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Sample records for 3-4 months postpartum

  1. Normative longitudinal maternal sleep: the first four postpartum months

    PubMed Central

    MONTGOMERY-DOWNS, Hawley E.; INSANA, Salvatore P.; CLEGG-KRAYNOK, Megan M.; MANCINI, Laura M.

    2010-01-01

    Objective To describe the normative course of maternal sleep during the first four months postpartum. Study Design Sleep was objectively measured using continuous wrist actigraphy. This was a longitudinal, field-based assessment of nocturnal sleep during postpartum weeks two through 16. Fifty mothers participated during postpartum weeks two through 13; 24 participated during postpartum weeks nine through 16. Results Maternal nocturnal sleep time was 7.2 (SD±.95) hours and did not change significantly across postpartum weeks two through 16. Maternal sleep efficiency did improve across weeks two (79.7% [SD±5.5]) through 16 (90.2% [SD±3.5]) as a function of decreased sleep fragmentation across weeks two (21.7 [SD±5.2]) through 16 (12.8 [SD±3.3]). Conclusion Though postpartum mothers’ total sleep time was higher than expected during the initial postpartum months, this sleep was highly fragmented (similar to fragmenting sleep disorders) and inefficient. This profile of disturbed sleep should be considered in intervention designs and family leave policies. PMID:20719289

  2. A comparison of fatigue and energy levels at 6 weeks and 14 to 19 months postpartum.

    PubMed

    Troy, N W

    1999-05-01

    It has been assumed that women recover from pregnancy and childbirth within 6 weeks. Recent research shows that women's fatigue levels are the same, or higher, at 6 weeks postpartum as at the time of delivery. This study determined the differences in primiparous women's fatigue and energy levels at 6 weeks and 14 to 19 months postpartum. Determinations of how some contributing factors and outcomes of postpartum fatigue relate to each other and to fatigue and energy at 14 to 19 months postpartum were also made. Analyses revealed that women are more fatigued and less energetic at 14 to 19 months than they were at 6 weeks postpartum. Quality of sleep did not correlate with fatigue or energy. At 14 to 19 months postpartum return to full functional status is almost complete, with household and infant care responsibilities being most complete. The women were experiencing mild life crises of various sorts, were somewhat depressed, and were gratified in the mothering role.

  3. Doing the month in a Taiwanese postpartum nursing center: an ethnographic study.

    PubMed

    Yeh, Yueh-Chen; St John, Winsome; Venturato, Lorraine

    2014-09-01

    Traditionally Chinese and Taiwanese postpartum women conducted postpartum ritual practices, called "doing the month," at home. Today, many Taiwanese women undertake this ritual in postpartum nursing centers. However, little is known about how the traditional practices are being transformed in relation to contemporary health care in Taiwan. In this ethnographic study observations were carried out in a large post-partum center attached to a major hospital in Taipei for nine months, and 27 postpartum women were interviewed. Data were analyzed using ethnographic approaches to extract codes and categories. Doing the month was reshaped by being relocated from the home to a healthcare setting. Midwives took on roles traditionally taken by family members, which had an impact on family roles and relationships. Some postpartum practices were maintained, based on traditional explanations. However, many were modified or challenged, based on explanations from contemporary scientific knowledge. Midwives need to be aware that there could be differences between their culture of care and the cultural values of the women they care for. This study informs culturally appropriate postpartum care and support for women with traditional and contemporary cultural beliefs and attitudes to doing the month in a range of healthcare contexts.

  4. School outcomes for minority-group adolescent mothers at 28 to 36 months postpartum: a longitudinal follow-up.

    PubMed

    Leadbeater, B J

    1996-01-01

    This study examines the educational status of 120 adolescent postpartum women in the US during 1987-88. Mothers were 14-19 years old at delivery. 53.1% were African American and 42.5% were Puerto Rican. All but 2 deliveries were first births. 71.7% lived with their own mothers. 64.6% came from families on welfare. The average number of years of completed schooling was 9.5. At 28-36 months postpartum the average age was 19.7 years, 52.4% lived with their mothers, 52.4% lived off their mother's public assistance, and 17.9% supported themselves. 7.9% were married. Interviews were conducted at 3-4 weeks, 6 months, 12 months, and 28-36 months postpartum. 94% had completed interviews by 12 months, and 71% had completed interviews by 28-36 months. 33% of mothers had attended school or graduated through the pregnancy and the last follow-up period. 19% who were not in school at the first birth returned or graduated by 28-36 months postpartum. 12% dropped out before the pregnancy and never returned; 36% dropped out during the pregnancy and never returned. Greater risk of delayed grade placement by 28-36 months was significantly associated with age at delivery and reports of stressful life events 1 year postpartum. Mothers who were more grade-delayed reported more depressive symptoms, more repeat pregnancies, and lower work plans. At 1 year postpartum, school returners reported significantly fewer stresses and more child care support than dropouts. 41% of the mothers had a new mate. 25.7% reported a close relationship with the baby's father. About 80% reported problems with the fathers such as drugs, promiscuity, jail, death, machismo, or physical abuse. Only 39% of attenders had a repeat pregnancy compared to 68% of returners, 93% of dropouts during pregnancy, and 70% of dropouts before pregnancy. Only half of the mothers were likely to pursue educational and occupational goals.

  5. Biopsychosocial determinants of treatment outcome for mood and anxiety disorders up to 8 months postpartum.

    PubMed

    Misri, Shaila; Albert, Gillian; Abizadeh, Jasmin; Kendrick, Kristin; Carter, Diana; Ryan, Deirdre; Oberlander, Tim F

    2012-08-01

    Little is known about the biopsychosocial determinants that predict postpartum treatment outcome for mood and anxiety disorders. Postpartum mood and anxiety symptoms and psychosocial/biological variables were recorded for 8 months of 22 women treated with antidepressants during pregnancy. Depression scores decreased by 58%, whereas anxiety scores decreased by 35%. Family history of psychiatric illness and prior psychiatric illness unrelated to pregnancy predicted depressive treatment outcome, and sexual abuse history and prior psychiatric illness unrelated to pregnancy predicted anxiety outcome. Biological and psychosocial variables predicted pharmacological treatment outcome in postpartum-depressed and anxious women.

  6. Intrauterine Device Placement During Cesarean Delivery and Continued Use 6 Months Postpartum: A Randomized Controlled Trial

    PubMed Central

    Levi, Erika E; Stuart, Gretchen S; Zerden, Matthew L; Garrett, Joanne M; Bryant, Amy G

    2017-01-01

    Objective To compare intrauterine device (IUD) use at 6 months postpartum among women who underwent intracesarean delivery (during cesarean delivery) IUD placement versus women who planned for interval IUD placement 6 or more weeks postpartum. Methods In this non-blinded randomized trial women who were undergoing a cesarean and desired an IUD were randomized to intracesarean cesarean delivery or interval IUD placement. The primary outcome was IUD use at 6 months postpartum. A sample size of 112 (56 in each group) was planned to detect a 15% difference in IUD use at 6 months postpartum between groups. Results From March 2012 to June 2014, 172 women were screened and 112 women were randomized into the trial. Baseline characteristics were similar between groups. Data regarding IUD use at 6 months postpartum was available for 98 women, 48 and 50 women in the intracesarean and interval groups, respectively. A larger proportion of the women in the intracesarean group were using an IUD at 6 months postpartum ((40/48), 83%) compared to those in the interval group ((32/50) 64%, relative risk [RR]=1.3, 95% confidence interval [CI]: 1.02, 1.66). Among the 56 women randomized to interval IUD insertion, 22 (39%) of them never received an IUD; 14 (25%) never returned for IUD placement, five (9%) women declined an IUD, and three (5%) had a failed IUD placement. Conclusion IUD placement at the time of cesarean delivery leads to a higher proportion of IUD use at 6 months postpartum when compared to interval IUD placement. PMID:26241250

  7. Pattern and determinants of breast feeding and contraceptive practices among mothers within six months postpartum.

    PubMed

    Kunwar, Shipra; Faridi, Mohammad M A; Singh, Shivani; Zahra, Fatima; Alizaidi, Zeashan

    2010-08-01

    The present study aims to determine the patterns of breast feeding, return of menstruation, and contraceptive practices in the first six months postpartum in women visiting the outpatient department at a teaching hospital in Lucknow, Northern India. Mothers of infants between six to eight months of age visiting the outpatient department of Era's Lucknow Medical College were interviewed regarding breast feeding practices, return of menstruation, sexual activity, and contraceptive practices within the first six months postpartum using a structured questionnaire. Of all women interviewed only 75.8% practiced exclusive breast feeding with the mean duration of exclusive breast feeding (EBF) being 3.5 months with only 41% practicing EBF for six months, 28% were sexually active within six weeks postpartum, 64.5% women had a return of menstruation within six months. Contraception was practiced by only 54.4% women with a barrier method such as a condom, being the most common. Better education was the only factor significantly affecting EBF (p < 0.004) and use of contraception (p < 0.027). There were a total of 10 pregnancies within six months postpartum. In conclusion, optimal breast feeding practices are poor in this part of the country and lactational amenorrhoea cannot be effectively and reliably used as a method of contraception. Therefore, optimal breast feeding practices, timely introduction of contraception and institutional delivery need to be encouraged.

  8. 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

  9. Infant formula samples: perinatal sources and breast-feeding outcomes at 1 month postpartum.

    PubMed

    Thurston, Amanda; Bolin, Jocelyn H; Chezem, Jo Carol

    2013-01-01

    The purpose was to describe sources of infant formula samples during the perinatal period and assess their associations with breast-feeding outcomes at 1 month postpartum. Subjects included expectant mothers who anticipated breast-feeding at least 1 month. Infant feeding history and sources of formula samples were obtained at 1 month postpartum. Associations between sources and breast-feeding outcomes were assessed using partial correlation. Of the 61 subjects who initiated breast-feeding, most were white (87%), married (75%), college-educated (75%), and planned exclusive breast-feeding (82%). Forty-two subjects (69%) continued breast-feeding at 1 month postpartum. Subjects received formula samples from the hospital (n = 40; 66%), physician's office (n = 10; 16%), and mail (n = 41; 67%). There were no significant correlations between formula samples from the hospital, physician's office, and/or mail and any or exclusive breast-feeding at 1 month (P > .05). In addition to the hospital, a long-standing source of formula samples, mail was also frequently reported as a route for distribution. The lack of statistically significant associations between formula samples and any or exclusive breast-feeding at 1 month may be related to small sample size and unique characteristics of the group studied.

