMed Central

    2014-01-01

    Background While many women and infants have an uneventful course during the postpartum period, others experience significant morbidity. Effective postpartum care in the community can prevent short, medium and long-term consequences of unrecognised and poorly managed problems. The use of rigorously developed, evidence-based guidelines has the potential to improve patient care, impact on policy and ensure consistency of care across health sectors. This study aims to compare the scope and content, and assess the quality of clinical guidelines about routine postpartum care in primary care. Methods PubMed, the National Guideline Clearing House, Google, Google Scholar and relevant college websites were searched for relevant guidelines. All guidelines regarding routine postpartum care published in English between 2002 and 2012 were considered and screened using explicit selection criteria. The scope and recommendations contained in the guidelines were compared and the quality of the guidelines was independently assessed by two authors using the AGREE II instrument. Results Six guidelines from Australia (2), the United Kingdom (UK) (3) and the United States of America (USA) (1), were included. The scope of the guidelines varied greatly. However, guideline recommendations were generally consistent except for the use of the Edinburgh Postnatal Depression Scale for mood disorder screening and the suggested time of routine visits. Some recommendations lacked evidence to support them, and levels or grades of evidence varied between guidelines. The quality of most guidelines was adequate. Of the six AGREE II domains, applicability and editorial independence scored the lowest, and scope, purpose and clarity of presentation scored the highest. Conclusions Only one guideline provided comprehensive recommendations for the care of postpartum women and their infants. As well as considering the need for region specific guidelines, further research is needed to strengthen the evidence supporting recommendations made within guidelines. Further improvement in the editorial independence and applicability domains of the AGREE ll criteria would strengthen the quality of the guidelines. PMID:24475888

  12. CoRoT 101186644: A transiting low-mass dense M-dwarf on an eccentric 20.7-day period orbit around a late F-star. Discovered in the CoRoT lightcurves

    NASA Astrophysics Data System (ADS)

    Tal-Or, L.; Mazeh, T.; Alonso, R.; Bouchy, F.; Cabrera, J.; Deeg, H. J.; Deleuil, M.; Faigler, S.; Fridlund, M.; Hébrard, G.; Moutou, C.; Santerne, A.; Tingley, B.

    2013-05-01

    We present the study of the CoRoT transiting planet candidate 101186644, also named LRc01_E1_4780. Analysis of the CoRoT lightcurve and the HARPS spectroscopic follow-up observations of this faint (mV = 16) candidate revealed an eclipsing binary composed of a late F-type primary (Teff = 6090 ± 200 K) and a low-mass, dense late M-dwarf secondary on an eccentric (e = 0.4) orbit with a period of ~20.7 days. The M-dwarf has a mass of 0.096 ± 0.011 M⊙, and a radius of 0.104-0.006+0.026 R⊙, which possibly makes it the smallest and densest late M-dwarf reported so far. Unlike the claim that theoretical models predict radii that are 5-15% smaller than measured for low-mass stars, this one seems to have a radius that is consistent and might even be below the radius predicted by theoretical models. Based on observations made with the 1-m telescope at the Wise Observatory, Israel, the Swiss 1.2-m Leonhard Euler telescope at La Silla Observatory, Chile, the IAC-80 telescope at the Observatory del Teide, Canarias, Spain, and the 3.6-m telescope at La Silla Observatory (ESO), Chile (program 184.C-0639).

  13. Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women

    PubMed Central

    2010-01-01

    Background Whilst the prevalence and correlates of postpartum depression are well established, far less is known about postpartum anxiety. Studies have described the association between socio-demographic factors and postpartum depression, yet few have explored the association between stressors in women's lives around the time of having a baby and maternal psychological morbidity. This study aimed to describe the population prevalence of postpartum depression, anxiety, co-morbid anxiety and depression and social health issues; and to examine the association between postpartum psychological and social health issues experienced in the six months following birth. Methods Population-based survey of all women who gave birth in Victoria and South Australia in September/October 2007. Women were mailed the survey questionnaire six months following birth. Anxiety and depression were measured using the Depression Anxiety Stress Scales (DASS-21). Results Questionnaires were completed by 4,366 women. At six months postpartum the proportion of women scoring above the 'normal' range on the DASS-21 was 12.7% for anxiety,17.4% for depression, and 8.1% for co-morbid depression and anxiety. Nearly half the sample reported experiencing stressful life events or social health issues in the six months following birth, with 38.3% reporting one to two and 8.8% reporting three or more social health issues. Women reporting three or more social health issues were significantly more likely to experience postnatal anxiety (Adj OR = 4.12, 95% CI 3.0-5.5) or depression (Adj OR = 5.11, 95% CI = 3.9-6.7) and co-morbid anxiety and depression (Adj OR = 5.41, 95% CI 3.8-7.6) than women who did not report social health issues. Conclusions Health care providers including midwives, nurses, medical practitioners and community health workers need to be alert to women's social circumstances and life events experienced in the perinatal period and the interplay between social and emotional health. Usual management for postpartum mental health issues including Cognitive Behavioural Therapy and pharmacological approaches may not be effective if social health issues are not addressed. Coordinated and integrated perinatal care that is responsive to women's social health may lead to improvements in women's emotional wellbeing following birth. PMID:21167078

  14. Preventing postpartum depression: A meta-analytic review

    PubMed Central

    Sockol, Laura E.; Epperson, C. Neill; Barber, Jacques P.

    2014-01-01

    This meta-analysis assessed the efficacy of a wide range of preventive interventions designed to reduce the severity of postpartum depressive symptoms or decrease the prevalence of postpartum depressive episodes. A systematic review identified 37 randomized or quasi-randomized controlled trials in which an intervention was compared to a control condition. Differences between treatment and control conditions in the level of depressive symptoms and prevalence of depressive episodes by 6 months postpartum were assessed in separate analyses. Depressive symptoms were significantly lower at post-treatment in intervention conditions, with an overall effect size in the small range after exclusion of outliers (Hedges' g = 0.18). There was a 27% reduction in the prevalence of depressive episodes in intervention conditions by 6 months postpartum after removal of outliers and correction for publication bias. Later timing of the postpartum assessment was associated with smaller differences between intervention and control conditions in both analyses. Among studies that assessed depressive symptoms using the EPDS, higher levels of depressive symptoms at pre-treatment were associated with smaller differences in depressive symptoms by 6 months postpartum. These findings suggest that interventions designed to prevent postpartum depression effectively reduce levels of postpartum depressive symptoms and decrease risk for postpartum depressive episodes. PMID:24211712

  15. Sleep and Sleepiness among First-Time Postpartum Parents: A Field- and Laboratory-Based Multimethod Assessment

    PubMed Central

    Insana, Salvatore P.; Montgomery-Downs, Hawley E.

    2012-01-01

    The study aim was to compare sleep, sleepiness, fatigue, and neurobehavioral performance among first-time mothers and fathers during their early postpartum period. Participants were 21 first-time postpartum mother-father dyads (N=42) and seven childless control dyads (N=14). Within their natural environment, participants completed one week of wrist actigraphy monitoring, along with multi-day self-administered sleepiness, fatigue, and neurobehavioral performance measures. The assessment week was followed by an objective laboratory based test of sleepiness. Mothers obtained more sleep compared to fathers, but mothers sleep was more disturbed by awakenings. Fathers had greater objectively measured sleepiness than mothers. Mothers and fathers did not differ on subjectively measured sleep quality, sleepiness, or fatigue; however, mothers had worse neurobehavioral performance than fathers. Compared to control dyads, postpartum parents experienced greater sleep disturbance, sleepiness, and sleepiness associated impairments. Study results inform social policy, postpartum sleep interventions, and research on postpartum family systems and mechanisms that propagate sleepiness. PMID:22553114

  16. What patterns of postpartum psychological distress are associated with maternal concerns about their children's emotional and behavioural problems at the age of three years?

    PubMed Central

    Benzies, Karen; Mychasiuk, Richelle; Tough, Suzanne

    2015-01-01

    Mothers experiencing psychological distress in the postpartum period may have difficulties parenting their children. Inconsistent and unresponsive parenting may increase the risk of later emotional and behavioural problems in children. The purpose of this study was to identify how maternal psychological characteristics cluster at eight weeks postpartum, and whether these clusters were associated with maternal-reported child emotional and behavioural problems at the age of three years, as measured by the Parents' Evaluation of Developmental Status (PEDS) questionnaire. In a longitudinal pregnancy cohort (N?=?647), three clusters of postpartum psychological characteristics were identified. Contrary to expectations, mothers with the greatest psychological distress did not report concerns about their child's emotional and behavioural problems; rather, they reported concerns about global developmental delay. These findings suggest that infants of mothers experiencing postpartum psychological distress should receive additional follow-up to reduce the risk for global developmental delay. PMID:25544794

  17. The Technical and Financial Effects of Parenteral Supplementation with Selenium and Vitamin E during Late Pregnancy and the Early Lactation Period on the Productivity of Dairy Cattle.

