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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. [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

  3. 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

  4. Possible Rivaroxaban Failure during the Postpartum Period.

    PubMed

    Rudd, Kelly M; Winans, Amanda R McFee; Panneerselvam, Narmadha

    2015-11-01

    Rivaroxaban, a factor Xa inhibitor, is a direct-acting oral anticoagulant (DOAC) indicated for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and for reducing the risk of DVT and PE recurrence. To our knowledge, no data are presently available to guide DOAC dosing in the postpartum period when pharmacokinetic and pharmacodynamic changes induced by pregnancy have an impact on drug clearance and increase hypercoagulability for a period of 6-8 weeks after delivery. We describe the case of a 35-year-old postpartum woman who presented to the emergency department with a diagnosis of a new multiple segmental PE 5 days after starting rivaroxaban therapy for a diagnosis of DVT. No precipitating cause, including noncompliance, was identified as a source of thrombosis embolization or extension. The patient was admitted, a heparin infusion was started for the management of PE, and rivaroxaban was discontinued. She was transitioned to enoxaparin 1 mg/kg (90 mg) subcutaneously every 12 hours the next day, bridged to warfarin, and discharged home on the overlapping regimen with close follow-up by the pharmacist-managed outpatient Anticoagulation Management Service. To our knowledge, this is the first case report of potential failure associated with rivaroxaban therapy in the postpartum period, possibly due to pharmacokinetic alterations seen in the postpartum period contributing to decreased drug exposure, yielding reduced anticoagulant efficacy. Clinicians should carefully weigh the risks and benefits of DOAC therapy in postpartum patients or other special populations requiring anticoagulation therapy. This report also highlights the need for further research identifying the impact of pharmacokinetic changes induced by special populations and the need to develop monitoring assays for such clinical situations. PMID:26598101

  5. Hormones and Cognitive Functioning During Late Pregnancy and Postpartum: A Longitudinal Study

    PubMed Central

    Henry, Jessica F.; Sherwin, Barbara B.

    2013-01-01

    This longitudinal study investigated the possible influence of estradiol (E2), progesterone (P), testosterone (T), cortisol (CORT), and prolactin (PRL) levels on cognitive functioning during late pregnancy and the early postpartum period. The performance of 55 pregnant women on a battery of neuropsychological tests, tested once during the third trimester of pregnancy and once during the early postpartum period, was compared with that of 21 nonpregnant controls matched for age and education. Women in the pregnancy group had significantly lower scores than the controls during both the pre- and postpartum visits on tasks of verbal recall and processing speed. CORT levels were significantly associated, in an inverted-U function, with verbal recall scores at both the pregnancy and at postpartum periods and with spatial abilities at postpartum only. During pregnancy, PRL levels were associated in both a linear and an inverted-U function with scores on tests of paragraph recall and in a linear function with scores on tests of executive function. At postpartum, E2 and CORT were negatively associated in a linear fashion with attention scores. These findings provide new evidence that fluctuating hormone levels during late pregnancy and early postpartum may modulate selected cognitive abilities. PMID:21928875

  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-17β concentration, with r = 0.69 at the beginning of growth phase and r = 0.86 in association with the largest dominant follicle. Plasma estradiol-17β 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. [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

  9. 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

  10. Analyses of mothers' sleep logs in postpartum periods.

    PubMed

    Horiuchi, S; Nishihara, K

    1999-04-01

    In order to investigate mothers' sleep-wake patterns from five to 12 weeks in the postpartum period, we analyzed continuous sleep logs. Data for 341 days from seven mothers were analyzed for each postpartum week. There were significant differences in total sleep time and wake time at night. Wake time at night gradually decreased from the fifth to the twelfth week. These results from continuous sleep logs support the results of our previous polysomnographic findings based on intermittent measurements. A transition from interrupted sleep to noninterrupted sleep was observed from the ninth to twelfth week of postpartum. The mothers' sleep-wake patterns are discussed focusing on their relationships to the infants' sleep-wake patterns and feeding rhythm. PMID:10459671

  11. 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

  12. Treatment of psychosis and mania in the postpartum period.

    PubMed

    Bergink, Veerle; Burgerhout, Karin M; Koorengevel, Kathelijne M; Kamperman, Astrid M; Hoogendijk, Witte J; Lambregtse-van den Berg, Mijke P; Kushner, Steven A

    2015-02-01

    Postpartum psychosis is a severe disorder that warrants acute clinical intervention. Little is known, however, about what interventions are most effective. The authors present treatment response and remission outcomes at 9 months postpartum using a four-step algorithm in patients with first-onset psychosis or mania in the postpartum period. Treatment involved the structured sequential administration of benzodiazepines, antipsychotics, lithium, and ECT. The outcome of clinical remission was examined in 64 women consecutively admitted for postpartum psychosis. Remission was defined as the absence of psychotic, manic, and severe depressive symptoms for at least 1 week. Women who remitted on antipsychotic monotherapy were advised to continue this treatment as maintenance therapy, and women who required both antipsychotics and lithium to achieve remission were maintained on lithium monotherapy. Relapse was defined as the occurrence of any mood or psychotic episode fulfilling DSM-IV-TR criteria. Using this treatment algorithm, the authors observed that nearly all patients (98.4%) achieved complete remission within the first three steps. None of the patients required ECT. At 9 months postpartum, sustained remission was observed in 79.7%. Patients treated with lithium had a significantly lower rate of relapse compared with those treated with antipsychotic monotherapy. Multiparity and nonaffective psychosis were identified as risk factors for relapse. The authors conclude that a structured treatment algorithm with the sequential addition of benzodiazepines, antipsychotics, and lithium may result in high rates of remission in patients with first-onset postpartum psychosis and that lithium maintenance may be most beneficial for relapse prevention. PMID:25640930

  13. The changing role of the medial preoptic area in the regulation of maternal behavior across the postpartum period: facilitation followed by inhibition.

    PubMed

    Pereira, Mariana; Morrell, Joan I

    2009-12-14

    Maternal behavior in rats undergoes considerable plasticity in parallel to the developmental stage of the pups, resulting in distinct patterns of maternal behavior and care at different postpartum time points. The medial preoptic area (mPOA) of the hypothalamus is one critical neural substrate underlying the onset and early expression of maternal behavior in rats but little is known about its specific functional role in the evolving expression of maternal behavior across the postpartum period. The present study uses a reversible local neural inactivation method to examine the role of the mPOA in the regulation of maternal behavior throughout the postpartum period, particularly extending into the late postpartum, a little examined period. This approach avoids the compensatory plasticity in CNS that occurs after permanent lesions, and allows the repeated testing of same individuals. Early (PPD7-8) and late (PPD13-14) postpartum maternal behavior was evaluated in female rats following infusions of bupivacaine or vehicle into the mPOA or into control areas. As expected, mPOA inactivation severely but transiently disrupted early postpartum maternal behavior whereas infusion of vehicle or inactivation of adjacent control sites did not. Later in the postpartum period, however, transient mPOA inactivation facilitated the expression of maternal behaviors, highly contrasting the behavioral expression levels characteristic of late postpartum. Results strongly demonstrate that the mPOA is differentially engaged throughout postpartum in orchestrating appropriate maternal responses with the developmental stage of the pups. PMID:19549547

  14. Do changes in mood and concerns about weight relate to smoking relapse in the postpartum period?

    PubMed

    Levine, M D; Marcus, M D

    2004-07-01

    The majority of women who quit smoking during pregnancy will resume smoking during the postpartum period. Little is known, however, about the predictors of postpartum relapses to smoking. Changes in mood and increases in concerns about weight are common during the postpartum period, and these factors may affect women's postpartum smoking behavior. In this paper, we present a model of the relationship among mood, weight concerns and postpartum smoking. Data from previous postpartum relapse prevention trials are reviewed and evidence of a connection between changes in mood and weight concerns to postpartum relapse is presented. Directions for future research on the prevention of smoking relapses during the postpartum period, and the roles of mood and weight concerns in smoking relapse are presented. PMID:15241661

  15. Hematobiochemical profile in Surti goats during post-partum period

    PubMed Central

    Manat, Tanvi D.; Chaudhary, Sandhya S.; Singh, Virendra Kumar; Patel, Sanjay B.; Puri, Gopal

    2016-01-01

    Aim: The study was undertaken to find out the changes in hematobiochemical profile in post-partum Surti goats. Materials and Methods: The present study was conducted on 40 Surti goats out of which 20 goats who had undergone recent parturition acted as treatment group and 20 non-pregnant animals comprised control group. Blood samples were collected from the treatment group on 0, 7, 14, 21, 30, and 45 days post kidding and once from the control group. Blood samples were analyzed for hematological parameters such as hemoglobin (Hb), packed cell volume (PCV), total erythrocyte count (TEC), total leukocyte count (TLC), differential leukocyte count, and biochemical metabolites such as total protein (TP), albumin, globulin, total cholesterol (TC), triglycerides (TG), non-esterified fatty acid (NEFA), glucose, and urea. Results: Hb level was the highest on the 45th day and lowest on the day of parturition. Significantly low level of Hb, PCV, and lymphocyte was found on 0 day and significantly high level was found on the 45th day. TEC was also low on the 0 day and high on the 45th day post kidding, but the difference was non-significant. Mid-sized cells and granulocyte percentage decreased significantly from 0 to 45th day post-partum. TP, albumin, and urea were found to be lowest on 0 day and highest on 45th day post-partum. Urea concentration increased parallel to TP indicating an increase in urea production with catabolism of protein. The globulin concentration also increased from 0 to 45th day post-partum, but the difference was non-significant. TC, TG, and NEFA were the highest on 0 day and lowest on the 45th day post-partum. Decrease in TC and TG from 0 to 45th day post-partum indicates that the animals utilized the lipids for the supply of energy for milk production. High level of NEFA acts as an indicator of negative energy status but in the present study, the high glucose level on 0 day indicates that the animals were in positive energy status. The glucose concentration decreased up to 14th day post-partum and then started increasing from 21st day onward. Conclusion: Hematobiochemical parameters are indicative of health status of animals. Significantly low values of Hb, PCV, and TLC during first 2 weeks post-partum are indicative of stress. Catabolism of protein occurred during 2 weeks post-partum, as observed from increase in urea concentration. Decrease TGs and high level of NEFA during the transition period are suggestive of utilization of lipids for the supply of energy. High glucose level on 0 day indicates that the animals were in positive energy status. PMID:27051179

  16. 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

  17. 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

  18. 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

  19. Laparoscopic Sleeve Gastrectomy in the Postpartum Period: Increased Risk of Bleeding, a Challenging Situation.

    PubMed

    Abouzahr, Omar; Garofalo, Fabio; Garneau, Pierre Y

    2016-06-01

    The female population represents three-fourths of patients undergoing a bariatric procedure and could be scheduled for surgery in their postpartum period. We report a difficult case of a female patient who underwent a laparoscopic sleeve gastrectomy 6 weeks postpartum. The postpartum period is accompanied by pronounced vasodilatation with transient portal hypertension. Most of the hemodynamic alterations occurring during pregnancy return to baseline within 6-8 weeks after delivery. Bariatric surgery in the postpartum period should be avoided in order for the cardiovascular system to regain its normality. PMID:27034060

  20. [Children murdered by their mothers in the postpartum period].

    PubMed

    Trautmann-Villalba, P; Hornstein, C

    2007-11-01

    The parental killing of children constitutes a complex phenomenon which has been reported across numerous cultures and throughout history. Children in the 1st year of life are at the highest risk of filicide. Types of filicide in the postpartum period include altruistic filicide, extended suicide, fatal child maltreatment, and neonaticide. Babies are murdered more frequently by mothers who are psychiatrically disturbed. With high frequency, depressive and psychotic symptoms are related to the newborn or to the maternity itself. The knowledge about maternal factors associated with filicide is not homogeneous. Sociodemographic characteristics are presented in relation to the different types of filicide. Risk constellations that may lead to a child's murder are described. PMID:17926015

  1. Problem-Solving Appraisal and the Prediction of Depression during Pregnancy and in the Postpartum Period.

    ERIC Educational Resources Information Center

    Elliott, Timothy R.; And Others

    1996-01-01

    Tested hypothesis that higher levels of positive affect and lower levels of negative affect would predict depression during pregnancy and in the postpartum period. Analysis of 100 women indicated that women at risk for depression during pregnancy and in the postpartum period may exhibit heightened negative moods and a dearth of positive affective…

  2. 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

  3. 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

  4. 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.

  5. Effects of Group Prenatal Care on Food Insecurity during Late Pregnancy and Early Postpartum.

    PubMed

    Heberlein, Emily C; Frongillo, Edward A; Picklesimer, Amy H; Covington-Kolb, Sarah

    2016-05-01

    Objective This study compared the effects of group to individual prenatal care in late pregnancy and early postpartum on (1) women's food security and (2) psychosocial outcomes among food-insecure women. Methods and Results We recruited 248 racially diverse, low-income, pregnant women receiving CenteringPregnancy™ group prenatal care (N = 124) or individual prenatal care (N = 124) to complete surveys in early pregnancy, late pregnancy, and early postpartum, with 84 % completing three surveys. Twenty-six percent of group and 31 % of individual care participants reported food insecurity in early pregnancy (p = 0.493). In multiple logistic regression models, women choosing group versus individual care were more likely to report food security in late pregnancy (0.85 vs. 0.66 average predicted probability, p < 0.001) and postpartum (0.89 vs. 0.78 average predicted probability, p = 0.049). Among initially food-insecure women, group participants were more likely to become food-secure in late pregnancy (0.67 vs. 0.35 individual care average predicted probability, p < 0.001) and postpartum (0.76 vs. 0.57 individual care average predicted probability, p = 0.052) in intention-to-treat models. Group participants were more likely to change perceptions on affording healthy foods and stretching food resources. Group compared to individual care participants with early pregnancy food insecurity demonstrated higher maternal-infant attachment scale scores (89.8 vs. 86.2 points for individual care, p = 0.032). Conclusions Group prenatal care provides health education and the opportunity for women to share experiences and knowledge, which may improve food security through increasing confidence and skills in managing household food resources. Health sector interventions can complement food assistance programs in addressing food insecurity during pregnancy. PMID:26662280

  6. 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

  7. Eating habits and attitudes in the postpartum period.

    PubMed

    Stein, A; Fairburn, C G

    1996-01-01

    The object of this study was to examine the changes in women's eating habits and attitudes in the 6 months after childbirth, focusing particularly on eating-disorder psychopathology. A general population sample of 97 primigravid women originally studied during pregnancy were followed for 6 months postpartum to describe their changes in eating and weight after childbirth with particular reference to the behaviors and attitudes characteristic of clinical eating disorders. Assessment was by standardized interview. It was found that eating disorder symptoms increased markedly in the 3 months postpartum and then plateaued over the next 6 months. This overall plateauing masked substantial variation in different domains; in particular, weight concern continued to increase to the 6-month assessment, although shape concern decreased. Concern about residual weight gain after the birth of a child was described by many mothers as particularly distressing and seemed to precipitate a clinical eating disorder in a few cases. Many women would have welcomed educational advice about how to deal with changes in eating, weight, and shape after pregnancy. It was concluded, therefore, that overall, there is evidence of an increase in eating-disorder psychopathology in the 6 months after childbirth. It is argued that education about how to deal with the changes in weight and shape after pregnancy might decrease the risk of developing frank eating disorder psychopathology. PMID:8827794

  8. 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…

  9. 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

  10. 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

  11. Management of Toxoplasmic Retinochoroiditis during Pregnancy, Postpartum Period and Lactation: Clinical Observations

    PubMed Central

    Brydak-Godowska, Joanna; Moneta-Wielgoś, Joanna; Kęcik, Dariusz; Borkowski, Piotr Karol

    2015-01-01

    Background During pregnancy and labor, the immune response is physiologically impaired and women are more susceptible to infections. Since many drugs may have potentially adverse effects on the fetus and newborn, less aggressive treatment regimens should be considered in pregnant and lactating patients. The aim of our study was to present the management of toxoplasmic retinochoroiditis during pregnancy, postpartum period, and lactation. Material/Methods A retrospective study was undertaken of the clinical records of 24 women during pregnancy, postpartum period, and lactation who were referred in the years 1994–2014 to the Department of Zoonoses and Tropical Diseases or the Department of Ophthalmology, Medical University of Warsaw for toxoplasmic retinochoroiditis. The diagnosis was based on the typical ophthalmoscopic picture, confirmed by serological testing using an ELISA method. Results A total of 28 attacks of toxoplasmic retinochoroiditis were observed in 24 patients during pregnancy, postpartum period, and lactation. The choice of treatment was guided by the character and location of the inflammatory lesion and the gestational age. Topical (steroidal/nonsteroidal eye drops) and systemic treatments with spiramycin or azithromycin, Fansidar (pyrimethamine 25 mg/sulfadoxine 500 mg), and prednisone were used. Conclusions Management of toxoplasmic retinochoroiditis during pregnancy, postpartum period, or lactation must be individualized and guided by the gestational age and location of the active lesion. Women of childbearing age with toxoplasma ocular lesions should be informed by their doctors about possible active recurrences during pregnancy and followed carefully by an ophthalmologist when pregnant. PMID:25711713

  12. 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

  13. Course and predictors of maternal eating disorders in the postpartum period

    PubMed Central

    Knoph, Cecilie; Holle, Ann Von; Zerwas, Stephanie; Torgersen, Leila; Tambs, Kristian; Stoltenberg, Camilla; Bulik, Cynthia M; Reichborn-Kjennerud, Ted

    2012-01-01

    Objective To investigate course and predictors of eating disorders in the postpartum period. Method A total of 77,807 women, participating in the Norwegian Mother and Child Cohort Study (MoBa), completed questionnaires during pregnancy including items covering DSM-IV criteria for pre-pregnancy anorexia nervosa (AN), bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS-P), and binge eating disorder (BED). Additional questionnaires were completed at 18 and 36 months postpartum. Results Proportions of women remitting at 18 months and 36 months postpartum were 50% and 59% for AN, 39% and 30% for BN, 46% and 57% for EDNOS-P, and 45% and 42% for BED, respectively. However, disordered eating persisted in a substantial proportion of women meeting criteria for either full or subthreshold eating disorders. BN during pregnancy increased the risk for continuation of BN. BMI and psychological distress were significantly associated with course of BED. Discussion This is the first large-scale population-based study on course of eating disorders in the postpartum period. The results indicated that disordered eating persists in a substantial proportion of women with pre-pregnancy eating disorders. Health care professionals working with women in this phase of life need to pay specific attention to eating disorder symptoms and behaviors. PMID:23307499

  14. 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

  15. Prevalence and rates of intimate partner violence among South African women during pregnancy and the postpartum period

    PubMed Central

    Groves, Allison K.; Moodley, Dhayendre; McNaughton-Reyes, Luz; Martin, Sandra L.; Foshee, Vangie; Maman, Suzanne

    2014-01-01

    Objectives Intimate partner violence (IPV) is a significant public health problem in South Africa. However, limited research exists on IPV during pregnancy and the postpartum period in South Africa. The purpose of this study is to describe the prevalence, rates and correlates of IPV among South African women during pregnancy and the first nine months postpartum. Methods Data are from a longitudinal study with women recruited during pregnancy between 2008 and 2010 at a public clinic in Durban. We used a modified version of the World Health Organization’s IPV scale to estimate prevalence and rates of IPV during pregnancy, at four months postpartum and nine months postpartum and we used logistic regression to assess the correlates of IPV during this time. Results More than 20% of all women experienced at least one act of physical, psychological or sexual IPV during pregnancy. Nearly one-quarter of all women experienced at least one act of physical, psychological or sexual IPV during the first nine months postpartum. Psychological IPV was the most prevalent type of IPV during pregnancy and the first four months postpartum. Age and previous violence within the relationship were associated with IPV during pregnancy and IPV during the postpartum period. Conclusions The high levels of IPV during pregnancy and the postpartum period highlight the need to develop screening and intervention strategies specifically for this time. Further, women should be screened not only for physical violence but also psychological violence given that psychological violence may result in distinct negative consequences. PMID:24889116

  16. Influence of Body Composition on Gait Kinetics throughout Pregnancy and Postpartum Period

    PubMed Central

    Branco, Marco; Santos-Rocha, Rita; Vieira, Filomena; Silva, Maria-Raquel; Aguiar, Liliana; Veloso, António P.

    2016-01-01

    Pregnancy leads to several changes in body composition and morphology of women. It is not clear whether the biomechanical changes occurring in this period are due exclusively to body composition and size or to other physiological factors. The purpose was to quantify the morphology and body composition of women throughout pregnancy and in the postpartum period and identify the contribution of these parameters on the lower limb joints kinetic during gait. Eleven women were assessed longitudinally, regarding anthropometric, body composition, and kinetic parameters of gait. Body composition and body dimensions showed a significant increase during pregnancy and a decrease in the postpartum period. In the postpartum period, body composition was similar to the 1st trimester, except for triceps skinfold, total calf area, and body mass index, with higher results than at the beginning of pregnancy. Regression models were developed to predict women's internal loading through anthropometric variables. Four models include variables associated with the amount of fat; four models include variables related to overall body weight; three models include fat-free mass; one model includes the shape of the trunk as a predictor variable. Changes in maternal body composition and morphology largely determine kinetic dynamics of the joints in pregnant women. PMID:27073713

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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, β-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

  2. 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

  3. Opinions of women towards cesarean delivery and priority issues of care in the postpartum period.

    PubMed

    Kisa, Sezer; Zeyneloğlu, Simge

    2016-05-01

    This study was conducted, in order to determine the opinions of women who had a cesarean delivery and the problems that they faced in the postpartum period. This descriptive study was conducted with 337 women who delivered babies by cesarean section. The data were collected using a semi-structured questionnaire. The results of the study showed that 53.4% of women underwent cesarean delivery for the first time, and 83.1% said that it was the obstetrician's decision to have a cesarean delivery. More than half of the women (61.1%) had a negative experience with cesarean delivery due to postpartum pain (44.7%) and inability to care for their infant (35.9%). The most common problems associated with cesarean delivery were postpartum pain (96.1%), back pain (68.2%), problems passing gas (62.0%), bleeding (56.1%), breastfeeding problems (49.6%) and limitation of movement (43.6%) respectively. Understanding the the opinions and problems of women towards cesarean delivery assists healthcare professionals in identifying better ways to provide appropriate care and support. PMID:27091257

  4. Value of UVJ-M in the diagnosis of SUI in late pregnancy and postpartum

    PubMed Central

    ZHANG, GUIXIN; JIANG, WEI; GUO, QUANWEI; GUO, QUANRONG

    2016-01-01

    Stress urinary incontinence (SUI) is a common pelvic floor dysfunctional disorder in which leakage of urine occurs when there is abdominal pressure. The aim of the present study was to determine the value of stress urinary incontinences (SUIs) in late pregnancy and postpartum via detection of the mobility of the ureterovesical junction (UVJ-M) by using transperineal ultrasound. The study involved the continuous and random selection of 120 cases of early pregnant women and single births. The patients were divided into the SUI and non-SUI groups dependent on whether there was leakage of urine when abdominal pressure in the form of coughing, laughing and sneezing, was increased. UVJ-M was measured, the receiver operating characteristic (ROC) curve was drawn up and the threshold value was predicted. The results showed that, the SUI prevalence was 7.5 (9/120), 22.5 (27/120), 43.3 (52/120), and 5.8% (7/100), respectively, in 34, 36, and 38 gestational weeks, and 6 weeks after delivery. The SUI prevalence gradually increased with the gestational weeks, and differences were statistically significant. UVJ-M values increased with the gestational weeks, at 3.43±1.52, 6.77±0.98 and 2.35±1.04 mm, respectively. Statistically significant differences were identified. Results of the ROC analysis, based on measurement of UVJ-M between the late pregnancy and non-SUI groups, revealed that the optimal threshold was 8.66 mm, corresponding to a sensitivity of 89.5% and specificity of 66.7%. In conclusion, UVJ-M ≥6.59 mm was identified as the predicted value of SUI during late pregnancy, and UVJ-M ≥8.66 mm the predicted value of SUI after delivery.

  5. 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...

  6. Weight change in the postpartum period. A review of the literature.

    PubMed

    Crowell, D T

    1995-01-01

    Women who gain excessive weight during pregnancy are at risk for postpartum weight retention and long-term obesity. Familiarity with current research related to postpartum weight loss can aid the nurse-midwife in providing sound, clinical advice to women at risk for postpartum weight retention. This article provides a review of current literature and research studies related to postpartum weight loss, weight retention, and weight gain. An overview of gestational weight gain and fetal growth, recommendations of the Institute of Medicine, complications of maternal obesity, postpartum weight-loss patterns, and factors that affect postpartum weight loss are discussed. PMID:7472647

  7. 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

  8. 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

  9. 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

  10. 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

  11. Chromium propionate supplementation during the peripartum period interacts with starch source fed postpartum: Production responses during the immediate postpartum and carryover periods.