  10. Breastfeeding Practices During the First Month Postpartum and Associated Factors: Impact on Breastfeeding Survival

    PubMed Central

    Mortazavi, Forough; Mousavi, Seyed Abbas; Chaman, Reza; Wambach, Karen Ann; Mortazavi, Saideh Sadat; Khosravi, Ahmad

    2015-01-01

    Background: The introduction of fluids to infants during the first days postpartum, which may be harmful to infant health, is a common practice in Iran. Objectives: This study aimed to find the prevalence of breastfeeding practices using monthly dietary recall and factors associated with introduction of fluids during the first month of life and determine the effects of these supplementations on breastfeeding survival. Patients and Methods: This longitudinal study carried out in Shahroud, Iran from May 2011 to October 2013. Using convenient sampling strategy, 358 mothers in their third trimester of pregnancy were enrolled in the study and completed the questionnaires. Then the data regarding the introduction of fluids during first month postpartum was collected. We followed women monthly up to breastfeeding cessation. Kaplan-Meier and time-to-event methods were used to assess breastfeeding survival. A multinomial logistic regression analysis was used to identify the variables that determined breastfeeding practices at the first month postpartum. The Cox regression analysis was used to estimate the effect of variables on breastfeeding survival. Results: The prevalence of exclusive, predominant, and partial breastfeeding during the first month postpartum were 33.1%, 58.2%, and 8.6%, respectively. Predominant breastfeeding was associated with the lack of breastfeeding experience (OR = 1.93; 95% CI [1.02 - 3.66]). Partial breastfeeding was associated with the maternal age ≥ 30 y (OR = 5.96; CI [1.66 - 21.37]), family income higher than the mean (OR = 3.39; 95% CI [1.17 - 9.81]), and breastfeeding difficulties score higher than mean (OR = 3.09; 95% CI [1.10 - 8.71]). The Cox regression analysis revealed that breastfeeding practices at the first month was associated with an increased risk for breastfeeding discontinuation. The hazard ratio of breastfeeding discontinuation for predominant and partial breastfeeding groups were 1.11 (95% CI: 0.82, 1.51; P = 0.49) and 2

  11. Infant sleep development from 3 to 6 months postpartum: links with maternal sleep and paternal involvement.

    PubMed

    Tikotzky, Liat; Sadeh, Avi; Volkovich, Ella; Manber, Rachel; Meiri, Gal; Shahar, Golan

    2015-03-01

    The aims of this longitudinal study were to examine (a) development of infant sleep and maternal sleep from 3 to 6 months postpartum; (b) concomitant and prospective links between maternal sleep and infant sleep; and (c) triadic links between paternal involvement in infant caregiving and maternal and infant sleep. The study included 57 families that were recruited during pregnancy. Maternal and infant sleep was assessed using actigraphy and sleep diaries for 5 nights. Both fathers and mothers completed a questionnaire assessing the involvement of fathers relative to mothers in infant caregiving. The results demonstrated moderate improvement in infant and maternal sleep percent between 3 and 6 months. Maternal sleep percent at 3 months significantly predicted infant sleep percent at 6 months. Greater paternal involvement in infant daytime and nighttime caregiving at 3 months significantly predicted more consolidated maternal and infant sleep at 6 months. These findings suggest that maternal sleep is an important predictor of infant sleep and that increased involvement of fathers in infant caregiving responsibilities may contribute to improvements in both maternal and infant sleep during the first 6 months postpartum.

  12. Bridging the Gap across the Transition to Coparenthood: Triadic Interactions and Coparenting Representations from Pregnancy through 12 Months Postpartum

    PubMed Central

    Kuersten-Hogan, Regina

    2017-01-01

    Most family researchers agree that the coparenting relationship emerges some time during the transition to parenthood, though it is unclear whether it originates in pregnancy. Previous studies demonstrated that couples' positive representations of their future coparenting relationship and harmonious coparenting behaviors observed during prenatal triadic interactions predicted better postpartum functioning. However, previous studies did not simultaneously assess prenatal coparenting behaviors and representations as predictors of postpartum coparenting. If the coparenting relationship originates during pregnancy, these behavioral and cognitive aspects of prenatal coparenting should show associations with their postpartum counterparts. Based on family systems-, attachment-, and social-learning theory, the first aim in this study was to explore whether prenatal coparenting representations and behaviors are associated with postpartum coparenting, which would suggest that both cognitive and behavioral aspects of the coparenting relationship emerge during pregnancy. A second aim was to determine whether parental coparenting representations are consistent with concurrently observed coparenting behaviors. A sample of 55 couples expecting their first child was observed during triadic interactions during pregnancy and at 3- and 12-months postpartum. Observations were coded using the Coparenting and Family Rating System. Composite scores were formed to reflect harmonious and antagonistic coparenting behaviors. Parents' representations of harmonious and antagonistic coparenting were assessed via interviews and questionnaires during pregnancy and at 3- and 12-months postpartum. Results indicated that prenatal representations of harmonious and antagonistic coparenting were associated with and predicted unique variance in respective postpartum coparenting representations. Prenatal coparenting behaviors were also associated with coparenting behaviors observed during 3-months

  13. Postpartum Varicose Veins: Supplementation with Pycnogenol or Elastic Compression-A 12-Month Follow-Up.

    PubMed

    Belcaro, Gianni; Dugall, Mark; Luzzi, Roberta; Ippolito, Edmondo; Cesarone, M Rosaria

    2017-03-01

    This open registry aimed to evaluate the clinical evolution of postpartum varicose veins (VVs), in healthy women after the second pregnancy, how these veins regain shape and competence, and possible treatments. The registry included two groups of women: (1) those who used elastic compression stockings, and (2) who used an oral venotonic agent (Pycnogenol, 100 mg/d). A total of 12 evaluation targets were established. Minor symptoms were scored in an analogue scale line. A visual analogue scale line evaluated the overall satisfaction relative to elastic compression or Pycnogenol. Overall 133 women completed the registry evaluation with at least 3 months of follow-up. The resulting two registry groups were comparable. At 3 and 6 months in the Pycnogenol group the number of veins and incompetent sites were lower. At 6 months there were 13.3% of patients with edema in controls versus 3.2% in the Pycnogenol group. Spider veins decreased in Pycnogenol patients. Cramps and other minor symptoms were less common in the Pycnogenol group. In both groups there was a significant improvement at 6 months with better results in the Pycnogenol group. The need for treatment was limited with a decreased need for sclerotherapy, surgery, and conservative treatments in the Pycnogenol group. The overall satisfaction was higher among Pycnogenol patients, and compliance was optimal. Re-evaluation at 12 months indicated that the variations in VVs and spider vein clusters and the associated symptoms did not change. Most remodeling appeared to happen within 6 months after the pregnancy. It was concluded that the use of Pycnogenol improves signs/symptoms of postpartum VVs, and venous function and shape seem to return faster to prepartum, physiological pattern with its use.

  14. 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

  15. HIV status, breastfeeding modality at 5 months and postpartum maternal weight changes over 24 months in rural South Africa

    PubMed Central

    Chetty, Terusha; Carter, Rosalind J; Bland, Ruth M; Newell, Marie-Louise

    2014-01-01

    Objective To determine the effect of infant feeding practices on postpartum weight change among HIV-infected and -uninfected women in South Africa. Methods In a non-randomised intervention cohort study of antiretroviral therapy-naïve women in South Africa, infants were classified as exclusive (EBF), mixed (MF) or non-breastfed (NBF) at each visit. We analysed infant feeding cumulatively from birth to 5 months using 24-hour feeding history (collected weekly for each of the preceding 7 days). Using generalised estimating equation mixed models, allowing for repeated measures, we compared postpartum weight change (kg) from the first maternal postpartum weight within the first 6 weeks (baseline weight) to each subsequent visit through 24 months among 2340 HIV-infected and -uninfected women with live births and at least two postpartum weight measurements. Results HIV-infected (−0.2 kg CI: −1.7 to 1.3 kg; P = 0.81) and -uninfected women (−0.5 kg; 95% CI: −2.1 to 1.2 kg; P = 0.58) had marginal non-significant weight loss from baseline to 24 months postpartum. Adjusting for HIV status, socio-demographic, pregnancy-related and infant factors, 5-month feeding modality was not significantly associated with postpartum weight change: weight change by 24 months postpartum, compared to the change in the reference EBF group, was 0.03 kg in NBF (95% CI: −2.5 to +2.5 kg; P = 0.90) and 0.1 kg in MF (95% CI: −3.0 to +3.2 kg; P = 0.78). Conclusion HIV-infected and -uninfected women experienced similar weight loss over 24 months. Weight change postpartum was not associated with 5-month breastfeeding modality among HIV-infected and -uninfected women. PMID:24720779

  16. Six-Week Postpartum Maternal Self-Criticism and Dependency and 4-Month Mother-Infant Self- and Interactive Contingencies

    ERIC Educational Resources Information Center

    Beebe, Beatrice; Jaffe, Joseph; Buck, Karen; Chen, Henian; Cohen, Patricia; Blatt, Sidney; Kaminer, Tammy; Feldstein, Stanley; Andrews, Howard

    2007-01-01

    Associations of 6-week postpartum maternal self-criticism and dependency with 4-month mother-infant self- and interactive contingencies during face-to-face play were investigated in 126 dyads. Infant and mother face, gaze, touch, and vocal quality were coded second by second from split-screen videotape. Self- and interactive contingencies were…

  17. Mother-infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories.

    PubMed

    Muzik, Maria; Bocknek, Erika London; Broderick, Amanda; Richardson, Patricia; Rosenblum, Katherine L; Thelen, Kelsie; Seng, Julia S

    2013-02-01

    Our goal was to examine the trajectory of bonding impairment across the first 6 months postpartum in the context of maternal risk, including maternal history of childhood abuse and neglect and postpartum psychopathology, and to test the association between self-reported bonding impairment and observed positive parenting behaviors. In a sample of women with childhood abuse and neglect histories (CA+, n = 97) and a healthy control comparison group (CA-, n = 53), participants completed questionnaires related to bonding with their infants at 6 weeks, 4 months, and 6 months postpartum and psychopathology at 6 months postpartum. In addition, during a 6-month postpartum home visit, mothers and infants participated in a dyadic play interaction subsequently coded for positive parenting behaviors by blinded coders. We found that all women, independent of risk status, increased in bonding with their infant over the first 6 months postpartum; however, women with postpartum psychopathology (depression and posttraumatic stress disorder [PTSD]) showed consistently greater bonding impairment scores at all timepoints. Moreover, we found that, at the 6-month assessment, bonding impairment and observed parenting behaviors were significantly associated. These results highlight the adverse effects of maternal postpartum depression and PTSD on mother-infant bonding in early postpartum in women with child abuse and neglect histories. These findings also shed light on the critical need for early detection and effective treatment of postpartum mental illness in order to prevent problematic parenting and the development of disturbed mother-infant relationships. Results support the use of the Postpartum Bonding Questionnaire as a tool to assess parenting quality by its demonstrated association with observed parenting behaviors.

  18. Mothers who are securely attached in pregnancy show more attuned infant mirroring 7 months postpartum.

    PubMed

    Kim, Sohye; Fonagy, Peter; Allen, Jon; Martinez, Sheila; Iyengar, Udita; Strathearn, Lane

    2014-11-01

    This study contrasted two forms of mother-infant mirroring: the mother's imitation of the infant's facial, gestural, or vocal behavior (i.e., "direct mirroring") and the mother's ostensive verbalization of the infant's internal state, marked as distinct from the infant's own experience (i.e., "intention mirroring"). Fifty mothers completed the Adult Attachment Interview (Dynamic Maturational Model) during the third trimester of pregnancy. Mothers returned with their infants 7 months postpartum and completed a modified still-face procedure. While direct mirroring did not distinguish between secure and insecure/dismissing mothers, secure mothers were observed to engage in intention mirroring more than twice as frequently as did insecure/dismissing mothers. Infants of the two mother groups also demonstrated differences, with infants of secure mothers directing their attention toward their mothers at a higher frequency than did infants of insecure/dismissing mothers. The findings underscore marked and ostensive verbalization as a distinguishing feature of secure mothers' well-attuned, affect-mirroring communication with their infants.

  19. Fatigue, depression, maternal confidence, and maternal satisfaction during the first month postpartum: A comparison of Japanese mothers by age and parity.