    PubMed

    Bayril, T; Yildiz, A S; Akdemir, F; Yalcin, C; Köse, M; Yilmaz, O

    2015-08-01

    This study aimed to determine the effects of parenteral selenium (Se) and vitamin E supplementation on economic impact, milk yield, and some reproductive parameters in high-yield dairy cows in the dry period and in those at the beginning of lactation. At the beginning of the dry period, cows (n = 323) were randomly divided into three groups as follows: Treatment 1 (T1), Treatment 2 (T2), and Control (C). Cows in group T1 received this preparation 21 days before calving and on calving day, and cows in group T2 received it only on calving day. The cows in the control group did not receive this preparation. Supplementation with Se increased Se serum levels of cows treated at calving day (p<0.05). Differences in milk yield at all weeks and the electrical conductivity values at the 8th and 12th weeks were significant (p<0.05). Supplementation with Se and Vitamin E decreased the incidence of metritis, the number of services per conception and the service period, but had no effects on the incidence of retained fetal membrane. A partial budgeting analysis indicated that Se supplementation was economically profitable; cows in group T1 averaged 240.6$ per cow, those in group T2 averaged 224.6$ per cow. Supplementation with Se and Vitamin E has been found to increase serum Se levels, milk yield, and has positive effects on udder health by decreasing milk conductivity values and incidence of sub-clinical mastitis. PMID:26104521

  18. The Technical and Financial Effects of Parenteral Supplementation with Selenium and Vitamin E during Late Pregnancy and the Early Lactation Period on the Productivity of Dairy Cattle

    PubMed Central

    Bayril, T.; Yildiz, A. S.; Akdemir, F.; Yalcin, C.; Köse, M.; Yilmaz, O.

    2015-01-01

    This study aimed to determine the effects of parenteral selenium (Se) and vitamin E supplementation on economic impact, milk yield, and some reproductive parameters in high-yield dairy cows in the dry period and in those at the beginning of lactation. At the beginning of the dry period, cows (n = 323) were randomly divided into three groups as follows: Treatment 1 (T1), Treatment 2 (T2), and Control (C). Cows in group T1 received this preparation 21 days before calving and on calving day, and cows in group T2 received it only on calving day. The cows in the control group did not receive this preparation. Supplementation with Se increased Se serum levels of cows treated at calving day (p<0.05). Differences in milk yield at all weeks and the electrical conductivity values at the 8th and 12th weeks were significant (p<0.05). Supplementation with Se and Vitamin E decreased the incidence of metritis, the number of services per conception and the service period, but had no effects on the incidence of retained fetal membrane. A partial budgeting analysis indicated that Se supplementation was economically profitable; cows in group T1 averaged 240.6$ per cow, those in group T2 averaged 224.6$ per cow. Supplementation with Se and Vitamin E has been found to increase serum Se levels, milk yield, and has positive effects on udder health by decreasing milk conductivity values and incidence of sub-clinical mastitis. PMID:26104521

  19. Postpartum deaths: piglet, placental, and umbilical characteristics.

    PubMed

    Rootwelt, V; Reksen, O; Farstad, W; Framstad, T

    2013-06-01

    The fetal growth of the piglet is highly dependent on its placenta, and the newborn piglet birth weight is highly associated with postpartum death. However, there is little information available in the literature on the assessment of the placenta in relation to postpartum death in piglets. The aim of this study was to evaluate the impact of the placental area and placental weight, status of the umbilical cord, and piglet birth characteristics, such as blood parameters, vitality score, and birth weight on postpartum death. All live born piglets in litters from 26 Landrace-Yorkshire sows were monitored during farrowing and the status of each was recorded, including placental area and placental weight and blood variables obtained from the piglets and umbilical veins. Out of the 386 live-born piglets, 16.8% died before weaning at 5 wk. Among these, 78.5% died within the first 3 d of life. Mean blood concentration of lactate was increased in piglets that did not survive to weaning (P = 0.003). Concentrations of hemoglobin and hematocrit were decreased (P < 0.001) compared with survivors. Piglets born with a broken umbilical cord had a reduced vitality score vs. piglets born with an intact umbilical cord (P = 0.021), and they had an increased probability of dying before weaning (P = 0.050). Mean birth weight, body mass index, placental area (P < 0.001), and placental weight (P = 0.020) were reduced in piglets that died before weaning vs. those that survived. Birth weight and placental area were furthermore negatively associated with live litter size. Blood concentrations of IgG and albumin recorded at d 1 were decreased in piglets that died before weaning (P < 0.01), and blood concentration of albumin was positively associated with placental area (P < 0.001). We conclude that placental area and placental weight, status of the umbilical cord, birth weight, body mass index, blood concentrations of lactate, hemoglobin, and hematocrit recorded at birth, and blood concentrations of IgG and albumin recorded at d 1 were associated with postpartum death in this study. These results may indicate that there is an upper uterine limitation of litter size and that placental area and placental weight influence postpartum survival. PMID:23482582

  20. Uptake of contraception during postpartum amenorrhoea: understandings and preferences of poor, urban women in Bangladesh.

    PubMed

    Salway, S; Nurani, S

    1998-10-01

    In urban Bangladesh, as in many other settings, an immediate postpartum family planning strategy prevails, where providers seek to promote and provide contraception at 40-45 days following birth to women regardless of their breastfeeding or menstrual status. Despite such practices, the majority of women choose to delay the initiation of contraception until menses resumes, often several months after birth. The present paper seeks to explain this discrepancy by describing poor, urban women's understandings regarding the chances of conception and the risks associated with contraceptive use in the postpartum period. Findings from in-depth interviews reveal that the majority of women perceive no personal risk of pregnancy during amenorrhoea, though most do not recognise an association between this diminished risk of conception and breastfeeding. In addition, the data illustrate that women are primarily concerned with their own and their newly born child's health and well-being in the period following childbirth, both of which are perceived to be extremely vulnerable. These perceptions, plus an understanding that modern methods of contraception are "strong" and potentially damaging to the health, mean that the majority of women are reluctant to adopt family planning methods soon after birth, particularly during postpartum amenorrhoea. The paper advocates that, since breastfeeding affords good protection against pregnancy for six to nine months following birth, efforts should be made to actively incorporate lactational amenorrhoea into postpartum family planning strategies in Bangladesh. Recommendations are also made for ways in which women may be encouraged to adopt contraception during amenorrhoea beyond the period of high natural protection. The paper highlights the importance of taking the client's perspective into consideration in attempts to improve the quality and effectiveness of family planning programmes. PMID:9722110

  1. Changes in Survival in Head and Neck Cancers in the Late 20th and Early 21st Century: A Period Analysis

    PubMed Central

    Brenner, Hermann

    2010-01-01

    Background. Therapy for head and neck cancers has evolved over the past decade, but few detailed analyses of recent developments in survival on the population level have been published. Methods. We use period analysis and modeled period analysis to disclose recent trends in survival in patients with head and neck cancer. Data are derived from the Surveillance, Epidemiology, and End Results limited-use database. Results. A major, statistically significant improvement in survival was observed, with the overall 5-year relative survival rate going from 54.7% in 1992–1996 to 65.9% in 2002–2006. Subgroup analysis showed improvement in cancers of the oral cavity, tongue, tonsils, and nasopharynx, with the greatest improvements observed in tonsillar carcinoma (+22.2 percentage points) and carcinoma of the tongue (+14.4 percentage points). Further analysis of survival for oral cavity, tonsillar, and tongue carcinoma revealed improvements in survival at each stage and across all age groups except for patients aged ≥75 years, with the greatest improvement occurring in locally advanced disease and in patients aged 55–64 years for carcinoma of the tongue and tonsils and those aged 15–44 years for oral cavity cancers. Conclusions. Survival has substantially improved for head and neck cancer patients over the past decade. The greatest improvement was seen in tonsillar and tongue cancers. PMID:20798198

  2. Chronologic evidence for multiple periods of loess deposition during the Late Pleistocene in the Missouri and Mississippi River Valley, United States: Implications for the activity of the Laurentide ice sheet

    USGS Publications Warehouse

    Forman, S.L.; Bettis, E. Arthur, III; Kemmis, T.J.; Miller, B.B.

    1992-01-01

    The loess stratigraphy of the mid-continental U.S. is an important proxy record for the activity of the Laurentide Ice Sheet in North America. One of the most outstanding problems is deciphering the age of loess deposits in this area during the late Pleistocene. Radiocarbon dating of snails and thermoluminescence dating of the fine-silt fraction (4-11 ??m) from loess at the Loveland Loess type section, Loveland, Iowa and a recent excavation at the Pleasant Grove School section. Madison County, Illinois provide new chronologic control on loess deposition in the Mississippi/Missouri River Valley chronology indicates that the Loveland Loess is Illinoian in age (135??20 ka) but is not correlative with the Teneriffe Silt which is dated to 77 ?? 8 ka. Concordant radiocarbon and thermoluminescence age estimates demonstrate that the Roxana Silt and a correlative loess in Iowa, the Pisgah Formation, is probably 40-30 ka old. These age estimates in conjunction with previous results indicate that there were four periods of loess deposition during the last 150 ka at 25-12 ka, 45-30 ka, 85-70 ka and at ca. 135 ?? 20 ka. This chronology of loess deposition supports the presence of both a late Illinoian and early Wisconsinan loess and associated soils. Thus, there may be more than one soil in the loess stratigraphy of the mid-continental U.S. with morphologies similar to the Sangamon Soil. The last three periods of loess deposition may be correlative with periods of elevated dust concentrations recorded in the Dye 3 ice core from southern Greenland. This is particularly significant because both areas possibly had the same source for eolian particles. Reconstructions of atmospheric circulation for glacial periods show a southerly deflected jet stream that could have transported dust from the mid-continental USA to southern Greenland. Lastly, the inferred record of loess deposition is parallel to a chronology for deglaciation of the Laurentide Ice Sheet deciphered from chronologic and stratigraphic studies of raised glacial and marine sediments in the Hudson Bay Lowlands, Canada. These chronologies indicate that the Laurentide Ice Sheet was quite dynamic during the late Pleistocene, advancing and retreating across North America at least four times during the last 150 ka. ?? 1992.