    PubMed

    Rockwell, R J; Allen, M S

    2016-06-01

    Forty-eight multiparous cows were used in a randomized complete block design experiment with a 2×2 factorial arrangement of treatments to determine the interaction between chromium propionate (CrPr) supplementation and sources of corn varying in ruminal starch fermentability on production responses during the postpartum (PP) and carryover periods. During the peripartum period (28d before expected parturition until 28d PP), diets were top-dressed (20g/d) with either CrPr (KemTRACE Chromium Propionate, Kemin Industries, Des Moines, IA; 8mg of Cr/cow per day) or control (Con; ground corn). At parturition, cows were randomly assigned to corn treatment within CrPr and Con treatments: dry corn (DC) or high-moisture corn (HMC). Treatment combinations (CrPr/DC, CrPr/HMC, Con/DC, and Con/HMC) were fed from parturition until 28d PP (treatment period). Cows were fed a common diet to evaluate potential carryover effects of the treatment diets from 29 to 84d PP (carryover period). The CrPr and corn treatments interacted over time to affect yield of 3.5% fat-corrected milk (FCM) during both the treatment and carryover periods. The CrPr/HMC treatment combination tended to increase FCM compared with Con/DC and Con/HMC by 28d PP (57.4 vs. 48.6 and 48.5kg/d, respectively) and increased FCM compared with Con/DC by 42d PP (59.2 vs. 44.8kg/d). The CrPr tended to increase milk yield (55.4 vs. 51.9kg/d) regardless of corn source during the carryover period after treatment ceased. Daily and cumulative DMI were not affected by treatment during the PP period, but CrPr and corn treatments interacted over time to affect daily DMI during the carryover period; DMI was generally higher for CrPr/HMC, lower for Con/DC, and intermediate for CrPr/DC and Con/HMC from 29 to 84d PP. Supplementation of CrPr throughout the peripartum period interacted with starch source in PP diets over time to affect production responses that were sustained after treatment application ceased. PMID:26995130

  12. Levator ani muscle activity in pregnancy and the postpartum period: a myoelectric study.

    PubMed

    Shafik, A; El-Sibai, O

    2000-01-01

    The levator ani (LA) is a muscle of evacuation and acts as well to support the pelvic viscera. An increase of the intra-abdominal pressure beyond the physiologic limits and visceral overload are speculated to interfere with LA functional activity. This consideration was a stimulus to study the effect of pregnancy on the LA muscle. The EMG activity of the LA muscle was recorded before and during pregnancy and after delivery in 36 women (mean age 27.2+/-3.1 years, 20 multigravida, 16 primigravida). A needle electrode was inserted into the muscle and LA activity was recorded at rest, and on squeezing and straining in both the erect and recumbent position. In the erect position, the resting and squeezing EMG activity during the first 8 weeks of pregnancy, showed no significant difference (p>0.05) from that before pregnancy, and after that, increased progressively and significantly until delivery. On straining, the EMG activity showed no significant difference from that before pregnancy in the first 8 weeks, and after that, decreased progressively and significantly till delivery. In the recumbent position, the LA EMG registered similar activity to that in the erect position but with significantly lower values (p<0.05). The reduction in the LA EMG activity was more evident in the multi-than in the primigravida. In the postpartum period, no LA EMG activity was recorded in the first month; the activity increased progressively after that time to reach the pre-pregnancy level in the forth postpartum month. In conclusion, pregnancy interferes with EMG and functional activity of the LA from the 8th week onwards due to the progressively increasing size and weight of the uterus. This effect was most marked in the last 12 weeks. Delivery seems to maximally inhibit the LA activity in the first postpartum month. Excessive LA traumatization may eventually lead to levator dysfunction syndrome. PMID:10968354

  13. Effect of lavender scent inhalation on prevention of stress, anxiety and depression in the postpartum period

    PubMed Central

    Kianpour, Maryam; Mansouri, Akram; Mehrabi, Tayebeh; Asghari, Gholamreza

    2016-01-01

    Background: Stress, anxiety, and postpartum depression are the most common problems among women in their childbearing age. Research has shown that aromatherapy administered during labor reduces anxiety in mothers. With regard to the specific biological conditions in postpartum period and the subsequent drop in hormone levels, this study investigated the effect of lavender on prevention of stress, anxiety, and postpartum depression in women. Materials and Methods: In a clinical trial, 140 women admitted to the obstetric and gynecological unit were randomly divided into aromatherapy and non-aromatherapy groups immediately after delivery. Intervention with aromatherapy consisted of inhaling three drops of lavender essential oil every 8 h with for 4 weeks. The control group received routine care after discharge and was followed up by telephone only. After 2 weeks, 1 and 3 months of delivery, women were assessed by the 21-item Depression, Anxiety, and Stress Scale and the Edinburgh stress, anxiety, and depression scale in the two groups. Data analysis was performed by Mann-Whitney, analysis of variance (ANOVA), and post hoc tests. Level of significance was set as 0.05 for all tests. Results: The results showed that the mean stress, anxiety, and depression at time point of 2 weeks (P = 0.012, P < 0.0001, and P = 0.003, respectively) and stress, anxiety, and depression scores at time points of 1 month (P < 0.0001) and 3 months after delivery (P < 0.0001) were significantly lower in the study group compared with the control group. Conclusions: Inhaling the scent of lavender for 4 weeks can prevent stress, anxiety, and depression after childbirth. PMID:27095995

  14. An Assessment of Maternal Quality of Life in the Postpartum Period in Southern Brazil: A Comparison of Two Questionnaires

    PubMed Central

    Zubaran, Carlos; Foresti, Katia; Schumacher, Marina Verdi; Muller, Lucia Cristina; Amoretti, Aline Luz

    2009-01-01

    OBJECTIVES To assess maternal quality of life (QoL) during the postpartum period and to compare the performance of two QoL questionnaires across a sample of 101 women in southern Brazil. To our knowledge, this is the first study that measures maternal quality of life during the postpartum period in Brazil. INTRODUCTION There is limited information about postpartum maternal quality of life in Brazil. The are no Portuguese versions of instruments specifically designed to measure quality of life during the postpartum period. METHODS Research participants completed the Portuguese version of the World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) and Multicultural Quality of Life Index (MQLI) questionnaires. The correlations between the MQLI and the discrete areas of WHOQOL-BREF were examined using Pearson Product-Moment Correlation Coefficients. RESULTS We report a significant correlation between the global MQLI and the four domains of the WHOQOL-BREF scores (p < 0.01). An analysis of variance revealed a significant difference in mean scores in the Psychological and Environment domains according to different socio-economic strata: F (3, 97) = 3.81, p = 0.012 and F (3, 97) = 4.03, p = 0.01, respectively. DISCUSSION The WHOQOL-BREF questionnaire may be more sensitive than the MQLI in detecting the impact of socioeconomic status on the QoL of postpartum women. CONCLUSION The sample of postpartum women evaluated in this study presented favorable QoL scores according to both the MQLI and WHOQOL-BREF questionnaires. Our results also indicate that the WHOQOL-BREF and the MQLI questionnaires have a significant correlation in terms of their assessments of postpartum mothers. PMID:19690658

  15. Depression and suicidality during the postpartum period after first time deliveries, active component service women and dependent spouses, U.S. Armed Forces, 2007-2012.

    PubMed

    Do, Tai; Hu, Zheng; Otto, Jean; Rohrbeck, Patricia

    2013-09-01

    Although suicide is a leading cause of death among new mothers during the postpartum period, there has been limited research on self-harm in the postpartum period and associated risk factors. One potential risk factor for suicidality (completed suicides, suicide attempts, and suicide ideation including thoughts of self harm) during the postpartum period is postpartum depression (PPD). In this study of women who gave birth for the first time between 1 January 2007 and 31 December 2011, 5,267 (9.9% of all who delivered) active component service women and 10,301 (8.2%) dependent spouses received incident PPD diagnoses during the one year postpartum period; 213 (0.4%) service women and 221 (0.2%) dependent spouses were diagnosed with incident suicidality. After adjusting for the effects of other covariates, service women with PPD had 42.2 times the odds to be diagnosed with suicidality in the postpartum period compared to service women without PPD; dependent spouses with PPD had 14.5 times the odds compared to those without PPD. The findings of this report suggest that a history of mental disorders was common among service women and dependent spouses with PPD in the postpartum period, and, in turn, PPD was a strong predictor for suicidality in the postpartum period. These results emphasize the importance of PPD screening during the postpartum period. They also suggest that additional focused screening for suicidal behavior among those already diagnosed with PPD may be warranted. PMID:24093957

  16. 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

  17. 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

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

    PubMed

    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

  19. 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

  20. The Efficiency of Reproduction Health Education Given to Adolescents during the Postpartum Period.

    PubMed

    Topatan, Serap; Demirci, Nurdan

    2015-10-01

    Our research, partly experimental and partly prospective, was conducted for the purpose of evaluating the efficiency of reproductive health education given to adolescents during the postpartum period. The study comprised with 120 adolescents aged 15 to 19 (60 experimental group, 60 control group). Follow-up was conducted every 3 months for a total of 12 months, and the study concluded with 55 individuals from the experimental group and 46 individuals from the control group having participated fully, for the full 12 months. At the end of the research, it was found that the reproductive health knowledge of the experimental (103.10 ± 11.43) and control (99.15 ± 9.53) groups were similar before education. A statistically significant difference was also found between the total points for the scale determining the reproductive health of the experimental and control groups before and after education (P < .001). The socio-demographic variables affecting the total points for the scale determining the reproductive health-protective behavior of women were evaluated by multiple regression analysis; the most effective variables were found to be age and educational status. A statistically significant difference was also found between the total points for the family planning behavior scale of the experimental and control groups before and after education (P < .001). From this, it was understood that reproductive health education given during the postpartum and follow-up periods has a positive effect on adolescents' developing reproductive health behaviors and on creating knowledge and awareness related to family planning behavior. But there needs to be follow-up and supporting specific for adolescents in the current health system. PMID:26173382

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. Seizures in the early post-partum period: A diagnostic dilemma.

    PubMed

    Jamadarkhana, Sunil; Law, Robert C

    2012-03-01

    We discuss the differential diagnosis and management of early post-partum seizures and headache following a presumed dural puncture in a 20-year-old female. She initially presented with generalised tonic-clonic seizures preceded by nausea and headache on the fourth post-partum day along with a decreased Glasgow Coma Scale (8/15). Although clinical and laboratory examination including lumbar puncture, computerized tomography and magnetic resonance imaging were normal, a persistent headache was the only symptom. This headache improved dramatically after an epidural blood patch on the eighth post-partum day. The following discussion emphasises that various causes of post-partum seizures and headache should be considered before attributing it to dural puncture alone. PMID:22701214

  8. Seizures in the early post-partum period: A diagnostic dilemma

    PubMed Central

    Jamadarkhana, Sunil; Law, Robert C

    2012-01-01

    We discuss the differential diagnosis and management of early post-partum seizures and headache following a presumed dural puncture in a 20-year-old female. She initially presented with generalised tonic–clonic seizures preceded by nausea and headache on the fourth post-partum day along with a decreased Glasgow Coma Scale (8/15). Although clinical and laboratory examination including lumbar puncture, computerized tomography and magnetic resonance imaging were normal, a persistent headache was the only symptom. This headache improved dramatically after an epidural blood patch on the eighth post-partum day. The following discussion emphasises that various causes of post-partum seizures and headache should be considered before attributing it to dural puncture alone. PMID:22701214

  9. 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

  10. Are Unhygienic Practices During the Menstrual, Partum and Postpartum Periods Risk Factors for Secondary Infertility?

    PubMed Central

    Ali, Tazeen Saeed; Sami, Neelofar; Khuwaja, Ali Khan

    2007-01-01

    This study was aimed at identifying practices during the menstrual, partum and postpartum periods posing possible risk factors contributing towards secondary infertility in women of a selected population in Karachi, Pakistan. A matched case-control study was conducted from April 2003 to March 2004. Four hundred cases were selected from five infertility clinics affiliated with tertiary-care hospitals, and 400 age-matched controls were recruited from the neighbourhood of each case. After taking written consents, trained interviewers conducted interviews using a pretested structured questionnaire. Factors found to be independently associated with secondary infertility were: previous delivery at an unclean place (adjusted odds ratio [AOR]=1.7, 95% confidence interval [CI] 1.1-2.6), delivery by a birth attendant without washing hands with soap (AOR=4.2, 95% CI 2.36-7.47), use of unclean material for absorption of lochia (AOR=3.1, 95% CI 1.5-6.5), non-washing of perineal area after urination/defaecation (AOR=7.1, 95% CI 1.4-35.7), and insertion of home-made vaginal medications (AOR=2.5, 95% CI 1.3-4.7). Since these factors are preventable/modifiable to a great extent, public-health interventions are, thus, recommended to address these risk factors at various levels. PMID:17985820

  11. [Management of women with bipolar disorders from conception through the postpartum period].

    PubMed

    Nordon, Clémentine; Sutter, Anne-Laure; Verdoux, Hélène

    2007-12-01

    Any plans for pregnancy must be discussed in detail with women with bipolar disorders. They must be informed about the risks related to it and the need for some precautions. Because of the risk of relapse during pregnancy, the risk/benefit ratio of maintaining or starting prophylactic treatment should be assessed, taking into account family history and frequency of recurrences. Lithium may be used during pregnancy under close monitoring. Most anticonvulsants are contraindicated because of their teratogenicity. During the post-partum period, prophylaxis is required in most cases because of the high risk of relapse. If no prophylaxis was given during pregnancy, it must be started quickly after delivery to be effective when the risk is at its highest, i.e., during the first two weeks after delivery. Women with bipolar disorders should be advised against breast-feeding to avoid exposure of the infant to psychotropic medication. Because breast-feeding can be stressful and causes sleep deprivation, it may increase the risk of relapse. Second-generation antipsychotic agents should not be used during pregnancy or breast-feeding because inadequate information is currently available about their safety. PMID:17572050

  12. 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

  13. The association between physical activity and maternal sleep during the postpartum period

    PubMed Central

    Vladutiu, Catherine J.; Evenson, Kelly R.; Borodulin, Katja; Deng, Yu; Dole, Nancy

    2014-01-01

    Background Physical activity is associated with improved sleep quality and duration in the general population, but its effect on sleep in postpartum women is unknown. Methods We examined cross-sectional and longitudinal associations between hours/week of self-reported domain-specific and overall moderate to vigorous physical activity (MVPA) and sleep quality and duration at 3- and 12-months postpartum among a cohort of 530 women in the Pregnancy, Infection, and Nutrition Postpartum Study. Results MVPA was not associated with sleep quality or duration at 3-months postpartum. At 12-months postpartum, a one hour/week increase in recreational MVPA was associated with higher odds of good (vs. poor) sleep quality (odds ratio, OR=1.14; 95% confidence interval, CI, 1.03–1.27) and a one hour/week increase in child/adult care MVPA was associated with lower odds of good (vs. poor) sleep quality (OR=0.93; 95% CI=0.88–0.99). A one hour/week increase in child/adult care MVPA (OR=1.08, 95% CI=1.00–1.16) was associated with higher odds of long sleep duration and one hour/week increases in indoor household (OR=1.09, 95% CI=1.01–1.18) and overall MVPA (OR=1.04, 95% CI=1.01–1.07) were associated with higher odds of short (vs. normal) sleep duration. Comparing 3-months postpartum to 12-months postpartum, increased work MVPA was associated with good sleep quality (OR=2.40, 95% CI=1.12–5.15) and increased indoor household MVPA was associated with short sleep duration (OR=1.85, 95% CI=1.05–3.27) as measured at 12-months postpartum. Conclusions Selected domains of MVPA and their longitudinal increases were associated with sleep quality and duration at 12-months postpartum. Additional research is needed to elucidate whether physical activity can improve postpartum sleep. PMID:24577601

  14. 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

  15. 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

  16. 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

  17. 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

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

    PubMed

    Zhao, Changjiu; Gammie, Stephen C

    2014-12-01

    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

  19. 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 patient’s PRES resolved. Early diagnosis and treatment are the keys to reverse PRES. A literature review for PRES is provided in this report. PMID:26807372

  20. 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

  1. Adverse events from spinal manipulation in the pregnant and postpartum periods: a critical review of the literature

    PubMed Central

    2012-01-01

    Background The safety of spinal manipulation during pregnancy and the postpartum periods has been a matter of debate among manual therapists. Spinal manipulative therapy during these periods is a commonly performed intervention as musculoskeletal pain is common in these patients. To date there has not been an evaluation of the literature on this topic exclusively. Methods A literature search was conducted on PubMed, CINAHL and the Index to Chiropractic Literature along with reference searching for articles published in English and French in the peer-reviewed literature that documented adverse effects of spinal manipulation during either pregnancy or postpartum. Case reports, case series, and any other clinical study designs were deemed acceptable for inclusion, as were systematic reviews. The appropriate Scottish Intercollegiate Guidelines Network (SIGN) tools were used to rate included articles for quality when applicable. Results Five articles identifying adverse events in seven subjects following spinal manipulation were included in this review, along with two systematic reviews. The articles were published between 1978 and 2009. Two articles describing adverse effects from spinal manipulation on two postpartum patients were included, while the remaining three articles on five patients with adverse effects following spinal manipulation were on pregnant patients. Injury severity ranged from minor injury such as increasing pain after treatment that resolved within a few days to more severe injuries including fracture, stroke, and epidural hematoma. SIGN scores of the prospective observational cohort study and systematic reviews indicated acceptable quality. Conclusions There are only a few reported cases of adverse events following spinal manipulation during pregnancy and the postpartum period identified in the literature. While improved reporting of such events is required in the future, it may be that such injuries are relatively rare. PMID:22455720

  2. 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, João 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

  3. 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. PMID:27022506

  4. Massive Hemothorax Occurring with Intramural Hematoma of the Descending Aorta in the Early Postpartum Period

    PubMed Central

    Yun, Jeong Hee; Jeon, Yeong Jeong; Hong, Tae Hee; Byun, Joung Hun; Hwang, Sang Won; Park, Jae Hong

    2016-01-01

    Postpartum aortic intramural hematoma (IMH) is a rare but potentially lethal condition. We report a case of aortic IMH with massive hemothorax in a postpartum woman. The patient was a 31-year-old woman who had delivered twins by cesarean section. Two days after delivery, she complained of sudden-onset dyspnea. Chest computed tomography revealed a massive left hemothorax. Exploratory thoracotomy was performed, and we found a defect measuring approximately 6 mm in the adventitial layer of the thoracic aorta and an IMH. We repaired the defect primarily, and no more bleeding was observed. The patient was discharged on the 19th postoperative day without any complications. PMID:27066436

  5. Massive Hemothorax Occurring with Intramural Hematoma of the Descending Aorta in the Early Postpartum Period.

    PubMed

    Yun, Jeong Hee; Jeon, Yeong Jeong; Hong, Tae Hee; Byun, Joung Hun; Hwang, Sang Won; Park, Jae Hong

    2016-04-01

    Postpartum aortic intramural hematoma (IMH) is a rare but potentially lethal condition. We report a case of aortic IMH with massive hemothorax in a postpartum woman. The patient was a 31-year-old woman who had delivered twins by cesarean section. Two days after delivery, she complained of sudden-onset dyspnea. Chest computed tomography revealed a massive left hemothorax. Exploratory thoracotomy was performed, and we found a defect measuring approximately 6 mm in the adventitial layer of the thoracic aorta and an IMH. We repaired the defect primarily, and no more bleeding was observed. The patient was discharged on the 19th postoperative day without any complications. PMID:27066436

  6. 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

  7. 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

  8. The Antecedents and Consequences of Maternal Adaptation in the Postpartum Period. Project Prepare.

    ERIC Educational Resources Information Center

    Bradley, Christine F.

    A prospective, longitudinal investigation was made of psychological aspects of pregnancy, birth, and the first year postpartum. The majority of participants were Caucasian (90 percent) and Chinese-Canadian (5 percent) men and women and their infant children. Adult participants completed a series of psychological and attitude measures selected to…

  9. 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

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

    PubMed

    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

  11. 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

  12. Changes in sleep-wake cycle during the period from late pregnancy to puerperium identified through the wrist actigraph and sleep logs.

    PubMed

    Shinkoda, H; Matsumoto, K; Park, Y M

    1999-04-01

    The purpose of this study was to understand the sleep-wake cycle during the period from late pregnancy to about 3 months of postpartum by evaluating the number of actigraphic activities in four women (one multipara and three primi gravidae), and to compare the results with the findings from sleep logs. An irregularity of the sleep-wake cycle with increased number of wakings at night was notable during about 1 month after delivery, compared to the late pregnancy period, and subsequently this number tended to decrease. These results were indicative of the association between the lactation cycle to neonates and the sleep-wake cycle. PMID:10459670

  13. 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…

  14. 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

  15. Use of bovine pregnancy-associated glycoproteins to predict late embryonic mortality in postpartum Nelore beef cows.

    PubMed

    Pohler, K G; Peres, R F G; Green, J A; Graff, H; Martins, T; Vasconcelos, J L M; Smith, M F

    2016-06-01

    The primary objective was to determine if circulating concentration of bovine pregnancy-associated glycoproteins (bPAGs) on Day 30 after artificial insemination (AI) may serve as a marker of late embryonic mortality in Bos indicus (Nelore) beef cows. In experiment 1, postpartum Nelore beef cows (n = 56) were artificially inseminated at a fixed time (Day 0) after synchronization of ovulation. Serum samples were collected on Days 0, 21, 24, 27, and 30 after AI. The first significant increase (P < 0.0001) in serum bPAGs after insemination occurred on Day 24 of gestation. In experiment 2, ovulation was synchronized in postpartum Nelore beef cows (n = 1460) and AI was received at a fixed time. Pregnancy diagnosis and blood sample collection were carried out on Days 28 to 30 after insemination. Cows that maintained a pregnancy from Days 28 to 100 of gestation (n = 714) had significantly (P < 0.0001) higher circulating concentrations of bPAGs on Day 28 compared with cows that did not maintain a pregnancy (embryonic mortality [EM]) until Day 100 (n = 89). When Day 28 bPAG concentration was included in a logistic regression model to predict pregnancy maintenance until Day 100 of gestation, there was an increase (P < 0.0001) in the probability of maintaining pregnancy as maternal concentrations of bPAGs increased. A receiver operating characteristic curve was generated to determine bPAG concentrations on Day 28 that should predict embryonic survival or mortality with an accuracy of 95% or more. On the basis of the positive and negative predicative value analysis, at Day 28 of gestation a circulating concentration of bPAGs greater than 7.9 ng/mL was 95% accurate in predicting embryonic maintenance (to Day 100); a concentration of bPAGs less than 0.72 ng/mL was 95% accurate in predicting EM by Day 100. In experiment 3, the preceding model was tested in a separate set of Nelore beef cows to validate whether bPAGs would serve as an accurate measure of late embryonic mortality. Ovulation was synchronized in 650 Nelore cows and received AI at a fixed time. Pregnancy diagnosis and bPAG sampling were performed at Day 28 of gestation. Only pregnant cows were included in the analysis. On the basis of the previously reported bPAG cutoff values, the test was 95% accurate in predicting late embryonic mortality at Day 28 of gestation. In summary, bPAGs seem to be a good marker for predicting EM between Days 28 and 100 of gestation and suggest that this model could help dissect the molecular mechanisms leading to late EM. PMID:26928645

  16. Evaluation of the French version of the multidimensional scale of perceived social support during the postpartum period.

    PubMed

    Denis, A; Callahan, S; Bouvard, M

    2015-06-01

    In the presence of physical and psychological disturbances in the postpartum period, perceived social support is often regarded as a protective factor in women's mental health. This work evaluates the psychometric properties of the French version of a questionnaire widely used internationally to measure perceived social support, which has not been yet validated in French: the Multidimensional Scale of Perceived Social Support (MSPSS). This study collected data from 148 women (30.5 ± 5.12 years) who agreed to complete the MSPSS and a scale assessing symptoms of postpartum depression (Edinburgh Post-Natal Depression Scale, EPDS) 1 and 4 months after childbirth. The results confirm the original three-factor structure of the scale. The Cronbach's alpha coefficients are excellent. The total scale score is correlated with all three dimensions and a significantly negative correlation is found between MSPSS and EPDS. The results suggest that the French tool has generally good internal reliability. The MSPSS can provide useful data helping to identify French-speaking people at risk for negative feelings (e.g., mood disorders of perinatal period). PMID:25366102

  17. Relationship between plasma beta-carotene concentrations during the peripartum period and ovulation in the first follicular wave postpartum in dairy cows.

    PubMed

    Kawashima, C; Kida, K; Schweigert, F J; Miyamoto, A

    2009-03-01

    Beta-carotene functions independently of vitamin A in the reproductive performance of dairy cows. The concentrations of beta-carotene in plasma decrease during the dry period, and reach a nadir in about the first week postpartum. This coincides with a negative energy balance, which affects the onset of the first ovulation in early postpartum cows. Thus, we hypothesised that plasma beta-carotene concentrations during the peripartum period may affect ovulation in the first follicular wave postpartum in dairy cows. The aim of the present study was to investigate changes in the profiles of plasma beta-carotene concentrations during the peripartum period in ovulatory and anovulatory cows during the first follicular wave postpartum. We used 22 multiparous Holstein cows, which were fed a total mixed ration consisting of grass, corn silage and concentrate, and collected blood samples for beta-carotene and progesterone analysis from week 3 prepartum to week 3 postpartum when the period of day 0-6 after parturition was regarded as the parturient week (week 0). The first ovulation was confirmed using the profile of plasma progesterone concentrations and colour Doppler ultrasound. Thirteen cows ovulated during the first postpartum follicular wave. Parity, the dry-off period, calving interval, mastitis episodes, and actual 305 days' milk yield during the previous lactation, and milk composition in the last month during the previous lactation in this study did not differ between ovulatory and anovulatory cows. Differences in the plasma beta-carotene profile were observed between ovulatory and anovulatory cows. Plasma beta-carotene concentrations at week 3 prepartum were greater in ovulatory cows (2.97+/-0.24 mg/L) than in anovulatory cows (1.53+/-0.14 mg/L; P<0.001), after that its concentrations in ovulatory cows decreased and reached the lowest level at week 1 postpartum, although its concentrations in anovulatory cows remained unchanged. No differences in plasma beta-carotene concentrations between the two groups were observed postpartum. The present study indicates for the first time that the lower beta-carotene concentrations in plasma during the prepartum period is associated with anovulation during the first follicular wave postpartum. PMID:18359584

  18. Eating Disorders, Pregnancy, and the Postpartum Period: Findings from the Norwegian Mother and Child Cohort Study (MoBa)

    PubMed Central

    Watson, Hunna J.; Torgersen, Leila; Zerwas, Stephanie; Reichborn-Kjennerud, Ted; Knoph, Cecilie; Stoltenberg, Camilla; Siega-Riz, Anna Maria; Von Holle, Ann; Hamer, Robert M.; Meltzer, Helle; Ferguson, Elizabeth H.; Haugen, Margaretha; Magnus, Per; Kuhns, Rebecca; Bulik, Cynthia M.

    2016-01-01

    This review summarizes studies on eating disorders in pregnancy and the postpartum period that have been conducted as part of the broader Norwegian Mother and Child Cohort Study (MoBa). Prior to the 2000s, empirical literature on eating disorders in pregnancy was sparse and consisted mostly of studies in small clinical samples. MoBa has contributed to a new era of research by making population-based and large-sample research possible. To date, MoBa has led to 19 studies on diverse questions including the prevalence, course, and risk correlates of eating disorders during pregnancy and the postpartum. The associations between eating disorder exposure and pregnancy, birth and obstetric outcomes, and maternal and offspring health and well-being, have also been areas of focus. The findings indicate that eating disorders in pregnancy are relatively common and appear to confer health risks to mother and her child related to sleep, birth outcomes, maternal nutrition, and child feeding and eating.

  19. 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 ...

  20. 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

  1. 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

  2. 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

  3. Postpartum Sterilization

    MedlinePlus

    ... Gynecologists f AQ FREQUENTLY ASKED QUESTIONS FAQ052 Contraception Postpartum Sterilization • What is sterilization? • What is postpartum sterilization? • What is the most common method of ...

  4. A prospective study of thoughts of self-harm and suicidal ideation during the postpartum period in women with mood disorders.

    PubMed

    Pope, Carley J; Xie, Bin; Sharma, Verinder; Campbell, M Karen

    2013-12-01

    Individuals with mood disorders are at higher risk for self-harm and suicidal ideation than other psychiatric group. However, the risk of self-harm and suicidal ideation after pregnancy for women with mood disorders is unknown. This investigation assessed the prevalence of thoughts of self-harm and suicidal ideation during the 1-year postpartum period in women with major depressive disorder or bipolar II disorder. Data were collected between June 2005 and March 2010 from a convenience sample of women participating in a study on the course of mood disorders during pregnancy and postpartum. Participant diagnosis was confirmed using the Structured Clinical Interview for DSM-IV. Thoughts of self-harm were assessed using the Edinburgh Postnatal Depression Scale item 10 and suicidal ideation was assessed using the Hamilton Depression Rating Scale item 3. During the 1-year postpartum period, 16.97 % reported thoughts of self-harm while 6.16 % reported suicidal ideation. Further, those reporting thoughts of self-harm or suicidal ideation postpartum also reported higher levels of depression and hypomanic symptoms. We found that a number of women in our sample of women with a diagnosed mood disorder report experiencing thoughts of self-harm and suicidal ideation during the postpartum. PMID:23784481

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

    PubMed

    Tesařová, Drahomíra

    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

  6. Prevalence of psychiatric disorders and associated risk factors in women during their postpartum period: a major public health problem and global comparison

    PubMed Central

    Bener, Abdulbari; Gerber, Linda M; Sheikh, Javaid

    2012-01-01

    Background Postnatal depression has received considerable research and clinical attention; however, anxiety and stress in postpartum women have been relatively neglected. Objective The aim of this study was to determine the prevalence of depression, anxiety, and stress during the postpartum period of women using the Depression Anxiety Stress Scales, and to examine the associated correlates of these conditions. Design This was a cross-sectional study conducted from January 2010 to May 2011. Setting Primary health care centers of the State of Qatar Supreme Council of Health. Subjects A representative sample of 2091 women who attended primary health care centers was surveyed. From this sample, 1659 women (79.3%) consented to participate in the study. Methods The study was based on a face-to-face interview using a designed questionnaire covering sociodemographic characteristics, family history, medical history, the obstetric variables of patients, and stressful life events. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales. Results In the study sample, the prevalence of depression, anxiety, and stress was 18.6%, 13.1%, and 8.7%, respectively. Young mothers and those with higher education (above secondary level) were more depressed (35.7% and 67.5%, respectively), anxious (34.9% and 68.3%, respectively), and under stress (29.7% and 62.1%, respectively) in their postpartum period. Postpartum working women were more stressed (60.7%) and anxious (51.8%), while housewives were more depressed (51.6%). Nearly half of the depressed mothers reported experiencing more than one stressful life event in their postpartum period, such as low income (41.9%; P = 0.05) or unplanned pregnancy (60.4%; P < 0.001). Unplanned pregnancy (OR = 1.9; P < 0.001) was the major significant correlate for postpartum depression, while a lack of family support (OR = 1.9; P < 0.001) was the major significant correlate for postpartum anxiety. For stress, being an older mother aged from 40 to 45 years of age (OR = 2.0; P = 0.04) and having dissatisfaction in married life (OR = 1.9; P = 0.006) were the significant correlates. Conclusion The study found clearly defined groups of women at risk for postpartum depression, anxiety, and stress. There was a marked association between stressful life events and postpartum depression, anxiety, and stress disorders. PMID:22654524

  7. 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

  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. 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

  10. Mental health of HIV-seropositive women during pregnancy and postpartum period: a comprehensive literature review.

    PubMed

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

    2014-06-01

    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

  11. [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

  12. Potential of acute phase proteins as predictor of postpartum uterine infections during transition period and its regulatory mechanism in dairy cattle

    PubMed Central

    Manimaran, A.; Kumaresan, A.; Jeyakumar, S.; Mohanty, T. K.; Sejian, V.; Kumar, Narender; Sreela, L.; Prakash, M. Arul; Mooventhan, P.; Anantharaj, A.; Das, D. N.