    PubMed

    Mori, Emi; Tsuchiya, Miyako; Maehara, Kunie; Iwata, Hiroko; Sakajo, Akiko; Tamakoshi, Koji

    2017-02-01

    The aim of the study was to assess fatigue, depressive symptoms, and maternal confidence or satisfaction among older primiparae during the first month postpartum. The number of older Japanese primiparae has rapidly increased. Older primiparae are believed to be at high risk for puerperal morbidity. A multicentre prospective cohort study design was used. Data were examined from 2854 Japanese women who participated in a 6-month prospective cohort study conducted between May 2012 and September 2013. The women were classified into 4 groups based on maternal age and parity. All participants completed the Postnatal Accumulated Fatigue Scale, Japanese Edinburgh Postnatal Depression Scale, Postpartum Maternal Confidence Scale, and Postpartum Maternal Satisfaction Scale. Primiparae in all age groups were more severely fatigued and had a higher risk of postpartum depression than multiparous mothers during the first month postpartum. Older primiparae had significantly lower scores on maternal confidence and maternal satisfaction than the other 3 groups at 1 month postpartum. These findings suggest that postpartum nursing should focus on promoting adequate sleep, providing emotional support, and fostering the process of maternal role adaptation among older Japanese primiparae, particularly during the first postpartum month.

  20. Maternal postpartum depressive symptoms predict delay in non-verbal communication in 14-month-old infants.

    PubMed

    Kawai, Emiko; Takagai, Shu; Takei, Nori; Itoh, Hiroaki; Kanayama, Naohiro; Tsuchiya, Kenji J

    2017-02-01

    We investigated the potential relationship between maternal depressive symptoms during the postpartum period and non-verbal communication skills of infants at 14 months of age in a birth cohort study of 951 infants and assessed what factors may influence this association. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, and non-verbal communication skills were measured using the MacArthur-Bates Communicative Development Inventories, which include Early Gestures and Later Gestures domains. Infants whose mothers had a high level of depressive symptoms (13+ points) during both the first month postpartum and at 10 weeks were approximately 0.5 standard deviations below normal in Early Gestures scores and 0.5-0.7 standard deviations below normal in Later Gestures scores. These associations were independent of potential explanations, such as maternal depression/anxiety prior to birth, breastfeeding practices, and recent depressive symptoms among mothers. These findings indicate that infants whose mothers have postpartum depressive symptoms may be at increased risk of experiencing delay in non-verbal development.

  1. Implementation of Routine Postpartum Depression Screening and Care Initiation Across a Multispecialty Health Care Organization: An 18-Month Retrospective Analysis.

    PubMed

    Lind, April; Richter, Sara; Craft, Cheryl; Shapiro, Alice C

    2017-02-01

    Objectives Postpartum depression (PPD) affects approximately 10-20% of all mothers after giving birth. Adequate screening and follow-up care for the postpartum mother with depression is an essential component of quality care in this population. The purpose of this quality improvement project was to evaluate the quality and quantity of a postnatal PPD screening program and the subsequent initiation of needed PPD treatment in an integrated health system. Methods After implementing a standardized PPD screening process, we conducted an 18-month retrospective study of patient visits that required a PPD screen. Data were abstracted from medical records and analyzed to determine if postnatal PPD screening occurred, what quality of the screening was, and what follow-up measures were taken. Results Within the study timeframe, 28,389 postpartum and well-child visits were eligible for PPD screening. PPD screening occurred at 88% of eligible visits for approximately 5000 unique women. PPD was identified in 8.1% of screened women. Conclusions Of women with PPD, at least 44.8% were prescribed an SSRI and 21.4% attended a visit with a mental health professional, which is consistent with other studies. Screening can be successful through collaboration, although ongoing evaluation and process modification are necessary.

  2. Postpartum Psychosis

    MedlinePlus

    ... Depression During Pregnancy & Postpartum Anxiety During Pregnancy & Postpartum Pregnancy or Postpartum Obsessive Symptoms Postpartum Post-Traumatic Stress Disorder Bipolar Mood Disorders Postpartum Psychosis Tools for ...

  3. "I can't stop worrying about everything"—experiences of rural Bangladeshi women during the first postpartum months.

    PubMed

    Edhborg, Maigun; Nasreen, Hashima E; Kabir, Zarina Nahar

    2015-01-01

    Over recent years, researchers have found evidence which indicates that the prevalence of postpartum depressive symptoms crosses cultural boundaries and is reported to be at least as high in non-Western countries as in Western countries. However, qualitative studies about new mothers' experiences from non-Western countries, such as Bangladesh, are rare, particularly in rural areas. This study aims to describe the experiences and concerns of rural Bangladeshi mothers with postpartum depressive symptoms. Open narrative interviews were conducted with 21 mothers with depressive symptoms 2-3 months postpartum, consecutively selected from a longitudinal study about prevalence and risk factors of perinatal depressive symptoms. Inductive content analysis was used to analyse data and three themes emerged: family dynamics, living at the limits of survival, and role of the cultural context after childbirth. These themes were based on six categories and 15 subcategories. The findings show that troublesome family relationships, including intimate partner violence and violence in the family, influenced the mothers' mental well-being. They and their families lived at the limit of survival and the mothers expressed fear and worries about their insecure situation regarding economic difficulties and health problems. They felt sorry for being unable to give their infants a good start in life and sad because they could not always follow the traditional norms related to childbirth. Thus, it is important to focus on the depressive symptoms among new mothers and offer counselling to those showing depressive symptoms, as the cultural traditions do not always alleviate these symptoms in the changing Bangladeshi society today.

  4. The Influence of Back Pain and Urinary Incontinence on Daily Tasks of Mothers at 12 Months Postpartum

    PubMed Central

    McDonald, Sheila W.; Tough, Suzanne C.

    2015-01-01

    Objective The present study examined back pain (BP) and/or urinary incontinence (UI) impact on the ability to perform daily tasks at 12 months after childbirth in healthy reproductive women who sought maternity care in community based family practice clinics. Methods This study is a secondary analysis from the All Our Babies Study, a prospective, community-based pregnancy cohort in Calgary, Alberta. Maternal self-reported information on demographics, lifestyle, experiences with pregnancy and childbirth, occurrence of BP, UI and consequent impairment of daily tasks were collected by questionnaires administered before 25 weeks, at 34-36 weeks gestation and at 4 and 12 months postpartum. The occurrence and severity of BP and UI at one year after childbirth was assessed using descriptive and bivariate analyses. Logistic regression models examined the association between demographic and obstetrical variables and the severity of functional impairment due to UI and BP. Results From 1574 women with singleton pregnancies included in the study, 1212 (77%) experienced BP, 773 (49%) UI, and 620 (40%) both BP and UI. From the 821 women reporting impairment of daily tasks due to BP, 199 (24 %) were moderately and 90 (11%) severely affected with the remainder, 532 (64%) being mildly affected. From 267 women with functional impairment due to UI, 52 (19%) reported moderately to severe impairment in their ability to perform daily tasks. Obesity and parity were risk factors for impairment of daily functioning due to BP, whereas obesity and vaginal delivery increased the risk of moderate to severe impairment due to UI. Conclusions BP and UI are common occurrences 1 year after childbirth. Maternal performance of daily tasks and women’s health and quality of life are more often impaired due to BP than UI. Our study brings new evidence of the risk factors that predict severity and impact of these conditions on women functioning at 12 months postpartum. PMID:26083252

  5. Postpartum Hemorrhage Treated with Gelfoam Slurry Embolization Using the Superselective Technique: Immediate Results and 1-Month MRI Follow-up

    SciTech Connect

    Pellerin, Olivier; Bats, Anne-Sophie; Primio, Massimiliano Di; Palomera-Ricco, Ana; Pinot de Villechenon, Gabrielle; and others

    2013-02-15

    To evaluate the efficacy and safety of superselective embolization of the uterine arteries in a postpartum hemorrhage. Between November 2004 and January 2011, a total of 44 consecutive women (median {+-} standard deviation age 34 {+-} 3 years, range 23-41 years) were referred to our institution for postpartum intractable hemorrhage management. All patients were embolized with a microcatheter that was placed deep into the uterine arteries upstream of the cervical arteries. The embolic agent was a mixture of contrast medium and 5 Multiplication-Sign 5 Multiplication-Sign 5 cm pieces of gelfoam (Gelita-Spon) modified into a gelatin emulsion as follows: rapid mixing through a three-way stopcock with two 2.5-ml syringes. A 1-ml syringe was used for injection. One month after embolization, all patients underwent magnetic resonance imaging and clinical examination. Technical and clinical success was obtained in all cases. Thirty-five patients experienced bleeding related to poor retraction of the uterus, 7 patients because of a tear of the cervix and 2 because of a vaginal hematoma. Pre- and postembolization red blood cell transfusions were (mean {+-} standard deviation [SD]) 6 {+-} 1.2 (range 3-8) U and 2 {+-} 0.7 (range 2-4) U, respectively. One-month magnetic resonance imaging follow-up revealed no sign of ischemic myometrium or necrosis, and no instances of uterine rupture and no pelvic vein thrombosis. Incidental findings included two small intramyometrial hematic collections. All uterine arteries were patent via magnetic resonance angiography. Seventeen patients had concomitant fibroids, all of which appeared hypovascular. This technique permits good, safe clinical results with no marked damage to the uterine arteries or the uterus itself.

  6. Determinants of postnatal depression in Sudanese women at 3 months postpartum: a cross-sectional study

    PubMed Central

    Khalifa, Dina Sami; Glavin, Kari; Bjertness, Espen; Lien, Lars

    2016-01-01

    Objectives Maternal mental health is a neglected issue in Sudanese healthcare. The aim of this study was to explore the factors associated with postnatal depression (PND) at 3 months postpartum in a sample of Sudanese women in Khartoum state. Setting Recruitment was from two major public antenatal care (ANC) clinics in two maternity teaching hospitals in Khartoum state. The study participants were recruited during their pregnancy and were followed up and screened for PND at 3 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Participants A sample of 300 pregnant Sudanese women in their second or third trimester was included in the study. The inclusion criteria were Sudanese nationality, pregnancy in the second or third trimester and satisfactory contact information. Outcome measures PND was assessed using the EPDS at a cut-off score of ≥12. Maternal and sociodemographic factors of interest were illustrated in a directed acyclic graph (DAG) to identify which variables to adjust for in multivariate analyses and to show their type of effect on PND. A forward logistic regression model was built to assess the factors that are independently associated with PND. Results History of violence increased the odds of PND sevenfold, OR=7.4 (95% CI 1.9 to 27.6). Older age of mothers decreased the odds of PND by almost 20%, OR=0.82 (95% CI 0.73 to 0.92). Exclusive breast feeding and regular prenatal vitamins during pregnancy are associated with an 80% decrease in odds of PND, OR=0.2 (95% CI 0.06 to 0.70) and 0.17 (95% CI 0.06 to 0.5), respectively. Conclusions Factors associated with PND in this study are comparable to factors from other developing countries, although findings should be judged with caution owing to the high number of women who refused recruitment into the study. PMID:26966055

  7. Higher Leptin but Not Human Milk Macronutrient Concentration Distinguishes Normal-Weight from Obese Mothers at 1-Month Postpartum

    PubMed Central

    Frasquet-Darrieux, Marine; Gaud, Marie-Agnès; Christin, Patricia; Boquien, Clair-Yves; Millet, Christine; Herviou, Manon; Darmaun, Dominique; Robins, Richard J.; Ingrand, Pierre; Hankard, Régis

    2016-01-01

    Introduction Exclusively breastfed infants born to obese mothers have previously been shown to gain less weight by 1-month postpartum than infants of normal-weight mothers. Our hypothesis is that human milk composition and volume may differ between obese and normal-weight mothers. Objective To compare human milk leptin, macronutrient concentration, and volume in obese and normal-weight mothers. Mother and infant characteristics were studied as secondary aims. Materials and Methods This cross-sectional observational study compared 50 obese mothers matched for age, parity, ethnic origin, and educational level with 50 normal-weight mothers. Leptin, macronutrient human milk concentration, and milk volume were determined at 1 month in exclusively breastfed infants. Mother characteristics and infant growth were recorded. Results Human milk leptin concentration was higher in obese mothers than normal-weight mothers (4.8±2.7 vs. 2.5±1.5 ng.mL-1, p<0.001). No difference was observed between obese and normal-weight mothers in protein, lipid, carbohydrate content, and volume, nor in infant weight gain. Conclusion Leptin concentration was higher in the milk of obese mothers than that of normal-weight mothers, but macronutrient concentration was not. It remains to be established whether the higher leptin content impacts on infant growth beyond the 1-month of the study period. PMID:28005966

  8. Maternal prenatal felt security and infant health at birth interact to predict infant fussing and crying at 12 months postpartum.