  3. Modulation of the immune system during postpartum uterine inflammation.

    PubMed

    Walker, Caroline G; Meier, Susanne; Hussein, Hassan; McDougall, Scott; Burke, Chris R; Roche, John R; Mitchell, Murray D

    2015-04-01

    Postpartum uterine inflammation (endometritis) in the dairy cow is associated with lower fertility at both the time of infection and after the inflammation has resolved. We hypothesized that aberrant DNA methylation may be involved in the subfertility associated with uterine inflammation. The objective of this study was to characterize genome-wide DNA methylation and gene expression in the endometrium of dairy cows with subclinical endometritis (SCE). Endometrial tissues were obtained at 29 days postpartum (n = 12), and microarrays were used to characterize transcription and DNA methylation. Analyses revealed 1,856 probes differentially expressed in animals with SCE (n = 6) compared with controls (CON, n = 6, P < 0.05, Storey Multiple testing correction) and 2,976 probes with significant correlation between gene expression and bacteriology score. No significant associations among DNA methylation and gene expression were detected. Analysis of transcription data using the Database for Annotation, Visualization, and Integrated Discovery and Gene Set Enrichment Analysis identified several pathways and processes enriched in SCE cows, with the majority related to the immune response. Furthermore, the top ontology terms enriched in genes that had expression data correlated to bacteriology score were: Defense response, inflammatory response, and innate immune response. Gene expression profiles in cows with subclinical endometritis in this study indicate that the immune response is activated, potentially resulting in a local proinflammatory environment in the uterus. If this period of inflammation is prolonged it could result in tissue damage or failure to complete involution of the uterus, which may create a suboptimal environment for future pregnancy. PMID:25604124

  4. Challenges in Diagnosing and Treating Postpartum Blues, Depression and Psychosis

    ERIC Educational Resources Information Center

    Lewis, Carol A.; Byers, Alison Daly; Malard, Sarah Deann; Dawson, Gregory A.

    2010-01-01

    With recent media attention and a growing awareness in popular culture, the appropriate treatment for postpartum depression has taken center stage as a prevalent women's health issue. There is little agreement on the definition, existence and treatment of postpartum depression. Contributing to this factor is the lack of research that exists to…

  5. Women's Experiences with Postpartum Anxiety: Expectations, Relationships, and Sociocultural Influences

    ERIC Educational Resources Information Center

    Wardrop, Andrea A.; Popadiuk, Natalee E.

    2013-01-01

    Evidence about anxiety in the postpartum is sparse and contradictory. Our research expands this knowledge by using a qualitative methodology, the Feminist Biographical Method, to explore first time mothers' experiences of postpartum anxiety. Data collection included 1.5 to 2.0 hour interviews with six women about their experiences of anxiety in…

  6. Efferocytosis produces a prometastatic landscape during postpartum mammary gland involution.

    PubMed

    Stanford, Jamie C; Young, Christian; Hicks, Donna; Owens, Philip; Williams, Andrew; Vaught, David B; Morrison, Meghan M; Lim, Jiyeon; Williams, Michelle; Brantley-Sieders, Dana M; Balko, Justin M; Tonetti, Debra; Earp, H Shelton; Cook, Rebecca S

    2014-11-01

    Breast cancers that occur in women 2-5 years postpartum are more frequently diagnosed at metastatic stages and correlate with poorer outcomes compared with breast cancers diagnosed in young, premenopausal women. The molecular mechanisms underlying the malignant severity associated with postpartum breast cancers (ppBCs) are unclear but relate to stromal wound-healing events during postpartum involution, a dynamic process characterized by widespread cell death in milk-producing mammary epithelial cells (MECs). Using both spontaneous and allografted mammary tumors in fully immune-competent mice, we discovered that postpartum involution increases mammary tumor metastasis. Cell death was widespread, not only occurring in MECs but also in tumor epithelium. Dying tumor cells were cleared through receptor tyrosine kinase MerTK-dependent efferocytosis, which robustly induced the transcription of genes encoding wound-healing cytokines, including IL-4, IL-10, IL-13, and TGF-β. Animals lacking MerTK and animals treated with a MerTK inhibitor exhibited impaired efferocytosis in postpartum tumors, a reduction of M2-like macrophages but no change in total macrophage levels, decreased TGF-β expression, and a reduction of postpartum tumor metastasis that was similar to the metastasis frequencies observed in nulliparous mice. Moreover, TGF-β blockade reduced postpartum tumor metastasis. These data suggest that widespread cell death during postpartum involution triggers efferocytosis-induced wound-healing cytokines in the tumor microenvironment that promote metastatic tumor progression. PMID:25250573

  7. Efferocytosis produces a prometastatic landscape during postpartum mammary gland involution

    PubMed Central

    Stanford, Jamie C.; Young, Christian; Hicks, Donna; Owens, Philip; Williams, Andrew; Vaught, David B.; Morrison, Meghan M.; Lim, Jiyeon; Williams, Michelle; Brantley-Sieders, Dana M.; Balko, Justin M.; Tonetti, Debra; Earp, H. Shelton; Cook, Rebecca S.

    2014-01-01

    Breast cancers that occur in women 25 years postpartum are more frequently diagnosed at metastatic stages and correlate with poorer outcomes compared with breast cancers diagnosed in young, premenopausal women. The molecular mechanisms underlying the malignant severity associated with postpartum breast cancers (ppBCs) are unclear but relate to stromal wound-healing events during postpartum involution, a dynamic process characterized by widespread cell death in milk-producing mammary epithelial cells (MECs). Using both spontaneous and allografted mammary tumors in fully immunecompetent mice, we discovered that postpartum involution increases mammary tumor metastasis. Cell death was widespread, not only occurring in MECs but also in tumor epithelium. Dying tumor cells were cleared through receptor tyrosine kinase MerTKdependent efferocytosis, which robustly induced the transcription of genes encoding wound-healing cytokines, including IL-4, IL-10, IL-13, and TGF-?. Animals lacking MerTK and animals treated with a MerTK inhibitor exhibited impaired efferocytosis in postpartum tumors, a reduction of M2-like macrophages but no change in total macrophage levels, decreased TGF-? expression, and a reduction of postpartum tumor metastasis that was similar to the metastasis frequencies observed in nulliparous mice. Moreover, TGF-? blockade reduced postpartum tumor metastasis. These data suggest that widespread cell death during postpartum involution triggers efferocytosis-induced wound-healing cytokines in the tumor microenvironment that promote metastatic tumor progression. PMID:25250573

  8. Postpartum emotional distress: a controlled study of Nigerian women after caesarean childbirth.

    PubMed

    Ukpong, D I; Owolabi, A T

    2006-02-01

    The study investigated postpartum emotional distress including depression among 47 Nigerian women who had a caesarean section by comparing them at 6-8 weeks following childbirth with 47 matched controls who had normal vaginal delivery. Analysis of scores on the General Health Questionnaire (GHQ-30) and the Beck Depression Inventory (BDI) showed that women that delivered by caesarean section were significantly different from the controls on the GHQ and BDI scores in the postpartum period. Apart from marital status, other sociodemographic variables did not significantly contribute to psychopathology in this group of women. This observation is in support of the view that caesarean childbirth may predispose Nigerian women to adverse psychological sequelae. PMID:16483968

  9. A rare cause of postpartum low back pain: pregnancy- and lactation-associated osteoporosis.

    PubMed

    Terzi, Rabia; Terzi, Hasan; zer, Tlay; Kale, Ahmet

    2014-01-01

    Pregnancy- and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis. It results in severe low back pain in the last trimester of pregnancy and in the postpartum period, decreases in height, and fragility fractures, particularly in the vertebra. The current case report presents a 32-year-old patient who presented with back and low back pain that began in the last trimester of the pregnancy and worsened at two months postpartum and who was diagnosed with pregnancy- and lactation-associated osteoporosis after exclusion of other causes; the findings are discussed in view of the current literature. PLO is a rare clinical condition causing significant disability. PLO must be kept in mind in the differential diagnosis in patients presenting with low back pain during or after pregnancy. The patients must be evaluated for the risk factors of PLO, and an appropriate therapy must be initiated. PMID:25525595

  10. Contraceptive Adoption, Discontinuation, and Switching among Postpartum Women in Nairobi's Urban Slums.

    PubMed

    Mumah, Joyce N; Machiyama, Kazuyo; Mutua, Michael; Kabiru, Caroline W; Cleland, John