    2016-01-01

    Among the various systemic reactions against infection or injury, the acute phase response is the cascade of reaction and mostly coordinated by cytokines-mediated acute phase proteins (APPs) production. Since APPs are sensitive innate immune molecules, they are useful for early detection of inflammation in bovines and believed to be better discriminators than routine hematological parameters. Therefore, the possibility of using APPs as a diagnostic and prognostic marker of inflammation in major bovine health disorders including postpartum uterine infection has been explored by many workers. In this review, we discussed specifically importance of postpartum uterine infection, the role of energy balance in uterine infections and potential of APPs as a predictor of postpartum uterine infections during the transition period and its regulatory mechanism in dairy cattle. PMID:27051191

  13. Clinical practice guideline for hypotalamic-pituitary disturbances in pregnancy and the postpartum period.

    PubMed

    Halperin Rabinovich, Irene; Obiols Alfonso, Gabriel; Soto Moreno, Alfonso; Torres Vela, Elena; Tortosa Henzi, Frederic; Català Bauset, Miguel; Gilsanz Peral, Alberto; Girbés Borràs, Juan; Moreno Esteban, Basilio; Picó Alfonso, Antonio; Del Pozo Picó, Carlos; Zugasti Murillo, Ana; Lucas Morante, Tomás; Páramo Fernández, Concha; Varela da Sousa, César; Villabona Artero, Carles

    2008-01-01

    During pregnancy, the body undergoes a major adaptation process as a result of the interaction between mother, placenta and fetus. Major anatomical and histological changes are produced in the pituitary, with an increase of up to 40% in the size of the gland. There are wide variations in the function of the hypothalamus-pituitary-thyroid axis that effect iodine balance, the overall activity of the gland, as well as transport of thyroid hormones in plasma and peripheral metabolism of thyroid hormones. The incidence of goiter and thyroid nodules increases throughout pregnancy. The management of differentiated thyroid carcinoma should be individually tailored according to tumoral type and pregnancy stage. Given the effects of hypothyroidism on fetal development, both the diagnosis and appropriate therapeutic management of thyroid hypofunction are essential. The most important modification to the hypothalamus-pituitary-adrenal axis during pregnancy is the rise in serum cortisol levels due to an increase in cortisol-binding proteins. Although Cushing's syndrome during pregnancy is infrequent, both diagnosis and treatment of this disorder are especially difficult. Adrenal insufficiency during pregnancy does not substantially differ from that occurring outside pregnancy. However, postpartum pituitary necrosis (Sheehan's syndrome) is a well-known complication that occurs after delivery and, together with lymphocytic hypophysitis, constitutes the most frequent cause of adrenal insufficiency. The management of prolactinoma during pregnancy requires suppression of dopaminergic agonists and their reintroduction if there is tumoral growth. Notable among the neuropituitary disorders that can occur throughout pregnancy is diabetes insipidus, which occurs as a consequence of increased vasopressinase activity. PMID:22967849

  14. [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

  15. 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; Sylvén, Sara; Skalkidou, Alkistis; Kask, Kristiina; Wikström, Johan; Sundström-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 maternal–infant 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 4–6 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

  16. Factors associated with ovarian structures and intrauterine fluid in the postpartum period in dairy cows.

    PubMed

    López-Helguera, I; Colazo, M G; Garcia-Ispierto, I; López-Gatius, F

    2016-05-01

    The objective was to examine risk factors for the interval to resumption of ovarian cyclicity (ROC), multiple ovulations (MCL), ovarian follicular cysts (OC), and presence of intrauterine fluid (IUF) at 22 to 28 [visit (V) 1] and 36 to 42 (V2) days in milk (DIM) in dairy cows. The study was conducted retrospectively by evaluating records from 1,155 Holstein cows from 3 herds. Ovaries and uteri were examined at V1 and V2 by transrectal ultrasonography to determine ovarian structures and IUF. Based on the odds ratio, multiparous cows were more likely to have ROC at V1 by a factor of 1.79 compared with primiparous cows. The likelihood of ROC at V1 was lower in cows with higher milk production, in cows with retained fetal membranes (RFM) or cows with IUF at V1 by factors of 0.98 (for each kg of milk increased), 0.52, and 0.61, respectively. Based on the odds ratio, cows diagnosed with IUF at V2 were 2.85 times more likely to have attained ROC at V2. Multiparous cows and cows that delivered twins were 2.73 and 2.16 times, respectively, more likely to have MCL at V1, whereas cows with RFM were 0.38 times less likely to have MCL at V1. The likelihood of MCL at V2 was higher in cows with MCL and OC at V1 by factors of 2.67 and 1.91, respectively. Multiparous cows were 8.51 times more likely to have OC at V1 than primiparous cows. Higher producing cows were more likely to have OC at V2 by a factor of 1.04 compared with lower producing cows. Parity, stillbirth, RFM, and ROC at V1 were all identified as risk factors for IUF at V1. Cows with RFM and delivering twins were more likely to be diagnosed with IUF at V2 by a factor of 3.43 and 4.07, respectively. In summary, parity, twinning, RFM, metritis, IUF, and milk production were all associated with altered ovarian structures, and the presence of IUF was related to parity, twinning, RFM, and ROC in postpartum dairy cows. PMID:26947303

  17. 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

  18. Anhedonia in postpartum rats.

    PubMed

    Navarre, Brittany M; Laggart, Jillian D; Craft, Rebecca M

    2010-01-12

    Postpartum depression (PPD) is a debilitating illness, yet little is known about its causes. The purpose of this study was to examine a major symptom of depression during the postpartum period, anhedonia, by comparing sucrose preference in female rats that had undergone actual pregnancy or hormone-simulated pregnancy (HSP) to their respective controls. Whereas HSP rats showed significantly less preference than vehicle control rats for 1% sucrose solution during the first three weeks of the "postpartum" period, previously pregnant females showed only slightly depressed sucrose preference for the first 1-2 days postpartum, compared to non-pregnant controls. Habituation to 1% sucrose during the pregnancy period, which increased preference upon later testing in previously pregnant rats tested on postpartum day 2, did not significantly increase preference in HSP rats, suggesting that depressed preference in the latter group was not due to neophobia. Pre-treatment with desipramine did not prevent suppressed sucrose preference in HSP rats, and preference was even further suppressed following chronic sertraline treatment. These results suggest that estradiol withdrawal following HSP may cause anhedonia during the early "postpartum" period. In contrast, females that have undergone actual pregnancy are less likely to show this effect, suggesting that postpartum hormonal changes other than the dramatic decline in estradiol may buffer its negative mood effects. PMID:19850056

  19. 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

  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. Postpartum Depression

    MedlinePlus

    ... Women with postpartum depression have intense feelings of sadness, anxiety, or despair that prevent them from being ... of female reproductive organs. Postpartum Blues: Feelings of sadness, fear, anger, or anxiety occurring about 3 days ...

  2. 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 ...

  3. 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 ...

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

    PubMed Central

    do Prado, Mara Rúbia Maciel Cardoso; Oliveira, Fabiana de Cássia 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 Viçosa (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 α <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

  5. Psychological Distress in the Postpartum Period: The Significance of Social Support.

    ERIC Educational Resources Information Center

    Stemp, Peter S.; And Others

    1986-01-01

    Examined changes in the psychological distress of 280 new mothers over a one-year period. Regression analyses showed mother's social network had no impact on changes in psychological distress. However, the cognitive experience of social support and the degree of marital intimacy make significant independent contributions to changes in…

  6. Your Postpartum Checkup

    MedlinePlus

    ... Home > Pregnancy > Postpartum care > Your postpartum checkup Your postpartum checkup Now playing: E-mail to a friend ... but some get infected. What happens at a postpartum checkup? Here’s what to expect at your postpartum ...

  7. 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

  8. 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.

  9. 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, Ángeles; Muñoz-Gámez, José Antonio; Abril-Molina, Ana; Salmerón-Ruiz, María Angustias; Muñoz-de-Rueda, Paloma; Pavón-Castillero, Esther José; Quiles-Pérez, Rosa; Carazo, Ángel; Gila, Ana; Jimenez-Ruiz, Sergio Manuel; Casado, Jorge; Martín, Ana Belén; Sanjuán-Núñez, Laura; Ocete-Hita, Esther; Viota, Julián López; León, Josefa; Salmerón, 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 (INFγ, 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 (INFγ 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

  10. Predictors of body image during the first year postpartum:a prospective study.

    PubMed

    Rallis, Sofia; Skouteris, Helen; Wertheim, Eleanor H; Paxton, Susan J

    2007-01-01

    This longitudinal study investigated body image changes and possible predictors of multiple dimensions of body image in the first year postpartum. Women (N = 79) who had been followed up since early pregnancy (including reporting retrospectively about pre-pregnancy and concurrently about late pregnancy) completed questionnaires at 6 weeks, 6 months, and 12 months postpartum that focussed on body image measures of feeling fat, attractiveness, salience of shape and weight, and strength and fitness. Women experienced greater body dissatisfaction in the postpartum in comparison to pre-pregnancy and late pregnancy, with 6 months postpartum being the time of most body concern. In ratings of perceived current and ideal figure size, women decreased their current size ratings over the postpartum period; however, ratings of ideal figure remained stable over the three time points. The findings also revealed that higher frequency of physical comparison tendencies at 6 weeks postpartum, and depressive symptoms and dieting behaviours at 6 months postpartum were predictors of body image of different types at 12 months post birth. PMID:17613464

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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 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

  16. 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

  17. 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 2×2 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

  18. 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.

  19. Integrated maternal and infant health care in the postpartum period in a poor neighborhood in Santiago, Chile.

    PubMed

    Alvarado, R; Zepeda, A; Rivero, S; Rico, N; López, S; Díaz, S

    1999-06-01

    An integrated postpartum health-care program was established by the Consultorio San Luis de Huechuraba (CSLH), a nongovernmental organization in a neighborhood of extreme poverty in Santiago, Chile. The main components were education, maternal and infant health care, support for the mothers, and active participation of women from the community served. The program was evaluated through indicators of contraceptive use, breastfeeding performance, infant growth and health, and a qualitative assessment of women's satisfaction. Controls were women of similar characteristics attending the nearby public clinic. Acceptability of contraceptive methods was similar but contraceptive options differed between clinics. The total number of pregnancies and of respondents lost to follow-up was significantly higher for the public clinic than for the CSLH. Breastfeeding duration was significantly longer and infant growth and health were found to be significantly better at the CSLH than at the public clinic. Women valued being treated with respect, receiving education and support, and being offered timesaving services and wider contraceptive choices at the CSLH. This study demonstrates that such interventions are possible for poor communities, providing significant advantages for women and children. PMID:16617547

  20. Hypophagic effects of propionate increase with elevated hepatic acetyl coenzyme A concentration for cows in the early postpartum period.

    PubMed

    Stocks, S E; Allen, M S

    2012-06-01

    Thirty multiparous lactating dairy cows were used in a randomized block design experiment to evaluate factors related to the degree of hypophagia from intraruminal infusion of propionate. Cows between 3 and 40 d postpartum at the start of the experiment were blocked by calving date and randomly assigned to treatment. Treatments were 1.0 mol/L propionic acid or 1.0 mol/L acetic acid adjusted to pH 6 with sodium hydroxide and infused at 0.5 mol of volatile fatty acid/h from 6h before feeding until 12h after feeding. Propionate infusion decreased dry matter intake by 20.0%, total metabolizable energy intake by 22.5%, and plasma β-hydroxybutyrate concentration by 54.3% compared with acetate infusion. Effects of treatment on dry matter intake were related to concentration of acetyl coenzyme A (CoA) in the liver; hypophagic effects of propionate compared with acetate increased as liver acetyl CoA concentration increased. Hypophagic effects of propionate are greater for cows with elevated concentrations of acetyl CoA in the liver. PMID:22612960

  1. 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

  2. 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)...

  3. [Use of the bio-active intrauterine devices TCu 200 and IPCS 52 during the post-partum period].

    PubMed

    Lavin, P; Bravo, C; Waskaz, C; Andrade, M I; Bravo, M; Caceres, R; Castro, J; Miranda, L; Namur, L; Olmos, G

    1984-03-01

    The author presents a comparative analysis of results obtained in a follow-up study of the 1st 12 months following insertion immediately postpartum (following delivery) of the TCu200 and IPCS 52 IUDs in a group of 400 women. The devices were inserted either manually or by using a plastic insertion aid at the maternity unit of the Barros Luco-Trudeau Hospital, Santiago, Chile, between November 1978-February 1980. The devices were retained during the 1st 12 months in 86.1% of the cases in which the TCu200 was inserted manually, 86.3% of cases in which they were inserted using the plastic aid, 59.3% of those cases in which the IPCS devices were inserted manually, and 57.2% of cases in which the IPCS was inserted using the aid. The different levels of retention among the 2 groups was due mainly to the high levels of expulsion in the IPCS 52 patients. The expulsion levels in the TCu200 groups were 9.2 and 8.1% respectively and 35.8 and 35.2% in the IPCS 52 groups. Although an IUD contraceptive system involving progesterone was selected in order to reduce bleeding and pain associated with the IUD, the incidence of such reactions was no lower in the IPCS 52 groups than in the others. However, specific levels of dysmenorrhea were significantly lower (p0.05) among IPCS 52 groups than among TCu200 groups. In general, results obtained with the TCu200 were better than those obtained with the IPCS 52, and the insertion method had no influence on the recorded reactions. (author's modified) PMID:12265945

  4. 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

  5. [Postpartum thyroiditis. A review].

    PubMed

    Hurtado-Hernández, Z; Segura-Domínguez, A

    2013-01-01

    Postpartum thyroiditis (PPT) is a transient thyroid dysfunction of autoimmune origin that can occur in the first year postpartum in women who have not been previously diagnosed with thyroid disease. It may start with clinical thyrotoxicosis followed by hypothyroidism and the subsequent recovery of thyroid function, or may just appear as isolated thyrotoxicosis or hypothyroidism. PPT recurs in high percentage of patients after subsequent pregnancies. Many women develop permanent hypothyroidism sometime during the 3 to 10 year period after an episode of PPT. It is important for family physicians to be familiar with this disease, due to its high prevalence in order to make a correct diagnosis and therapeutic intervention. Family doctors also play a crucial role in the monitoring of these patients, given the negative implications of established hypothyroidism on reproduction in the female population during their reproductive years. This article reviews the principle characteristics of PPT along with its diagnosis and treatment. PMID:23834978

  6. 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

  7. Metabotropic glutamate receptor 3 is downregulated and its expression is shifted from neurons to astrocytes in the mouse lateral septum during the postpartum period.

    PubMed

    Zhao, Changjiu; Gammie, Stephen C

    2015-06-01

    The inhibitory metabotropic glutamate receptor 3 (mGluR3) plays diverse and complex roles in brain function, including synaptic plasticity and neurotransmission. We recently found that mGluR3 is downregulated in the lateral septum (LS) of postpartum females using microarray and qPCR analysis. In this study, we used double fluorescence immunohistochemical approaches to characterize mGluR3 changes in LS of the postpartum brain. The number of mGluR3-immunoractive cells was significantly reduced in the dorsal (LSD) and intermediate (LSI) but not ventral (LSV) parts of the LS in postpartum versus virgin females. mGluR3 immunoreactivity in the LS was found predominantly in neurons (~70%), with a smaller portion (~20%-30%) in astrocytes. Colocalization analysis revealed a reduced mGluR3 expression in neurons but an increased astrocytic localization in postpartum LSI. This change in the pattern of expression suggests that mGluR3 expression is shifted from neurons to astrocytes in postpartum LS, and the decrease in mGluR3 is neuron-specific. Because mGluR3 is inhibitory and negatively regulates glutamate and GABA release, decreases in neuronal expression would increase glutamate and GABA signaling. Given our recent finding that ~90% of LS neurons are GABAergic, the present data suggest that decreases in mGluR3 are a mechanism for elevated GABA in LS in the postpartum state. PMID:25739438

  8. 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

  9. Active ghrelin and the postpartum.

    PubMed

    Baker, Jessica H; Pedersen, Cort; Leserman, Jane; Brownley, Kimberly A

    2016-06-01

    Postpartum depression (PPD) occurs in 10-15 % of women. The appetite hormone ghrelin, which fluctuates during pregnancy, is associated with depression in nonpregnant samples. Here, we examine the association between PPD and active ghrelin from pregnancy to postpartum. We additionally examine whether ghrelin changes from pregnancy to postpartum and differs between breastfeeding and non-breastfeeding women. Sixty women who participated in a survey examining PPD and had information in regard to ghrelin concentrations were included in the study. The Edinburgh Postnatal Depression Scale was used to assess symptoms of PPD. Raw ghrelin levels and ghrelin levels adjusted for creatinine were included as outcomes. Women screening positive for PPD at 12 weeks postpartum had higher pregnancy ghrelin concentrations. Ghrelin concentrations significantly decreased from pregnancy to 6 weeks postpartum and this change differed based on pregnancy depression status. Finally, ghrelin levels were lower in women who breastfed compared with women who were bottle-feeding. No significant findings remained once ghrelin levels were adjusted for creatinine. Although results do not suggest an association between PPD and ghrelin after adjusting for creatinine, future research should continue to explore this possibility extending further across the postpartum period with larger sample sizes. PMID:26424410

  10. Short communication: Oxidative status and incidence of mastitis relative to blood α-tocopherol concentrations in the postpartum period in dairy cows.

    PubMed

    Politis, I; Theodorou, G; Lampidonis, A D; Kominakis, A; Baldi, A

    2012-12-01

    Vitamin E supplementation, when combined with high blood α-tocopherol (>6.25 μg/mL) at dry off, has been reported to unexpectedly increased the risk for clinical mastitis in dairy cows. Furthermore, higher levels of oxidative stress in the postpartum period were related to higher risk of mastitis. The objective of the present study was to determine the relationship between various serum biomarkers of oxidative status, incidence of mastitis, and blood α-tocopherol concentrations at dry off and at calving. A total of 146 dairy cows from a commercial farm were used in an observational field study. All cows were supplemented with 3,000 and 50 IU/cow per day of all-rac-α-tocopherol during the dry period and lactation, respectively. Blood samples were collected at dry off and at calving. Serum was analyzed for α-tocopherol, levels of reactive oxygen metabolites (ROM), thiol groups (SH), and ferric-reducing ability. Three α-tocopherol groups at calving were created: high (>3 μg/mL), medium (2-3 μg/mL), and low (<2 μg/mL). Three α-tocopherol groups at dry off were created: high (>6.25 μg/mL), medium (4.25-6.25 μg/mL), and low (<4.25 μg/mL). All cases of clinical mastitis that occurred during the dry period and the entire subsequent lactation were verified by a veterinarian. No differences were observed in the incidence of mastitis between the 3 α-tocopherol groups based on the serum levels at dry off. Incidence of mastitis was 4 times lower in the high and medium groups when compared with the corresponding value for the low-α-tocopherol group based on the serum levels at calving. Lower levels of ROM and SH at dry off and at calving were found in the group of cows with the highest α-tocopherol values at dry off when compared with the corresponding values in the low-α-tocopherol group. The ROM values at dry off but not at calving were lower in the group of cows with the highest α-tocopherol values at calving when compared with the corresponding values in the low-α-tocopherol group. No differences were observed in ferric-reducing ability values between the 3 α-tocopherol groups at dry off or calving. No differences were observed in all biomarkers of oxidative status between healthy cows and those with mastitis. Thus, blood α-tocopherol is inversely related to certain biomarkers of oxidative stress in the postpartum period and incidence of mastitis. However, reduction in the incidence of mastitis is not mediated through a reduction in the levels of various biomarkers of oxidative stress. PMID:23063158

  11. Pharmacokinetics of sertraline across pregnancy and postpartum.

    PubMed

    Freeman, Marlene P; Nolan, Paul E; Davis, Melinda F; Anthony, Marietta; Fried, Karen; Fankhauser, Martha; Woosley, Raymond L; Moreno, Francisco

    2008-12-01

    Insufficient data inform dosing of antidepressants and clinical monitoring for major depressive disorder (MDD) during the perinatal period. The objectives were to assess the pharmacokinetics of sertraline (SER) across pregnancy and postpartum. Participants treated with SER for MDD underwent serial sampling to measure steady-state concentrations of SER and norsertraline during the second and third trimesters and postpartum (total of 3 assessments). Blood was drawn before observed SER administration and 0.5, 1, 2, 4, 6, 8, 10, 12, and 24 hours after administration. A sensitive high-performance liquid chromatography/mass spectrometric method for simultaneous determination of serum concentrations of SER and norsertraline was developed and validated. For each sampling period for SER, area under the serum concentration versus time curve, maximal serum concentration (Cmax), and the time at which Cmax occurred (Tmax) were determined. Of 11 women initially enrolled, 6 completed second- and third-trimester assessments, and 3 completed all 3 assessments (including the postpartum assessment). Mean changes on all pharmacokinetic parameters were nonsignificant between assessments, although there was a marked heterogeneity among individuals. Results were not significantly altered by incorporation of body weights into the analyses. The range of pharmacokinetic changes between individuals was broad, indicating heterogeneity regarding the impact of pregnancy on SER metabolism. Overall, lowest observed SER area under the curve and Cmax occurred in the third trimester (observed in 5 of 6 participants). Despite nonsignificant mean pharmacokinetic changes, the range of pharmacokinetic changes across pregnancy warrants careful monitoring of depressive symptoms in women with MDD in late pregnancy and further study. PMID:19011433

  12. 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

  13. Autoimmune Encephalitis in Postpartum Psychosis

    PubMed Central

    Bergink, Veerle; Armangue, Thaís; Titulaer, Maarten J.; Markx, Sander; Dalmau, Josep; Kushner, Steven A.

    2016-01-01

    Objective Significant immunological alterations have been observed in women with first-onset affective psychosis during the postpartum period. Recent studies have highlighted the possibility that a subset of patients with first-onset severe psychiatric episodes might suffer from undiagnosed autoimmune encephalitis. Therefore, the authors performed a three-step immunohistochemistry-based screening for CNS autoantibodies in a large cohort of patients with postpartum psychosis and matched postpartum comparison subjects. Method Ninety-six consecutive patients with postpartum psychosis and 64 healthy postpartum women were included. Screening for antibodies in patient serum was performed using immunohistochemistry. Samples showing any staining were further examined by immunocytochemistry using live hippocampal neurons and cell-based assays to test for anti-N-methyl-d-aspartate (NMDA) receptor antibodies. Cell-based assays for all other known CNS antigens were performed in those samples with immunocytochemistry labeling but negative for NMDA receptor antibodies. Results Four patients (4%) with neuropil labeling suggestive for extracellular antigen reactivity were identified. Serum samples from all four patients showed clear extracellular labeling of live hippocampal neurons. Two women had the specific staining pattern characteristic for anti-NMDA receptor antibody positivity, which was confirmed by cell-based assays. Neither patient with anti-NMDA receptor antibody positivity had evidence of an ovarian teratoma. The other two patients tested negative by cell-based assays for all known CNS antigens. None of the matched postpartum comparison subjects had confirmed neuronal surface antibodies. The two patients with anti-NMDA receptor antibodies both showed extrapyramidal symptoms following initiation of treatment with low-dose haloperidol. Conclusions In patients with acute psychosis during the postpartum period, systematic screening for anti-NMDA receptor autoantibodies should be considered. The acute onset of severe atypical psychiatric symptoms in young female patients should raise the index of suspicion for anti-NMDA receptor encephalitis, particularly in the setting of neurological symptoms, including extrapyramidal side effects of antipsychotic treatment. PMID:26183699

  14. Origin of the cataclysmic Late Heavy Bombardment period of the terrestrial planets.

    PubMed

    Gomes, R; Levison, H F; Tsiganis, K; Morbidelli, A

    2005-05-26

    The petrology record on the Moon suggests that a cataclysmic spike in the cratering rate occurred approximately 700 million years after the planets formed; this event is known as the Late Heavy Bombardment (LHB). Planetary formation theories cannot naturally account for an intense period of planetesimal bombardment so late in Solar System history. Several models have been proposed to explain a late impact spike, but none of them has been set within a self-consistent framework of Solar System evolution. Here we propose that the LHB was triggered by the rapid migration of the giant planets, which occurred after a long quiescent period. During this burst of migration, the planetesimal disk outside the orbits of the planets was destabilized, causing a sudden massive delivery of planetesimals to the inner Solar System. The asteroid belt was also strongly perturbed, with these objects supplying a significant fraction of the LHB impactors in accordance with recent geochemical evidence. Our model not only naturally explains the LHB, but also reproduces the observational constraints of the outer Solar System. PMID:15917802

  15. 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}⊙ and {M}2=0.34{M}⊙ . 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}⊙ . 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.

  16. 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

  17. Chronic Gestational Stress Leads to Depressive-Like Behavior and Compromises Medial Prefrontal Cortex Structure and Function during the Postpartum Period

    PubMed Central

    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

  18. 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

  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. Fifty cases of late prosthetic valve endocarditis: improvement in prognosis over a 15 year period.