    PubMed

    Sawada, Natsumi; Gagné, Faby M; Séguin, Louise; Kramer, Michael S; McNamara, Helen; Platt, Robert W; Goulet, Lise; Meaney, Michael J; Lydon, John E

    2015-08-01

    Infants born with medical problems are at risk for less optimal developmental outcomes. This may be, in part, because neonatal medical problems are associated with maternal distress, which may adversely impact infants. However, the reserve capacity model suggests that an individual's bank of psychosocial resources buffers the adverse effects of later-encountered stressors. This prospective longitudinal study examined whether preexisting maternal psychosocial resources, conceptualized as felt security in close relationships, moderate the association between neonatal medical problems and infant fussing and crying 12 months postpartum. Maternal felt security was measured by assessing its indicators in 5,092 pregnant women. At birth, infants were classified as healthy or having a medical problem. At 12 months, experience sampling was used to assess daily maternal reports of fussing and crying in 135 mothers of infants who were healthy or had medical problems at birth. Confirmatory factor analyses revealed that attachment, relationship quality, self-esteem, and social support can be conceptualized as indicators of a single felt security factor. Multiple regression analyses revealed that prenatal maternal felt security interacts with infant health at birth to predict fussing and crying at 12 months. Among infants born with medical problems, higher felt security predicted decreased fussing and crying. Maternal felt security assessed before birth dampens the association between neonatal medical problems and subsequent infant behavior. This supports the hypothesis that psychosocial resources in reserve can be called upon in the face of a stressor to reduce its adverse effects on the self or others.

  9. Postpartum Depression

    MedlinePlus

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

  10. Observed coparenting and triadic dynamics in African American fragile families at 3 months' postpartum.

    PubMed

    McHale, James P; Coates, Erica E

    2014-01-01

    This report examines coparenting and triadic interactions in 19 unmarried, first-time African American families as fathers, mothers, and 3-month-old infants navigated the Lausanne Trilogue Play (LTP; E. Fivaz-Depeursinge & A. Corboz-Warnery, ). Parents in 10 of the 19 families reported coresidence at the time of the 3-month assessment, and the other 9 sets of coparents lived apart. All participating families had taken part in a prenatal intervention emphasizing the importance of father engagement in children's lives, and in all families, parents reported episodic to regular father contact with the children at 3 months. Analyses of LTP sessions revealed that 9 of the 19 families exhibited high levels of coparenting solidarity-cooperation and family warmth accompanied by low levels of coparenting competition and disengagement. Among the remaining 10 families, competitiveness (verbal sparring, interference) and/or disengagement (repeated, episodic absenting by one or both parents from the ongoing interaction) signaled strain and challenges to solidarity. Differences between the higher and lower solidarity groups were found in father-reported relationship rapport. However, coresidentiality versus noncoresidentiality of the parents did not distinguish high- from low-solidarity groups. A case analysis of one family's triadic session is presented to elucidate the rich potential for clinical intervention in triadic work with fragile family systems. Implications of the study and its findings for theory, research, and clinical work with unmarried fathers and families, along with limits of the study design and generalizability of findings, are discussed.

  11. Evaluation of home testing to improve follow up after gestational diabetes (Fingerstick Assessments of Sugar Two-months postpartum or FAST)

    PubMed Central

    Lewis, Beth G; Pagan, Elvis R; Evers, Martin

    2013-01-01

    Objective Historically the rates of postpartum glucose tolerance testing for women with gestational diabetes (GDM) average a suboptimal 33%. Barriers include the need for new mothers to miss work and/or arrange for childcare in order to engage in a two-hour test at a commercial lab. This pilot study was initiated to test the theory that a home testing regimen would be accepted by patients and increase the rate of postpartum glucose assessments relative to published rates, without requiring additional health-care staff or resources to achieve this goal. Study design Six weeks postpartum, women with GDM from an academic private practice were asked to check fingerstick blood glucose (FAST Protocol) four times a day for two days, and then obtain an oral glucose tolerance test (OGTT). The physician consultants saw the women each month during pregnancy and arranged the postpartum testing. Results Two of 69 refused to be consented. Twelve of the remaining 67(18%) women completed both the FAST regimen and the OGTT, three completed only the OGTT and five completed only the FAST regimen for a final follow-up rate of 20/67 (30%). The demands of caring for a newborn, or the annoyance of fingersticks, were barriers to compliance. Conclusions In spite of intense physician involvement, this home testing regimen was not associated with an increase in the rates of women participating in postpartum glucose assessments. PMID:27708703

  12. Postnatal depression among Sudanese women: prevalence and validation of the Edinburgh Postnatal Depression Scale at 3 months postpartum

    PubMed Central

    Khalifa, Dina Sami; Glavin, Kari; Bjertness, Espen; Lien, Lars

    2015-01-01

    Purpose Postnatal depression (PND) rates in low-resource countries have reached levels between 4.9% and 59%. Maternal mental health has not been researched in Sudan, and there are no existing statistics on prevalence or significant risk factors for PND. Consequently, no screening test has been validated to screen for PND at the primary health care level. This study investigates the 3 months prevalence of PND and validates the Edinburgh Postnatal Depression Scale (EPDS) against the Mini-International Neuropsychiatric Interview (MINI). Methodology Pregnant Sudanese women in the second and third trimesters were recruited to the study during routine antenatal care visits in two major maternity hospitals in Khartoum state. They were screened for PND at 3 months postpartum using the EPDS. Test positive women were matched with test negative women according to nearest date of birth. A clinical psychologist verified their depression status using the MINI. Results The follow-up rate was 79%. At a cutoff point of ≥12, the 3 months prevalence of PND was 9.2%. The sensitivity and specificity of the EPDS were 89% and 82%, respectively. The EPDS and MINI showed a strong positive relationship (odds ratio =36). The positive predictive value and negative predictive value, using this study’s prevalence, were 33% and 98.7%, respectively. The receiver operator characteristic analysis showed an area under the curve of 0.89. The cut-off point ≥12 was the most acceptable point as it had the lowest number needed to diagnose (1.4) and a false-positive rate of 18%. Conclusion The EPDS is a valid tool for screening for PND on a Sudanese population. It was accepted, easily administered, and understood by postnatal women. Health care personnel, especially village midwives, should be trained on screening and referral of depressed women for clinical evaluation and management. Due to limited resources available in Sudan, shorter screening tests need to be validated in the future. PMID

  13. Six-week postpartum maternal self-criticism and dependency and 4-month mother-infant self- and interactive contingencies.

    PubMed

    Beebe, Beatrice; Jaffe, Joseph; Buck, Karen; Chen, Henian; Cohen, Patricia; Blatt, Sidney; Kaminer, Tammy; Feldstein, Stanley; Andrews, Howard

    2007-11-01

    Associations of 6-week postpartum maternal self-criticism and dependency with 4-month mother-infant self- and interactive contingencies during face-to-face play were investigated in 126 dyads. Infant and mother face, gaze, touch, and vocal quality were coded second by second from split-screen videotape. Self- and interactive contingencies were defined as auto- and lagged cross-correlation, respectively, using multilevel time-series models. Statistical significance was defined as p<.05. Regarding self-contingency, (a) more self-critical mothers showed primarily lowered self-contingency, whereas their infants showed both lowered and heightened, and (b) infants of more dependent mothers showed primarily lowered self-contingency, whereas findings were absent in mothers. Regarding interactive contingency, (a) more self-critical mothers showed lowered attention and emotion contingencies but heightened contingent touch coordination with infant touch, and (b) more dependent mothers and their infants showed heightened facial/vocal interactive contingencies. Thus, maternal self-criticism and dependency have different effects on mother-infant communication.

  14. Immunogenicity and safety of a pentavalent acellular pertussis combined vaccine including diphtheria, tetanus, inactivated poliovirus and conjugated Haemophilus Influenzae type b polysaccharide for primary vaccination at 2, 3, 4 or 3, 4, 5 months of age in infants in China.

    PubMed

    Li, Rong Cheng; Li, Feng Xiang; Li, Yan Ping; Hou, Qi Ming; Li, Chang Gui; Li, Ya Nan; Chen, Fu Sheng; Hu, Xue Zhong; Su, Wen Bin; Zhang, Shu Min; Fang, Han Hua; Ye, Qiang; Zeng, Tian De; Liu, Tao Xuan; Li, Xiu Bi; Huang, Yun Neng; Deng, Man Ling; Zhang, Yan Ping; Ortiz, Esteban

    2011-02-24

    The aim was to demonstrate the immunogenicity and safety of a DTaP-IPV//PRP-T combined vaccine (Pentaxim(®)) compared to individual vaccines in infants in the People's Republic of China. Infants (N=792) were randomly assigned to receive DTaP-IPV//PRP-T at 2, 3 and 4 months of age (Group A) or 3, 4 and 5 months of age (Group B), or DTaP (Wuhan Institute of Biological Products), PRP-T (Act-Hib(®)) and IPV (Imovax(®) Polio) at 3, 4 and 5 months of age (Group C). Antibody titers were measured pre- and 1 month after the third vaccination; non-inferiority analyses were performed for seroprotection/seroconversion (SP/SC) rates. Safety was assessed 1 month after the primary series. SP/SC rates for the DTaP-IPV//PRP-T vaccine were high and non-inferior to the controls. Reactogenicity was low for each group and no hypotonic hyporesponsive episode or seizure was reported. In conclusion, the DTaP-IPV//PRP-T vaccine was highly immunogenic, non-inferior to the commercially available control vaccines and had a good safety profile for both primary administration schedules.

  15. Postpartum Depression

    MedlinePlus

    ... Crying Reduced concentration Appetite problems Trouble sleeping Postpartum depression symptoms Postpartum depression may be mistaken for baby ... drugs, which can make mood swings worse Postpartum depression Postpartum depression is often treated with psychotherapy (also ...

  16. Postpartum Sterilization

    MedlinePlus

    f AQ FREQUENTLY ASKED QUESTIONS FAQ052 CONTRACEPTION Postpartum Sterilization • What is sterilization? • What is postpartum sterilization? • How is postpartum sterilization performed? • What kind of anesthesia is used for postpartum sterilization? • How ...