    2015-12-01

    Unmet need for contraception is highest within 12 months post-delivery, according to research. Using longitudinal data from the Nairobi Urban Health and Demographic Surveillance System, we assess the dynamics of contraceptive use during the postpartum period among women in Nairobi's slums. Results show that by 6 months postpartum, 83 percent of women had resumed sexual activity and 51 percent had resumed menses, yet only 49 percent had adopted a modern contraceptive method. Furthermore, almost half of women discontinued a modern method within 12 months of initiating use, with many likely to switch to another short-term method with high method-related dissatisfaction. Women who adopted a method after resumption of menses had higher discontinuation rates, though the effect was much reduced after adjusting for other variables. To reduce unmet need, effective intervention programs are essential to lower high levels of discontinuation and encourage switching to more effective methods. PMID:26643488

  11. A Rare Cause of Postpartum Low Back Pain: Pregnancy- and Lactation-Associated Osteoporosis

    PubMed Central

    Terzi, Rabia; Terzi, Hasan; Özer, Tülay; Kale, Ahmet

    2014-01-01

    Pregnancy- and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis. It results in severe low back pain in the last trimester of pregnancy and in the postpartum period, decreases in height, and fragility fractures, particularly in the vertebra. The current case report presents a 32-year-old patient who presented with back and low back pain that began in the last trimester of the pregnancy and worsened at two months postpartum and who was diagnosed with pregnancy- and lactation-associated osteoporosis after exclusion of other causes; the findings are discussed in view of the current literature. PLO is a rare clinical condition causing significant disability. PLO must be kept in mind in the differential diagnosis in patients presenting with low back pain during or after pregnancy. The patients must be evaluated for the risk factors of PLO, and an appropriate therapy must be initiated. PMID:25525595

  12. Spatial variability of the species composition, abundance, and productivity of the phytoplankton in the white sea in the late summer period

    NASA Astrophysics Data System (ADS)

    Ilyash, L. V.; Radchenko, I. G.; Kuznetsov, L. L.; Lisitzyn, A. P.; Martynova, D. M.; Novigatskiy, A. N.; Chul'Tsova, A. L.

    2011-02-01

    The species composition, cell concentration ( N), and biomass ( B) of the phytoplankton, as well as the chlorophyll a (Chl a) concentration, primary production ( PP), and the concentrations of the dissolved inorganic micronutrients (phosphorus, silica, nitrogen as nitrite), were estimated for Kandalaksha Bay (KB), Dvina Bay (DB), and the basin (Bas) of the White Sea in August of 2004. The micronutrient concentrations were lower compared to the average long-term values for the summer period. The Chl a concentration varies from 0.9 to 2.0 mg/m3 for most of the studied areas, reaching up to 7.5 mg/m3 in the Northern Dvina River estuary. The surface water layer of the DB was the most productive area, where the PP reached up to 270-375 mg C/(m3 day). The phytoplankton biomass varied from 11 to 205 mg C/m3 with the highest values observed in the Bas and DB. Three groups of stations were defined during the analysis of the phytoplankton's species composition similarity. The dinoflagellates Dinophysis norvegica and Ceratium fusus were particular to the phytoplankton assemblages in the KB; the diatom Ditylum brightwellii was particular to the upper and central parts of the DB. These three phytoplankton species were less abundant in the Bas.

  13. Early hippocampal cell death, and late learning and memory deficits in rats exposed to the environmental toxin BMAA (?-N-methylamino-L-alanine) during the neonatal period.

    PubMed

    Karlsson, Oskar; Roman, Erika; Berg, Anna-Lena; Brittebo, Eva B

    2011-06-01

    We have reported previously that exposure to the cyanobacterial neurotoxin ?-N-methylamino-L-alanine (BMAA) during the neonatal period causes cognitive impairments in adult rats. The aim of this study was to investigate the long-term effects of neonatal BMAA exposure on learning and memory mechanisms and to identify early morphological changes in the neonatal brain. BMAA was injected subcutaneously in rat pups on postnatal days 9-10. BMAA (50 and 200 mg/kg) caused distinct deficits in spatial learning and memory in adult animals but no morphological changes. No impairment of recognition memory was detected, suggesting that neonatal exposure to BMAA preferentially affects neuronal systems that are important for spatial tasks. Histopathological examination revealed early neuronal cell death as determined by TUNEL staining in the hippocampus 24 h after a high dose (600 mg/kg) of BMAA whereas no changes were observed at lower doses (50 and 200 mg/kg). In addition, there was a low degree of neuronal cell death in the retrosplenial and cingulate cortices, areas that are also important for cognitive function. Taken together, these results indicate that BMAA is a developmental neurotoxin inducing long-term changes in cognitive function. The risk posed by BMAA as a potential human neurotoxin merits further consideration, particularly if the proposed biomagnifications in the food chain are confirmed. PMID:21315110

  14. Pathways Linking Socioeconomic Status and Postpartum Smoking Relapse

    PubMed Central

    Businelle, Michael S.; Kendzor, Darla E.; Reitzel, Lorraine R.; Vidrine, Jennifer Irvin; Castro, Yessenia; Mullen, Patricia Dolan; Velasquez, Mary M.; Cofta-Woerpel, Ludmila; Cinciripini, Paul M.; Greisinger, Anthony J.; Wetter, David W.

    2012-01-01

    Background Low socioeconomic status (SES) exacerbates the high rate of smoking relapse in women following childbirth. Purpose This study examined multiple models of potential mechanisms linking SES and postpartum smoking relapse among women who quit smoking due to pregnancy. Methods Participants were 251 women enrolled in a randomized clinical trial of a new postpartum smoking relapse prevention intervention. Four models of the prepartum mechanisms linking SES and postpartum smoking relapse were evaluated using a latent variable modeling approach. Results Each of the hypothesized models were a good fit for the data. As hypothesized, SES indirectly influenced postpartum smoking relapse through increased prepartum negative affect/stress, reduced sense of agency, and increased craving for cigarettes. However, the model that included craving as the sole final pathway between SES and relapse demonstrated superior fit when compared with all other models. Conclusions Findings have implications for future interventions that aim to reduce postpartum relapse. PMID:23086590

  15. Characterization of ruminal dynamics in Holstein dairy cows during the periparturient period.

    PubMed

    Park, A F; Shirley, J E; Titgemeyer, E C; DeFrain, J M; Cochran, R C; Wickersham, E E; Nagaraja, T G; Johnson, D E

    2011-10-01

    We used four pregnant Holstein cows to delineate ruminal adaptations as cows transitioned from one lactation to the next. Cows were fed typical diets through far-off and close-up dry periods and lactation. We measured ruminal characteristics on day 72 (late lactation), 51 (far-off dry), 23 and 9 (close-up dry) prepartum and on days 6, 20, 34, 48, 62, 76 and 90 postpartum (early lactation). Measurements included: ruminal fill (weight of actual contents), ruminal capacity (volume of rumen when fully filled), digestibilities and ruminal passage rates. Ruminal capacity tended to increase linearly during early lactation but was stable during dry and transition periods. Both total and liquid fill decreased linearly during the dry period, increased across parturition, and increased linearly through early lactation. Dry matter fill decreased as cows were fed the close-up diet at day 23 prepartum then increased near parturition and continued to increase across early lactation. Solid passage rate was greatest when cows were fed the close-up diet, and decreased throughout the transition period. In lactation, solid passage rate responded quadratically with peak at day 48 followed by decreases through day 90 postpartum. Liquid passage increased linearly across the transition period. Total tract organic matter digestibilities increased linearly over the dry period with significant increases prior to or immediately after parturition, then they remained relatively stable over early lactation until they increased at day 90. Fibre digestibilities demonstrated quadratic responses over early lactation, being higher on day 6 and day 90 than at other times. Starch digestibilities decreased linearly across both the dry and transition periods with decreases in lactation until day 62 followed by increases until day 90. High producing lactating dairy cows go through a multitude of ruminal adaptations, in terms of digestion, passage, capacity and fill, as they transition from one lactation to the next. PMID:21091551

  16. Thrombophlbite crbrale inhabituelle du post-partum

    PubMed Central

    El Hassani, Moulay Elmehdi; Habib, Abdellah Baba; Kouach, Jaouad; Sekkach, Youssef; Bakkali, Hicham; Jira, Mohamed; Elqatni, Mohamed; Abouzahir, Ali; Ghafir, Dris; Moussaoui, Dris; Dehayni, Mohamed

    2014-01-01

    La thrombophlbite crbrale du post-partum immdiat constitue un vnement rare et gravissime pouvant mettre en jeu le pronostic vital court terme. Celle-ci doit tre systmatiquement voque devant la persistance d'une fivre dans les suites de couches. La prise en charge associera le plus souvent, des antibiotiques large spectre et des anticoagulants. Le suivi volutif est indispensable, afin d'apprcier l'efficacit thrapeutique. A travers une observation singulire et prsentation inhabituelle, nous insistons sur le grand intrt des moyens d'imagerie dont nous disposons afin de porter le diagnostic et de choisir le traitement le mieux adapt. PMID:25478039

  17. [Postpartum spontaneous pneumomediastinum and subcutaneous emphysema].