    PubMed

    Leport, C; Vilde, J L; Bricaire, F; Cohen, A; Pangon, B; Gaudebout, C; Valere, P E

    1987-07-01

    The clinical course, prognostic factors, and management of 50 cases of late prosthetic valve endocarditis, occurring more than two months after valve replacement, were reviewed. Twenty nine cases that presented from 1971 to 1980 were compared with 21 cases that presented from 1981 to 1985. Apart from an appreciable decrease in the frequency of neurological complications between the first period (38%) and the second period (10%) no differences in clinical or bacteriological features were seen. Seventeen (59%) of the 29 cases in the earlier period and four (19%) of the 21 cases in the later period died. The rationale for antimicrobial treatment was similar during both periods. Cardiac surgery was performed in eight of 29 cases between 1971 and 1980 and in 11 of 21 between 1981 and 1985; the mean (SD) time between diagnosis of endocarditis and operation was 28 (19) days and 43 (44) days respectively. Six of the eight cases operated on in the first period died as did two of the 11 operated on in the second period. Twenty seven of the 29 cases presenting between 1971 and 1980 were treated with anticoagulants--either warfarin (15 of 27) or heparin sodium (12 of 27). Sixteen of the 21 cases presenting later were given anticoagulants and 15 of these cases were given heparin sodium. Control of anticoagulation was inadequate in nine of the 27 cases treated with anticoagulants during the first period and in only two of 16 treated during the second period. During the first treatment period neurological complications were more frequent when control of anticoagulation was inadequate. PMID:3620245

  1. 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

  2. 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.

  3. Effects of feeding wheat straw or orchardgrass at ad libitum or restricted intake during the dry period on postpartum performance and lipid metabolism.

    PubMed

    Litherland, N B; Weich, W D; Hansen, W P; Linn, J G

    2012-12-01

    The objectives of this study were to investigate the effects of forage source [wheat straw (WS) or orchardgrass hay (OG)] and total amount of diet dry matter fed [ad libitum or restricted to 70% of predicted dry matter intake (DMI)] prepartum on postpartum performance. The study design was a 2×2 factorial design with 10 cows per treatment. Treatments were WS total mixed ration (TMR) ad libitum, OG TMR ad libitum, WS TMR restricted, and OG TMR restricted. The WS TMR (dry matter basis) contained 30% WS, 20.7% corn silage, 10.0% alfalfa hay, 18.2% ground corn, 16.8% soybean meal, and 4.3% molasses mineral mix (14.7% CP, 1.5 Mcal/kg of net energy for lactation, 37.0% neutral detergent fiber). The OG TMR contained 30% OG, 46.2% corn silage, 10.0% alfalfa hay, 9.5% soybean meal, and 4.3% molasses (14.2% CP, 1.5 Mcal/kg of net energy for lactation, 41.0% neutral detergent fiber). Cows received 1 lactation diet after calving (17.7% CP, 1.6 Mcal/kg of net energy for lactation, 27.3% neutral detergent fiber). Total diet DMI prepartum was higher for ad libitum than for restricted as designed, but forage source had no effect on DMI. Total tract apparent digestibilities of DM and NDF were greater for OG than for WS. Postpartum DMI expressed as a percentage of body weight for the first week of lactation was higher for ad libitum than for restricted diets. Postpartum DMI during the first 30 d of lactation was higher for OG than for WS, but no effect was observed for the amount fed prepartum. Milk yield during the first week of lactation was higher for OG than for WS; however, during the first 30 d, 3.5% fat-corrected milk yield and yield of milk fat were highest for OG TMR restricted and WS TMR ad libitum. Prepartum treatments had a limited effect on pre- and postpartum lipid metabolism; however, cows fed WS TMR ad libitum had the highest postpartum β-hydroxybutyrate. Eating behavior was observed by 10-min video scans of 24-h video surveillance for 5d pre- and postpartum. Prepartum eating time and eating bouts tended to be greater by WS than for OG, and postpartum eating time per kilogram of neutral detergent fiber intake tended to be greater for WS than for OG. Results indicate that forage source and amount of DM fed prepartum affected postpartum performance and tended to alter the behavior of cows in tie-stall barns. PMID:23040018

  4. 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

  5. Forced swim test behavior in postpartum rats.

    PubMed

    Craft, R M; Kostick, M L; Rogers, J A; White, C L; Tsutsui, K T

    2010-10-01

    This study was undertaken to determine whether depression-like behavior can be observed in gonadally intact females that have experienced normal pregnancy. When tested on the forced swim test (FST) on postpartum days 1-7, previously pregnant rats spent slightly more time immobile, significantly less time swimming and diving, and defecated more than virgin controls. Subchronic treatment with nomifensine (DA reuptake inhibitor, 2.5mg/kg) but not sertraline (serotonin reuptake inhibitor, 10mg/kg) or desipramine (norepinephrine reuptake inhibitor, 10mg/kg) significantly decreased immobility on postpartum day 2. In rats pre-exposed to the FST in mid-pregnancy, neither subchronic nor chronic treatment with desipramine or sertraline decreased immobility on postpartum day 2; in contrast, chronic desipramine significantly decreased immobility in virgin controls. These results indicate that postpartum female rats, compared to virgin controls, show a reduction in some "active coping behaviors" but no significant increase in immobility when tested during the early postpartum period, unlike ovariectomized females that have undergone hormone-simulated pregnancy (HSP). Additionally, immobility that is increased by FST pre-exposure is not readily prevented by treatment with standard antidepressant medications in postpartum females. Depression-like behaviors previously observed in females that have undergone HSP may result from the more dramatic changes in estradiol, prolactin or corticosterone that occur during the early "postpartum" period, compared to the more subtle changes in these hormones that occur in actual postpartum females. PMID:20600244

  6. Disturbed Sleep and Postpartum Depression.

    PubMed

    Okun, Michele L

    2016-07-01

    The perinatal period introduces a myriad of changes. One important but often overlooked change is an increased reporting of sleep disturbance. Although casually regarded as a consequence of pregnancy or postpartum, there is emerging evidence implicating significant sleep disturbance, characterized by insomnia symptoms and/or poor sleep quality, with adverse outcomes, such as an increase in depressive symptomatology or the development postpartum depression (PPD). Significant consequences may arise as a result including issues with maternal-infant bonding, effective care for the infant, and behavioral or emotional difficulties in the infant. This review discusses the relevant literature as to how disturbed sleep during pregnancy as well as in the postpartum may increase the risk for PPD. PMID:27222140

  7. 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

  8. Postpartum Depression Facts

    MedlinePlus

    ... a free hardcopy With postpartum depression, feelings of sadness and anxiety can be extreme and might interfere ... Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult ...

  9. 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 ...

  10. Plasma concentrations of 15-ketodihydro-PGF2 alpha, progesterone, oestrone sulphate, oestradiol-17 beta and cortisol during late gestation, parturition and the early post partum period in llamas and alpacas.

    PubMed

    Aba, M A; Sumar, J; Kindahl, H; Forsberg, M; Edqvist, L E

    1998-02-27

    Plasma concentrations of 15-ketodihydroprostaglandin (PG) F2 alpha, progesterone, oestrone sulphate, oestradiol-17 beta and cortisol during late gestation, parturition and the early post-partum period were measured in six llamas and five alpacas. During the last 100 days of pregnancy, 15-ketodihydro-PGF2 alpha concentrations increased steadily until the day of parturition when a massive release was detected (P < 0.01) concomitant with a decrease in progesterone concentrations (P < 0.01). The highest PGF2 alpha metabolite concentrations (159 +/- 35 nmol l-1 and 92 +/- 29 nmol l-1 in llamas and alpacas respectively) were detected in the sample collected during the morning on the day of parturition. Basal concentrations were registered by day 3 after delivery. Plasma concentrations of oestrone sulphate started to increase 80 days before parturition and reached peak concentrations immediately before parturition (15 +/- 3 nmol l-1 in llamas and 18 +/- 5 nmol l-1 in alpacas). Oestrone sulphate concentrations dropped sharply (P < 0.01) on the day of parturition in llamas and one day later in alpacas, whereupon they remained relatively unchanged until at least 20 days postpartum. Oestradiol-17 beta concentrations were higher than 180 pmol l-1 during the last 45 days of pregnancy, began to decrease on the day of parturition and reached very low concentrations within the following two days. High oestradiol-17 beta concentrations were registered 7 days postpartum in all alpacas (P < 0.05) and within 10 days of parturition in five of six llamas (P < 0.01). No significant cortisol peaks were observed around parturition, but mean concentrations were increased in both species. PMID:9615184

  11. The initial period function of late-type binary stars and its variation

    NASA Astrophysics Data System (ADS)

    Kroupa, P.; Petr-Gotzens, M. G.

    2011-05-01

    The variation in the period distribution function of late-type binaries is studied. It is shown that the Taurus-Auriga pre-main-sequence population and the main-sequence G dwarf sample do not stem from the same parent period distribution with better than 95 per cent confidence probability. The Lupus, Upper Scorpius A, and Taurus-Auriga populations are shown to be compatible with being drawn from the same initial period function (IPF), which is inconsistent with the main-sequence data. Two possible IPF forms are used to find parent distributions to various permutations of the available data, which include Upper Scorpius B (UScB), Chameleon, and Orion Nebula Cluster pre-main-sequence samples. All the pre-main-sequence samples studied here are consistent with the hypothesis that there exists a universal IPF that is modified by binary-star disruption if it forms in an embedded star cluster leading to a general decline of the observed period function with increasing period. The pre-main-sequence data admit a log-normal IPF similar to that arrived at by Duquennoy & Mayor (1991, A&A, 248, 485) for main-sequence stars, provided the binary fraction among pre-main-sequence stars is significantly higher. However, for consistency with proto-stellar data, the possibly universal IPF ought to be flat along the log-P or log-semi-major axis and must be similar to the K1 IPF form derived by means of inverse dynamical population synthesis, which has been shown to lead to the main-sequence period function if most stars form in typical embedded clusters.

  12. 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…

  13. [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

  14. 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

  15. Committee Opinion No. 666: Optimizing Postpartum Care.

    PubMed

    2016-06-01

    In the weeks after birth, postpartum care often is fragmented among maternal and pediatric health care providers, and communication between inpatient and outpatient settings is inconsistent. To optimize postpartum care, anticipatory guidance should begin during pregnancy. During antenatal care, it is recommended that the patient and her obstetrician-gynecologist or other obstetric care provider formulate a postpartum care plan and identify the health care professionals who will comprise the postpartum care team for the woman and her infant. Ideally, during the postpartum period, a single health care practice assumes responsibility for coordinating the woman's care. At discharge from maternity care, the woman should receive contact information for her postpartum care team and written instructions regarding the timing of follow-up postpartum care. It is recommended that all women undergo a comprehensive postpartum visit within the first 6 weeks after birth. This visit should include a full assessment of physical, social, and psychological well-being. Systems should be implemented to ensure each woman can receive her desired form of contraception during the comprehensive postpartum visit, if not done earlier. At the conclusion of the postpartum visit, the woman and her obstetrician-gynecologist or other obstetric care provider should determine who will assume primary responsibility for her ongoing care. If responsibility is transferred to another primary care provider, the obstetrician-gynecologist or other obstetric care provider is responsible for ensuring that there is communication with the primary care provider so that he or she can understand the implications of any pregnancy complications for the woman's future health and maintain continuity of care. PMID:27214194

  16. 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

  17. Locally applied simvastatin improves fracture healing at late period in osteoporotic rat

    NASA Astrophysics Data System (ADS)

    Tian, Faming; Zhang, Liu; Kang, Yuchuan; Zhang, Junshan; Ao, Jiao; Yang, Fang

    effect of simvastatin locally applied from a bioactive polymer coating of implants on osteoporotic fracture healing at late period. Methods:Femur fracture model was established on normal or osteotoporotic mature female SD rats, intramedullary stabilization was achieved with uncoated titanium Kirschnerwires in normal rats(group A),with polymer-only coated vs. polymer plus simvastatin coated titanium Kirschner wires in osteoporotic rats(group B and C, respectively).Femurs were harvested after 12 weeks, and underwent radiographic and histologic analysis, as well as immunohistochemical evaluation for BMP-2 expression. Results:Radiographic results demonstrated progressed callus in the simvastatin-treated groups compared to the uncoated group.The histologic analysis revealed a significantly processed callus with irregular-shaped newly formed bone trabeculae in simvastatin-treated group. Immunohistochemical evaluation showed markedly higher expression levels of B:MP-2 in simvastatin-treated group.Conclusions: The present study revealed a improved fracture healing under local application of simvastatin in osteoporotic rat,which might partially from upregulation of the B:MP-2 expression at fractured site.

  18. 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

  19. 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):73–81. PMID:23288973

  20. 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

  1. Organic matter production during late summer-winter period in a temperate sea

    NASA Astrophysics Data System (ADS)

    Marić, Daniela; Frka, Sanja; Godrijan, Jelena; Tomažić, Igor; Penezić, Abra; Djakovac, Tamara; Vojvodić, Vjeročka; Precali, Robert; Gašparović, Blaženka

    2013-03-01

    The quantity and quality of fresh organic matter (OM) formed by primary production in relation to phytoplankton community structure was calculated for the late summer-winter 2009/2010 in the northern Adriatic Sea (Mediterranean). Phytoplankton species, as a direct measure of fresh OM, chlorophyll a, the OM pool (DOC and POC) and lipids, including classes, were analyzed. Data for temperature, salinity and nutrients enabled deeper insight into the conditions that promoted fresh OM production and associated processes at two stations of different trophic status. Phytoplankton growth was controlled by bottom regenerated nutrients and to lesser extent by riverine nutrients. The phytoplankton community was mainly dominated by nanoplankton. Species of moderate carbon content Chaetoceros compressus, Asterionellopsis glacialis, Leptocylindrus danicus and Bacteriastrum jadranum dominated the microplankton fraction. Availability of orthophosphates was the key factor influencing fresh OM production. POC varied from 37-522 μg l-1. Freshphyto POC, i.e. carbon fixed in phytoplankton cells, contributed 7-79% to the POC pool. The DOC (890-1560 μg l-1) level decreased during the investigated period. Calculation of fresh DOC, i.e. carbon fixed during primary production and released as dissolved OM, revealed it as a minor part (0-2%) of the DOC pool. Lipid concentrations varied from 9.9-55.0 μg l-1 and 20.0-40.2 μg l-1 in the particulate and dissolved fractions, respectively. Nutrient limitation caused increased synthesis of lipids, among which energy reserve lipids triacylglycerols, which are further immobilized for the construction of glycolipids with increasing depletion of orthophosphates.

  2. 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…

  3. 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…

  4. 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

  5. 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

  6. 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

  7. Self-reported and Objectively Measured Physical Activity Among a Cohort of Postpartum Women: The PIN Postpartum Study

    PubMed Central

    Evenson, Kelly R.; Herring, Amy H.; Wen, Fang

    2010-01-01

    Background Few studies measure physical activity objectively or at multiple time points during postpartum. We describe physical activity at 3- and 12-months postpartum among a cohort of women using both self-reported and objective measures. Methods In total, 181 women completed the 3-month postpartum measures, and 204 women completed the 12-month postpartum measures. Participants wore an Actigraph accelerometer for one week and completed in-home interviews that included questions on physical activity. A cohort of 80 women participated at both time points. Poisson regression models were used to determine whether physical activity differed over time for the cohort. Results For the cohort, average counts/minute were 364 at 3-months postpartum and 394 at 12-months postpartum. At both time periods for the cohort, vigorous activity averaged 1 to 3 minutes/day, and moderate activity (NHANES cutpoints) averaged 16 minutes/day. Sedentary time averaged 9.3 hours at 3-months postpartum and 8.8 hours at 12-months postpartum, out of a 19-hour day. Average counts/minute increased and sedentary behavior declined from 3- to 12-months postpartum. Conclusion Interventions are needed to help women integrate more moderate to vigorous physical activity and to capitalize on the improvements in sedentary behavior that occur during postpartum. PMID:22232505

  8. Physical Activity Beliefs, Barriers, and Enablers among Postpartum Women

    PubMed Central

    Aytur, Semra A.; Borodulin, Katja

    2009-01-01

    Abstract Background and Methods Physical activity during postpartum is both a recommended and an essential contributor to maternal health. Understanding the beliefs, barriers, and enablers regarding physical activity during the postpartum period can more effectively tailor physical activity interventions. The objective of this study was to document self-reported beliefs, barriers, and enablers to physical activity among a cohort of women queried at 3 and 12 months postpartum. Five questions about beliefs and two open-ended questions about their main barriers and enablers regarding physical activity and exercise were asked of 667 women at 3 months postpartum. Among the sample, 530 women answered the same questions about barriers and enablers to physical activity at 12 months postpartum. Results Agreement on all five beliefs statements was high (≥89%), indicating that women thought that exercise and physical activity were appropriate at 3 months postpartum, even if they continued to breastfeed. For the cohort, the most common barriers to physical activity at both 3 and 12 months postpartum were lack of time (47% and 51%, respectively) and issues with child care (26% and 22%, respectively). No barrier changed by more than 5% from 3 to 12 months postpartum. For the cohort, the most common enablers at 3 months postpartum were partner support (16%) and desire to feel better (14%). From 3 to 12 months postpartum, only one enabler changed by >5%; women reported baby reasons (e.g., baby older, healthier, not breastfeeding, more active) more often at 12 months than at 3 months postpartum (32% vs. 10%). Environmental/policy and organizational barriers and enablers were reported less often than intrapersonal or interpersonal barriers at both time points. Conclusions A number of barriers and enablers were identified for physical activity, most of which were consistent at 3 and 12 months postpartum. This study provides information to create more successful interventions to help women be physically active postpartum. PMID:20044854

  9. Postpartum Psychosis: Risk Factors Identification

    PubMed Central

    Upadhyaya, Suneet Kumar; Sharma, Archana; Raval, Chintan M

    2014-01-01

    Background: A better understanding of risk factors associated with postpartum psychosis may contribute to the better management. Aims: This study was to identify the risk factors contributing to postpartum psychosis. Materials and Methods: In this cross-sectional, case control study 100 patients of postpartum psychosis (PP) were compared with the healthy controls. Risk factors explored were sociodemographic factors (age, education, occupation, income, and family type); positive family history; pregnancy and perinatal factors (number of antenatal check-up, parity, and complications during pregnancy, perinatal phase or in newborn); and presence of husband during peripartum period. Data were analyzed by graph pad instat software using chi square test and Fisher's exact test. Results: Total of 64% patients and 42% controls were less than 25 years of age (P = 0.001). Among the patients, 62% were primiparae compared with 46% in the controls (P = 0.02). Per capita family income was less than 5000 INR in 72% patients and 56% controls (P = 0.01). Maternal complications during perinatal period were observed in 38% patients and 22% controls (P = 0.01), while the complications in newborns were seen in 21% patients and 8% controls (P = 0.009). Husband was present in 58% patients and 76% controls. (P = 0.006). Conclusions: The risk factors related to PP were younger age, lower per capita income, perinatal and neonatal complications, and absence of husband in peripartum phase. PMID:25006563

  10. 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

  11. Rethinking postpartum family planning.

    PubMed

    Winikoff, B; Mensch, B

    1991-01-01

    This article examines the rationales for commonly advocated postpartum family planning services and challenges the behavioral and biological assumptions on which they are based. An alternative approach to service delivery is suggested. Services should be designed to incorporate breastfeeding and to increase their acceptability to postpartum women. PMID:1759275

  12. [Postpartum pulmonary hypertension].

    PubMed

    Escalante, Juan Pablo; Diez, Ana; Figueroa Casas, Marcelo; Lasave, Alejandro; Cursack, Guillermo; Poy, Carlos; Rodríguez, María Soledad; Galuppo, Marcela; Zapata, Gerardo

    2015-01-01

    Pulmonary hypertension (PH) in pregnancy is a rare disorder that carries a high risk to mother and child, and as such, it is considered a contraindication to becoming pregnant. However, there are few published reports related to the diagnosis of this condition after delivery. We describe three PH cases diagnosed after their normal pregnancies and deliveries. Although the causes are unknown, several mechanisms such as hypercoagulation, placental hypoxia or amniotic fluid embolism have been considered as possible causes. It is difficult to define whether a PH diagnosed in the postpartum period, relates to an earlier asymptomatic PH period that was triggered by the physiological stress of labor or if it is a recently acquired condition. Despite the lack of data to support the absence of PH previous to pregnancy in our three patients, lack of events during this period, asymptomatic and normal deliveries, lead us to believe that they did not suffer this disease prior to pregnancy; considering that high hemodynamic demands impair a ventricle with little reserve, and its subsequent appearance at time of delivery. PMID:25637900

  13. Risk factors for postpartum ovarian cysts and their spontaneous recovery or persistence in lactating dairy cows.

    PubMed

    López-Gatius, F; Santolaria, P; Yániz, J; Fenech, M; López-Béjar, M

    2002-11-01

    Cystic ovarian disease is a major cause of reproductive failure and economic loss for the dairy industry. Many cysts that develop during the early postpartum period regress spontaneously. However, it is difficult to decide at what point it would be more cost effective to treat ovarian cysts than to wait for spontaneous recovery. The objective of this study was to analyze risk factors for the development of the ovarian cystic condition during early and late postpartum, and for its persistence or recovery during the pre-service period in lactating dairy cows. Using multiple logistic regression, we analyzed data derived from 873 lactating dairy cows from a single herd. An ovarian cyst was diagnosed if it was possible to observe a single follicular structure with an antrum diameter > or = 25 mm in the absence of a corpus luteum in three sonograms performed at 7-day intervals. The cystic condition was denoted as early if the cyst was diagnosed 43-49 days postpartum, and late if detected 57-63-day postpartum. Spontaneous cyst regression before 60-day postpartum was regarded as early cystic recovery. For the early cystic group, there were no significant effects of lactation number, body condition score on prepartum Day 60, at parturition or on postpartum Day 30, or of body condition loss from parturition to 30-day postpartum. Cows calving in summer were 2.6 times more likely to develop ovarian cysts than those giving birth in winter. The risk of having a cyst was 1.9 times higher in cows with an abnormal puerperium. A 1-kg increase in milk yield raised the risk of cysts by a factor of 1.05. A 1-unit increase in body condition score (scale from 1 to 5) from prepartum Day 60 to parturition increased the risk of cyst development 8.4 times. Milk production and lactation number were negatively correlated with spontaneous early cyst recovery. A 1-kg decrease in milk production increased the probability of cyst recovery by a factor of 1.06, and a 1-unit drop in lactation number was associated with a 1.4-fold increased probability of cyst recovery. For the late cystic group, there were no significant effects of abnormal puerperium and body score data, except for a prepartum change in body score. Calving season (Odds ratio: 2.3), lactation number (Odds ratio: 1.36), increased milk production (Odds ratio: 1.05) and increased body condition score during the prepartum period (Odds ratio: 4.3) were all related to an increased risk of ovarian cysts. The probability of having a late cyst was 36.6 times greater in cows with early cysts. These findings suggest that it would be profitable to treat multiparous cows having cysts very early in the postpartum period, while treatment of primiparous cows should be delayed, at least until the end of the pre-service period, to provide the opportunity for spontaneous recovery. PMID:12374132

  14. 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…

  15. 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

  16. 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);…

  17. The relationship between depression and body dissatisfaction across pregnancy and the postpartum: a prospective study.

    PubMed

    Clark, Abigail; Skouteris, Helen; Wertheim, Eleanor H; Paxton, Susan J; Milgrom, Jeannette

    2009-01-01

    The overall aim of this study was to examine the relationship between depression and body dissatisfaction across pregnancy and the first 12 months postpartum. During pregnancy, women's (N = 116) perceived attractiveness and strength/fitness remained stable, while feeling fat and salience of weight/shape decreased in late pregnancy. During the postpartum, feeling fat and salience of weight/shape increased. Depression and body dissatisfaction scores were correlated with each other concurrently and across multiple time points. However, in baseline-controlled prospective analyses, only a model of greater depression late in pregnancy predicting body dissatisfaction at six weeks postpartum and feeling fat throughout the postpartum was supported. PMID:19129334

  18. 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

  19. 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.

  20. The effect of soy isoflavones on egg quality and bone mineralisation during the late laying period of quail.

    PubMed

    Sahin, N; Onderci, M; Balci, T A; Cikim, G; Sahin, K; Kucuk, O

    2007-06-01

    1. Soy isoflavones play a role in calcium and bone metabolism. Poor egg quality, skeletal abnormalities and architectural deterioration of bone tissue are common problems under hot climate conditions and with increased age in poultry. 2. In this study, we investigated the effects of soy isoflavone supplementation on egg production, egg quality, bone mineral density (BMD), levels of osteocalcin (OC), vitamin D, calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) activity in quail (Coturnix coturnix japonica) during the late laying period. 3. The birds (n = 180; 28 weeks old) were randomly assigned to 6 treatment groups consisting of 6 replicates of 5 birds each in a 2 x 3 factorial arrangement of treatments (temperatures, soy isoflavone concentration). Birds were kept in wire cages in a temperature-controlled room at either 22 degrees C (thermo-neutral, TN) or 34 degrees C (heat stress, HS) for 8 h/d (09:00 to 17:00 h; until the end of the study) and fed either on a basal (control) diet or on the basal diet supplemented with either 400 or 800 mg of soy isoflavones/kg of diet. 4. Heat exposure reduced feed intake, egg production, egg quality, BMD, OC, vitamin D, Ca, P and ALP when the basal diet was given. Feed intake, egg production and egg weight were not affected, while eggshell thickness and eggshell weight increased in soy isoflavone-supplemented quails reared under TN conditions. However, feed intake, egg production, egg weight, eggshell thickness, eggshell weight and Haugh units were positively influenced by soy isoflavone supplementation in HS groups for quail during the late laying period. Bone mineral density, serum OC, vitamin D, Ca, P levels and ALP activity were significantly improved by soy isoflavone supplementation in both the TN and HS groups in quail during the late laying period. 5. Soy isoflavone supplementation of basal diet significantly improved egg quality and bone mineralisation in quail during the late laying period. PMID:17578700

  1. 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

  2. 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

  3. 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 Edition–based 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

  4. 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.

  5. Management of postpartum depression.

    PubMed

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

    2013-01-01

    The mainstays of treatment for peripartum depression are psychotherapy and antidepressant medications. More research is needed to understand which treatments are safe, preferable, and effective. 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 option for women with mild to moderate peripartum depression. Antidepressant medication in combination with therapy is recommended for women with moderate to severe depression. Although 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 controlling for maternal depression. Pharmacologic treatment recommendations for 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 nonpharmacologic interventions including repetitive transcranial magnetic stimulation, which may offer an attractive option for women who wish to continue to breastfeed and are concerned about their infants being exposed to medication. Among severe cases of peripartum depression with psychosis, referral to a psychiatrist or psychiatric advanced practice registered nurse is warranted. Suicidal or homicidal ideation with a desire, intent, or plan to harm oneself or anyone 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 sample 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

  6. Giant Thyroid Abscess Related to Postpartum Brucella Infection

    PubMed Central

    Akdemir, Zülküf; Karaman, Erbil; Akdeniz, Hüseyin; Alptekin, Cem

    2015-01-01

    Thyroid gland infection, although rare, may be a life threatening disease. Thyroid abscess, arising from acute suppurative thyroiditis (AST), is a rare clinic condition depending on widespread use of antibiotics. Infection may involve one or both lobes and abscess formation may not be apparent until late stage of the progress of illness. Thyroid left lobe is more often affected than the right one. Brucellosis, especially obvious in endemic areas, is a widely seen zoonosis around the world. Although brucella infection can affect many organs through various complications, thyroid gland infection is rare. We aimed to present ultrasonography (USG) and magnetic resonance images (MRI) of a case with an acute thyroiditis which rapidly developed and grew fast on the left half of the neck during the first postpartum month. As far as we know from literature reviewing, our case is the first case report of a thyroid abscess arising from brucella infection which is developed in first postpartum period with images of ultrasonography and MRI. PMID:25861492

  7. Giant thyroid abscess related to postpartum Brucella infection.

    PubMed

    Akdemir, Zülküf; Karaman, Erbil; Akdeniz, Hüseyin; Alptekin, Cem; Arslan, Harun

    2015-01-01

    Thyroid gland infection, although rare, may be a life threatening disease. Thyroid abscess, arising from acute suppurative thyroiditis (AST), is a rare clinic condition depending on widespread use of antibiotics. Infection may involve one or both lobes and abscess formation may not be apparent until late stage of the progress of illness. Thyroid left lobe is more often affected than the right one. Brucellosis, especially obvious in endemic areas, is a widely seen zoonosis around the world. Although brucella infection can affect many organs through various complications, thyroid gland infection is rare. We aimed to present ultrasonography (USG) and magnetic resonance images (MRI) of a case with an acute thyroiditis which rapidly developed and grew fast on the left half of the neck during the first postpartum month. As far as we know from literature reviewing, our case is the first case report of a thyroid abscess arising from brucella infection which is developed in first postpartum period with images of ultrasonography and MRI. PMID:25861492

  8. 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).