  17. Docosahexaenoic Acid Status in Pregnancy Determines the Maternal Docosahexaenoic Acid Status 3-, 6- and 12 Months Postpartum. Results from a Longitudinal Observational Study

    PubMed Central

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

    2015-01-01

    Background Essential fatty acid status as well as docosahexaenoic acid (DHA, 22:6n-3) declines during pregnancy and lactation. As a result, the DHA status may not be optimal for child development and may increase the risk for maternal postpartum depression. The objective of this study was to assess changes in the maternal fatty acid status from pregnancy to 12 months postpartum, and to study the impact of seafood consumption on the individual fatty acid status. Methods Blood samples and seafood consumption habits (gestation week 28, and three-, six- and 12 months postpartum) were collected in a longitudinal observational study of pregnant and postpartum women (n = 118). Multilevel linear modeling was used to assess both changes over time in the fatty acid status of red blood cells (RBC), and in the seafood consumption. Results Six fatty acids varied the most (>80%) across the four time points analyzed, including the derivative of the essential α-linoleic acid (ALA, 18:3n-3), DHA; the essential linoleic acid (LA, 18:2 n-6); and the LA derivative, arachidonic acid (AA, 20:4n-6). Over all, a large variation in individuals’ DHA- and AA status was observed; however, over the 15-month study period only small inter-individual differences in the longitudinal trajectory of DHA- and AA abundance in the RBC were detected. The median intake of seafood was lower than recommended. Regardless, the total weekly frequency of seafood and eicosapentaenoic acid (EPA, 20:5n-3)/DHA-supplement intake predicted the maternal level of DHA (μg/g RBC). Conclusion The period of depletion of the maternal DHA status during pregnancy and lactation, seem to turn to repletion from about six months postpartum towards one year after childbirth, irrespective of RBC concentration of DHA during pregnancy. Seafood and EPA/DHA-supplement intake predicted the DHA levels over time. Trial Registration www.helseforskning.etikkom.no 2009/570/REC, project number: 083.09 PMID:26331947

  18. The effects of different levels of calcium supplementation on the bone mineral status of postpartum lactating Chinese women: a 12-month randomised, double-blinded, controlled trial.

    PubMed

    Zhang, Zhe-Qing; Chen, Yu-Ming; Wang, Ruo-Qin; Huang, Zhen-Wu; Yang, Xiao-Guang; Su, Yi-Xiang

    2016-01-14

    Increasing dietary Ca intake may prevent the excessive mobilisation of bone mineral in nursing mothers. We aimed to investigate whether higher Ca intake could positively modulate the bone mineral changes in Chinese postpartum lactating women. The study was a 12-month randomised, double-blinded, parallel group trial conducted over 12 months. A total of 150 postpartum women were randomly selected to receive either 40 g of milk powder containing 300 mg of Ca and 5 μg of vitamin D (Low-Ca group) or same milk powder additionally fortified with 300 mg of Ca (Mid-Ca group) or 600 mg of Ca (High-Ca group). Bone mineral density (BMD) for the whole body, the lumbar spine, the total left hip and its sub-regions was measured using dual-energy X-ray absorptiometry. A total of 102 subjects completed the whole trial. The duration of total lactating time was 7·9 (SD 2·8) months on average. The intention-to-treat analysis yielded the following mean percentage changes in BMD for the whole body, the lumbar spine and the total left hip, respectively: -0·93 (SD 1·97), 2·11 (SD 4·90) and -1·60 (SD 2·65)% for the Low-Ca group; -0·56 (SD 1·89), 2·21 (SD 3·77) and -1·43 (SD 2·30)% for the Mid-Ca group; and -0·44 (SD 1·67), 2·32 (SD 4·66) and -0·95 (SD 4·08)% for the High-Ca group. The differences between the groups were not statistically significant (P: 0·5-0·9). The results of the complete case analysis were similar. In sum, we found no significant differences in the bone mineral changes from baseline to 12 months in postpartum lactating women consuming milk powder fortified with different levels of Ca.

  19. Twelve-month, 12 km resolution North American WRF-Chem v3.4 air quality simulation: performance evaluation

    DOE PAGES

    Tessum, C. W.; Hill, J. D.; Marshall, J. D.

    2015-04-07

    We present results from and evaluate the performance of a 12-month, 12 km horizontal resolution year 2005 air pollution simulation for the contiguous United States using the WRF-Chem (Weather Research and Forecasting with Chemistry) meteorology and chemical transport model (CTM). We employ the 2005 US National Emissions Inventory, the Regional Atmospheric Chemistry Mechanism (RACM), and the Modal Aerosol Dynamics Model for Europe (MADE) with a volatility basis set (VBS) secondary aerosol module. Overall, model performance is comparable to contemporary modeling efforts used for regulatory and health-effects analysis, with an annual average daytime ozone (O3) mean fractional bias (MFB) of 12%more » and an annual average fine particulate matter (PM2.5) MFB of −1%. WRF-Chem, as configured here, tends to overpredict total PM2.5 at some high concentration locations and generally overpredicts average 24 h O3 concentrations. Performance is better at predicting daytime-average and daily peak O3 concentrations, which are more relevant for regulatory and health effects analyses relative to annual average values. Predictive performance for PM2.5 subspecies is mixed: the model overpredicts particulate sulfate (MFB = 36%), underpredicts particulate nitrate (MFB = −110%) and organic carbon (MFB = −29%), and relatively accurately predicts particulate ammonium (MFB = 3%) and elemental carbon (MFB = 3%), so that the accuracy in total PM2.5 predictions is to some extent a function of offsetting over- and underpredictions of PM2.5 subspecies. Model predictive performance for PM2.5 and its subspecies is in general worse in winter and in the western US than in other seasons and regions, suggesting spatial and temporal opportunities for future WRF-Chem model development and evaluation.« less

  20. Twelve-month, 12 km resolution North American WRF-Chem v3.4 air quality simulation: performance evaluation

    NASA Astrophysics Data System (ADS)

    Tessum, C. W.; Hill, J. D.; Marshall, J. D.

    2015-04-01

    We present results from and evaluate the performance of a 12-month, 12 km horizontal resolution year 2005 air pollution simulation for the contiguous United States using the WRF-Chem (Weather Research and Forecasting with Chemistry) meteorology and chemical transport model (CTM). We employ the 2005 US National Emissions Inventory, the Regional Atmospheric Chemistry Mechanism (RACM), and the Modal Aerosol Dynamics Model for Europe (MADE) with a volatility basis set (VBS) secondary aerosol module. Overall, model performance is comparable to contemporary modeling efforts used for regulatory and health-effects analysis, with an annual average daytime ozone (O3) mean fractional bias (MFB) of 12% and an annual average fine particulate matter (PM2.5) MFB of -1%. WRF-Chem, as configured here, tends to overpredict total PM2.5 at some high concentration locations and generally overpredicts average 24 h O3 concentrations. Performance is better at predicting daytime-average and daily peak O3 concentrations, which are more relevant for regulatory and health effects analyses relative to annual average values. Predictive performance for PM2.5 subspecies is mixed: the model overpredicts particulate sulfate (MFB = 36%), underpredicts particulate nitrate (MFB = -110%) and organic carbon (MFB = -29%), and relatively accurately predicts particulate ammonium (MFB = 3%) and elemental carbon (MFB = 3%), so that the accuracy in total PM2.5 predictions is to some extent a function of offsetting over- and underpredictions of PM2.5 subspecies. Model predictive performance for PM2.5 and its subspecies is in general worse in winter and in the western US than in other seasons and regions, suggesting spatial and temporal opportunities for future WRF-Chem model development and evaluation.

  1. 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.

  2. 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

  3. Postpartum depression

    MedlinePlus

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

  4. “I can't stop worrying about everything”—Experiences of rural Bangladeshi women during the first postpartum months

    PubMed Central

    Edhborg, Maigun; Nasreen, Hashima E; Kabir, Zarina Nahar

    2015-01-01

    Over recent years, researchers have found evidence which indicates that the prevalence of postpartum depressive symptoms crosses cultural boundaries and is reported to be at least as high in non-Western countries as in Western countries. However, qualitative studies about new mothers’ experiences from non-Western countries, such as Bangladesh, are rare, particularly in rural areas. This study aims to describe the experiences and concerns of rural Bangladeshi mothers with postpartum depressive symptoms. Open narrative interviews were conducted with 21 mothers with depressive symptoms 2–3 months postpartum, consecutively selected from a longitudinal study about prevalence and risk factors of perinatal depressive symptoms. Inductive content analysis was used to analyse data and three themes emerged: family dynamics, living at the limits of survival, and role of the cultural context after childbirth. These themes were based on six categories and 15 subcategories. The findings show that troublesome family relationships, including intimate partner violence and violence in the family, influenced the mothers’ mental well-being. They and their families lived at the limit of survival and the mothers expressed fear and worries about their insecure situation regarding economic difficulties and health problems. They felt sorry for being unable to give their infants a good start in life and sad because they could not always follow the traditional norms related to childbirth. Thus, it is important to focus on the depressive symptoms among new mothers and offer counselling to those showing depressive symptoms, as the cultural traditions do not always alleviate these symptoms in the changing Bangladeshi society today. PMID:25595913

  5. Impact of the Great East Japan Earthquake on feeding methods and newborn growth at 1 month postpartum: results from the Fukushima Health Management Survey.

    PubMed

    Kyozuka, Hyo; Yasuda, Shun; Kawamura, Makoto; Nomura, Yasuhisa; Fujimori, Keiya; Goto, Aya; Yasumura, Seiji; Abe, Masafumi

    2016-05-01

    This study examined the effects of three disasters (the Great East Japan Earthquake of March 11, 2011, followed by a tsunami and the Fukushima Daiichi Nuclear Power Plant accident) on feeding methods and growth in infants born after the disasters. Using results from the Fukushima Health Management Survey, Soso District (the affected area where the damaged nuclear power plant is located) and Aizu District (a less-affected area located farthest from the plant) were compared. In this study, newborn and maternal background characteristics were examined, as well as feeding methods, and other factors for newborn growth at the first postpartum examination for 1706 newborns born after the disaster in the affected (n = 836) and less-affected (n = 870) areas. Postpartum examinations took place 1 month after birth. Feeding method trends were examined, and multivariate regression analyses were used to investigate effects on newborn mass gain. There were no significant differences in background characteristics among newborns in these areas. When birth dates were divided into four periods to assess trends, no significant change in the exclusive breastfeeding rate was found, while the exclusive formula-feeding rate was significantly different across time periods in the affected area (p = 0.02). Multivariate analyses revealed no significant independent associations of maternal depression and change in medical facilities (possible disaster effects) with other newborn growth factors in either area. No area differences in newborn growth at the first postpartum examination or in exclusive breastfeeding rates were found during any period. Exclusive formula-feeding rates varied across time periods in the affected, but not in the less-affected area. It is concluded that effective guidance to promote breast-feeding and prevent exclusive use of formula is important for women in post-disaster circumstances.

  6. Effectiveness of a 12-month randomized clinical trial to increase physical activity in multiethnic postpartum women: Results from Hawaii’s Nā Mikimiki Project

    PubMed Central

    Albright, Cheryl L.; Steffen, Alana D.; Wilkens, Lynne R.; White, Kami K.; Novotny, Rachel; Nigg, Claudio R.; Saiki, Kara; Brown, Wendy J.