    PubMed

    Lpez-Hernndez, Juan Carlos; Bedolla-Barajas, Martn

    2015-02-01

    Spontaneous pneumomediastinum is the presence of free air contained within the mediastinum, frequently associated with subcutaneous emphysema and of atraumatic origin. Frequency during childbirth is 1 in 100,000. We report the case of a 19 year old woman without respiratory disease history, in her first pregnancy with 39.5 weeks of gestation patient had, prolonged latent phase and sudden postpartum onset of dyspnea, thoracic pain and subcutaneous emphysema. Simple X ray film and thoracic tomography revealed the presence of free air in the mediastinum. The association of pneumomediastinum during delivery is an uncommon event. PMID:25993775

  18. Maternal Diet and Weight at 3 Months Postpartum Following a Pregnancy Intervention with a Low Glycaemic Index Diet: Results from the ROLO Randomised Control Trial

    PubMed Central

    Horan, Mary K.; McGowan, Ciara A.; Gibney, Eileen R.; Donnelly, Jean M.; McAuliffe, Fionnuala M.

    2014-01-01

    Pregnancy increases the risk of being overweight at a later time period, particularly when there is excessive gestational weight gain. There remains a paucity of data into the effect of low glycaemic index (GI) pregnancy interventions postpartum. Aim: To examine the impact of a low glycaemic index diet during pregnancy on maternal diet 3 months postpartum. Methodology: This analysis examined the diet, weight and lifestyle of 460 participants of the ROLO study 3 months postpartum. Questionnaires on weight, physical activity, breastfeeding, supplement use, food label reading and dietary habits were completed. Results: The intervention group had significantly greater weight loss from pre-pregnancy to 3 months postpartum than the control group (1.3 vs. 0.1 kg, p = 0.022). The intervention group reported greater numbers following a low glycaemic index diet (p < 0.001) and reading food labels (p = 0.032) and had a lower glycaemic load (GL) (128 vs. 145, p = 0.014) but not GI (55 vs. 55, p = 0.809) than controls. Conclusions: Low GI dietary interventions in pregnancy result in improved health-behaviours and continued reported compliance at 3 months postpartum possibly through lower dietary GL as a result of portion control. Greater levels of weight loss from pre-pregnancy to 3 months postpartum in the intervention group may have important positive implications for overweight and obesity. PMID:25057103

  19. Consequences of maternal complications in women's lives in the first postpartum year: a prospective cohort study.

    PubMed

    Iyengar, Kirti; Yadav, Ranjana; Sen, Swapnaleen

    2012-06-01

    Maternal complications are common during and following childbirth. However, little information is available on the psychological, social and economic consequences of maternal complications on women's lives, especially in a rural setting. A prospective cohort study was conducted in southern Rajasthan, India, among rural women who had a severe or less-severe, or no complication at the time of delivery or in the immediate postpartum period. In total, 1,542 women, representing 93% of all women who delivered in the field area over a 15-month period and were examined in the first week postpartum by nurse-midwives, were followed up to 12 months to record maternal and child survival. Of them, a subset of 430 women was followed up at 6-8 weeks and 12 months to capture data on the physical, psychological, social, or economic consequences. Women with severe maternal complications around the time of delivery and in the immediate postpartum period experienced an increased risk of mortality and morbidity in the first postpartum year: 2.8% of the women with severe complications died within one year compared to none with uncomplicated delivery. Women with severe complications also had higher rates of perinatal mortality [adjusted odds ratio (AOR)=3.98, confidence interval (CI) 1.96-8.1, p=0.000] and mortality of babies aged eight days to 12 months (AOR=3.14, CI 1.4-7.06, p=0.004). Compared to women in the uncomplicated group, women with severe complications were at a higher risk of depression at eight weeks and 12 months with perceived physical symptoms, had a greater difficulty in completing daily household work, and had important financial repercussions. The results suggest that women with severe complications at the time of delivery need to be provided regular follow-up services for their physical and psychological problems till about 12 months after childbirth. They also might benefit from financial support during several months in the postpartum period to prevent severe economic consequences. Further research is needed to identify an effective package of services for women in the first year after delivery. PMID:22838164

  20. Effect of shortening or omitting the dry period of Holstein-Friesian cows on casein composition of milk.

    PubMed

    de Vries, Ruben; van Knegsel, Ariëtte; Johansson, Monika; Lindmark-Månsson, Helena; van Hooijdonk, Toon; Holtenius, Kjell; Hettinga, Kasper

    2015-12-01

    The aim of this study was to evaluate the effect of shortening or omitting the dry period of dairy cows on milk casein composition. For this study, we analyzed milk samples of 90 cows with a dry period of 0, 30, or 60d and either a glucogenic or a lipogenic ration in early lactation. Milk was sampled at 6 and 2wk prepartum and at 2, 6, and 12wk postpartum. Milk was analyzed for casein (CN) composition by capillary zone electrophoresis, and isoforms of κ-CN were measured by reversed phase-HPLC. Shortening the dry period from 60 to 30d reduced the αS1-CN fraction by 3.8% and increased the αS2-CN fraction by 5.5%. In milk from cows with a 0-d dry period, the glycosylated κ-CN fraction in late lactation increased from 8 to 12% between 6 and 2wk prepartum. After calving, the glycosylated κ-CN fraction in milk was higher for cows with a 0-d dry period (6.7%) compared with cows with a 60-d dry period (5.2%). The glycosylated κ-CN fraction at 2wk postpartum was negatively correlated with milk yield, suggesting that glycosylation was related to reduced productivity of mammary epithelial cells. In early lactation, the β-CN fraction was reduced in milk of cows with a 0-d dry period. A lowered β-CN fraction was associated with high somatic cell count and greater parity, indicating that it was the result of proteolytic activity. In conclusion, casein composition changes that result from shortening the dry period from 60 to 30d are not expected to affect processing characteristics of milk. Applying a 0-d dry period may affect processability of milk because of a higher glycosylated κ-CN fraction, and possibly because of higher proteolytic activity compared with a 60-d dry period. PMID:26454294

  1. Effects of hypergravity on ovarian-hypophyseal function in antepartum and postpartum rats

    NASA Technical Reports Server (NTRS)

    Burden, Hubert W.; Zary, Joan T.; Hodson, Charles A.; Gregory, Heather L.; Baer, Lisa A.; Ronca, April E.

    2003-01-01

    BACKGROUND: Rats exposed to microgravity during the post-implantation phase of pregnancy had minimal alterations in ovarian and hypophyseal parameters during the antepartum and postpartum periods. In the current study, a similar parallel experimental design was employed to ascertain the effects of hypergravity on ovarian and hypophyseal function. HYPOTHESIS: We hypothesized that hypergravity exposure during the post-implantation stage of pregnancy would not alter antepartum and postpartum ovarian and hypophyseal function. METHODS: Pregnant rats were assigned to hypergravity (1.5 G, 1.75 G, or 2.0 G), rotational control, or stationary control groups (n = 10 each group) beginning on gestation day 11 and ending on day 20. Hypophyseal and ovarian analyses were conducted on 5 of the animals from each group at day 20. The remaining animals in each group were allowed to go to term and the same analyses were conducted 3 h postpartum. RESULTS: Hypergravity at all levels decreased the percent body mass gain from gestation day 11 to 20 (p < 0.05); however, the wet weight of the pituitaries and ovaries was not changed. There was no effect of hypergravity on the number of healthy or atretic antral follicles of any size at gestation day 20 or postpartum. The number of corpora lutea of pregnancy was decreased in all hypergravity groups, but the number of live fetuses at gestation day 20 or pups at term was not altered. Plasma concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, and progesterone were not changed at gestation day 20 or postpartum. Pituitary content of LH, FSH, and prolactin was not altered by hypergravity at gestation day 20, but LH content was significantly increased (p < 0.05) at 1.5 and 1.75 G postpartum. CONCLUSIONS: We conclude that hypergravity, up to and including 2.0 G, is compatible with maintenance of pregnancy and has minimal effects on hypophyseal parameters. Ovarian follicles are not altered by hypergravity, but corpora lutea may regress at a more rapid rate.

  2. Extended negative dietary cation-anion difference feeding does not negatively affect postpartum performance of multiparous dairy cows.