  9. 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

  10. 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

  11. Modern use of extracorporeal life support in pregnancy and postpartum.

    PubMed

    Sharma, Nirmal S; Wille, Keith M; Bellot, Scott C; Diaz-Guzman, Enrique

    2015-01-01

    Extracorporeal membrane oxygenation (ECMO) use during pregnancy and the postpartum period are thought to be associated with an increased risk for maternal or fetal bleeding complications. We present our recent institutional experience in managing pregnant and postpartum patients with ECMO. We also performed a literature review of modern use of ECMO in pregnant and postpartum patients utilizing Pubmed and Embase databases. ECMO was used for severe cardiopulmonary failure due to multiple conditions. Based on published reports, overall maternal and fetal survival on ECMO were 80% and 70%, respectively. Mild-to-moderate vaginal bleeding was reported in a few cases, with rare occurrences of catastrophic postpartum hemorrhage. There was no consensus on an optimal anticoagulation strategy in these patients, though most preferred to keep anticoagulation at lower therapeutic levels. We conclude that ECMO, in well-selected pregnant and postpartum patients, appears to be safe and associated with low risk of maternal and fetal complications. PMID:25248040

  12. 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

  13. 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).…

  14. Effect of Previous Miscarriage on Depressive Symptoms during Subsequent Pregnancy and Postpartum in the First Baby Study

    PubMed Central

    Bicking Kinsey, Cara; Baptiste-Roberts, Kesha; Zhu, Junjia; Kjerulff, Kristen H.

    2014-01-01

    Objectives Our objective was to test the hypothesis that nulliparous women with a history of miscarriage have an increased risk of depression during late pregnancy, and at 1, 6, and 12 months postpartum compared to women without a history of miscarriage. Methods We conducted secondary analysis of a longitudinal cohort study, the First Baby Study, and compared 448 pregnant women with a history of miscarriage to 2343 pregnant women without a history of miscarriage on risk of probable depression (score >12 on the Edinburgh Postnatal Depression Scale). Logistic regression models were used to estimate odds ratios at each time point and generalized estimating equations were used to obtain estimates in longitudinal analysis. Results Women with a history of miscarriage were not more likely than woman without a history of miscarriage to score in the probable depression range during the third trimester or at 6 or 12 months postpartum but were more likely at 1 month postpartum, after adjustment for sociodemographic factors (OR 1.66, 95% CI 1.03 – 2.69). Conclusions Women with a history of miscarriage may be more vulnerable to depression during the first month postpartum than women without prior miscarriage, but this effect does not appear to persist beyond this time period. We support the promotion of awareness surrounding this issue and recommend that research is planned to identify risk factors that may position a woman with a history of miscarriage to be at higher risk for depression. PMID:24894728

  15. 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.

  16. Postpartum sacral insufficiency fractures.

    PubMed

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

    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

  17. Competence and Responsiveness in Mothers of Late Preterm Infants Versus Term Infants

    PubMed Central

    Baker, Brenda; McGrath, Jacqueline M.; Pickler, Rita; Jallo, Nancy; Cohen, Stephen

    2013-01-01

    Objective To compare maternal competence and responsiveness in mothers of late preterm infants (LPIs) with mothers of full-term infants. Design A nonexperimental repeated-measures design was used to compare maternal competence and responsiveness in two groups of postpartum mothers and the relationship of the theoretical antecedents to these outcomes. Setting Urban academic medical center. Participants Mothers of late preterm infants (34–36, 6/7-weeks gestation) and mothers of term infants (≥37-weeks gestation), including primiparas and multiparas. Data were collected after delivery during the postpartum hospital stay and again at 6-weeks postpartum. Methods Descriptive and inferential analysis. Results A total of 70 mothers completed both data collection periods: 49 term mothers and 21 LPI mothers. There were no differences between the two groups related to their perception of competence or responsiveness at delivery or 6-weeks postpartum. At 6-weeks postpartum, none of the assessed factors in the model was significantly related to competence or responsiveness. Conclusions The results, which may have been limited by small sample size, demonstrated no difference in the perceptions of LPI and term mothers related to competence or responsiveness. Maternal stress and support were significantly related to other factors in the model of maternal competence and responsiveness. PMID:23601024

  18. 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

  19. [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

  20. 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

  1. Committee Opinion No. 666 Summary: Optimizing Postpartum Care.

    PubMed

    2016-06-01

    In the weeks after birth, postpartum care often is fragmented among maternal and pediatric health care providers, and communication between inpatient and outpatient settings is inconsistent. To optimize postpartum care, anticipatory guidance should begin during pregnancy. During antenatal care, it is recommended that the patient and her obstetrician-gynecologist or other obstetric care provider formulate a postpartum care plan and identify the health care professionals who will comprise the postpartum care team for the woman and her infant. Ideally, during the postpartum period, a single health care practice assumes responsibility for coordinating the woman's care. At discharge from maternity care, the woman should receive contact information for her postpartum care team and written instructions regarding the timing of follow-up postpartum care. It is recommended that all women undergo a comprehensive postpartum visit within the first 6 weeks after birth. This visit should include a full assessment of physical, social, and psychological well-being. Systems should be implemented to ensure each woman can receive her desired form of contraception during the comprehensive postpartum visit, if not done earlier. At the conclusion of the postpartum visit, the woman and her obstetrician-gynecologist or other obstetric care provider should determine who will assume primary responsibility for her ongoing care. If responsibility is transferred to another primary care provider, the obstetrician-gynecologist or other obstetric care provider is responsible for ensuring that there is communication with the primary care provider so that he or she can understand the implications of any pregnancy complications for the woman's future health and maintain continuity of care. PMID:27214188

  2. 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.

  3. Postpartum psychiatric disorders.

    PubMed Central

    Robinson, G E; Stewart, D E

    1986-01-01

    Postpartum blues, postpartum neurotic depression and puerperal psychoses have distinct clinical features; they affect women in all social classes and in all cultures, and despite numerous studies they have not been linked definitively with any biologic or psychosocial variables. The only possible exception is puerperal psychosis, which emerges much more often in women with a personal or family history of a bipolar affective disorder than in women without, a finding that probably explains the reluctance of some researchers to recognize puerperal psychotic episodes as distinct from psychotic episodes at other times. If postpartum blues last longer than 2 weeks and are disabling they are classified as neurotic depression and warrant treatment, often requiring both psychosocial approaches and psychotropic drug therapy. Antidepressants, major tranquillizers, electroconvulsive therapy and lithium have proved effective in the treatment of postpartum psychoses, depending on the symptoms. Both lithium and diazepam have been reported to cause deleterious side effects on breast-fed infants, and as the side effects of other psychotropic drugs given to a nursing mother are imperfectly understood, bottle feeding seems prudent. PMID:3510069

  4. Vitamin E supplementation during the dry period in dairy cattle. Part I: adverse effect on incidence of mastitis postpartum in a double-blind randomized field trial.

    PubMed

    Bouwstra, R J; Nielen, M; Stegeman, J A; Dobbelaar, P; Newbold, J R; Jansen, E H J M; van Werven, T

    2010-12-01

    A randomized, controlled field trial with dairy cows demonstrated an adverse effect of vitamin E supplementation during the dry period on mastitis incidence in early lactation. This study was conducted on farms with historically high rates of mastitis to investigate the benefit of vitamin E supplementation on udder health; however, the outcome showed an adverse effect. The aim of the study was to evaluate whether daily supplementation of 3,000 IU of vitamin E to dairy cows during the dry period could improve udder health in commercial herds with a high incidence of mastitis. On 5 dairy farms, dry cows were randomly divided into 2 experimental groups: a high and a low group. Both groups received a dry cow mineral mix providing 3,000 or 135 IU of vitamin E/cow per day, respectively, between dry-off and calving for a mean period of 8 wk. Providing 3,000 IU of vitamin E exceeds NRC standards, but this amount has been used in previous studies. The experiment, as well as the majority of the statistical analysis, were carried out blinded. Blood was sampled 3 times before calving and on calving day. Serum was analyzed for vitamin E and cholesterol. Vitamin E and the vitamin E:cholesterol ratio were analyzed as dependent variables in mixed models and Student's t-tests to study trends in time and differences between groups. Relative risk calculation and survival analysis were used to study the effect of supplementation on mastitis incidence in the first 3 mo of lactation. The results showed that vitamin E supplements increased both absolute vitamin E and the ratio of vitamin E to cholesterol in blood. In the high group, significantly more subclinical and clinical cases occurred, showing the same trend on all farms. In this study, an initial vitamin E level at dry off above 14.5 μmol/L was a risk factor for clinical mastitis, suggesting that the vitamin E status at the start of the dry period is important. It is recommended to work out exactly at what threshold vitamin E is harmful for udder health before new trials with high dosages of vitamin E are started. Additionally, further research is required to investigate the mechanism by which vitamin E affects udder health. PMID:21094740

  5. Postpartum Bilateral Sacroiliitis caused by Brucella Infection

    PubMed Central

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

    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

  6. 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

  7. 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

  8. Osteological and dental markers of health in the transition from the Late Antique to the Early Medieval period in Croatia.

    PubMed

    Slaus, Mario

    2008-08-01

    The purpose of this study is to analyze health at the transition from the Late Antique (LA) to the Early Medieval (EM) period in Croatia. Results of the analyses of skeletal remains are compared with historical and archaeological data to test the hypothesis that the transition was catastrophic. An additional objective is to determine whether the transition was a uniform process, or differentially affected the past inhabitants of Croatia because of various local considerations. To accomplish this, four markers of health: cribra orbitalia, linear enamel hypoplasia, nonspecific periostitis, and trauma were compared in 981 skeletons: 477 from nine urban LA sites, and 504 from six rural EM sites. Data were collected by sex and age for individual, and for co-occurrences of various features. Because continental and Adriatic Croatia has different ecological features, data were specifically tabulated for the two regions. Comparisons between the continental and Adriatic regions of the LA series showed no significant differences in the frequencies of the analyzed markers of stress. Comparisons between the LA and EM series showed similar frequencies in continental Croatia--suggesting no significant discontinuity of living conditions, and a significant increase of cribra orbitalia, periostitis, and trauma frequencies during the EM period in Adriatic Croatia. The deterioration of living conditions primarily affected subadults and males. These data suggest that the transition from the LA to the EM period in Croatia was not a uniform process, but differentially affected population biology most likely because of local cultural, socio-economical or political considerations. PMID:18383158

  9. 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 (647±32 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

  10. 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

  11. Postpartum bonding: the role of perinatal depression, anxiety and maternal-fetal bonding during pregnancy.

    PubMed

    Dubber, S; Reck, C; Müller, M; Gawlik, S

    2015-04-01

    Adverse effects of perinatal depression on the mother-child interaction are well documented; however, the influence of maternal-fetal bonding during pregnancy on postpartum bonding has not been clearly identified. The subject of this study was to investigate prospectively the influence of maternal-fetal bonding and perinatal symptoms of anxiety and depression on postpartum mother-infant bonding. Data from 80 women were analyzed for associations of symptoms of depression and anxiety as well as maternal bonding during pregnancy to maternal bonding in the postpartum period using the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI), the Pregnancy Related Anxiety Questionnaire (PRAQ-R), the Maternal-Fetal Attachment Scale (MFAS) and the Postpartum Bonding Questionnaire (PBQ-16). Maternal education, MFAS, PRAQ-R, EPDS and STAI-T significantly correlated with the PBQ-16. In the final regression model, MFAS and EPDS postpartum remained significant predictors of postpartum bonding and explained 20.8 % of the variance. The results support the hypothesized negative relationship between maternal-fetal bonding and postpartum maternal bonding impairment as well as the role of postpartum depressive symptoms. Early identification of bonding impairment during pregnancy and postpartum depression in mothers plays an important role for the prevention of potential bonding impairment in the early postpartum period. PMID:25088531

  12. 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…

  13. Vitamin E supplementation during the dry period in dairy cattle. Part II: oxidative stress following vitamin E supplementation may increase clinical mastitis incidence postpartum.

    PubMed

    Bouwstra, R J; Nielen, M; Newbold, J R; Jansen, E H J M; Jelinek, H F; van Werven, T

    2010-12-01

    The aim of this study was to evaluate, retrospectively, which physiological states influenced the effect of vitamin E supplements during the dry period on the level of oxidative stress at 2 wk antepartum. Furthermore the effect of oxidative stress at 2 wk antepartum on the risk of clinical mastitis in early lactation was investigated. Cows experience oxidative stress around calving. Vitamin E is able to decrease oxidative stress by scavenging free radicals. Normally, vitamin E radicals formed when vitamin E reacts with free radicals are regenerated by a network of other antioxidants, termed the "vitamin E regeneration system" (VERS). In case of vitamin E supplementation, VERS should be sufficient to regenerate formed vitamin E radicals; if not, oxidative stress might increase instead of decrease. Additionally, the level of oxidative stress and vitamin E might be important physiological states to evaluate before supplementation. In a clinical trial, 296 cows on 5 farms were randomly divided into 2 groups, supplemented with a mineral mix between dry off and calving that supplied 3,000 or 135 IU/d, respectively. Blood samples collected at dry off and 2 wk antepartum were analyzed for vitamin E, reactive oxygen metabolites, ferric-reducing ability of plasma, glutathione peroxidase, and malondialdehyde. Cows were allocated retrospectively into 8 subgroups based on the level of oxidative stress, vitamin E, and VERS status at dry off. To evaluate whether differences in physiological states at dry off influenced the effect of vitamin E supplementation on the level of oxidative stress, group effects (supplemented vs. control) were studied with Student's t-test for all 8 subgroup at 2 wk antepartum. Differences in physiological states at dry off influenced the effect of vitamin E supplements. In 2 insufficient VERS subgroups, the supplemented group had higher levels of free radicals at 2 wk antepartum compared with the control group. Relative risk calculation was used to study the effect of oxidative stress at 2 wk antepartum on the incidence of mastitis in the first 100 d of lactation. Higher levels of oxidative stress at 2 wk antepartum were related to higher risk of clinical mastitis. In conclusion, not every dry cow responded well to high vitamin E supplementation. This subgroup analysis provides a possible explanation for the unexpected adverse effects observed in the clinical trial. PMID:21094741

  14. Maternal and infant sleep postpartum.

    PubMed

    McGuire, Elizabeth

    2013-07-01

    New parents should be aware that infants' sleep is unlike that of adults and that meeting their infant's needs is likely to disrupt their own sleep. They will need to adjust their routine to manage their own sleep needs. Parental sleep patterns in the postpartum period are tied to the infant's development of a circadian sleep-wake rhythm, and the infant's feeds. Close contact with the mother and exposure to light/dark cues appear to assist in the development of the infant's circadian rhythm. The composition of breastmilk varies over the course of 24 hours and some components produced at night are likely to contribute to the infant's day/night entrainment. There is no clear evidence that using artificial feeds improves maternal sleep. Most infants need night feeds but requirements for nighttime feeds vary with the individual. PMID:23957180

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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.

  20. Association of fewer hours of sleep at 6 months postpartum with substantial weight retention at 1 year postpartum.

    PubMed

    Gunderson, Erica P; Rifas-Shiman, Sheryl L; Oken, Emily; Rich-Edwards, Janet W; Kleinman, Ken P; Taveras, Elsie M; Gillman, Matthew W

    2008-01-15

    Shorter sleep duration is linked to obesity, coronary artery disease, and diabetes. Whether sleep deprivation during the postpartum period affects maternal postpartum weight retention remains unknown. This study examined the association of sleep at 6 months postpartum with substantial postpartum weight retention (SPPWR), defined as 5 kg or more above pregravid weight at 1 year postpartum. The authors selected 940 participants in Project Viva who enrolled during early pregnancy from 1999 to 2002. Logistic regression models estimated odds ratios of SPPWR for sleep categories, controlling for sociodemographic, prenatal, and behavioral attributes. Of the 940 women, 124 (13%) developed SPPWR. Sleep distributions were as follows: 114 (12%) women slept < or =5 hours/day, 280 (30%) slept 6 hours/day, 321 (34%) slept 7 hours/day, and 225 (24%) slept > or =8 hours/day. Adjusted odds ratios of SPPWR were 3.13 (95% confidence interval (CI): 1.42, 6.94) for < or =5 hours/day, 0.99 (95% CI: 0.50, 1.97) for 6 hours/day, and 0.94 (95% CI: 0.50, 1.78) for > or =8 hours/day versus 7 hours/day (p = 0.012). The adjusted odds ratio for SPPWR of 2.05 (95% CI: 1.11, 3.78) was twofold greater (p = 0.02) for a decrease in versus no change in sleep at 1 year postpartum. Sleeping < or =5 hours/day at 6 months postpartum was strongly associated with retaining > or =5 kg at 1 year postpartum. Interventions to prevent postpartum obesity should consider strategies to attain optimal maternal sleep duration. PMID:17971337

  1. DSM-V: modifying the postpartum-onset specifier to include hypomania.

    PubMed

    Sharma, Verinder; Burt, Vivien K

    2011-02-01

    By failing to include it under the rubric of the postpartum-onset specifier, Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR has ignored the clinical reality that childbirth is a potent trigger of hypomania. Given the serious and occasionally tragic consequences of misdiagnosis of bipolar II depression as unipolar depression in the postpartum period, it is argued that DSM-V should consider modifying the postpartum-onset specifier to include episodes of hypomania. PMID:20872155

  2. 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

  3. [Influence of compendium of Materia Medica on the materia medica in the late period of the Chosun Dynasty].

    PubMed

    Oh, Chae-Kun

    2012-08-31

    In this paper, I investigated the influence of Compendium of Materia Medica (CM) on Records for Rural Life of Chosun Gentlemen (RRC), and refuted Miki Sakae's opinion, CM did not have much impact on the Materia Medica in the late period of the Chosun Dynasty. When Li Shizhen published CM, it resulted in a shift of mainstream of Materia Medica in Eastern Asia from Classified Emergency Materia Medica to CM and a new categorizing system of Materia Medica by CM led to the division of Materia Medica into medicine and natural history. It is obvious that doctors of the Chosun Dynasty also adopted the latest achievements of Materia Medica by CM, but so far there have been few studies to clarify this. Seo yugu was a scholar of the Realist School of Confucianism during the late period of the Chosun Dynasty, and RRC is his representative work. RRC is a massive encyclopedia of natural history that covers vast areas of science from agriculture, floriculture, writing and drawing, architecture, diet, and medicine, among others which absorbed the achievements of CM, the best Materia Medica book at that time. Miki Sakae also highly regarded the encyclopedic knowledge of RRC, but devalued the results of Materia Medica. He only described a part of RRC's Materia Medica, nurturing volume, on the view of life nurturing and mentioned that it had been strongly influenced by China. According to this study, a large portion of RRC, especially regarding Materia Medica, depends on CM. Seo yugu had accepted the categorizing system and new medicinal information of CM, at the same time he modified the categorizing system of CM practically by the subject of each volume of RRC. We can find many quotations of CM except the nurturing volume, but other books, Treasured Mirror of Eastern Medicine, Materia Medica for Relief of Famines are also quoted. Furthermore, Seo yugu emphasized the differences of natural environments between Chosun and China, and specified the editing criteria, "to be useful in Chosun." This is the most obvious evidence that Materia Medica of Chosun had not remained in the framework of Treasured Mirror of Eastern Medicine which succeeded Classified Emergency Materia Medica, but had been developed into medicine and natural history based on CM. PMID:22948165

  4. Short communication: Characterizing metabolic and oxidant status of pastured dairy cows postpartum in an automatic milking system.

    PubMed

    Elischer, M F; Sordillo, L M; Siegford, J M; Karcher, E L

    2015-10-01

    The periparturient period represents a stressful time for dairy cows as they transition from late gestation to early lactation. Undesirable fluctuations in metabolites and impaired immune defense mechanisms near parturition can severely affect cow health and have residual effects on performance and longevity. Metabolic and oxidative stress profiles of multiparous and primiparous dairy cows in traditional parlor and feeding systems are well characterized, but status of these profiles in alternative management systems, such as grazing cows managed with an automatic milking system (AMS), are poorly characterized. Therefore, the objective of this case study was to characterize the metabolic and oxidant status of pastured cows milked with an AMS. It was hypothesized that primiparous and multiparous cows milked with an AMS would experience changes in oxidative and metabolic status after parturition; however, these changes would not impair cow health or production. Blood was collected from 14 multiparous and 8 primiparous Friesian-cross dairy cows at 1, 7, 14, and 21 d relative to calving for concentrations of insulin, glucose, nonesterified fatty acids (NEFA), β-hydroxybutyrate, reduced glutathione, oxidized glutathione, and antioxidant potential. Milk production and milking frequency data were collected postpartum. Milk production differed on d 7 and 14 between primiparous and multiparous cows and frequency was not affected by parity. Primiparous cows had higher levels of glucose than multiparous cows. No differences in insulin, NEFA, or β-hydroxybutyrate concentrations were noted between multiparous and primiparous cows postpartum, though days relative to calving significantly affected insulin and NEFA. Primiparous cows also had higher antioxidant potential than multiparous cows during the postpartum period. Results from this study show that, although responses were within expected ranges, periparturient multiparous cows responded differently than periparturient primiparous cows with respect to metabolic and oxidative measures during the postpartum period at this pastured-AMS dairy, suggesting different management strategies may need to be considered with primiparous and multiparous cows. PMID:26277310

  5. Greater nutrition knowledge is associated with lower 1-year postpartum weight retention in low-income women

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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 ...

  6. 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 α 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 γ 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

  7. 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

  8. 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.

  9. Proxy records of Late Holocene climate events in the eastern United States: Medieval Warm Period and Little Ice Age

    NASA Astrophysics Data System (ADS)

    Willard, D. A.; Cronin, T. M.; Hayo, K. M.

    2006-12-01

    We are conducting a multiproxy, regional reconstruction of climate variability during the last two millennia including the Medieval Warm Period (MWP) and Little Ice Age (LIA) in eastern North America. Pollen, benthic foraminifers, ostracodes, and other proxies were analyzed from high-resolution sampling of continuous sedimentary records from lakes, wetlands, and estuaries in Florida, North Carolina, Chesapeake Bay, and Lake Champlain. These records document multi-decadal changes in vegetation, temperature, precipitation, and estuarine salinity across a latitudinal transect. During both the MWP and LIA, decreased precipitation altered plant community composition and distribution in the southeastern United States, and the LIA triggered threshold changes in vegetation that persisted until anthropogenic land-cover change overwhelmed the climate signature. In the mid-Atlantic region, progressively cooler and wetter late Holocene springs culminated in a cool, wet LIA; this trend correlates with observed oceanic changes. Trend analysis of the data suggest that inter-regional correlation of multi-decadal and centennial-scale Holocene climate events will be forthcoming.

  10. The detection of nicotine in a Late Mayan period flask by gas chromatography and liquid chromatography mass spectrometry methods.

    PubMed

    Zagorevski, Dmitri V; Loughmiller-Newman, Jennifer A

    2012-02-29

    Several ancient Mayan vessels from the Kislak Collection of the US Library of Congress were examined for the presence of alkaloids. One of them, a codex-style flask, bears a text that appears to read yo-'OTOT-ti 'u-MAY, spelling y-otoot 'u-may 'the home of its/his/her tobacco'. Samples extracted from this Late Classic period (600 to 900 AD) container were analyzed by gas chromatography/mass spectrometry (GC/MS) and liquid chromatography/mass spectrometry (LC/MS) methods. Nicotine was identified as the major component of the extracts. LC/MS analyses also yielded signals due to nicotine mono-oxides. The identities of the compounds were determined by comparison of the chromatographic and/or mass spectral characteristics with those from standards and literature data. High-resolution high mass accuracy tandem mass spectrometry (MS/MS) spectra of protonated nicotine and nicotine mono-oxides were measured to verify and to correct previous product ion assignments. These analyses provided positive evidence for nicotine from a Mayan vessel, indicating it as a likely holder of tobacco leafs. The result of this investigation is the first physical evidence of tobacco from a Mayan container, and only the second example where the vessel content recorded in a Mayan hieroglyphic text has been confirmed directly by chromatography/mass spectrometry trace analysis. PMID:22279016

  11. 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.

  12. 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

  13. 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…

  14. Histopathological and molecular evaluation of Holstein-Friesian cows postpartum: toward an improved understanding of uterine innate immunity.

    PubMed

    Chapwanya, Aspinas; Meade, Kieran G; Doherty, Michael L; Callanan, John J; Mee, John F; O'Farrelly, Cliona

    2009-06-01

    Bovine uterine disease reduces milk yield, impairs fertility and has implications for animal welfare. During involution, the uterus is usually exposed to multiple potential bacterial pathogens which are cleared by successful orchestration of the local inflammatory response. Unsuccessful resolution leads to the development of disease. The aim of this study was to characterize the local innate immune response in the uterus during physiological involution using histopathological and molecular analyses in 9 cows, 2 weeks after calving (early postpartum, EPP), and 4 cows, 9 weeks after calving (late postpartum, LPP). Uterine biopsies taken from each cow were classified by histopathology, and RNA was extracted for molecular analysis. Two EPP cows were classified with a mild, 5 with a moderate and 2 with a severe inflammatory response. Relative gene expression analysis was then performed using quantitative real-time PCR (qRT-PCR) and specific primers for genes encoding Toll-like receptors (TLRs), chemokines, cytokines, acute phase proteins (APPs) and antimicrobial peptides (AMPs). TLR4, transcription factor NFKB1 and the inflammatory cytokines IFNG, IL1A, IL6, IL8, IL12A were all significantly increased in EPP cows (P<0.05). Increase in HP, SAA3, TAP and DEFB5 genes was particularly marked in cows with severe inflammation. These results reveal evidence of an inflammatory uterine environment in the early postpartum period with significant induction of both AMP and APP genes. Histopathological grades in EPP cows are underpinned by quantitative changes in gene expression. Understanding the molecular mechanisms contributing to uterine immunity in the early postpartum period may identify candidate genes associated with the resolution of inflammation. PMID:19233457

  15. 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…

  16. 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…

  17. 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

  18. Maternal Postpartum Quality of Life Questionnaire.

    PubMed

    Hill, Pamela D; Aldag, Jean C; Hekel, Barbara; Riner, Gina; Bloomfield, Pamela

    2006-01-01

    This article summarizes the development and psychometric properties of the first self-administered, paper-and-pencil instrument that measures maternal quality of life during the early postpartum period. The definition, domains, and conceptual model by Ferrans and Powers (QLI) were used to develop the Maternal Postpartum Quality of Life (MAPP-QOL) tool. A convenience sample of 184 mothers completed the MAPP-QOL at week 1 and 3 postpartum. Component analysis revealed five domains: psychological/baby; socioeconomic; relational/spouse-partner; relational/family-friends; and health & functioning. Internal consistency reliability for the five subscales resulted in Cronbach's alpha coefficients ranging from .82 to .96. Stability reliability ranged from .66 to .76. The MAPP-QOL and a single-item measure of life satisfaction correlated (r = .69), suggesting convergent validity; discriminant validity was supported by negative correlations with the three negative mood states of the Multiple Affect Adjective Check List-Revised (MAACL-R) as well as poor sleep and fatigue scores. Acceptable reliability and construct validity suggest that the MAPP-QOL may be used in research. Further testing with larger and more diverse samples is recommended. PMID:17278340

  19. 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

  20. 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

  1. 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

  2. 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.