    2015-01-01

    Objective Few postpartum ethnic minority women perform leisure-time moderate-to-vigorous physical activity (MVPA). The study tested the effectiveness of a 12-month tailored intervention to increase MVPA in women with infants 2–12 months old. Methods From 2008–2011, women (n=311) with infants (average age = 5.7 months) from Honolulu, Hawaii were randomly assigned to receive tailored telephone calls and access to a mom-centric website (n=154) or access to a standard PA website (n=157). MVPA was measured at baseline, 6, and 12 months using self-report and acclerometers. Results Controlling for covariates, the tailored condition significantly increased self-reported MVPA from an average of 44 to 246 minutes/week compared with 46 to 156 minutes/week for the standard condition (p=0.027). Mothers with ≥ 2 children had significantly greater increases in MVPA in response to the tailored intervention than those with one child (p=0.016). Accelerometer-measured MVPA significantly increased over time (p=0.0001), with no condition differences. There was evidence of reactivity to initially wearing accelerometers; the tailored intervention significantly increased MVPA among women with low baseline accelerometer MVPA minutes, but not among those with high minutes (pinteraction=0.053). Conclusion A tailored intervention effectively increased MVPA over 12 months in multiethnic women with infants, particularly those with more than one child. PMID:25285751

  7. Perinatal Parenting Stress, Anxiety, and Depression Outcomes in First-Time Mothers and Fathers: A 3- to 6-Months Postpartum Follow-Up Study

    PubMed Central

    Vismara, Laura; Rollè, Luca; Agostini, Francesca; Sechi, Cristina; Fenaroli, Valentina; Molgora, Sara; Neri, Erica; Prino, Laura E.; Odorisio, Flaminia; Trovato, Annamaria; Polizzi, Concetta; Brustia, Piera; Lucarelli, Loredana; Monti, Fiorella; Saita, Emanuela; Tambelli, Renata

    2016-01-01

    Objective: Although there is an established link between parenting stress, postnatal depression, and anxiety, no study has yet investigated this link in first-time parental couples. The specific aims of this study were 1) to investigate whether there were any differences between first-time fathers’ and mothers’ postnatal parenting stress, anxiety, and depression symptoms and to see their evolution between three and 6 months after their child’s birth; and 2) to explore how each parent’s parenting stress and anxiety levels and the anxiety levels and depressive symptoms of their partners contributed to parental postnatal depression. Method: The sample included 362 parents (181 couples; mothers’ MAge = 35.03, SD = 4.7; fathers’ MAge = 37.9, SD = 5.6) of healthy babies. At three (T1) and 6 months (T2) postpartum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Postnatal Depression Scale, and the State-Trait Anxiety Inventory. Results: The analyses showed that compared to fathers, mothers reported higher scores on postpartum anxiety, depression, and parenting stress. The scores for all measures for both mothers and fathers decreased from T1 to T2. However, a path analysis suggested that the persistence of both maternal and paternal postnatal depression was directly influenced by the parent’s own levels of anxiety and parenting stress and by the presence of depression in his/her partner. Discussion: This study highlights the relevant impact and effects of both maternal and paternal stress, anxiety, and depression symptoms during the transition to parenthood. Therefore, to provide efficacious, targeted, early interventions, perinatal screening should be directed at both parents. PMID:27445906

  8. 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 ...

  9. 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 ...

  10. Comparisons of different instruments to measure blues and to predict depressive symptoms 2 months postpartum: a study of new mothers and fathers.

    PubMed

    Edhborg, Maigun

    2008-06-01

    The aim of the study was to investigate 'blues' during the first week postpartum in new mothers and fathers and to compare different instruments for measuring blues, as well as their ability to predict depressive symptoms at 2 months. Parents were informed while at the maternity clinic about the study and asked to independently answer questions for 5 days during the first week on the Blues Questionnaire, a VAS questionnaire and on the Edinburgh Postnatal Depression Scale (EPDS) at 1 week and 2 months. Of the parents who initially agreed to participate in the study 171 (38%) of the mothers and 133 (31%) of the fathers returned all questionnaires completely filled-out after the first week, and of these, 155 mothers and 113 fathers also completed the EPDS at 2 months. The results showed that mothers experienced more blues than fathers, and that mothers' blues peaked on day 3, while fathers' peaked on day 1 after the delivery-day. The Blues Questionnaire and the VAS subscale 'depressed mood' identified more women as having blues (64% and 52%, respectively) during the first week over the EPDS (24%), but the EPDS identified women with the highest scores on the Blues Questionnaire. At 2 months, 19 (12%) of the mothers, and one father scored 10 or more on the EPDS. All these women, except for one, had experienced severe blues according to the Blues Questionnaire, the first week. Regression analyses showed that the Blues Questionnaire subscale 'depression' was the best predictor for a high EPDS score at 2 months in mothers, while the subscales 'primary blues', 'hypersensitivity' and 'despondency' best predicted depressive symptoms in fathers. Our results indicate that the EPDS could be a valuable instrument to measure 'blues', as EPDS seemed to indicate women with the highest risk for depressive symptoms.

  11. [Contraceptive advice for the postpartum period].

    PubMed

    Couvreur, I; Delcroix, M

    1984-04-01

    The immediate postpartum period and the week of hospitalization is a privileged time for imparting information about the physiology of reproduction and contraception. Contraceptive counseling at this time may be done in groups or in individual sessions. Apart from the usual requirements of efficacy, innocuity, acceptability, and reversibility, postpartum contraception must respect lactation and the return of menstruation. 3/4 of women ovulate before the 1st postpartum mentstrual period, but never before the 25th postpartum day. In the absence of lactation, about 80% ovulate within 9 weeks. If lactation occurs ovulation is delayed and usually 1 or more anovulatory cycles occur, but the rate of conception is difficult to estimate. Methods that are unsuitable for postpartum use include the temperature method because of the absence of the hyperthermic plateau, cervical caps and diaphragms because correct measurements cannot be made until 5-6 months after delivery, and IUDs becuase of the large size of the uterine cavity, the fragility of the walls, the presence of lochia, the large size of the cervix, and the absence of cervical mucus which protects against infection. Local contraception with tablets, spermicidal gels, or condoms is a good choice, especially for breastfeeding women, because of improved success rates, good tolerance, and acceptability. In prescribing oral contraceptives, pathologies of pregnancy such as hypertension and phlebitis must be considered along with the classical contraindicatins. The formulation must not affect the quality or quantity of milk. Standard dosed combined pills and monophasic and biphasic minidose pills increase the thromboembolic risk if they are taken soon after delivery, used by women who smoke, if the estrogen component is large, or if the women's cholesterol level is elevated. Minipills and progestagen-only micropills are interesting choices for postpartum women because of the reduced steroid doses. Micropills should be

  12. Month

    NASA Astrophysics Data System (ADS)

    Murdin, P.

    2000-11-01

    A unit of time based on the motion of the Moon around the Earth. The synodic (or lunar) month is the mean time interval between two successive new moons (i.e. the time taken for the Moon to pass through its cycle of phases) and is equal to 29.53059 mean solar days. Because the synodic month (the basis of the lunar calendar) is not equal to a whole number of days, the calendar month is rounded to ...

  13. 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.

  14. Postpartum Depression

    MedlinePlus

    ... It's important for new mothers — and those who love them — to understand the symptoms of postpartum depression ... Once she's receiving the care she needs, support, love, and friendship are good medicine, too. Here are ...

  15. 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.

  16. Docosahexaenoic Acid Supplementation from Mid-Pregnancy to Parturition Influenced Breast Milk Fatty Acid Concentrations at 1 Month Postpartum in Mexican Women1234

    PubMed Central

    Imhoff‐Kunsch, Beth; Stein, Aryeh D.; Villalpando, Salvador; Martorell, Reynaldo; Ramakrishnan, Usha

    2011-01-01

    (n-3) PUFA, including DHA, are essential for neural development and accumulate extensively in the fetal and infant brain. (n-3) PUFA concentrations in breast milk, which are largely dependent on maternal diet and tissue stores, are correlated with infant PUFA status. We investigated the effect of prenatal DHA supplementation on PUFA concentrations in breast milk at 1 mo postpartum. In a double-blind, randomized, controlled trial conducted in Mexico, pregnant women were supplemented daily with 400 mg DHA or placebo from 18–22 wk gestation to parturition. Fatty acid concentrations in breast milk obtained from 174 women at 1 mo postpartum were determined using GLC and were expressed as % by weight of total detected fatty acids. Breast milk DHA concentrations in the DHA and placebo groups were (mean ± SD) 0.20 ± 0.06 and 0.17 ± 0.07 (P < 0.01), respectively, and those of α-linolenic acid (ALA) were 1.38 ± 0.47 and 1.24 ± 0.46 (P = 0.01), respectively. Concentrations of EPA and arachidonic acid did not differ between groups (P > 0.05). Maternal plasma DHA concentrations at 1 mo postpartum correlated positively with breast milk DHA at 1 mo postpartum in both the placebo and DHA groups (r = 0.4; P < 0.01 for both treatment groups). Prenatal DHA supplementation from 18–22 wk gestation to parturition increased concentrations of DHA and ALA in breast milk at 1 mo postpartum, providing a mechanism through which breast-fed infants could benefit. PMID:21178076

  17. Postpartum Preeclampsia

    MedlinePlus

    ... after the 20th week of your pregnancy. Other risk factors include obesity, a family history of high blood pressure, age (younger than 20 and older than 40), and being pregnant with multiple babies (twins, triplets, or more). How is postpartum preeclampsia diagnosed? ...

  18. Postpartum Mood Disorders

    PubMed Central

    Misri, Shaila; Burgmann, Allan J.F.

    1992-01-01

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

  19. Changes in sexual relationships in postpartum couples.

    PubMed

    Fischman, S H; Rankin, E A; Soeken, K L; Lenz, E R

    1986-01-01

    To assess perceived changes in intimacy and sexuality in postpartum couples, an Intimate Relationship Scale was developed, tested for reliability (alpha = 0.86), and administered by mail. Sixty-eight, middle-class couples responded at four months postpartum and 126 couples at 12 months postpartum. Data revealed declines in the frequency of and desire for sexual activity, especially for mothers, when compared to sexual activity before the infant's birth. At four months postpartum, most women reported physical discomfort with sexual intercourse, a decline in physical strength, dissatisfaction with bodily appearance, and fatigue which interfered with sex. Strategies and techniques to promote and maintain intimacy and sexuality in postpartum couples are suggested to assist their transition to parenthood and may positively influence parenting behaviors.

  20. Postpartum Depression Facts

    MedlinePlus

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

  1. Delayed angiographic changes in postpartum cerebral angiopathy.

    PubMed

    Ghia, Darshan; Cuganesan, Ramesh; Cappelen-Smith, Cecilia

    2011-03-01

    Postpartum cerebral angiopathy is a well-recognised subgroup of the reversible vasoconstriction syndromes. Increasingly described is a delay between clinical onset and angiographic changes. We report a patient who presented 19 days postpartum with severe thunderclap headaches, vertigo and a seizure. The clinical syndrome preceded evidence of extensive vasoconstriction on MRA imaging by 15 days; the changes were reversible at 3 months.

  2. 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.

  3. Postpartum Post-Traumatic Stress Disorder

    MedlinePlus

    ... Depression During Pregnancy & Postpartum Anxiety During Pregnancy & Postpartum Pregnancy or Postpartum Obsessive Symptoms Postpartum Post-Traumatic Stress Disorder Bipolar Mood Disorders Postpartum Psychosis Tools for ...

  4. Tips for Postpartum Dads and Partners

    MedlinePlus

    ... Depression During Pregnancy & Postpartum Anxiety During Pregnancy & Postpartum Pregnancy or Postpartum Obsessive Symptoms Postpartum Post-Traumatic Stress Disorder Bipolar Mood Disorders Postpartum Psychosis Tools for ...

  5. Severe fatigue and depressive symptoms in lower-income urban postpartum women.

    PubMed

    Doering Runquist, Jennifer J; Morin, Karen; Stetzer, Frank C

    2009-08-01

    The purpose of this study was to identify whether severe postpartum fatigue at 1 and 3 months postpartum was associated with depressive symptomatology at 6 months in lower-income urban women. A convenience sample of 43 lower-income postpartum women completed the Modified Fatigue Symptoms Checklist and Edinburgh Postpartum Depression scale at 1, 3, and 6 months postpartum. Participants who were severely fatigued at both 1 and 3 months postpartum were significantly more likely to exhibit depressive symptomatology at 6 months. Fatigue and depressive symptoms were moderately to strongly correlated at 1 (r = .68), 3 (r = .74), and 6 (r = .70) months postpartum (p = .001). Severe fatigue and depressive symptomatology often co-exist for months after childbirth. Future research should examine whether interventions to targeting severe postpartum fatigue in lower-income urban women may also effectively reduce depressive symptoms.