    PubMed

    Weich, W; Block, E; Litherland, N B

    2013-09-01

    Low postpartum blood calcium remains one of the largest constraints to postpartum feed intake, milk yield, and energy balance in transitioning dairy cows. Supplemental dietary anions decrease the dietary cation-anion difference (DCAD) and reduce the risk for postpartum hypocalcemia. Prepartum management strategies aiming to minimize social stress and diet changes have resulted in a need to explore the effects of extended exposure to a negative DCAD (>21 d) diet. Holstein and Holstein-cross dairy cows (n=60) were assigned to 1 of 3 treatments 42 d before expected calving to evaluate effects of supplying anions for 21 or 42 d during the dry period on energy status, postpartum production, and Ca homeostasis. Treatments included (1) a control diet (CON; DCAD=12 mEq/100 g of DM), (2) a 21-d negative DCAD diet (21-ND; DCAD=12 and -16 mEq/100 g of DM), and (3) a 42-d negative DCAD diet (42-ND; DCAD=-16 mEq/100 g of DM). Cows fed CON were fed positive DCAD prepartum for 42 d. Cows fed 21-ND received the positive DCAD (12 mEq/100 g of DM) diet for the first 21 d of the dry period and the anionic diet (-16 mEq/100 g of DM) from d 22 until calving. Cows fed 42-ND received the anionic diet for the entire dry period. Control and anionic diets were formulated by using 2 isonitrogenous protein mixes: (1) 97.5% soybean meal and (2) 52.8% BioChlor (Church & Dwight Co. Inc.), 45.8% soybean meal. Supplementing anions induced a mild metabolic acidosis, reducing urine pH for 21-ND and 42-ND compared with CON. Prepartum DMI was not different among treatments. Postpartum DMI was higher for 21-ND compared with CON (20.8 vs. 18.11.1 kg/d), and 42-ND had similar DMI compared with 21-ND. During the first 56 d of lactation 21-ND had greater average milk production compared with CON (44.8 vs. 39.22.1 kg/d). Average milk production by 42-ND was similar to 21-ND. Postpartum total blood Ca concentration was greater for 42-ND. Cows fed anionic diets prepartum tended to have lower lipid accumulation in the liver after calving compared with CON. These data suggest low-DCAD diets fed for 21 or 42 d during the dry period can have positive effects on postpartum DMI, Ca homeostasis, and milk production. PMID:23831094

  3. Estimates of post-partum bleeding.

    PubMed

    Pedrn, N; Mondragn, H; Marcushamer, B; Aznar, R; Gallegos, A J

    1987-04-01

    Post-partum bleeding was estimated during the first 72 hours in 106 women with normal delivery at term, all had live child with a body weight between 2.5 and 3.5 Kg. Three groups of women were studied: Group 1 comprised 41 volunteers with normal deliveries to whom no medication had been administered; Group 2 comprised 39 volunteers receiving 20 IU of oxytocin in 250 ml of a 5% glucose solution, immediately after delivery; and in Group 3, 26 volunteers received 0.2 mg of ergonovine maleate, orally three times daily for three days. The average post-partum blood loss in Group 1 during the first 72 hours after delivery was 151.5 +/- 12.5 ml; for Group 2, 155.9 +/- 13.9 ml; and for Group 3, 135.5 +/- 15.9 ml. There were no significant differences among the groups and, most of the blood loss occurred during the first 24 hours after delivery. PMID:3497776

  4. Pre- and post-partum mild underfeeding influences gene expression in the reproductive tract of cyclic dairy cows.

    PubMed

    Valour, D; Hue, I; Degrelle, S A; Djean, S; Marot, G; Dubois, O; Germain, G; Humblot, P; Ponter, A A; Charpigny, G; Grimard, B

    2013-06-01

    Undernutrition before and after calving has a detrimental effect on the fertility of dairy cows. The effect of nutritional stress was previously reported to influence gene expression in key tissues for metabolic health and reproduction such as the liver and the genital tract early after calving, but not at breeding, that is, between 70 and 90days post-partum. This study investigated the effects of pre- and post-partum mild underfeeding on global gene expression in the oviduct, endometrium and corpus luteum of eight multiparous Holstein cows during the early and middle phases of an induced cycle 80days post-partum. Four control cows received 100% of energy and protein requirements during the dry period and after calving, while four underfed received 80% of control diet. Oestrous synchronization treatment was used to induce ovulation on D80 post-partum. Oviducts, ovaries and the anterior part of each uterine horn were recovered surgically 4, 8, 12 and 15days after ovulation. Corpora lutea were dissected from the ovaries, and the endometrium was separated from the stroma and myometrium in each uterine horn. The oviduct segments were comprised of ampulla and isthmus. RNAs from ipsi- and contralateral samples were pooled on an equal weight basis. In each tissue, gene expression was assessed on a custom bovine 10K array. No differentially expressed gene (DEG) in the corpus luteum was identified between underfed and control, conversely to 293 DEGs in the oviduct vs 1 in the endometrium under a false discovery rate (FDR) <0.10 and 1370 DEGs vs 3, respectively, under FDR<0.15. Additionally, we used dedicated statistics (regularized canonical correlation analysis) to correlate the post-partum patterns of six plasma metabolites and hormones related to energy metabolism measured weekly between calving and D80 with gene expression. High correlations were observed between post-partum patterns of IGF-1, insulin, ?-hydroxybutyrate and the expression in the oviduct of genes related to reproductive system disease, connective tissue disorders and metabolic disease. Moreover, we found special interest in the literature to retinoic acid-related genes (e.g. FABP5/CRABP2) that might indicate abnormalities in post-partum tissue repair mechanisms. In conclusion, this experiment highlights relationships between underfeeding and gene expression in the oviduct and endometrium after ovulation in cyclic Holstein cows. This might help to explain the effect of mild undernutrition on fertilization failure and early embryonic mortality in post-partum dairy cows. PMID:23131127

  5. Postpartum depression screening in the Neonatal Intensive Care Unit: program development, implementation, and lessons learned

    PubMed Central

    Cherry, Amanda S; Blucker, Ryan T; Thornberry, Timothy S; Hetherington, Carla; McCaffree, Mary Anne; Gillaspy, Stephen R

    2016-01-01

    Objective The aims of this project were to describe the development of a postpartum depression screening program for mothers of infants in the Neonatal Intensive Care Unit and assess the implementation of the screening program. Methods Screening began at 14 days postpartum and was implemented as part of routine medical care. A nurse coordinator facilitated communication with mothers for increasing screen completion, review of critical self-harm items, and making mental health referrals. During the 18-month study period, 385 out of 793 eligible mothers completed the screen. Results Approximately 36% of mothers had a positive screen that resulted in a mental health referral and an additional 30% of mothers had screening results indicating significant symptoms. Conclusion Several barriers were identified, leading to adjustments in the screening process, and ultimately recommendations for future screening programs and research. Development of a postpartum depression screening process in the Neonatal Intensive Care Unit involves support, training, implementation, and coordination from administrators, medical staff, new mothers, and mental health specialists. Several predictable challenges to program development require ongoing assessment and response to these challenges. Relevance This study highlights the expanding role of the psychologist and behavioral health providers in health care to intervene as early as possible in the life of a child and family with medical complications through multidisciplinary program development and implementation, as well as key considerations for institutions initiating such a program. PMID:26937199

  6. Postpartum vaginal cystic lesions: everyday practice or a differential diagnosis challenge?

    PubMed Central

    2013-01-01

    Postpartum vaginal cystic lesions constitute a common situation that is caused either by inflammation or by accumulation of lymph. We report a case of a 33-year-old woman who had bilateral duplication of the pelvicalyceal system and ureter, and after the labor of her second child, she had one ureter prolapse into the vagina after initially appearing as a cystic lesion. Ureteral duplication is the most common renal abnormality, occurring in approximately 1% of the population and in 10% of children who are diagnosed with urinary tract infections. In our case we consider possible that this clinical situation was a result of a combination of postpartum pelvic floor trauma and prolapse of the ureter. There are only several of these cases in the literature where ureter prolapse is associated and complicated by pelvic floor trauma caused during or after labor. The clinical approach of the cystic lesions located in the vagina during the postpartum period should include a meticulous examination of the urinary system before any other medical practice. PMID:23803247

  7. Negative energy balance affects imprint stability in oocytes recovered from postpartum dairy cows.

    PubMed

    O'Doherty, Alan M; O'Gorman, Aoife; al Naib, Abdullah; Brennan, Lorraine; Daly, Edward; Duffy, Pat; Fair, Trudee

    2014-09-01

    Ovarian follicle development in post-partum, high-producing dairy cows, occurs in a compromised endogenous metabolic environment (referred to as negative energy balance, NEB). Key events that occur during oocyte/follicle growth, such as the vital process of genomic imprinting, may be detrimentally affected by this altered ovarian environment. Imprinting is crucial for placental function and regulation of fetal growth, therefore failure to establish and maintain imprints during oocyte growth may contribute to early embryonic loss. Using ovum pick-up (OPU), oocytes and follicular fluid samples were recovered from cows between days 20 and 115 post-calving, encompassing the NEB period. In a complimentary study, cumulus oocyte complexes were in vitro matured under high non-esterified fatty acid (NEFA) concentrations and in the presence of the methyl-donor S-adenosylmethionine (SAM). Pyrosequencing revealed the loss of methylation at several imprinted loci in the OPU derived oocytes. The loss of DNA methylation was observed at the PLAGL1 locus in oocytes, following in vitro maturation (IVM) in the presence of elevated NEFAs and SAM. Finally, metabolomic analysis of postpartum follicular fluid samples revealed significant differences in several branched chain amino acids, with fatty acid profiles bearing similarities to those characteristic of lactating dairy cows. These results provide the first evidence that (1) the postpartum ovarian environment may affect maternal imprint acquisition and (2) elevated NEFAs during IVM can lead to the loss of imprinted gene methylation in bovine oocytes. PMID:25084396

  8. Postpartum depression: perceptions of a diverse sample of low-income women.

    PubMed

    Jarosinski, Judith M; Pollard, Deborah Lynn

    2014-03-01

    Postpartum depression (PPD) continues to significantly impact women and their families during the perinatal period. Consequences of untreated PPD in the mother may lead to impaired mother-infant bonding, recurring psychiatric illness, and fewer positive parenting behaviors. North Carolina participates in the Pregnancy Risk Assessment Monitoring System (PRAMS) survey and has the second highest self-reported rate of postpartum depressive symptoms at 19.0%. The full study used both quantitative and qualitative methods. The qualitative approach, an interpretive Heideggerian perspective, elicited the postpartum clients' perceptions of risk factors, how those perceptions affected the pregnancy experience, and how self-efficacy played a role in their perceived ability to make healthy choices. The sample was comprised of 60 pregnant women between the ages of 18 and 40. Four themes were found: (1) Feeling joy and apprehension at once, (2) Depression is something you think about (3) Rearranging your thinking, and (4) Garnering support. The women in this study believed that support was an indispensable tool in dealing with feelings of sadness and depression. Critical aspects of becoming involved in their pregnancy included changing their expectations and knowing how to detect and seek help when depressive symptoms occurred. PMID:24597584

  9. Baseline Results from Hawaii's Nā Mikiniiki Project: A Physical Activity Intervention Tailored to Multiethnic Postpartum Women

    PubMed Central

    Albright, Cheryl L.; Steffen, Alana D.; Novotny, Rachel; Nigg, Claudio R.; Wilkens, Lynne R.; Saiki, Kara; Yamada, Paulette; Hedemark, Brooke; Maddock, Jason E.; Dunn, Andrea L.; Brown, Wendy J.