  3. Prospective study of the hemodynamic behavior of ophthalmic arteries in postpartum preeclamptic women: A doppler evaluation.

    PubMed

    Alves Borges, José Hilário; Goes, Daniela A; de Araújo, Lúcio Borges; Dos Santos, Maria Célia; Debs Diniz, Angélica Lemos

    2016-02-01

    The aim of this study was to evaluate the hemodynamic behavior of the ophthalmic artery by means of the Doppler ultrasound, in postpartum preeclamptic women. It was an observational prospective study with 44 postpartum preeclamptic women (group 1) and 49 postpartum normal women with normal blood pressure and with no previous illnesses known (group 2). All the pregnant women had a Doppler ultrasound exam of the ophthalmic artery in the immediate puerperium, that is, 10 days for the delivery (time 1). Group 1 was then followed prospectively, 26 patients of which returned to the last test in the remote puerperium in 45 days (time 2) and 29 patients returned to the last test in the remote puerperium in 90 days (time 3). All these women had preeclampsia before the delivery. The resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), end diastolic flow velocity (EDV), second peak of systolic velocity (P2), and the peak ratio (PR) were calculated. The data obtained are expressed in average and standard deviation, by using the Lilliefors test for normality. The average of the Doppler indexes in groups 1 and 2 was compared by means of test t of the student. Group 1 was analyzed separately, comparing the three times, using the test of ANOVA for repetitive measures and Tukey post-hoc range test. In the "Results" section, the statically meaningful differences in RI, PI, P2, RPV, and EDV (p < 0.0001, p < 0.0001, p < 0.0009, p < 0.0001, p < 0.0028) were found in the immediate puerperium of group 1 in relation to group 2, indicating the persistence of hyperperfusion and orbital vasodilatation in the immediate postpartum period in patients who had complicated pregnancies previously due to preeclampsia. In the evolutionary analysis of group 1, comparing the Doppler indexes between the immediate and late puerperium, statistically relevant differences between the rates of RI, P2, and PR (p < 0,01) were observed, showing a raise of RI and reduction of P2 and PR, and also a tendency of normalization of these rates in the late puerperium. When the same indexes were compared (PI, P2, and PR) now in times 2 and 3, the remote, and late puerperium, respectively, there were no significant differences, indicating the stabilization of these indexes since the 45th day of the puerperium. Within 90 days, RI, PI, and PR are not stabilized yet in relation to the control, even though there is a tendency of these indexes to reach the control. In conclusion, there was persistence of signs of vasodilatation and hyperperfusion of the orbital territory, represented by Doppler of the ophthalmic artery in the immediate puerperium of preeclamptic women. A tendency of normalization of the orbital hemodynamic standard in the pregnant women from the period of the late puerperium was observed, but there was no complete normalization of the vascular pattern on the remote postpartum. PMID:26852911

  4. 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

  5. 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

  6. 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…

  7. Prospective Study on the Association between Harm Avoidance and Postpartum Depressive State in a Maternal Cohort of Japanese Women

    PubMed Central

    Okada, Takashi; Murase, Satomi; Aleksic, Branko; Hayakawa, Norika; Shiino, Tomoko; Nakamura, Yukako; Tamaji, Ai; Ishikawa, Naoko; Ohoka, Harue; Usui, Hinako; Banno, Naomi; Morita, Tokiko; Goto, Setsuko; Kanai, Atsuko; Masuda, Tomoko; Ozaki, Norio

    2012-01-01

    Background Recent studies have displayed increased interest in examining the relationship between personality traits and the onset, treatment response patterns, and relapse of depression. This study aimed to examine whether or not harm avoidance (HA) was a risk factor for postpartum depression measured by the Edinburgh Postnatal Depression Scale (EPDS) and the state dependency of HA. Methods Pregnant women (n=460; mean age 31.9±4.2 years) who participated in a prenatal program completed the EPDS as a measure of depressive state and the Temperament and Character Inventory (TCI) as a measure of HA during three periods: early pregnancy (T1), late pregnancy (around 36 weeks), and 1 month postpartum (T2). Changes in EPDS and HA scores from T1 to T2 were compared between the non depressive (ND) group and the postpartum depressive (PD) group. Results There was no significant difference in the level of HA between the ND and PD groups at T1. In the ND group, EPDS and HA scores did not change significantly from T1 to T2. In the PD group, both scores increased significantly from T1 to T2 (EPDS, p<0.0001; HA, p<0.048). In the ND and PD groups, a significant positive correlation was observed in changes in EPDS and HA scores from T1 to T2 (r=0.31, p=0.002). Conclusions These results suggest that HA cannot be considered a risk factor for the development of postpartum depression measured by EPDS. Furthermore, HA may be state dependent. PMID:22506046

  8. 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

  9. 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

  10. 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

  11. Postpartum nursing for Korean mothers.

    PubMed

    Schneiderman, J U

    1996-01-01

    Growing numbers of Korean-Americans require US health care workers to become knowledgeable of and sensitive to the cultural beliefs and customs of Korean patients. To further such understanding, health behaviors related to infant care and family involvement in the postpartum period were observed in a Los Angeles, California, hospital located in a Korean community. Notable in unassimilated Korean families were the power of the mother-in-law to assume control of decisions regarding infant care and the tendency of new mothers to defer to their mothers-in-law rather than ask nurses for advice. There is a cultural perception that the new mother is sick and unable to handle her infant. Other practices identified include a special diet of seaweed soup, avoidance of cold (including the rejection of ice packs against pain), resistance to breast feeding, preference for a male child, and modesty in the presence of men. In some cases, clinical considerations conflicted with cultural traditions. Respectful teaching, in nonverbal ways if there is a language barrier, and modeling of infant care techniques are recommended. Disregard for childbirth-associated cultural traditions on the part of medical staff can only increase the stress for the infant and family. PMID:8857400

  12. 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

  13. Poor sleep maintenance and subjective sleep quality are associated with postpartum maternal depression symptom severity.

    PubMed

    Park, Eliza M; Meltzer-Brody, Samantha; Stickgold, Robert

    2013-12-01

    Women are at increased risk of developing mood disorders during the postpartum period, and poor postpartum sleep may be a modifiable risk factor for the development of depression. This longitudinal study investigated the relationship between sleep variables and postpartum depression symptoms using wrist actigraphy and self-report surveys. Twenty-five healthy primiparous women were recruited from their outpatient obstetricians' offices from July 2009 through March 2010. Subjects wore wrist actigraphs for 1 week during the third trimester of pregnancy and again during the 2nd, 6th, 10th, and 14th weeks postpartum while completing sleep logs and sleep surveys. Subjective assessments of mood were collected at the end of each actigraph week. Subjective sleep assessments were strongly predictive of depression severity scores as measured by the Edinburgh Postnatal Depression Scale (EPDS) across all weeks (p < 0.001). Actigraphic measures of sleep maintenance, such as sleep fragmentation, sleep efficiency, and wake time after sleep onset, were also significantly correlated with EPDS scores postpartum. However, there was no relationship between nocturnal sleep duration and EPDS scores. This study provides additional evidence that poor sleep maintenance as measured by wrist actigraphy, rather than lesser amounts of sleep, is associated with EPDS scores during the postpartum period and that subjective assessments of sleep may be more accurate predictors of postpartum depression symptoms than wrist actigraphy. It also supports the hypothesis that disrupted sleep may contribute to the development and extent of postpartum depression symptoms. PMID:23733081

  14. 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.

  15. 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

  16. 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…

  17. 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…

  18. The late Holocene dry period: multiproxy evidence for an extended drought between 2800 and 1850 cal yr BP across the central Great Basin, USA

    USGS Publications Warehouse

    Mensing, Scott A.; Sharpe, Saxon E.; Tunno, Irene; Sada, Don W.; Thomas, Jim M.; Starratt, Scott W.; Smith, Jeremy

    2013-01-01

    Evidence of a multi-centennial scale dry period between ∼2800 and 1850 cal yr BP is documented by pollen, mollusks, diatoms, and sediment in spring sediments from Stonehouse Meadow in Spring Valley, eastern central Nevada, U.S. We refer to this period as the Late Holocene Dry Period. Based on sediment recovered, Stonehouse Meadow was either absent or severely restricted in size at ∼8000 cal yr BP. Beginning ∼7500 cal yr BP, the meadow became established and persisted to ∼3000 cal yr BP when it began to dry. Comparison of the timing of this late Holocene drought record to multiple records extending from the eastern Sierra Nevada across the central Great Basin to the Great Salt Lake support the interpretation that this dry period was regional. The beginning and ending dates vary among sites, but all sites record multiple centuries of dry climate between 2500 and 1900 cal yr BP. This duration makes it the longest persistent dry period within the late Holocene. In contrast, sites in the northern Great Basin record either no clear evidence of drought, or have wetter than average climate during this period, suggesting that the northern boundary between wet and dry climates may have been between about 40° and 42° N latitude. This dry in the southwest and wet in the northwest precipitation pattern across the Great Basin is supported by large-scale spatial climate pattern hypotheses involving ENSO, PDO, AMO, and the position of the Aleutian Low and North Pacific High, particularly during winter.

  19. The Late Holocene Dry Period: multiproxy evidence for an extended drought between 2800 and 1850 cal yr BP across the central Great Basin, USA

    NASA Astrophysics Data System (ADS)

    Mensing, Scott A.; Sharpe, Saxon E.; Tunno, Irene; Sada, Don W.; Thomas, Jim M.; Starratt, Scott; Smith, Jeremy

    2013-10-01

    Evidence of a multi-centennial scale dry period between ˜2800 and 1850 cal yr BP is documented by pollen, mollusks, diatoms, and sediment in spring sediments from Stonehouse Meadow in Spring Valley, eastern central Nevada, U.S. We refer to this period as the Late Holocene Dry Period. Based on sediment recovered, Stonehouse Meadow was either absent or severely restricted in size at ˜8000 cal yr BP. Beginning ˜7500 cal yr BP, the meadow became established and persisted to ˜3000 cal yr BP when it began to dry. Comparison of the timing of this late Holocene drought record to multiple records extending from the eastern Sierra Nevada across the central Great Basin to the Great Salt Lake support the interpretation that this dry period was regional. The beginning and ending dates vary among sites, but all sites record multiple centuries of dry climate between 2500 and 1900 cal yr BP. This duration makes it the longest persistent dry period within the late Holocene. In contrast, sites in the northern Great Basin record either no clear evidence of drought, or have wetter than average climate during this period, suggesting that the northern boundary between wet and dry climates may have been between about 40° and 42° N latitude. This dry in the southwest and wet in the northwest precipitation pattern across the Great Basin is supported by large-scale spatial climate pattern hypotheses involving ENSO, PDO, AMO, and the position of the Aleutian Low and North Pacific High, particularly during winter.

  20. 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

  1. 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

  2. Predictors of Postpartum Weight Change Among Overweight and Obese Women: Results from the Active Mothers Postpartum Study

    PubMed Central

    Peterson, Bercedis L.; Krause, Katrina M.; Swamy, Geeta K.; Lovelady, Cheryl A.

    2012-01-01

    Abstract Background The postpartum period may be critical for the development of midlife obesity. Identifying factors associated with postpartum weight change could aid in targeting women for healthy lifestyle interventions. Methods Data from Active Mothers Postpartum (AMP), a study of overweight and obese postpartum women (n=450), were analyzed to determine the effect of baseline characteristics, breastfeeding, diet, physical activity, and contraception on weight change from 6 weeks to 12, 18, and 24 months postpartum. The repeated measures mixed model was used to test the association of these effects with weight change. Results Although mean weight loss was modest (0.49 kg by 24 months), the range of weight change was striking (+21.5 kg to −24.5 kg, standard deviation [SD] 7.4). Controlling only for baseline weight, weight loss was associated with breastfeeding, hormonal contraception, lower junk food and greater healthy food intake, and greater physical activity. Only junk food intake and physical activity were significant after controlling for all other predictors. Conclusions Eating less healthy foods and being less physically active put overweight and obese women at risk of gaining more weight after a pregnancy. PMID:22092110

  3. Estudio Parto: postpartum diabetes prevention program for hispanic women with abnormal glucose tolerance in pregnancy: a randomised controlled trial – study protocol

    PubMed Central

    2014-01-01

    Background Diabetes and obesity have reached epidemic proportions in the U.S. with rates consistently higher among Hispanics as compared to non-Hispanic whites. Among Hispanic women diagnosed with gestational diabetes mellitus (GDM), 50% will go on to develop type 2 diabetes within 5 years of the index pregnancy. Although randomised controlled trials among adults with impaired glucose tolerance have shown that diet and physical activity reduce the risk of type 2 diabetes, such programs have not been tested in high-risk postpartum women. The overall goal of this randomised controlled trial is to test the efficacy of a culturally and linguistically modified, individually-tailored lifestyle intervention to reduce risk factors for type 2 diabetes and cardiovascular disease among postpartum Hispanic women with a history of abnormal glucose tolerance during pregnancy. Methods/Design Hispanic pregnant women who screen positive for GDM will be recruited and randomly assigned to a Lifestyle Intervention (n = 150) or a Health & Wellness (control) Intervention (n = 150). Multimodal contacts (i.e., in-person, telephone, and mailed materials) will be used to deliver the intervention from late pregnancy (29 weeks gestation) to 12 months postpartum. Targets of the intervention are to achieve Institute of Medicine Guidelines for postpartum weight loss; American Congress of Obstetrician and Gynecologist guidelines for physical activity; and American Diabetes Association guidelines for diet. The intervention draws from Social Cognitive Theory and the Transtheoretical Model and addresses the specific cultural and environmental challenges faced by low-income Hispanic women. Assessments will be conducted at enrollment, and at 6-weeks, 6-months, and 12-months postpartum by trained bicultural and bilingual personnel blinded to the intervention arm. Efficacy will be assessed via postpartum weight loss and biomarkers of insulin resistance and cardiovascular risk. Changes in physical activity and diet will be measured via 7-day actigraph data and three unannounced 24-hour dietary recalls at each assessment time period. Discussion Hispanic women are the fastest growing minority group in the U.S. and have the highest rates of sedentary behavior and postpartum diabetes after a diagnosis of GDM. This randomised trial uses a high-reach, low-cost strategy that can readily be translated into clinical practice in underserved and minority populations. Trial registration NCT01679210 PMID:24606590

  4. 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

  5. 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 ...

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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 (β=0.082, SE=0.032, p=0.012) and internalizing behaviors (β=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 (β=0.051, SE=0.034, p=0.138) and internalizing behaviors (β=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 (β=-0.074, SE=0.030, p=0.014), and of internalizing behaviors was white non-Hispanic ethnicity (β=-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

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

    PubMed Central

    Montufar-Rueda, Carlos; Rodriguez, Laritza; Jarquin, José 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

  13. 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

  14. Preservation of bone collagen from the late Cretaceous period studied by immunological techniques and atomic force microscopy.

    PubMed

    Avci, R; Schweitzer, M H; Boyd, R D; Wittmeyer, J L; Terán Arce, F; Calvo, J O

    2005-04-12

    Late Cretaceous avian bone tissues from Argentina demonstrate exceptional preservation. Skeletal elements are preserved in partial articulation and suspended in three dimensions in a medium-grained sandstone matrix, indicating unusual perimortem taphonomic conditions. Preservation extends to the microstructural and molecular levels. Bone tissues respond to collagenase digestion and histochemical stains. In situ immunohistochemistry localizes binding sites for avian collagen antibodies in fossil tissues. Immunohistochemical studies do not, however, guarantee the preservation of molecular integrity. A protein may retain sufficient antigenicity for antibody binding even though degradation may render it incapable of original function. Therefore, we have applied atomic force microscopy to address the integrity and functionality of retained organic structures. Collagen pull-off measurements not only support immunochemical evidence for collagen preservation for antibody recognition but also imply preservation of the whole molecular integrity. No appreciable differences in collagen pull-off properties were measured between fossil and extant bone samples under physiological conditions. PMID:15807605

  15. 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

  16. 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

  17. 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

  18. 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…

  19. 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…

  20. 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.

  1. Anxiety symptoms and coping strategies in the perinatal period

    PubMed Central

    2013-01-01

    Background The aim of the present study was to explore the prospective relationship between anxiety symptoms and coping strategies during late pregnancy and early postpartum. Methods Participants completed the Hospital Anxiety Depression-Anxiety subscale and Carver’s Brief COPE at two time points, namely during the last trimester of pregnancy (N = 400) and at two months postpartum (N = 158). Results Antenatally, 18.8% of pregnant women presented severe anxiety symptoms while 20.2% of women presented severe anxiety symptoms after birth. Carver's proposed coping styles allowed to significantly distinguish between anxious and non anxious women during these two periods. Anxious women used significantly more inappropriate coping and less adaptive coping responses, such as self-blame and denial of reality, which remained associated with anxiety in the perinatal period. Our results also indicated a decrease in adaptive coping in women without anxiety after birth (e.g. acceptance, positive reframing). Conclusion Our findings confirm that antenatal and postnatal anxiety symptoms occur frequently and that inappropriate and/or non functional coping may account for persisting anxiety after childbirth. Limitations: Data were based on self-reports and participating women were predominantly primiparous. A high drop-out rate at two months postpartum must also be acknowledged. PMID:24330429

  2. 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

  3. 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

  4. [Comparative assessment of ct-bypass angiography and invasive coronary angiography in patients after coronary bypass surgery in the late postoperative period].

    PubMed

    Men'kov, I A; Trufanov, G E; Zhelezniak, I S; Rud', S D; Kniazev, E A

    2013-10-01

    The aim of the study was to evaluate the diagnostic accuracy of ct-bypass angiography in the evaluation of significant stenosis and occlusion of grafts, recipient and nongrafted vessels in patients after coronary bypass surgery in the late postoperative period. Ct-bypass angiography was performed on 64-slice ct scanner with a slice thickness of 0.5 mm and a gantry rotation time of 0.4 s. All results were compared with quantitative invasive coronary angiography. 43 patients with 113 grafts were included in the study. Sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy for the evaluation of significant stenosis were 94%, 95%, 88%, 98%, 95%, respectively. Diagnostic accuracy for the evaluation of significant stenosis in the recipient and nongrafted vessels were 91% and 90%, respectively. The diagnostic accuracy for the evaluation graft occlusion, recipient and nongrafted vessels was 100%, 100% and 98%, respectively. Ct-bypass angiography allows accurate non-invasive assessment of significant stenosis and occlusion of coronary bypass grafts and native coronary arteries in patients after coronary bypass surgery in the late postoperative period. PMID:24611296

  5. Eating attitudes and behaviors in pregnancy and postpartum: global stability versus specific transitions.

    PubMed

    Baker, C W; Carter, A S; Cohen, L R; Brownell, K D

    1999-01-01

    Global changes in eating attitudes were examined prospectively across pregnancy and 4 months postpartum in a sample of 90 women. In addition, specific changes in dieting behavior and weight/shape satisfaction were assessed at 4 months postpartum for concurrent and retrospective time points. Measures included the Eating Attitudes Test (EAT) and weight/shape satisfaction in pregnancy and at 4 months postpartum, as well as prepregnancy, pregnancy, and postpartum weight loss efforts. While global EAT scores were stable across time, dieting scores (Factor I) increased between pregnancy and postpartum. Weight/shape satisfaction was higher in pregnancy, and satisfaction was related to EAT scores at 4 months postpartum but not during pregnancy. Prepregnancy dieters and nondieters were best discriminated by higher weights, elevated pregnancy dieting scores, and lower postpartum weight/shape satisfaction. Results emphasize the importance of looking beyond changes in global eating attitudes and behaviors to more specific eating concerns or behaviors. Lastly, the results have implications for identifying women at risk for eating- and weight-related concerns during this period of rapid physical change. PMID:10499135

  6. 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

  7. 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

  8. [Postpartum contraceptive practice in hospitals of the Federal District].

    PubMed

    Morán, C; Fuentes, G; Amado, F; Higareda, H; Bailón, R; Zárate, A

    1992-01-01

    For many women living in developing areas, childbirth is the only time when they receive medical care in a clinical setting. These women may not return until they are ready to deliver their next baby. Without access to family planning counseling and effective contraceptive methods, they are likely to become pregnant again within a year or two. Where contraceptive information and services are available to women receiving maternity care, many choose to begin using contraception in the postpartum period. Some elect to have an IUD inserted immediately after delivery or to undergo sterilization while still in the hospital. Under a postpartum contraceptive program administered by the IMSS in one hospital and the same program established in another hospital of the SSA, more than half of postpartum and postabortion women began using contraception or underwent sterilization before they left the hospital. In contrast, the other hospitals under the analysis showed a wide range of contraception coverage from 7 to 55 percent. A formal postpartum contraception program is necessary to establish in all the hospitals in order to improve coverage. Counseling is an important component for all women who must have adequate information before they choose a contraceptive method. PMID:1549787

  9. Longitudinal Change in Sleep and Daytime Sleepiness in Postpartum Women

    PubMed Central

    Filtness, Ashleigh J.; MacKenzie, Janelle; Armstrong, Kerry

    2014-01-01

    Sleep disruption strongly influences daytime functioning; resultant sleepiness is recognised as a contributing risk-factor for individuals performing critical and dangerous tasks. While the relationship between sleep and sleepiness has been heavily investigated in the vulnerable sub-populations of shift workers and patients with sleep disorders, postpartum women have been comparatively overlooked. Thirty-three healthy, postpartum women recorded every episode of sleep and wake each day during postpartum weeks 6, 12 and 18. Although repeated measures analysis revealed there was no significant difference in the amount of nocturnal sleep and frequency of night-time wakings, there was a significant reduction in sleep disruption, due to fewer minutes of wake after sleep onset. Subjective sleepiness was measured each day using the Karolinska Sleepiness Scale; at the two earlier time points this was significantly correlated with sleep quality but not to sleep quantity. Epworth Sleepiness Scores significantly reduced over time; however, during week 18 over 50% of participants were still experiencing excessive daytime sleepiness (Epworth Sleepiness Score ≥12). Results have implications for health care providers and policy makers. Health care providers designing interventions to address sleepiness in new mothers should take into account the dynamic changes to sleep and sleepiness during this initial postpartum period. Policy makers developing regulations for parental leave entitlements should take into consideration the high prevalence of excessive daytime sleepiness experienced by new mothers, ensuring enough opportunity for daytime sleepiness to diminish to a manageable level prior to reengagement in the workforce. PMID:25078950

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

    PubMed

    Evenson, Kelly R

    2011-01-01

    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

  11. 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

  12. 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

  13. Postpartum septic sacroiliitis misdiagnosed as sciatic neuropathy.

    PubMed

    Liu, Xiao-Qing; Li, Fang-Cai; Wang, Jia-Wei; Wang, Shuang

    2010-03-01

    Early diagnosis of septic sacroiliitis is difficult because symptoms are nonspecific, especially during pregnancy and the postpartum period. We describe a female patient with left buttock pain radiating down the thigh after an uncomplicated induction delivery. She was afebrile and had no apparent abnormality on pelvic x-ray or computed tomography scan. A sensory deficit in the lateral portion of her left lower limb was found, and electromyography showed neurogenic abnormalities in the left lower limb. She was initially misdiagnosed as sciatic neuropathy. As her symptoms worsened, septic sacroiliitis is considered. Bone scintigraphy showed increased Tc-methylene diphosphonate uptake in the left sacroiliac joint, and magnetic resonance imaging scan showed a signal abnormality in the left sacroiliac joint. The diagnosis of septic sacroiliitis was then confirmed by the rapid efficacy of antibiotic therapy. This report suggests that irritation and injury of spinal nerves can be the presenting signs in septic sacroiliitis. PMID:20090512

  14. Tracing Late Holocene Warm Periods in the Galician Continental Margin (NW Spain): Detrital Control vs. Early Diagenetic Modulation.

    NASA Astrophysics Data System (ADS)

    Mohamed, K.; Rey, D.; Rubio, B.; Vilas, F.

    2007-12-01

    The sediments of the Galician continental margin (NW Spain) exhibit great but variable degrees of early diagenetic dissolution of magnetic minerals. This process completely erases any detrital magnetic signal at time-scales that range from about 1,000 years to less than 50 years in the highly productive estuarine-like environment of the Galician Rias Baixas. The more open marine conditions encountered in the adjoining continental shelf exhibit however a significantly different behavior. The singular balance between early diagenetic dissolution and lower sedimentation rates allows partial and variable preservation of the also variable detritally controlled magnetic inputs. In this context it is possible to reconstruct the recent environmental history of the area attending to the changes in the concentration of magnetically-interesting iron oxides. High-resolution magnetic and geochemical measurements carried out in 6 cores from the continental self evidenced the occurrence of correlatable peaks of magnetic mineral concentration that were interpreted as periods of enhanced detrital input. Magnetically depleted sediments were related to lower detrital input and/or to enhanced productivity that intensified the reductive conditions. The magnetic concentration peaks occurred within the Medieval (MWP) and Roman Warm Periods. Similar concentrations of hematite in the MWP and the RWP suggest that the lower concentration-dependent magnetic properties in the RWP are most likely caused by a greater degree of dissolution of magnetic detrital oxides due to a longer exposure to reducing conditions. These features could be traced over all the studied area, despite the great heterogeneity of the shelf sediments. This highlights the potential of magnetic properties as proxies of paleoenvironmental conditions in areas of similar complexity. This approach can be used as a rapid and cost-effective tool to screen large areas in the search for suitable settings for more precise, but time-consuming analysis, as well to extrapolate results through correlation of the appropriate magnetic features. We thank Prof. T. von Dobeneck and Dr. M. Dekkers for their kind support and advice during the stays of K. Mohamed in Bremen and Utrecht. The research of K. Mohamed in Bremen was funded by the EU Paleostudies program.

  15. Evolution, stress, and sensitive periods: the influence of unpredictability in early versus late childhood on sex and risky behavior.

    PubMed

    Simpson, Jeffry A; Griskevicius, Vladas; Kuo, Sally I-Chun; Sung, Sooyeon; Collins, W Andrew

    2012-05-01

    According to a recent evolutionary life history model of development proposed by Ellis, Figueredo, Brumbach, and Schlomer (2009), growing up in harsh versus unpredictable environments should have unique effects on life history strategies in adulthood. Using data from the Minnesota Longitudinal Study of Risk and Adaptation, we tested how harshness and unpredictability experienced in early childhood (age 0-5) versus in later childhood (age 6-16) uniquely predicted sexual and risky behavior at age 23. Findings showed that the strongest predictor of both sexual and risky behavior was an unpredictable environment between ages 0 and 5. Individuals exposed to more unpredictable, rapidly changing environments during the first 5 years of life displayed a faster life history strategy at age 23 by having more sexual partners, engaging in more aggressive and delinquent behaviors, and being more likely to be associated with criminal activities. In contrast, exposure to either harsh environments or experiencing unpredictability in later childhood (age 6-16) was, for the most part, not significantly related to these outcomes at age 23. Viewed together, these findings show that unpredictable rather than merely harsh childhood environments exert unique effects on risky behavior later in life consistent with a faster life history strategy. The findings also suggest that there is a developmentally sensitive period for assessing environmental unpredictability during the first 5 years of life. PMID:22329381

  16. The obstetrical and postpartum benefits of continuous support during childbirth.

    PubMed

    Scott, K D; Klaus, P H; Klaus, M H

    1999-12-01

    The purpose of this article is to review the evidence regarding the effectiveness of continuous support provided by a trained laywoman (doula) during childbirth on obstetrical and postpartum outcomes. Twelve individual randomized trials have compared obstetrical and postpartum outcomes between doula-supported women and women who did not receive doula support during childbirth. Three meta-analyses, which used different approaches, have been performed on the results of the clinical trials. Emotional and physical support significantly shortens labor and decreases the need for cesarean deliveries, forceps and vacuum extraction, oxytocin augmentation, and analgesia. Doula-supported mothers also rate childbirth as less difficult and painful than do women not supported by a doula. Labor support by fathers does not appear to produce similar obstetrical benefits. Eight of the 12 trials report early or late psychosocial benefits of doula support. Early benefits include reductions in state anxiety scores, positive feelings about the birth experience, and increased rates of breastfeeding initiation. Later postpartum benefits include decreased symptoms of depression, improved self-esteem, exclusive breastfeeding, and increased sensitivity of the mother to her child's needs. The results of these 12 trials strongly suggest that doula support is an essential component of childbirth. A thorough reorganization of current birth practices is in order to ensure that every woman has access to continuous emotional and physical support during labor. PMID:10643833

  17. 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.