  6. What barriers thwart postpartum women's physical activity goals during a 12-month intervention? A process evaluation of the Nā Mikimiki Project.

    PubMed

    Albright, Cheryl L; Saiki, Kara; Steffen, Alana D; Woekel, Erica

    2015-01-01

    Approximately 70% of new mothers do not meet national guidelines for moderate-to-vigorous physical activity (MVPA). The Nā Mikimiki ("the active ones") Project (2008-2011) was designed to increase MVPA among women with infants 2-12 months old. Participants' barriers to exercising and achievement of specific MVPA goals were discussed during telephone counseling calls over 12 months. Healthy, inactive women (n = 115, mean age = 31 ± 5 years, infants' mean age = 5.5 ± 3 months; 80% racial/ethnic minorities) received a total of 17 calls over 12 months in three phases. During Phase 1 weekly calls were made for a month, in Phase 2 biweekly calls were made for 2 months, and in Phase 3 monthly calls were made for 9 months. Across all phases, the most frequent barriers to achieving MVPA goals were: time/too busy (25%), sick child (11%), and illness (10%). Goals for MVPA minutes per week were achieved or surpassed 40.6% of the time during weekly calls, 39.9% during biweekly calls, and 42.0% during monthly calls. The least likely MVPA goals to be achieved (p < 0.04) were those which the woman encountered and for which she failed to overcome the barriers she had previously anticipated would impair her improvement of MVPA. This process evaluation demonstrated that telephone counseling somewhat facilitated the resolution of barriers and achievement of MVPA goals; thus, if clinical settings adopted such methods, chronic disease risks could be reduced in this vulnerable population of new mothers.

  7. 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.

  8. Postpartum contraceptive methods.

    PubMed

    1990-08-01

    Contraceptive methods suitable for postpartum women include sterilization, intrauterine devices (IUDs), barrier methods, oral contraceptives, implants, injectables, breastfeeding, and natural family planning. Couples considering either male or female sterilization should receive counseling since this method is irreversible; however, it is very effective. IUDs are effective, reversible, and can be inserted as early as 10 minutes following placental delivery. Barrier methods are not as effective and include condoms, spermicides, diaphragm, and cervical caps. While condoms and spermicides can be employed whenever sexual activity resumes, diaphragms and cervical caps can be used 4-6 weeks postpartum. The progestin-only and the combined oral contraceptives are both very effective. There is disagreement among professionals regarding when nursing mothers should start taking oral contraceptives and implant and injectable contraceptives. Implants and injectable contraceptives have long acting effects. Breastfeeding is a natural form of contraception which can last up to 6 months; it also supplies nutritional and immunological benefits. Natural family planning requires providing women with information on fertility awareness.

  9. 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…

  10. 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…

  11. Sheehan's syndrome presenting as postpartum seizures.

    PubMed

    Jain, G; Singh, D; Kumar, S

    2010-05-01

    We report a case where a patient presented with generalised tonic-clonic seizures secondary to nausea, vomiting and dehydration. She had suffered a postpartum haemorrhage six months previously. On laboratory assessment hyponatraemia and low hormone concentrations suggested pituitary failure. The diagnosis was confirmed by magnetic resonance imaging of the head, which showed a partially empty sella turcica. Given the severity of the morbidity in this case we emphasise that Sheehan's syndrome should be suspected in women presenting with postpartum seizures.

  12. Nurses' knowledge of traditional Chinese postpartum customs.

    PubMed

    Tien, Sheng-Fang

    2004-11-01

    This study was conducted to determine nurses' and postpartum women's knowledge of and attitudes toward the traditional Chinese custom of 1-month confinement following delivery, to discover factors influencing the attitudes, and to analyze the correlation between them. After a descriptive and inferential analysis of 173 questionnaires (121 recent mothers and 52 nurses), a significant difference was found in the women's and nurses' scores for knowledge of the postpartum confinement custom, with postpartum women scoring higher than the nursing staff on average. Both groups held positive attitudes toward the traditional custom. Attitudes and level of knowledge were positively correlated. Results of this study can serve as a reference for in-service nursing education, which should include information about traditional postpartum customs.

  13. Preventing postpartum depression: A meta-analytic review

    PubMed Central

    Sockol, Laura E.; Epperson, C. Neill; Barber, Jacques P.

    2014-01-01

    This meta-analysis assessed the efficacy of a wide range of preventive interventions designed to reduce the severity of postpartum depressive symptoms or decrease the prevalence of postpartum depressive episodes. A systematic review identified 37 randomized or quasi-randomized controlled trials in which an intervention was compared to a control condition. Differences between treatment and control conditions in the level of depressive symptoms and prevalence of depressive episodes by 6 months postpartum were assessed in separate analyses. Depressive symptoms were significantly lower at post-treatment in intervention conditions, with an overall effect size in the small range after exclusion of outliers (Hedges' g = 0.18). There was a 27% reduction in the prevalence of depressive episodes in intervention conditions by 6 months postpartum after removal of outliers and correction for publication bias. Later timing of the postpartum assessment was associated with smaller differences between intervention and control conditions in both analyses. Among studies that assessed depressive symptoms using the EPDS, higher levels of depressive symptoms at pre-treatment were associated with smaller differences in depressive symptoms by 6 months postpartum. These findings suggest that interventions designed to prevent postpartum depression effectively reduce levels of postpartum depressive symptoms and decrease risk for postpartum depressive episodes. PMID:24211712

  14. Suppression of natural killer cell cytotoxicity in postpartum women: time course and potential mechanisms.

    PubMed

    Groer, Maureen W; El-Badri, Nagwa; Djeu, Julie; Williams, S Nicole; Kane, Bradley; Szekeres, Karoly

    2014-07-01

    Little is known about the recovery of the immune system from normal pregnancy and whether the postpartum period is a uniquely adapted immune state. This report extends previous observations from our group of decreased natural killer (NK) cell cytotoxicity in the postpartum period. NK cytotoxicity was measured from 1 week through 9 months postpartum. In addition, NK cytotoxicity was assayed in the presence or absence of pooled plasmas collected from either postpartum or nonpostpartum women. Samples of cells were stained for inhibitory receptors and analyzed by flow cytometry. NK cytotoxicity remained decreased in postpartum women compared to controls through the first 6 postpartum months, returned to normal levels by 9 months, and remained normal at 12 months. NK cytotoxicity during the first 6 months was further inhibited by the addition of pooled plasma to NK cultures from postpartum women, but the addition of pooled plasma from the control group did not affect that group's NK cultures. There were differences in inhibitory receptor staining between the two groups, with decreased CD158a and CD158b and increased NKG2A expression on postpartum NK cells during the first 3 postpartum months. These data suggest that NK cytotoxicity postpartum inhibition lasts 6 months and is influenced by unidentified postpartum plasma components. The effect may also involve receptors on NK cells.

  15. [Postpartum endocrine syndrome].

    PubMed

    Ducarme, G; Châtel, P; Luton, D

    2008-05-01

    Postpartum endocrine syndromes occur in the year after delivery. They are due to immunologic and vascular modifications during pregnancy. The Sheehan syndrome is the first described postpartum endocrine syndrome and consists on a hypophyse necrosis in relation with a hypovolemic shock during delivery. The immunologic consequences of the pregnancy are the most frequent, sometimes discrete and transitory. The physiological evolution of the endocrine glands during pregnancy and the most frequent post-partum endocrine syndromes are discussed: postpartum lymphocytic hypophysitis, thyroiditis and Sheehan' syndrome.

  16. Oxytocin course over pregnancy and postpartum period and the association with postpartum depressive symptoms.

    PubMed

    Jobst, Andrea; Krause, Daniela; Maiwald, Carina; Härtl, Kristin; Myint, Aye-Mu; Kästner, Ralph; Obermeier, Michael; Padberg, Frank; Brücklmeier, Benedikt; Weidinger, Elif; Kieper, Susann; Schwarz, Markus; Zill, Peter; Müller, Norbert

    2016-08-01

    During the postpartum period, women are at higher risk of developing a mental disorder such as postpartum depression (PPD), a disorder that associates with mother-infant bonding and child development. Oxytocin is considered to play a key role in mother-infant bonding and social interactions and altered oxytocin plasma concentrations were found to be associated with PPD. In the present study, we evaluated oxytocin plasma levels and depressive symptoms during pregnancy and the postpartum period in healthy women. We evaluated 100 women twice during pregnancy (weeks 35 and 38) and three times in the postpartum period (within 2 days and 7 weeks and 6 months after delivery) by measuring oxytocin plasma levels with enzyme-linked immunosorbent assay (ELISA) and assessing depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Oxytocin plasma levels significantly increased from the 35th week of gestation to 6 months postpartum in all women. However, levels decreased from the 38th week of gestation to 2 days after delivery in participants with postpartum depressive symptoms, whereas they continuously increased in the group without postpartum depressive symptoms; the difference between the course of oxytocin levels in the two groups was significant (Δt2-t3: t = 2.14; p = 0.036*). Previous depressive episodes and breastfeeding problems predicted postpartum depressive symptoms. Our results indicate that alterations in the oxytocin system during pregnancy might be specific for women who develop postpartum depressive symptoms. Future studies should investigate whether oxytocin plasma levels might have predictive value in women at high risk for PPD.

  17. Safety and effectiveness of minimally invasive sacroiliac joint fusion in women with persistent post-partum posterior pelvic girdle pain: 12-month outcomes from a prospective, multi-center trial.

    PubMed

    Capobianco, Robyn; Cher, Daniel

    2015-01-01

    Postpartum posterior pelvic girdle pain (PPGP) affects nearly 20 % of women who experience back pain in the peripartum period. The sacroiliac joint is a source of this pain in 75 % of women with persistent PPGP. A subset of women will fail to obtain acceptable pain relief from the current array of non-surgical treatment options. The purpose of this study is to assess the safety and effectiveness of minimally invasive sacroiliac (SI) joint fusion in women with chronic SI joint dysfunction whose pain began in the peri-partum period whose symptoms were recalcitrant to non-surgical management. A sub-group analysis of subjects with sacroiliac joint disruption and/or degenerative sacroiliitis enrolled in a prospective, multi-center trial of SI joint fusion was performed. Subjects with PPGP were identified and compared with women without PPGP and with men. Of 172 enrolled subjects, 52 were male, 100 were females without PPGP and 20 females had PPGP. PPGP subjects were significantly younger (43.3 years, vs. 52.8 for females without PPGP and 50.5 for men, p = 0.002). There were no differences in any other demographic or baseline clinical measure. Women with PPGP experienced a significant improvement in pain (-51 mm on VAS), function (-20.6 pts on ODI) and quality of life (SF-36 PCS +10.4, MCS +7.2, EQ-5D +0.31) at 12 months after surgery. These improvements were characteristic of the overall study results; no difference was detected between sub-groups. The sacroiliac joint can be a source of pain in women with persistent PPGP and should be investigated as a pain generator. In this study, women with carefully diagnosed chronic SI joint pain from PPGP recalcitrant to conservative therapies experienced clinically beneficially improvements in pain, disability and quality of life after minimally invasive SI joint fusion using a series of triangular porous plasma spray coated implants.