    2012-01-01

    During the postpartum period, ethnic minority women have higher rates of inactivity/under-activity than white women. The Nā Mikimiki (“the active ones”) Project is designed to increase moderate-to-vigorous physical activity over 18 months among multiethnic women with infants 2–12 months old. The study was designed to test, via a randomized controlled trial, the effectiveness of a tailored telephone counseling of moderate-to-vigorous physical activity intervention compared to a print/website materials-only condition. Healthy, underactive women (mean age = 32 ± 5.6 years) with a baby (mean age = 5.7 ± 2.8 months) were enrolled from 2008–2009 (N = 278). Of the total sample, 84% were ethnic minority women, predominantly Asian–American and Native Hawaiian. Mean self-reported baseline level of moderate-to-vigorous physical activity was 40 minutes/week with no significant differences by study condition, ethnicity, infant's age, maternal body mass index, or maternal employment. Women had high scores on perceived benefits, self-efficacy, and environmental support for exercise but low scores on social support for exercise. This multiethnic sample's demographic and psychosocial characteristics and their perceived barriers to exercise were comparable to previous physical activity studies conducted largely with white postpartum women. The Nā Mikimiki Project's innovative tailored technology-based intervention and unique population are significant contributions to the literature on moderate-to-vigorous physical activity in postpartum women. PMID:22533900

  10. Baseline results from Hawaii's N? Mikimiki Project: a physical activity intervention tailored to multiethnic postpartum women.

    PubMed

    Albright, Cheryl L; Steffen, Alana D; Novotny, Rachel; Nigg, Claudio R; Wilkens, Lynne R; Saiki, Kara; Yamada, Paulette; Hedemark, Brooke; Maddock, Jason E; Dunn, Andrea L; Brown, Wendy J

    2012-01-01

    During the postpartum period, ethnic minority women have higher rates of inactivity/under-activity than white women. The N? Mikimiki ("the active ones") Project is designed to increase moderate-to-vigorous physical activity over 18 months among multiethnic women with infants 2-12 months old. The study was designed to test, via a randomized controlled trial, the effectiveness of a tailored telephone counseling of moderate-to-vigorous physical activity intervention compared to a print/website materials-only condition. Healthy, underactive women (mean age = 32 5.6 years) with a baby (mean age = 5.7 2.8 months) were enrolled from 2008-2009 (N = 278). Of the total sample, 84% were ethnic minority women, predominantly Asian-American and Native Hawaiian. Mean self-reported baseline level of moderate-to-vigorous physical activity was 40 minutes/week with no significant differences by study condition, ethnicity, infant's age, maternal body mass index, or maternal employment. Women had high scores on perceived benefits, self-efficacy, and environmental support for exercise but low scores on social support for exercise. This multiethnic sample's demographic and psychosocial characteristics and their perceived barriers to exercise were comparable to previous physical activity studies conducted largely with white postpartum women. The N? Mikimiki Project's innovative tailored technology-based intervention and unique population are significant contributions to the literature on moderate-to-vigorous physical activity in postpartum women. PMID:22533900

  11. Sustained Decrease of Early-Phase Insulin Secretion in Japanese Women with Gestational Diabetes Mellitus Who Developed Impaired Glucose Tolerance and Impaired Fasting Glucose Postpartum

    PubMed Central

    Katayama, Hiroko; Tachibana, Daisuke; Hamuro, Akihiro; Misugi, Takuya; Motoyama, Koka; Morioka, Tomoaki; Fukumoto, Shinya; Emoto, Masanori; Inaba, Masaaki; Koyama, Masayasu

    2015-01-01

    OBJECTIVE The aim of this study was to compare glucose intolerance in the antenatal and the postpartum periods using a 75-g oral glucose tolerance test (OGTT) in the Japanese women with gestational diabetes mellitus (GDM) using a retrospective design. PATIENTS AND METHODS Data were obtained from 85 Japanese women with GDM who delivered from April 2011 through April 2015 and who underwent an OGTT 6–14 weeks postpartum. The women were divided into two groups based on the results of the postpartum OGTT: one group with normal glucose tolerance (NGT) and the other with impaired glucose tolerance (IGT) as well as impaired fasting glucose (IFG). We analyzed the associations between postpartum IGT–IFG and various factors. RESULTS Antenatally, a significant difference was observed between the groups only in the 1-hour plasma glucose level of the 75-g OGTT. Postpartum results of plasma glucose level were significantly higher at 0.5, 1, and 2 hours in the IGT–IFG group than those in the NGT group. Moreover, a significant decrease in the levels of 0.5-hour immunoreactive insulin and insulinogenic index was observed in the IGT–IFG group compared to those in the NGT group. Homeostasis model assessment-insulin resistance and homeostasis model assessment β-cell function of both groups were found to significantly decrease in the postpartum period; however, there was no significant change in the insulinogenic index of either group. CONCLUSIONS Our study clearly showed that the postpartum IGT and IFG levels of Japanese women with GDM are affected by impaired early-phase insulin secretion; however, insulin resistance promptly improves. PMID:26688669

  12. Effect of suppression of postpartum ovulation on endometrial inflammation in dairy cows.

    PubMed

    Heppelmann, M; Brmmling, A; Ulbrich, S E; Weinert, M; Piechotta, M; Wrenzycki, C; Merbach, S; Schoon, H-A; Hoedemaker, M; Bollwein, H

    2015-07-01

    The objective of this study was to investigate the effect of time of first postpartum ovulation on endometrial inflammation in dairy cows with and without uterine disease during the early puerperal period. Transvaginal follicular puncture (FP) was carried out to suppress postpartum ovulation and formation of a CL until Day 42. Fifty-three lactating Holstein Friesian cows were divided into four groups on the basis of presence (UD+) or absence (UD-) of uterine disease, which was defined as retained fetal membranes and/or metritis, and whether FP had (FP+) or had not been (FP-) carried out. This resulted in the following groups: UD-FP- (n = 15), UD-FP+ (n = 13), UD+FP- (n = 13), and UD+FP+ (n = 12). Cloprostenol was given on Days 55 to 60 postpartum, and GnRH was administered 2 days later for synchronization of ovulation. In the FP- groups, endometrial swab and biopsy samples were collected during the second estrus (approximately Day 40) and during the estrus after synchronization. In the FP+ groups, the same samples were collected during the first estrus (approximately Day 49) and during the estrus after synchronization. The prevalence of positive bacteriologic cultures of the endometrium was not affected by FP (P > 0.05). Histologic signs of endometritis were more severe in UD+FP- cows at second sampling than in UD+FP+ cows (P ? 0.05). Endometrial expression of IL1? (in UD- after first sampling and in UD+ after second sampling) and IL1? (in UD- and UD+ after first sampling) was higher (P ? 0.05) in FP- cows than in FP+ cows. Regardless of group, cows with histopathologic evidence of endometritis had higher expression (P ? 0.05) of IL1?, IL1?, IL6, and TNF? than cows without endometritis. In conclusion, suppression of early ovulation by transvaginal FP enhances clearance of uterine inflammation in postpartum cows. PMID:25841545

  13. Prenatal β-Endorphin as an Early Predictor of Postpartum Depressive Symptoms in Euthymic Women

    PubMed Central

    Yim, Ilona S.; Glynn, Laura M.; Schetter, Christine Dunkel; Hobel, Calvin J.; Chicz-DeMet, Aleksandra; Sandman, Curt A.