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

    PubMed

    Muñoz-Rodríguez, José 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

  19. 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

  20. 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

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

    PubMed Central

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

    2016-01-01

    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] = 483±25.7 kg) and the treatment (Cr-Met feeding for 4 months, 4CM, ave. BW = 486±27.5 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

  2. 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

  3. 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 (1–10 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

  4. [Do's and don'ts in post-partum contraception].

    PubMed

    Buhler, M

    1985-10-01

    It is sometimes difficult to plan contraception with a woman who has just delivered a baby, because she is sometime not motivated in the week following delivery, feeling unable to contemplate intercourse because of perineal pain and other discomforts. Effective contraception should be used beginning with the 25th postpartum day because of the subsequent strong possibility of ovulation before the return of menstruation. The woman should be provided with as much information on contraception as possible during this period, and possible contraindications to specific methods should be sought, such as thromboembolic accidents, hyperlipidemia, hypertension, diabetes, infection, ectopic pregnancy, abortion, and desire for subsequent pregnancy. No request for contraception should be ignored and the same method should not be imposed on all women. The topic of contraception should not be deferred until the postpartum check-up in the 2nd month, because 50% of women will have had intercourse by the end of the 2nd month, often unprotected. Local methods such as spermicides and condoms are effective when the couple is motivated and they are well accepted. The thromboembolic risk appears minimal when oral contraceptives (OCs) are begun on the 15th postpartum day for non-breastfeeding women. OCs should not be prescribed for women after prolonged bedrest, and women who previously used pills should have lipid and glucose tests before the 2nd month postpartum consultation. The low dose progestin pill should be preferred to the low dose combined pill if a potential thromboembolic risk exists. Infants of breastfeeding women using pills receive 1/500 of the estrogen dose administered to the mother and 1/1000 of the progestin dose. No effects of these doses have been found on the growth or genital development of infants, and modifications of milk composition are not constant. A low dose progestin pill beginning on postpartum day 20 may however be preferred. It is better to await the return of menses before inserting an IUD because of the danger of expulsion prior to that time. Local methods should not be the only ones recommended in the immediate postpartum period because of the possibility of poor acceptance and unwanted pregnancy resulting from incorrect use. Very high dose OCs should not be prescribed. Long acting injectable progestins should be avoided for breastfeeding women except in cases of serious psychic disturbance because the quantity of hormones entering the milk is much greater than with pills. PMID:12267712

  5. Should antiplatelet therapy be interrupted in drug eluting stent recipients throughout the periendoscopic period? A very late stent thrombosis case report and review of the literature.

    PubMed

    Dong, Peng; Yang, Xin-Chun; Bian, Su-Yan

    2014-09-01

    In-stent thrombosis after cessation of antiplatelet medications in patients with drug-eluting stents (DES) is a significant problem in medical practice, particularly in the perioperative period. We report a case of an 87-year-old man with a medical history of hypertension, coronary artery disease and chronic atrophic gastritis. Very late thrombosis of a sirolimus-eluting stent occurred 1207 days after implantation, seven months after discontinuation of clopidogrel, and the interruption of aspirin 13 days in preparation of an elective endoscopic gastrointestinal procedure presented with acute myocardial infarction. The patient was treated with thrombectomy and successfully revascularized with superimposition of two sirolimus-eluting stents. Medications administered in the catheterization laboratory included low molecular weight heparin and nitroglycerin. Flow was defined as grade 2 according to the thrombolysis in myocardial infarction scale. Electrocardiogram after the procedure revealed persistent, but decreased, ST-segment elevation in the anterolateral leads. The patient recovered and was discharged on aspirin and clopidogrel indefinitely. There was no cardiac event during the two year follow-up period. This case underlines the importance of maintaining the balance of thrombosis and bleeding during perioperation of non-cardiac procedure and the possible need for continuation of aspirin therapy during periendoscopic procedures among patients with low bleeding risks who received DES. PMID:25278977

  6. The Effects of Rhodobacter capsulatus KCTC-2583 on Cholesterol Metabolism, Egg Production and Quality Parameters during the Late Laying Periods in Hens.

    PubMed

    Lokhande, Anushka; Ingale, S L; Lee, S H; Kim, J S; Lohakare, J D; Chae, B J; Kwon, I K

    2013-06-01

    An experiment was conducted to investigate the effects of dietary supplementation of Rhodobacter capsulatus KCTC-2583 on egg-yolk and serum cholesterol, egg production and quality parameters during the late laying periods in hens. A total of 160 Hy-Line Brown layers (54 wk-old) were randomly allotted to 4 treatment groups on the basis of laying performance. Each treatment had 4 replicates with 10 birds each (40 birds per treatment). Two hens were confined individually with cage size 35×35×40 cm and each 10 birds (5 cages) shared a common feed trough between them forming one experimental unit. Dietary treatments were; basal diet supplemented with 0 (control), 0.05, 0.10 and 0.15% R. capsulatus KCTC-2583. Experimental diets were fed in meal form for 56 d. Dietary supplementation of increasing levels of R. capsulatus KCTC-2583 reduced (linear, p<0.05) egg-yolk cholesterol and triglycerides (d 28, 42 and 56) concentrations. Also, serum cholesterol and triglycerides (d 21, 42 and 56) concentrations were linearly reduced (p<0.05) with increasing dietary R. capsulatus KCTC-2583. Laying hens fed a diet supplemented with increasing levels of R. capsulatus KCTC-2583 had increased (linear; p<0.05) overall egg production, egg weight, egg mass and feed efficiency. However, dietary treatments had no effect (linear or quadratic; p>0.05) on feed intake of laying hens. At d 28 and 56, breaking strength and yolk colour of eggs were linearly improved (p<0.05) in laying hens fed dietary increasing levels of R. capsulatus KCTC-2583. Dietary treatment had no effects (linear or quadratic; p>0.05) on albumin height, shell thickness and shell weight at any period of experiment. These results indicate that dietary supplementation of R. capsulatus KCTC-2583 has the potential to improve the laying hen performance and lead to the development of low cholesterol eggs during late laying period in Hy-Line Brown hens. PMID:25049857

  7. Malpositioned IUCD: the menace of postpartum IUCD insertion.

    PubMed

    Nigam, Aruna; Ahmad, Ayesha; Gupta, Neha; Kumari, Archana

    2015-01-01

    Use of a postpartum intrauterine contraceptive device (PPIUCD) is a highly effective, reversible and long-acting family planning method that can be initiated in the immediate postpartum period, especially in lactating women. PPIUCDs have been inserted in more than 65,000 women worldwide and the numbers are increasing with many countries introducing PPIUCDs as part of their family planning programme. As the numbers of PPIUCD insertions are increasing, we are getting wiser regarding complications of this procedure. One of the less-understood entities is a malpositioned PPIUCD, a situation where the IUCD is present inside the uterus but its placement is eccentric and a part or the whole of it may be embedded in the myometrium. It can present as lost strings or as a failure to remove the intrauterine device. We present a series of cases with malpositioned PPIUCDs and their management. PMID:26290564

  8. A qualitative meta-synthesis and theory of postpartum depression.

    PubMed

    Mollard, Elizabeth K

    2014-09-01

    To synthesize existing qualitative literature on the first-hand experiences of women suffering from postpartum depression (PPD), to uncover potential common themes, a meta-synthesis of 12 qualitative studies using Noblit and Hare's 7-phase model of meta-ethnography was used. Four themes were discovered: crushed maternal role expectation, going into hiding, loss of sense of self, intense feelings of vulnerability, plus practical life concerns. A preliminary theory of PPD as a 4-step process is proposed, based on the relationships between the themes in this meta-synthesis. This 4-step process is compared and contrasted with Cheryl Tatano Beck's 4-stage theory of PPD "Teetering on the Edge". This meta-synthesis and theory offers a significant contribution to the literature in helping identify PPD distinctly from depression outside of the postpartum period, and deserves further study. PMID:25162187

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. A systematic review of interventions to improve postpartum retention of women in PMTCT and ART care

    PubMed Central

    Geldsetzer, Pascal; Yapa, H Manisha N; Vaikath, Maria; Ogbuoji, Osondu; Fox, Matthew P; Essajee, Shaffiq M; Negussie, Eyerusalem K; Bärnighausen, Till

    2016-01-01

    Introduction The World Health Organization recommends lifelong antiretroviral therapy (ART) for all pregnant and breastfeeding women living with HIV. Effective transitioning from maternal and child health to ART services, and long-term retention in ART care postpartum is crucial to the successful implementation of lifelong ART for pregnant women. This systematic review aims to determine which interventions improve (1) retention within prevention of mother-to-child HIV transmission (PMTCT) programmes after birth, (2) transitioning from PMTCT to general ART programmes in the postpartum period, and (3) retention of postpartum women in general ART programmes. Methods We searched Medline, Embase, ISI Web of Knowledge, the regional World Health Organization databases and conference abstracts for data published between 2002 and 2015. The quality of all included studies was assessed using the GRADE criteria. Results and Discussion After screening 8324 records, we identified ten studies for inclusion in this review, all of which were from sub-Saharan Africa except for one from the United Kingdom. Two randomized trials found that phone calls and/or text messages improved early (six to ten weeks) postpartum retention in PMTCT. One cluster-randomized trial and three cohort studies found an inconsistent impact of different levels of integration between antenatal care/PMTCT and ART care on postpartum retention. The inconsistent results of the four identified studies on care integration are likely due to low study quality, and heterogeneity in intervention design and outcome measures. Several randomized trials on postpartum retention in HIV care are currently under way. Conclusions Overall, the evidence base for interventions to improve postpartum retention in HIV care is weak. Nevertheless, there is some evidence that phone-based interventions can improve retention in PMTCT in the first one to three months postpartum. PMID:27118443

  20. 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.

  1. 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

  2. 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

  3. 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

  4. Associations between Maternal Childhood Maltreatment and Psychopathology and Aggression during Pregnancy and Postpartum

    ERIC Educational Resources Information Center

    Lang, Ariel J.; Rodgers, Carie S.; Lebeck, Meredith M.

    2006-01-01

    Objective: This study examines the association between maternal childhood maltreatment and psychopathology and aggression in intimate relationships during pregnancy and the postpartum period. Method: Forty-four pregnant women who were recruited from an obstetric clinic and local advertising periodical completed questionnaires about childhood…

  5. 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.

  6. Pregnancy massage reduces prematurity, low birthweight and postpartum depression.

    PubMed

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria; Deeds, Osvelia; Figueiredo, Barbara

    2009-12-01

    Pregnant women diagnosed with major depression were given 12 weeks of twice per week massage therapy by their significant other or only standard treatment as a control group. The massage therapy group women versus the control group women not only had reduced depression by the end of the therapy period, but they also had reduced depression and cortisol levels during the postpartum period. Their newborns were also less likely to be born prematurely and low birthweight, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales. PMID:19646762

  7. Effects of prepartum diets supplemented with rolled oilseeds on calf birth weight, postpartum health, feed intake, milk yield, and reproductive performance of dairy cows.

    PubMed

    Salehi, R; Colazo, M G; Oba, M; Ambrose, D J

    2016-05-01

    The objectives were to determine the effects of supplemental fat (no oilseed vs. oilseed) during late gestation and the source of fat (canola vs. sunflower seed), on dry matter intake (DMI), plasma metabolite concentrations, milk production and composition, calf birth weight, postpartum health disorders, ovarian function and reproductive performance in dairy cows. Pregnant Holstein cows, blocked by body condition and parity, were assigned to 1 of 3 diets containing rolled canola seed (high in oleic acid; n=43) or sunflower (high in linoleic acid; n=45) at 8% of dry matter, or no oilseed (control; n=43), for the last 35±2 d of pregnancy. After calving, all cows received a common lactation diet. Blood samples were collected at wk -3 (i.e., 2 wk after initiation of prepartum diets) and at wk +1, +2, +3, +4 and +5 postpartum to determine the concentration of fatty acids (mEq/dL), β-hydroxybutyrate (mg/dL), and glucose (mg/dL). Ovarian ultrasonography was performed twice weekly to determine the first appearance of dominant (10mm) and preovulatory-size (≥16mm) follicles, and ovulation. Uterine inflammatory status based on the proportion of polymorphonuclear leukocytes (PMN; subclinical endometritis: >8% PMN) was assessed at d 25±1 postpartum. Significant parity by treatment interactions were observed for DMI and milk yield. Prepartum oilseed supplementation, more specifically sunflower seed supplementation, increased postpartum DMI in primiparous cows without affecting prepartum DMI or milk yield. Contrarily, in multiparous cows, prepartum oilseed supplementation decreased both prepartum and postpartum DMI and milk yield during the first 2 wk. Regardless of parity, prepartum feeding of canola reduced postpartum DMI compared with those fed sunflower. Mean fatty acids concentrations at wk -3 were greater in cows given supplemental oilseed than those fed no oilseeds. Gestation length and calf birth weight were increased in cows given supplemental oilseed prepartum compared with cows fed no oilseeds, and a disproportionate increase in the birth weight of female calves was evident in cows fed oilseed. Total reproductive disorders tended to be greater in cows fed supplemental oilseed than those fed no oilseed (42 vs. 23%). Furthermore, cows fed sunflower seed had greater incidences of dystocia (35 vs. 18%) and total health disorders (52 vs. 32%) than those fed canola seed. Added oilseed and type of oilseed did not affect uterine inflammation at 25±1 d postpartum. Oilseed supplementation did not alter the intervals from calving to establishment of the first dominant follicle, preovulatory-size follicle, and ovulation, nor did it affect fertility (conception rate to first artificial insemination and proportion of pregnant cows by 150 d after calving). In summary, prepartum oilseed supplementation (6.2 to 7.4% ether extract, % of dietary dry matter) decreased DMI during the entire experimental period (pre- and postpartum), decreased milk yield during early lactation in multiparous cows, and increased calf birth weight with no significant improvement in ovarian function and reproductive performance. PMID:26971151

  8. Bone fractures as indicators of intentional violence in the eastern Adriatic from the antique to the late medieval period (2nd-16th century AD).

    PubMed

    Slaus, Mario; Novak, Mario; Bedić, Zeljka; Strinović, Davor

    2012-09-01

    To test the historically documented hypothesis of a general increase in deliberate violence in the eastern Adriatic from the antique (AN; 2nd-6th c.) through the early medieval (EM; 7th-11th c.) to the late-medieval period (LM; 12th-16th c.), an analysis of the frequency and patterning of bone trauma was conducted in three skeletal series from these time periods. A total of 1,125 adult skeletons-346 from the AN, 313 from the EM, and 466 from the LM series-were analyzed. To differentiate between intentional violence and accidental injuries, data for trauma frequencies were collected for the complete skeleton, individual long bones, and the craniofacial region as well as by type of injury (perimortem vs. antemortem). The results of our analyses show a significant temporal increase in total fracture frequencies when calculated by skeleton as well as of individuals exhibiting one skeletal indicator of deliberate violence (sharp force lesions, craniofacial injuries, "parry" fractures, or perimortem trauma). No significant temporal increases were, however, noted in the frequencies of craniofacial trauma, "parry" fractures, perimortem injuries, or of individuals exhibiting multiple skeletal indicators of intentional violence. Cumulatively, these data suggest that the temporal increase in total fracture frequencies recorded in the eastern Adriatic was caused by a combination of factors that included not only an increase of intentional violence but also a significant change in lifestyle that accompanied the transition from a relatively affluent AN urban lifestyle to a more primitive rural medieval way of life. PMID:22552996

  9. 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.

  10. Rare earth element-enriched yeast improved egg production and egg quality in laying hens in the late period of peak egg production.

    PubMed

    Cai, L; Nyachoti, C M; Hancock, J D; Lee, J Y; Kim, Y H; Lee, D H; Kim, I H

    2016-06-01

    The objective of this study was to determine the effects of rare earth element-enriched yeast (RY) on egg production, coefficient of total tract apparent digestibility (CTTAD), egg quality, excreta gas emission and excreta microbiota of laying hens. A total of 216 ISA brown laying hens of 52 weeks of age were used in a 5-week feeding trial and data were collected every week. Birds were randomly allotted to three dietary treatments each with six replicates and 12 hens per replicate. Each cage (38 cm width × 50 cm length × 40 cm height) contained one hen. Treatments consisted of corn-soya bean meal-based diet supplemented with 0, 500 or 1000 mg/kg of RY. From weeks 55 to 56, inclusion of RY linearly increased (p < 0.05) egg production. The CTTAD of nitrogen was increased (linear, p < 0.05) with increasing dietary level of RY. In week 55, yolk height and Haugh units were increased linearly (p < 0.05) with increasing dietary RY content. However, no significant effects were observed in terms of excreta emissions and excreta microbiota in laying hens. In conclusion, dietary supplementation with RY improved egg production and CTTAD of nitrogen and slightly improved egg quality in laying hens of the late period of peak egg production. PMID:26250098

  11. POSTPARTUM DOULAS: MOTIVATIONS AND PERCEPTIONS OF PRACTICE

    PubMed Central

    McComish, Judith Fry; Visger, Joan M.; Rowland, Carolynn A.; Kelleher, Jacqueline

    2010-01-01

    Objective To describe the perceptions of a United States cohort of experienced birth doulas who were among the first in the country to be trained to provide postpartum support. Design A qualitative, longitudinal study using ethnographic methods; participant observation and semi-structured interviews. Setting Midwestern, urban, US; postpartum homecare over three months Participants Four postpartum doulas; 13 families Measurements Participant observation during six postpartum home visits per family; thirteen semi-structured interviews with doulas at the completion of each family’s care; four summative interviews with doulas at the end of the study. Findings When describing their postpartum practice, four themes emerged: supporting women, taking the mother’s perspective, empowering women, and empowering families. When speaking of the motivations three themes emerged: being “called” to practice, interest in preventing negative experiences, and career development. Key conclusions and implications for practice In the US, new mothers see midwives and physicians sporadically after discharge from the hospital. Postpartum doulas fill this gap in continuity of care by providing support for families as they transition to life with their new infant. Understanding the beliefs, values, and practices of these important paraprofessionals will help midwives effectively integrate postpartum doula care into the care of women and infants. PMID:21055853

  12. 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

  13. 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

  14. 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

  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. 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

  17. 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

  18. 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

  19. 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

  20. Adolescent motherhood and postpartum depression.

    PubMed

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

    2005-06-01

    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 and role restriction), maternal competence, weight/shape concerns, and depression. The sample was quite diverse, and no ethnic differences in base rate levels of the variables were detected. Regression analyses indicated that social isolation, maternal competence, and weight/shape concerns predicted unique variance associated with depression level. The findings are discussed in light of future work and the continued need to inform prevention and treatment programs for young mothers. PMID:15901229

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. Effect of postpartum propylene glycol allocation to over-conditioned Holstein cows on concentrations of milk metabolites.

    PubMed

    Bjerre-Harpøth, Vibeke; Storm, Adam C; Vestergaard, Mogens; Larsen, Mogens; Larsen, Torben

    2016-05-01

    The objective of the study was to investigate the effect of propylene glycol (PG) allocation on concentrations of milk metabolites with potential use as indicators of glucogenic status in high yielding postpartum dairy cows. At time of calving, nine ruminally cannulated Holstein cows were randomly assigned to ruminal dosing of 500 g/d tap water (CON, n = 4) or 500 g/d PG (PPG, n = 5). The PG was given with the morning feeding week 1-4 postpartum (treatment period) and cows were further followed during week 5-8 postpartum (follow-up period). All cows were fed the same postpartum diet. Milk samples were obtained at each milking (3 times/d) in the treatment period, and at morning milking during the follow-up period. Weekly blood samples were obtained from -4 to +8 weeks relative to calving and daily blood samples from -7 until +7 d relative to calving. The main effect of PG allocation was an increased glucogenic status, e.g. visualised by a prompt marked increase in blood fructosamine. During the treatment period, milk concentration of free glucose tended to be greater, whereas milk concentrations of isocitrate and BHBA were lower for PPG compared with CON. It is proposed that the ratio between free glucose and isocitrate in milk may be a potential biomarker for glucogenic status in the vulnerable early postpartum period. We will pursue this issue in the future. PMID:27032705

  10. 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

  11. 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

  12. 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

  13. Breastfeeding and Postpartum Depression: An Overview and Methodological Recommendations for Future Research.

    PubMed

    Pope, Carley J; Mazmanian, Dwight

    2016-01-01

    Emerging research suggests that a relationship exists between breastfeeding and postpartum depression; however, the direction and precise nature of this relationship are not yet clear. The purpose of this paper is to provide an overview of the relationship between breastfeeding and postpartum depression as it has been examined in the empirical literature. Also, the potential mechanisms of action that have been implicated in this relationship are also explored. PubMed and PsycINFO were searched using the keywords: breastfeeding with postpartum depression, perinatal depression, postnatal depression. Results of this search showed that researchers have examined this relationship in diverse ways using diverse methodology. In particular, researchers have examined the relationships between postpartum depression and breastfeeding intention, initiation, duration, and dose. Due to a number of methodological differences among past studies we make some recommendations for future research that will better facilitate an integration of findings. Future research should (1) use standardized assessment protocols; (2) confirm diagnosis through established clinical interview when possible; (3) provide a clear operationalized definition for breastfeeding variables; (4) clearly define the postpartum period interval assessed and time frame for onset of symptoms; (5) be prospective or longitudinal in nature; and (6) take into consideration other potential risk factors identified in the empirical literature. PMID:27148457

  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; Gröhn, 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. Breastfeeding and Postpartum Depression: An Overview and Methodological Recommendations for Future Research

    PubMed Central

    Pope, Carley J.; Mazmanian, Dwight

    2016-01-01

    Emerging research suggests that a relationship exists between breastfeeding and postpartum depression; however, the direction and precise nature of this relationship are not yet clear. The purpose of this paper is to provide an overview of the relationship between breastfeeding and postpartum depression as it has been examined in the empirical literature. Also, the potential mechanisms of action that have been implicated in this relationship are also explored. PubMed and PsycINFO were searched using the keywords: breastfeeding with postpartum depression, perinatal depression, postnatal depression. Results of this search showed that researchers have examined this relationship in diverse ways using diverse methodology. In particular, researchers have examined the relationships between postpartum depression and breastfeeding intention, initiation, duration, and dose. Due to a number of methodological differences among past studies we make some recommendations for future research that will better facilitate an integration of findings. Future research should (1) use standardized assessment protocols; (2) confirm diagnosis through established clinical interview when possible; (3) provide a clear operationalized definition for breastfeeding variables; (4) clearly define the postpartum period interval assessed and time frame for onset of symptoms; (5) be prospective or longitudinal in nature; and (6) take into consideration other potential risk factors identified in the empirical literature. PMID:27148457

  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. 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

  19. 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...

  20. 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

  1. 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

  2. Huwa Rog, Parhej, and Desi Dawai: Women's Perceptions of Postpartum Maternal Morbidity and Care in Rajasthan, India.

    PubMed

    Iyengar, Kirti; Pelto, Pertti; Iyengar, Sharad D

    2016-04-01

    Although more maternal deaths occur in the postpartum period, this period receives far less attention from the program managers. To understand how the women and their families perceive postpartum health problems, the culturally derived restrictions, and precautions controlling diets and behavior patterns, we conducted a mixed-method study in Rajasthan, India. The study methods included free listing of maternal morbidity conditions, interviews with 81 recently delivered women, case interviews with eight cases of huwa rog (postpartum illness), and interviews with nine key informants. The study showed that huwa rog refers to a broad category of serious postpartum illness, thought to affect women a few weeks to several months after delivery. Prevention of the illness involves a system of precautions referred to as parhej, which includes a distinctive set of "medicinal dietary items" referred to as desi dawai, or "country medicine," and restrictions about mobility and work patterns of a postpartum woman. This cultural framework around the concept of huwa rog and peoples' beliefs about it are of central importance for planning postpartum health interventions, including place of contact and communication messages. PMID:26984709

  3. 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. PMID:26937161

  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. [Health education in pregnancy and postpartum: meanings attributed by puerperal women].

    PubMed

    Guerreiro, Eryjosy Marculino; Rodrigues, Dafne Paiva; Queiroz, Ana Beatriz Azevedo; Ferreira, Márcia de Assunção

    2014-01-01

    Descriptive study, qualitative, that aimed to capture the content of social representations of puerperal women on health education in pregnancy and postpartum in primary health care. Users were 31 Family Health Centers in Fortaleza, Ceará, over 18 years in the postpartum period, with at least six visits to prenatal and one postpartum consultation. It was held a lexical analysis of data from semi-structured interviews with the software ALCESTE. The representations of puerperal women on health education are linked to institutional educational practices, with emphasis on lectures, family and school education, and community education. It predominate the traditional pedagogy, with the transmission of information, punctual and widespread. It is necessary to change the pedagogical logic, expanding educational groups with knowledge sharing. PMID:24676063

  6. Postpartum behaviour as predictor of weight change from before pregnancy to one year postpartum

    PubMed Central

    2011-01-01

    Background Postpartum weight retention affects many women and increases the risk of becoming overweight. The research objective was to study modifiable factors contributing to weight change at one year postpartum. Methods In this prospective cohort, postpartum behavior, such as physical activity, sedentary behavior, sleep, and intake of total energy, total fat and saturated fatty acids of 118 Dutch women were assessed in 2003/2004 by self-report at 6 weeks, 6 and 12 months postpartum. Mean postpartum scores were computed for the behavioral measures. In linear regression models it was determined which factors were associated with average weight change from before pregnancy to one year postpartum. Furthermore, factors associated with substantial postpartum weight retention (≥ 5 kg) were also studied in logistic regression models. Results At one year postpartum, the average weight of participants had increased by 0.9 kg (SD 4.4). Moreover, 20% of the women retained ≥ 5 kg. Women who perceived themselves more physically active than others were almost ten times less likely to retain ≥ 5 kg than women who perceived themselves equally active (OR = 0.11, 95%CI: 0.02 - 0.66). Exceeding the guideline for saturated fatty acid intake (OR = 3.40, 95%CI: 1.04 - 11.11), total gestational weight gain (OR = 1.14/kg, 95%CI: 1.01 - 1.27), and not having completed post high school education (OR = 5.13, 95%CI: 1.66 - 15.90) increased the odds of retaining ≥ 5 kg. Conclusions Since one in five women had substantial weight retention postpartum, effective interventions for the prevention of weight retention are much needed. Future studies should evaluate whether interventions focusing on the identified modifiable postpartum factors are successful in reducing weight retention after childbirth. PMID:21410953

  7. 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

  8. 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.

  9. 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.

  10. Effects of dietary L-arginine on laying performance and antioxidant capacity of broiler breeder hens, eggs, and offspring during the late laying period.

    PubMed

    Duan, Xiaoxue; Li, Feng; Mou, Shaoyang; Feng, Jiawei; Liu, Peifeng; Xu, Liangmei

    2015-12-01

    The effects of maternal L-arginine supplementation on laying performance and the antioxidant capacity of broiler breeder hens, egg yolk, and their one-day-old offspring were investigated. In a 9 wk experiment, 210 60-week-old Arbor Acres healthy female broiler breeders were randomly divided into 5 treatments with 6 replicates of 7 females and fed a corn and soybean meal diet with 5 arginine levels (0.96%, 1.16%, 1.36%, 1.56%, and 1.76% digestible arginine). Laying performance and anti-oxidant capacity of broiler breeder hens, eggs, and offspring were evaluated. Digestible arginine level in the broiler breeder diet had a significant effect on the laying rate (linear and quadratic effect, P<0.0001). The highest laying rate was obtained when the diet with 1.36% digestible arginine was fed. There was a significant effect of digestible arginine level in the broiler breeder diet on the total antioxidant capacity (T-AOC) levels and methane dicarboxylic aldehyde (MDA) concentration in the broiler breeder serum, egg yolk and serum, and liver and breast of one-day-old offspring (linear and quadratic effect, P<0.05). The T-AOC level was highest and the MDA concentration lowest in all tissues when a diet with 1.36% digestible arginine was fed. No difference in glutathione peroxidase (GSH-PX) activity in the broiler breeder serum was observed. There were significant effects of digestible arginine level in the broiler breeder diet on the GSH-PX activity of the egg yolk (linear effect, P<0.01; quadratic effect, P<0.05) and serum, liver, and breast of one-day-old offspring (linear and quadratic effect, P≤0.01). The GSH-PX activity in all tissues measured in this experiment was highest when the dietary digestible arginine was 1.36%. These results indicate that the diet with 1.36% digestible arginine (1,972 mg/d) is optimal to satisfy the nutritional needs of a female broiler breeder during the late laying period. PMID:26467009

  11. [Editing style of Imwon-Gyeongjeji, Inje-ji and inclusion of the medicinal knowledge of the late period of Joseon - Comparing mainly with Dongui-Bogam -].

    PubMed

    Jeon, Jongwook; Jo, Changrock

    2012-12-01

    Imwon-Gyeongjeji which was created by Seo Yu-gu in the first half of the 19th century is a encyclopedia of practical use in rural life. It consists of 113 volumes, 16 fields, and 2.52 million total characters. Of these, the field of medicine comes 11th of the contents covering 28 volumes and 1.1 million characters. Its name is Inje-ji. This paper examines the academic background of Seo Yu-gu and his life work briefly, and investigates the characteristics of medical knowledge of late Joseon period contained in the Imwon-Gyeongjeji, Inje-ji Here, we made key comparisons especially with Dongui-Bogam, Joseon's leading medical book. Of the pioneers of medical history studies of Joseon, a Japanese researcher Miki Sakae has made a negative evaluation to Inje-ji. But after concrete investigation we have come to conclude as follows. First, familial ancestors of Seo Yu-gu were engaged in the introduction of foreign-language books, so Seo Yu-gu as an officer of proof-reading and editing of the various books, also had a lot of knowledge on the medical books ever in history. On this background and experience, for over 36 years from 1,806 retirement from official position to his death, he had compiled and edited Imwon-Gyeongjeji. Second, unlike Dongui-Bogam which included improving health skill, Inje-ji focused on curing medicine readily accessible from the major population of that time. Its main features are as follows: i) prescriptions directly linked to the diseases and symptoms, ii) greatly increased medicinal knowledge especially on infectious diseases and trauma, iii) detailed index easy to look up for prescription and iv) his 'own opinions'[an-seol] which can indicate relevant contents within the book and organically combines the whole knowledge in it. Third, "Inje-ji" utilizing medical books in China and Korea even those of Japan, collected more massively almost all the medical knowledge, new illness, herbs of local area, private prescription. Meanwhile Inje-ji modified the errors of the older medical books like Dongui-Bogam or Bencao-Gangmu, expressed its own subjective views about controversial topics. In summary "Inje-ji" can be the last general medical book which collected and edited almost all the medical knowledge of the period in the East Asia with its own editing format. In addition it is recognized that it pursued an evidence-based medicine and the practical medicine relieving the people, rather than medico-philosophical theories in oriental traditional medicine which was criticized by many critical intellectuals afterwards. Given the scrutiny, it seems that evaluation of the "Inje-ji" by Miki Sakae should be revised by thorough investigations. We are just on the starting line of the Inje-ji research in earnest meaning, and expect this research would give more fruitful and deep perspective in the area of Korea history of medicine. PMID:23388488

  12. Postpartum corticosterone administration reduces dendritic complexity and increases the density of mushroom spines of hippocampal CA3 arbours in dams.

    PubMed

    Workman, J L; Brummelte, S; Galea, L A M

    2013-02-01

    Postpartum depression (PPD) affects approximately 15% of mothers after giving birth. A complete understanding of depression during the postpartum period has yet to be established, although disruptions in the hypothalamic-pituitary-adrenal axis and stress during the postpartum may be involved. To model these components in rats, we administered high corticosterone (CORT) postpartum, which increases immobility in the forced swim test (FST), and reduces maternal care, body weight and hippocampal cell proliferation in dams. The hippocampus is altered in response to chronic stress, exposure to high glucocorticoids and in major depression in humans. In the present study, we examined whether high CORT reduced dendritic complexity and spines in the CA3 region of the hippocampus. Additionally, housing complexity was manipulated so that dams and litters were housed either with tubes (complex) or without tubes (impoverished) to investigate the consequences of new animal care regulations. Dams received 40 mg/kg/day of CORT or oil starting on day 2 postpartum for 23 days. Maternal behaviours were assessed on postpartum days 2-8 and dams were tested using the FST on days 21 and 22. Dams were killed on day 24 and brains were processed for Golgi impregnation. Pyramidal cells in the CA3 subfield were traced using a camera lucida and analysed for branch points and dendritic complexity, as well as spine density and type on both basal and apical arbours. As previously established, high CORT postpartum reduced maternal care and increased immobility in the FST, which is a measure of depressive-like behaviour. High CORT postpartum reduced the complexity of basal arbours and increased mushroom spines on both apical and basal dendrites. Housing complexity had no effect on spines of CA3 pyramidal cells but modest effects on cell morphology. These data show that chronic high CORT in postpartum females alters hippocampal morphology and may provide insight regarding the neurobiological consequences of high stress or CORT during the postpartum period, as well as be relevant for postpartum stress or depression. PMID:22935038

  13. Depression Screening Should Include All Pregnant, Postpartum Women: Panel

    MedlinePlus

    ... news/fullstory_156904.html Depression Screening Should Include All Pregnant, Postpartum Women: Panel As many as 1 ... 26, 2016 TUESDAY, Jan. 26, 2016 (HealthDay News) -- All U.S. adults, including pregnant and postpartum women, should ...

  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. 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

  17. α-Methyldopa-induced hepatitis during the postpartum period

    PubMed Central

    Kashkooli, Soleiman; Baraty, Brandon; Kalantar, Jamshid

    2014-01-01

    A 34-year-old woman, with a history of pre-eclampsia, was diagnosed with α-methyldopa-induced hepatotoxicity, after she presented with severe jaundice and hepatitis 8 weeks following delivery. Laboratory investigations and liver biopsy ruled out other causes of hepatitis. She continued to improve clinically after cessation of α-methyldopa, and was discharged 10 days after admission. This case report emphasises that it may not be possible to predict which patients may develop α-methyldopa-induced hepatitis, hence regular monitoring of liver function tests during treatment should be implemented. PMID:24577181

  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. [Anesthesiological approach to postpartum hemorrhage].

    PubMed

    Knapp, J; Hofer, S; Lier, H

    2016-03-01

    Peripartum hemorrhage (PPH) is a frequent obstetric emergency situation with increasing incidence in the last decades. It requires a fast, coordinated and interdisciplinary management. This life-threatening situation is often recognized too late and not adequately treated (too little is done too late); therefore, it is important to be aware of the most important risk factors for PPH known as the 4 Ts (i.e. tonus, trauma, tissue and thrombin). Due to the special patient population there is only little evidence-based data on hemostatic therapy in this situation; therefore, the currently available studies on the therapy of PPH is discussed. PMID:26955831

  20. 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.

  1. 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

  2. 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...

  3. Magnitudes, rates and periodicities of early Late Cretaceous sea-level changes: evidence from sedimentary basin in Europe, northern Africa and the Middle East

    NASA Astrophysics Data System (ADS)

    Wilmsen, Markus; Richardt, Nadine

    2013-04-01

    Despite the mid-Cretaceous super-greenhouse with generally rising and high sea-level stands, the Cenomanian-Turonian interval (C-T, early Late Cretaceous, ~100-90 ma) was repeatedly punctuated by large and rapid sea-level drops, the reasons of which are still poorly understood. In order to test the isochrony of those early Late Cretaceous sea-level changes, an interplate sequence stratigraphic study of selected Cenomanian-Turonian basins on different tectonic plates (Europe, northern Africa, Middle East) has been conducted. Well exposed shelf sections have stratigraphically been calibrated and correlated by means of integrated approaches, especially high-resolution ammonoid biostratigraphy, carbon stable isotopes and cyclostratigraphy. In combination with analyses of (bio-)facies and stratal architectures (such as on-/offlap geometries or incision at sequence boundaries), a precise correlation of unconformities and an assessment of the magnitudes of sea-level changes involved in their formation has been possible. High-resolution orbital time-scales provide the possibilities to elucidate the rates of sea-level change. The study shows that C-T sea-level changes have in fact been strictly time-equivalent and iso-directional on different tectonic plates. Major sea-level falls, resulting in the development of depositional sequence (i.e., 3rd-order) bounding unconformities occurred in the latest Albian, the mid- and latest Early Cenomanian, the late Middle and mid-Late Cenomanian, the Lower-Middle Turonian boundary interval, the Middle Turonian as well as the early, mid-and late Late Turonian. Especially the sea-level falls were of high-magnitude and short duration (tens of metres in less than 100 kyr). The resulting rates of sea-level change are in the order of 150-1000 m/myr and can only be explained by glacio-eustasy (or a yet unknown process). The study also showed a regular temporal recurrence of unconformities and suggests that early Late Cretaceous 3rd-order sequences developed by low-frequency modulations of the Milankovitch oscillations, i.e. the nodes of obliquity cycle (ca. 1.2 myr), regularly amplified by the ca. 2.4 myr minima of Earth' eccentricity. High-frequency sequences, controlled by the ca. 400-kyr-long eccentricity cycle, are components of the depositional sequences. The study thus perfectly integrates the hitherto conflicting approaches of high-frequency and depositional sequence stratigraphy.

  4. 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

  5. The role of reproductive hormones in postpartum depression.

    PubMed

    Schiller, Crystal Edler; Meltzer-Brody, Samantha; Rubinow, David R

    2015-02-01

    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 nonhuman 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, hypothalamic-pituitary-adrenal (HPA) axis function, lactogenic hormones, and genetic expression that may contribute to affective dysfunction. There are 3 primary lines of inquiry that have addressed the role of reproductive hormones in PPD: nonhuman 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. Use of primary health care prior to a postpartum psychiatric episode

    PubMed Central

    Pedersen, Henrik Søndergaard; Laursen, Thomas Munk; Fenger-Grøn, Morten; Vedsted, Peter; Vestergaard, Mogens

    2015-01-01

    Objective. Childbirth is a strong trigger of psychiatric episodes. Nevertheless, use of primary care before these episodes is not quantified. The aim was to study the use of general practice in Denmark from two years before to one year after childbirth in women who developed postpartum psychiatric disorders. Design. A matched cohort study was conducted including women who gave birth in the period 1996–2010. Women were divided into four groups: (i) all mothers with postpartum psychiatric episodes 0–3 months after birth, n = 939; 2: All mothers with a postpartum psychiatric episode 3–12 months after birth, n = 1 436; and (iii) two comparison groups of mothers, total n = 6 630 among 320 620 eligible women. Setting. Denmark. Subjects. Women born in Denmark after 1 January 1960, restricting the cohort to women who gave birth to their first singleton child between 1 January 1996 and 20 October 2010. Main outcome measures. The main outcome measures were consultation rates, consultation rate ratios, and rate differences. Results. Women who developed a psychiatric episode after childbirth had higher GP consultation rates before, during, and after the pregnancy. Women with a psychiatric episode 0–3 months postpartum had 6.89 (95% CI 6.60; 7.18) mean number of consultations during pregnancy, corresponding to 1.52 (95% CI 1.22; 1.82) more visits than the comparison group. Conclusion. Women with a postpartum psychiatric episode had higher use of GP-based primary health care services years before the childbirth, and in this specific group of patients childbirth itself triggered a marked increase in the number of GP contacts postpartum. PMID:26174691

  12. Prepartum and postpartum rumen fluid microbiomes: characterization and correlation with production traits in dairy cows.

    PubMed

    Lima, Fabio S; Oikonomou, Georgios; Lima, Svetlana F; Bicalho, Marcela L S; Ganda, Erika K; Filho, Jose C de Oliveira; Lorenzo, Gustavo; Trojacanec, Plamen; Bicalhoa, Rodrigo C

    2015-02-01

    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

  13. 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

  14. Intimate partner violence during pregnancy and the first year postpartum in an Australian pregnancy cohort study.

    PubMed

    Gartland, D; Hemphill, S A; Hegarty, K; Brown, S J

    2011-07-01

    To assess intimate partner violence (IPV) in a longitudinal cohort study during and after pregnancy, and examine social and economic factors encouraging or inhibiting violence. Nulliparous women were recruited from 6 public hospitals in Melbourne, Australia. Self-administered questionnaires included standardised measures assessing fear of an intimate partner at enrolment, 6 and 12 months postpartum; and period prevalence of physical and emotional abuse in the first 12 months postpartum. 1,507 women completed baseline data (mean gestation 15 weeks). Response fractions at 3, 6 and 12 months postpartum were 95, 93 and 90%, respectively. 5.1 and 5.4% of women reported fear in pregnancy and the first year postpartum, respectively. 17% experienced physical and/or emotional abuse in the first year postpartum. Most women who reported fear of an intimate partner in the first year after the index birth reported fear before and/or during pregnancy. Women working in early pregnancy who qualified for paid maternity leave had significantly reduced odds of reporting combined physical and emotional IPV in the first 12 months postpartum compared with women not working (Adj. OR 0.21, 95% CI 0.08-0.55). Women working but not eligible for paid leave had reduced odds compared with women not working (Adj. OR 0.49, 95% CI 0.24-1.00). Models adjusted for maternal age, relationship status, income and education level. Few first time mothers reported fear for the first time after childbirth suggesting that IPV more commonly commences prior to the first birth. Paid maternity leave may have broader social benefits beyond immediate financial benefits to women and families. PMID:20628799

  15. Gestational and Postpartum Weight Change Patterns in Mothers with Eating Disorders

    PubMed Central

    ZERWAS, Stephanie C.; VON HOLLE, Ann; PERRIN, Eliana M.; SKINNER, Asheley Cockrell; REBA-HARRELSON, Lauren; HAMER, Robert M.; STOLTENBERG, Camilla; TORGERSEN, Leila; REICHBORN-KJENNERUD, Ted; BULIK, Cynthia M.

    2014-01-01

    Background Although pregnancy can be associated with adaptive changes in weight and eating behavior for women with eating disorders, less is known about whether these changes are maintained in the postpartum period. We used a longitudinal design to examine gestational and postpartum weight trajectories in mothers with and without eating disorders in the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Methods Fifty-six women reported anorexia nervosa (AN), 636 bulimia nervosa (BN), 3,327 binge eating disorder (BED), and 69 EDNOS purging type (EDNOS-P). The referent group included 61,233 mothers with no eating disorder. We used a mixed effects model to predict weight change over time by eating disorder subtype. Results Mothers with AN, BN, BED and EDNOS had greater increases in BMI during pregnancy and greater decreases in BMI over the first six months postpartum. Women with AN shifted from the underweight BMI range before pregnancy to the normal weight range at 36 months postpartum Conclusions Patterns of maternal weight gain and retention during the perinatal period vary across eating disorder subtype and warrant clinical attention. PMID:25201473

  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

    Sepúlveda-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. 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

  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 Women’s and Children’s Health Research’s 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. 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

  2. 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

  3. Treating postpartum depression and anxiety naturally.

    PubMed

    Zauderer, Cheryl; Davis, Wendy

    2012-01-01

    Postpartum depression and or perinatal mood disorders are complex phenomena with numerous interrelated factors. Approximately 13% of women experience some degree of depression following childbirth. Mental health professionals have described postpartum depression as encompassing a variety of syndromes and as ranging from mild depression and anxiety to more severe forms of emotional disorders. Evidence is accumulating that postpartum depression/perinatal mood disorders may adversely affect the mother-child relationship, and that it may also have long-term effects on the child if the mother does not receive treatment. Postpartum depression and anxiety disorders can have devastating effects on the mother, her baby, and the entire family. Frontline management typically includes medication, therapy, and social support. However, many women feel conflicted about using psychotropic medications during pregnancy and breastfeeding and are interested in learning about alternative therapies. If a pregnant or breastfeeding mother is prescribed psychiatric medications, she may not follow the prescription and may also be afraid to tell her provider. Women may refuse medications, even after weighing the pros and cons and safety issues with health care providers. For mild to moderate depression and anxiety, nonpharmacological choices need to be available for these women to provide them with alternative options and to encourage adherence to treatment. PMID:22694865

  4. Pelvic organ support in pregnancy and postpartum.

    PubMed

    O'Boyle, Amy L; O'Boyle, John D; Calhoun, Byron; Davis, Gary D

    2005-01-01

    The purpose of this study was to evaluate pelvic organ support during pregnancy and following delivery. This was a prospective observational study. Pelvic organ prolapse quantification (POPQ) examinations were performed during each trimester of pregnancy and in the postpartum. Statistical comparisons of POPQ stage and of the nine measurements comprising the POPQ between the different time intervals were made using Wilcoxon's signed rank and the paired t-test. Comparison of POPQ stage by mode of delivery was made using Fisher's exact test. One hundred thirty-five nulliparous women underwent 281 pelvic organ support evaluations. During both the third trimester and postpartum, POPQ stage was significantly higher compared to the first trimester (p<0.001). In the postpartum, POPQ stage was significantly higher in women delivered vaginally compared to women delivered by cesarean (p=0.02). In nulliparous pregnant women, POPQ stage appears to increase during pregnancy and does not change significantly following delivery. In the postpartum, POPQ stage may be higher in women delivered vaginally compared to women delivered by cesarean. PMID:15647966

  5. In oculo transplants of myometrium from postpartum guinea pigs fail to support sympathetic reinnervation

    PubMed Central

    BRAUER, M. MONICA; BURNSTOCK, GEOFFREY; THRASIVOULOU, CHRISTOPHER; COWEN, TIMOTHY

    1998-01-01

    Sympathetic nerves to the enlarged fetus-containing region of the uterus undergo degenerative changes during late pregnancy and show slow regrowth after parturition. It is not known whether this unusual response of sympathetic nerves to smooth muscle hypertrophy is due to the sensitivity of short adrenergic neurons to hormonal changes, or whether the nerves respond to changes in the neurotrophic capacity of the target. We have investigated this question using in oculo transplantation. Small pieces of myometrium from the uterine horn of virgin guinea pigs, or from the region previously occupied by the placenta and fetus in postpartum guinea pigs, were transplanted into the anterior eye chamber. After 3 wk in oculo, the pattern of reinnervation of the transplants was assessed on whole mount stretch preparations stained for tyrosine hydroxylase. The histology of the transplants was examined in toluidine blue-stained semithin sections. Myometrial transplants from virgin donors and uterine artery transplants from both virgin and postpartum donors became organotypically reinnervated by sympathetic fibres from the host iris. In contrast, sympathetic nerves did not reinnervate myometrial transplants from postpartum donors, although they approached the transplants and became distributed in the surrounding connective tissue. All transplanted tissues showed a normal histological appearance. Both the myometrium and uterine artery from postpartum donors retained a hypertrophic appearance after 3 wk in oculo. We interpret these results to indicate that the degeneration of sympathetic nerves in late pregnancy, as well as their slow regrowth to the uterus after delivery, may be due to changes in uterine smooth muscle rather than a particular sensitivity of short adrenergic neurons to hormonal changes. PMID:10029184

  6. 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

  7. 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-Ǻsberg 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

  8. 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

  9. 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

  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. Antenatal Cognitive-behavioral Therapy for Prevention of Postpartum Depression: A Pilot Study

    PubMed Central

    Kwon, Jung Hye; Lee, Jeong Jae

    2008-01-01

    Purpose To examine the efficacy of cognitive-behavioral therapy (CBT) for the prevention of postpartum depression (PPD) in "at risk" women. Materials and Methods We recruited 927 pregnant women in 6 obstetric and gynecology clinics and screened them using Beck Depression Inventory (BDI). Ninety-nine of the screened women who had significantly high scores in BDI (a score above 16) were selected for the study. They were contacted through by telephone, and 27 who had consented to participate in the study were interviewed via SCID-IV-I. Twenty-seven eligible women were randomly assigned to the CBT intervention (n = 15) and control condition (n = 12). All participants were required to complete written questionnaires, assessing demographic characteristics, depressive symptoms, negative thoughts, dyadic communication satisfaction, and global marital satisfaction prior to treatment and approximately 1 month postpartum. The 15 women in the CBT condition received 9 bi-weekly 1-hour individual CBT sessions, targeting and modifying negative patterns of thinking and behaviors occurring in the context of the dyadic relationship. Results The analysis of covariance (ANCOVA) showed that there were significant differences in all postpartum measures between the 2 groups, indicating that our antenatal intervention with CBT was effective in reducing depressive symptoms and improving marital satisfaction, which lasted until the postpartum period. Conclusion Our pilot study has provided preliminary empirical evidence that antenatal CBT intervention can be an effective preventive treatment for PPD. Further study in this direction was suggested. PMID:18729297

  12. Delusions related to infant and their association with mother-infant interactions in postpartum psychotic disorders.

    PubMed

    Chandra, P S; Bhargavaraman, R P; Raghunandan, V N G P; Shaligram, D

    2006-09-01

    The relationship between mother infant interactions and psychopathology in postpartum psychotic disorders has been recognised as being clinically important, however data in the field is sparse. The current study had two aims--firstly, to study the prevalence and nature of delusions towards the infant among mothers with postpartum onset severe mental illness and secondly, to study the association between delusional symptoms towards the infant and mother infant interactions. 108 consecutive women with onset of severe mental illness in the postpartum, who were admitted to an inpatient psychiatric unit in South India over a two-year period, were systematically assessed for presence of delusions related to the infant, using the Kannada version of the Birmingham Interview for Maternal Mental Health. Fifty-three percent of subjects reported delusions related to the infant, with 34% reporting more than one delusion. Mothers with infant related persecutory delusions were more likely to show affectionate behaviour and had normal competence and caring for baby's basic needs; however, they were more likely to get disturbed and agitated if separated from the baby. Mothers who had delusions that the baby was a devil or ill fated or someone else's baby, were more likely to have significant abusive incidents towards the baby. Overall, the mothers who had delusions related to the infant were seen to have more significant abusive incidents and were more likely to be considered unsafe in looking after the baby alone. The study emphasises the need for systematic clinical assessment of psychopathology in mothers with postpartum psychosis. PMID:16937315

  13. 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

  14. 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

  15. 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

  16. Is effective contraceptive use conceived prenatally in Florida? The association between prenatal contraceptive counseling and postpartum contraceptive use.

    PubMed

    Hernandez, Leticia E; Sappenfield, William M; Goodman, David; Pooler, Jennifer

    2012-02-01

    The objective of this study is to describe the prevalence of postpartum contraceptive use among women experiencing a live birth in Florida in 2004-2005. To examine the association between family planning counseling during prenatal care visits and the use of effective contraceptive methods among postpartum women. Matched data from Florida PRAMS and Vital Statistics were used (n = 3,962). Weighted logistic regression was used to determine the association between prenatal family planning counseling and effective postpartum contraceptive use. Odds ratios were adjusted for use of contraception prior to pregnancy, well-baby checkup, race, ethnicity, nativity, education, marital status, poverty level, stress before or during pregnancy, and parity. Women who reported discussing family planning with their prenatal care provider were more likely to use effective contraception postpartum (AOR: 1.5, 1.1-2.0) compared to women who did not report a discussion. Women who used contraception prior to pregnancy (AOR: 2.3, 1.7-3.2) and women who experienced no stress before or during pregnancy (AOR: 2.0, 1.2-3.4) were also more likely to use contraception in the postpartum period. A significant interaction was identified between family planning counseling during prenatal visits and maternal education. Stratum specific odds ratios for women who received prenatal family planning counseling were significant for women with less than high school education (AOR: 2.5, 1.3-5.1) and for women with high school education (AOR: 2.0, 1.2-3.4). Women reporting family planning counseling during prenatal care were more likely to use effective contraception postpartum. While women with high school or less than high school education levels benefited from prenatal family planning counseling, the greatest benefit was observed for women with less than high school education. Integrating family planning counseling into prenatal care may increase the use of effective contraceptive methods among postpartum women. PMID:21197562

  17. 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

  18. 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.

  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. 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.

  1. 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

  2. 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).

  3. [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

  4. 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

  5. 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

  6. 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

  7. GABAergic neuroactive steroids and resting-state functional connectivity in postpartum depression: a preliminary study.

    PubMed

    Deligiannidis, Kristina M; Sikoglu, Elif M; Shaffer, Scott A; Frederick, Blaise; Svenson, Abby E; Kopoyan, Andre; Kosma, Chelsea A; Rothschild, Anthony J; Moore, Constance M

    2013-06-01

    Postpartum depression (PPD) affects up to 1 in 8 women. The early postpartum period is characterized by a downward physiological shift from relatively elevated levels of sex steroids during pregnancy to diminished levels after parturition. Sex steroids influence functional brain connectivity in healthy non-puerperal subjects. This study tests the hypothesis that PPD is associated with attenuation of resting-state functional connectivity (rs-fc) within corticolimbic regions implicated in depression and alterations in neuroactive steroid concentrations as compared to healthy postpartum women. Subjects (n = 32) were prospectively evaluated during pregnancy and in the postpartum with repeated plasma neuroactive steroid measurements and mood and psychosocial assessments. Healthy comparison subjects (HCS) and medication-free subjects with unipolar PPD (PPD) were examined using functional magnetic resonance imaging (fMRI) within 9 weeks of delivery. We performed rs-fc analysis with seeds placed in the anterior cingulate cortex (ACC), and bilateral amygdala (AMYG), hippocampi (HIPP) and dorsolateral prefrontal cortices (DLPFCs). Postpartum rs-fc and perinatal neuroactive steroid plasma concentrations, quantified by liquid chromatography/mass spectrometry, were compared between groups. PPD subjects showed attenuation of connectivity for each of the tested regions (i.e. ACC, AMYG, HIPP and DLPFC) and between corticocortical and corticolimbic regions vs. HCS. Perinatal concentrations of pregnanolone, allopregnanolone and pregnenolone were not different between groups. This is the first report of a disruption in the rs-fc patterns in medication-free subjects with PPD. This disruption may contribute to the development of PPD, at a time of falling neuroactive steroid concentrations. PMID:23499388

  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 =