    2010-01-01

    Background After delivery, many women experience symptoms of postpartum depression (PPD), and early identification of women at risk is therefore important. The opioid peptide β-endorphin has been implicated in non-puerperal depression but its role in the development of PPD is unknown. Methods Three hundred and seven women with a singleton, full-term (>37.0 weeks’ GA) pregnancy were recruited early in pregnancy and followed up into the postpartum period. Blood samples were obtained at 15, 19, 25, 31 and 37 weeks’ gestational age (GA) and at 9 weeks postpartum for assessment of β-endorphin. Depressive symptoms were assessed with the Center for Epidemiological Studies – Depression scale at the last four pregnancy visits and with the Edinburgh Postnatal Depression Scale postpartum. Results Among women who were euthymic at 25 weeks’ GA, those who proceeded to develop PPD symptoms had higher levels of β-endorphin throughout pregnancy compared to women without PPD symptoms (all t > 2.11, p < .05). At each assessment, women above the cut-off score for β-endorphin were at more than three-fold risk for PPD symptoms (odds ratios 3.19 – 4.68) compared to women below the cut-off score. Limitations Self-report of depressive symptoms, no mental health history. Conclusions β-Endorphin may be a useful early predictor of PPD symptoms in women who do not report depressive symptoms in midpregnancy. If replicated, these findings have clinical implications for the identification and treatment of this at risk group and further suggest that some of the pathways leading to this complex disorder may be specific to subgroups of women. PMID:20051292

  14. Pharmacokinetics of paracetamol and its metabolites in women at delivery and post?partum

    PubMed Central

    Kulo, Aida; Peeters, Mariska Y.; Allegaert, Karel; Smits, Anne; de Hoon, Jan; Verbesselt, Rene; Lewi, Liesbeth; van de Velde, Marc; Knibbe, Catherijne A. J.

    2013-01-01

    Aim A recent report on intravenous (i.v.) paracetamol pharmacokinetics (PK) showed a higher total clearance in women at delivery compared with non?pregnant women. To describe the paracetamol metabolic and elimination routes involved in this increase in clearance, we performed a population PK analysis in women at delivery and post?partum in which the different pathways were considered. Methods Population PK parameters using non?linear mixed effect modelling were estimated in a two?period PK study in women to whom i.v. paracetamol (2?g loading dose followed by 1?g every 6?h up to 24?h) was administered immediately following Caesarean delivery and in a subgroup of the same women to whom single 2?g i.v.loading dose was administered 1015 weeks post?partum. Results Population PK analysis was performed based on 255 plasma and 71 urine samples collected in 39 women at delivery and in eight of these 39 women 12 weeks post?partum. Total clearance was higher in women at delivery compared with 12th post?partum week (21.1 vs. 11.7 l?h?1) due to higher clearances to paracetamol glucuronide (11.6 vs. 4.76 l?h?1), to oxidative metabolites (4.95 vs. 2.77 l?h?1) and of unchanged paracetamol (1.15 vs. 0.75 l?h?1). In contrast, there was no difference in clearance to paracetamol sulphate. Conclusion The increased total paracetamol clearance at delivery is caused by a disproportional increase in glucuronidation clearance and a proportional increase in clearance of unchanged paracetamol and in oxidation clearance, of which the latter may potentially limit further dose increase in this patient group. PMID:22845052

  15. Theoretical contributions to a program of research promoting postpartum health.

    PubMed

    Doering, Jennifer

    2013-05-01

    There is a need for interventions that address postpartum fatigue and sleep problems. Of the women who experience this, few receive the needed nursing care during the weeks after childbirth when severe postpartum fatigue and poor sleep are most prevalent. These health problems are significant not only for the well-being of the new mother, but for her infant and other family members. This article outlines four steps in applying theory in research, using a "top-down and bottom-up" approach to develop a nursing intervention for self-management of postpartum fatigue and sleep. PMID:23290532

  16. Postpartum Sexuality and the Lactational Amenorrhea Method for Contraception.

    PubMed

    Labbok, Miriam H

    2015-12-01

    This chapter reviews the literature on postpartum coital behavior, anovulatory and ovulatory bleeding episodes, and the methodology and efficacy of Lactational Amenorrhea Method and progesterone-only oral contraceptives. Of interest is the finding that breastfeeding women may resume coital behavior earlier postpartum, but report increased discomfort over time. The high efficacy of the Lactational Amenorrhea Method is confirmed and data illustrating possible relaxation of some criteria are presented. The conflicting guidance of CDC and WHO concerning immediate postpartum use of progestin-only methods is presented. The dearth of recent studies calls for new research on these topics. PMID:26457855

  17. Dream-associated Behaviors Affecting Pregnant and Postpartum Women

    PubMed Central

    Nielsen, Tore; Paquette, Tyna

    2007-01-01

    Study objectives: Evaluate the prevalence and phenomenology of dream-associated behaviors affecting pregnant and postpartum mothers. Episodes consist of anxious dreams and nightmares about the new infant that are accompanied by complex behaviors (motor activity, speaking, expressing emotion). Design: Three-group design (postpartum, pregnant, null gravida), self-report, and repeated measures. Setting: Pregnancy and postpartum groups: completion of questionnaires in hospital room within 48 hours of giving birth and home telephone interviews; null gravida group: completion of questionnaires and interview in person or by telephone. Participants: Two hundred seventy-three women in 3 groups: postpartum: n = 202 (mean age = 29.7 ± 4.94 years; 95 primiparas, 107 multiparas); pregnant: n = 50 (mean age = 31.1 ± 5.44 years); null gravida: n = 21 (mean age = 28.5 ± 6.34 years). Interventions: Subjects completed questionnaires about pregnancy and birth factors, personality, and sleep and participated in interviews concerning the prevalence of recent infant dreams and nightmares, associated behaviors, anxiety, depression, and other psychopathologic factors. Measurements and Results: Most women in all groups recalled dreams (88%-91%). Postpartum and pregnant women recalled infant dreams and nightmares with equal prevalence, but more postpartum women reported they contained anxiety (75%) and the infant in peril (73%) than did pregnant women (59%, P < 0.05 and 42%, P < 0.0001). More postpartum (63%) than pregnant (40%) women reported dream-associated behaviors (P < 0.01), but neither group differed from null gravida women (56%). This was due to different distributions over groups of the behavior subtypes. Motor activity was present in twice as many postpartum (57%) as pregnant (24%) or null gravida (25%) women (all P < 0.0001). Expressing emotion was more prevalent among null gravida (56%) than postpartum women (27%) (P < 0.05) but was not different from pregnant women (37%). Speaking was equally prevalent among the 3 groups (12%-19%). Behaviors were associated with nightmares, dream anxiety and, among postpartum women, post-awakening anxiety (41%), confusion (51%), and a need to check on the infant (60%). Primiparas and multiparas differed in dream and nightmare recall but not in prevalence of dream-associated behaviors. Conclusion: The prevalent occurrence of pregnancy and postpartum infant dreams and associated behaviors may reflect the pervasive emotional influence of maternal concerns or changes instigated by severe sleep disruption, rapid eye movement sleep deprivation, and altered hormone levels. Citation: Nielsen T; Paquette T. Dream-associated behaviors affecting pregnant and postpartum women. SLEEP 2007;30(9):1162-1169. PMID:17910388

  18. Rapunzel Syndrome: A Rare Postpartum Case

    PubMed Central

    Tegene, Teshome; Foda, Yahia; Hussain, Omar; Manikonda, Geeta

    2013-01-01

    The Rapunzel syndrome describes a disorder in which a significant amount of hair is swallowed, forming a trichobezoar that extends past the stomach into the small intestines. Given the indigestible nature of hair, it subsequently leads to obstruction within the gastrointestinal system. Clinically, patients may present with symptoms of gastrointestinal obstruction, including abdominal complaints such as pain, nausea, vomiting, and diarrhea. However, due to its broad and nonspecific presenting symptoms, the diagnosis of Rapunzel syndrome warrants consideration once other common etiologies have been excluded. Surgical intervention is often required to remove the abdominal mass. This unusual syndrome is often associated with psychiatric disorders, affecting young women most commonly. In this report, we will discuss a unique case of Rapunzel syndrome in a one-month postpartum woman. PMID:24171124

  19. Rapunzel syndrome: a rare postpartum case.

    PubMed

    Tegene, Teshome; Foda, Yahia; Hussain, Omar; Oloniyo, Kolawole; Ha, Ngoc-Tram; Manikonda, Geeta

    2013-01-01

    The Rapunzel syndrome describes a disorder in which a significant amount of hair is swallowed, forming a trichobezoar that extends past the stomach into the small intestines. Given the indigestible nature of hair, it subsequently leads to obstruction within the gastrointestinal system. Clinically, patients may present with symptoms of gastrointestinal obstruction, including abdominal complaints such as pain, nausea, vomiting, and diarrhea. However, due to its broad and nonspecific presenting symptoms, the diagnosis of Rapunzel syndrome warrants consideration once other common etiologies have been excluded. Surgical intervention is often required to remove the abdominal mass. This unusual syndrome is often associated with psychiatric disorders, affecting young women most commonly. In this report, we will discuss a unique case of Rapunzel syndrome in a one-month postpartum woman. PMID:24171124

  20. Postpartum depression among African-American women.

    PubMed

    Amankwaa, Linda Clark

    2003-01-01

    The purpose of this qualitative study was to describe the nature of postpartum depression (PPD) among African-American women. Twelve women, who had experienced PPD within the last three years, were interviewed for approximately one hour at two intervals. Nudist-4 software and the constant comparative method were used to analyze the data. Five themes "Stressing Out," "Feeling Down," "Losing It," "Seeking Help," and "Feeling Better" represented aspects of PPD as experienced by the participants. The last theme, "Dealing with It," represented the cultural ways in which African-American mothers managed their depression. These included Keeping the Faith, Trying to Be a Strong Black Woman, Living with Myths, and Keeping Secrets. Suggestions for future directions in nursing research are included. PMID:12623687