  18. 3,4-Dimethylphenol

    Integrated Risk Information System (IRIS)

    3,4 - Dimethylphenol ; CASRN 95 - 65 - 8 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for Noncarcinogen

  19. 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…

  20. Immune Changes and Dysphoric Moods across the Postpartum

    PubMed Central

    Groer, Maureen E.; Jevitt, Cecilia; Ji, Ming

    2014-01-01

    Problem Little is known about postpartum immune recovery and relationships of common dysphoric moods, stress, immunology and endocrinology. Method of Study Healthy women (n=72) were followed for six postpartum months with immune and hormone measures and dysphoric moods and stress scales. A panel of cytokines produced in mitogen-stimulated whole blood assays were measured at each time, along with plasma levels of hsC-reactive protein (hsCRP), Interleukin-6 (IL-6), and a panel of hormones. Results Cellular immunity, measured by production of Interferon-gamma (IFNγ) and (Interleukin-2 (IL-2) from stimulated whole blood culture, was low in the early postpartum with changes by 3 months. Tumor necrosis factor alpha (TNFα) showed a similar pattern. Plasma levels of C-reactive protein and Interleukin-6 (IL-6) showed higher levels in the early postpartum. Mood disturbance scores dropped across the postpartum with a change in slope at 3 months. No significant relationships were found between immune, endocrine, and psychosocial measures. Conclusions Return to normal cellular immune function may take 3 to 4 months in the postpartum. Some aspects of early immunology (hsCRP and IL-6) probably reflect the latter stage of pregnancy, the stress of birth and the inflammation associated with involution. Dysphoric moods are higher in the early postpartum but are not related to immune factors or hormones. PMID:25227158

  1. [Acute postpartum psychoses].

    PubMed

    Tabbane, K; Charfi, F; Dellagi, L; Guizani, L; Boukadida, L

    1999-11-01

    The post-partum is a high risk period for the development of acute psychotic disorders. The frequence of post-partum psychoses is evaluated at 1 to 2 per 1,000 births. Post-partum psychosis include major affective disorders which is the most frequent diagnosis. The clinical pictures have specific characteristics: rapid change of symptomatology, liability of mood, and frequent confusional signs. The short-term prognosis is generally good but the risk of recurrence of the mental disorder, in or outside puerperal context, is high. At clinical, evolutive and genetic levels, the studies do not provide arguments for nosological autonomy of post-partum psychosis. At therapeutic level, the ECT is particularly efficient in this indication.

  2. Postpartum Support International

    MedlinePlus

    ... Post-Traumatic Stress Disorder Bipolar Mood Disorders Postpartum Psychosis Tools for Mom Frequently Asked Questions Screening Recommendations ... the Blues: Partners Coping with Suicide & Loss Perinatal Psychosis Related Tragedies Professionals Overview PSI Certificate Trainings Trainings & ...

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

    PubMed

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

    2013-02-01

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

  4. 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).…

  5. Postpartum catatonia treated with electroconvulsive therapy: a case report.

    PubMed

    Strain, Angela Katherine; Meltzer-Brody, Samantha; Bullard, Elizabeth; Gaynes, Bradley N

    2012-01-01

    Catatonia is a rare syndrome that occurs in mood and psychotic disorders, and general medical conditions. Postpartum depression affects 10%-15% of women within 6 months after delivery. Postpartum psychosis affects 0.1%-0.5% of women within weeks after delivery, though it can occur within hours; it carries risk for suicide and infanticide. There is limited evidence available to guide treatment. We review a case of postpartum psychosis that presented with catatonia and was resistant to medications, but responded to electroconvulsive therapy.

  6. [Post-partum psychosis].

    PubMed

    Gressier, Florence; Letranchant, Aurélie; Hardy, Patrick

    2015-02-01

    Postpartum psychosis occurs in 1-2/1000 childbearing women. It is commonly admitted that it belongs to bipolar disorder with psychotic features. A strong link between puerperal psychosis and bipolar disorder has been established. Symptoms include rapid mood fluctuations, confusion, delusions, hallucinations and bizarre behaviour. It can lead to devastating consequences. It is a psychiatric emergency that requires an urgent evaluation to exclude any organic cause. Therefore, early identification and appropriate treatment are critical. A quick and effective relief is necessary for maternal and child health and mother-infant relationship. Perinatal health professionals have to be accurate screening postpartum psychosis symptoms and have to educate patients and their family.

  7. 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

  8. Association between sleep quality and postpartum depression

    PubMed Central

    Iranpour, Sohrab; Kheirabadi, Gholam Reza; Esmaillzadeh, Ahmad; Heidari-Beni, Motahar; Maracy, Mohammad Reza

    2016-01-01

    Background: The objective of this study was an investigation of the association between depression and sleep quality. Materials and Methods: This cross-sectional study was performed on 360 delivered women that referred to thirty health-care centers in Ardabil, Iran. The Standard Pittsburgh Sleep Quality Index questionnaire was used to the investigation of sleep quality. We used the Edinburgh Postnatal Depression Questionnaire to assess postpartum depression. Logistic regression was used to examine the association of sleep quality with postpartum depression. Results: Chance of depression in women with poor sleep quality was 3.34 times higher than those with good sleep quality (odds ratio = 3.34; 95% confidence interval: 2.04–5.48; P < 0.001). After controlling for some risk factors, an association observed between sleep quality and depression in postpartum women. Conclusion: we found an association between sleep quality in women who had given birth in the last 3 months and symptoms of postpartum depression. PMID:28250787

  9. Gender differences in postpartum depression: a longitudinal cohort study

    PubMed Central

    Artazcoz, Lucía

    2010-01-01

    Background The course of depression from pregnancy to 1 year post partum and risk factors among mothers and fathers are not known. Aims (1) To report the longitudinal patterns of depression from the third trimester of pregnancy to 1 year after childbirth; (2) to determine the gender differences between women and their partners in the effect of psychosocial and personal factors on postpartum depression. Methods A longitudinal cohort study was carried out over a consecutive sample of 769 women in their third trimester of pregnancy and their partners attending the prenatal programme in the Valencian Community (Spain) and follow-up at 3 and 12 months post partum. The outcome variable was the presence of depression at 3 or 12 months post partum measured by the Edinburgh Postnatal Depression Scale. Predictor variables were: psychosocial (marital dissatisfaction, confidant and affective social support) and personal (history of depression, partner's depression and negative life events, depression during the third trimester of pregnancy) variables. Logistic regression models were fitted via generalised estimating equations. Results At 3 and 12 months post partum, 9.3% and 4.4% of mothers and 3.4% and 4.0% of fathers, respectively, were newly diagnosed as having depression. Low marital satisfaction, partner's depression and depression during pregnancy increased the probability of depression during the first 12 months after birth in mothers and fathers. Negative life events increased the risk of depression only among mothers. Conclusions Psychosocial and personal factors were strong predictors of depression during the first 12 months post partum for both mothers and fathers. PMID:20515899

  10. 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

  11. [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.

  12. Postpartum female sexual function.

    PubMed

    Abdool, Zeelha; Thakar, Ranee; Sultan, Abdul H

    2009-08-01

    Although many women experience sexual problems in the postpartum period, research in this subject is under-explored. Embarrassment and preoccupation with the newborn are some of the reasons why many women do not seek help. Furthermore, there is a lack of professional awareness and expertise and recognition that a prerequisite in the definition of sexual dysfunction is that it must cause distress to the individual (not her partner). Sexual dysfunction is classified as disorders of sexual desire, arousal, orgasm and pain. However, in the postpartum period the most common disorder appears to be that of sexual pain as a consequence of perineal trauma. Health care workers need to be made aware of this silent affliction as sexual morbidity can have a detrimental effect on a women's quality of life impacting on her social, physical and emotional well-being.

  13. Management of postpartum haemorrhage

    PubMed Central

    Bonnet, Marie Pierre; Benhamou, Dan

    2016-01-01

    Postpartum Haemorrhage (PPH) is a major cause of maternal morbidity and mortality. Treatment of acquired coagulopathy observed in severe PPH is an important part of PPH management, but is mainly based on literature in trauma patients, and data thus should be interpreted with caution. This review describes recent advances in transfusion strategy and in the use of tranexamic acid and fibrinogen concentrates in women with PPH. PMID:27408694

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

    PubMed

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

    2014-11-01

    Physical activity is associated with improved sleep quality and duration in the general population, but its effect on sleep in postpartum women is unknown. 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. MVPA was not associated with sleep quality or duration at 3-months postpartum. At 12-months postpartum, a 1 h/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 1 h/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 1 h/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 1 h/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. 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.

  15. Postpartum period: three distinct but continuous phases

    PubMed Central

    Romano, Mattea; Cacciatore, Alessandra; Giordano, Rosalba; La Rosa, Beatrice

    2010-01-01

    Postpartum period is distinct in three phases. The third phase is the delayed postpartum period, which can last up to 6 months. Some changes to the genitourinary system are much longer in resolving, and some may never fully revert to the prepregnant state. A burgeoning volume of literature on pelvic floor support implicates childbirth as the initiation of a whole host of conditions including stress urinary incontinence, incontinence of flatus or feces, uterine prolapse, cystocele, and rectocele. The duration and severity of these conditions affect many variables, including the patientʼs intrinsic collagen support, the size of the infant, the route of delivery, and the degree of perineal trauma occurring either naturally (lacerations) or iatrogenically (episiotomy). PMID:22439056

  16. 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

  17. Latinas and Postpartum Depression: Role of Partner Relationship, Additional Children, and Breastfeeding

    ERIC Educational Resources Information Center

    Hassert, Silva; Kurpius, Sharon E. Robinson

    2011-01-01

    Breastfeeding, additional children, and partner relationship predicted postpartum depression among 59 Latinas who had an infant who was 6 months old or younger. The most powerful predictor was conflict with partner. Counselors working with Latinas experiencing postpartum depression should explore the partner relationship, particularly relationship…

  18. Comparison of Postpartum and Nonpostpartum Depression: Clinical Presentation, Psychiatric History, and Psychosocial Functioning.

    ERIC Educational Resources Information Center

    Whiffen, Valerie E.; Gotlib, Ian H.

    1993-01-01

    Compared postpartum women diagnosed with depression with nonpostpartum depressed group and two nondepressed groups. Postpartum depression tended to be relatively mild. Both depressed groups had high rates of positive psychiatric history and were equally likely to have recovered at six-month follow-up. Findings suggest little to distinguish…

  19. 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…

  20. Antiretroviral adherence during pregnancy and postpartum in Latin America.

    PubMed

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

    2012-08-01

    Adherence to antiretrovirals by pregnant women (and postpartum women if breastfeeding) is crucial to effectively decrease maternal viral load and decrease the risk of mother-to-child transmission of HIV. Our objectives were to describe self-reported adherence to antiretrovirals during the antepartum (after 22 weeks of pregnancy) and postpartum periods (6-12 weeks and 6 months), and identify predictors of adherence among HIV-infected women enrolled and followed in a prospective cohort study from June 2008 to June 2010 at multiple sites in Latin America. Adherence was evaluated using the number of missed and expected doses during the 3 days before the study visit. At the pre-delivery visit, 340 of 376 women (90%) reported perfect adherence. This rate significantly decreased by 6-12 weeks (171/214 [80%]) and 6 months postpartum (163/199 [82%], p<0.01). The odds for less than perfect adherence at the pre-delivery visit was significantly higher for pregnant women with current tobacco use (odds ratio [OR]=2.9, 95% confidence interval [CI]: 1.46-6.14; p=0.0029). At 6-12 weeks postpartum, the probability of non-perfect adherence increased by 6% for each 1 year increase in age (OR=1.06, 95% CI: 1.00-1.12, p=0.0497). At 6 months postpartum, the odds of nonperfect adherence was higher for those who were currently using alcohol (OR=3.04, 95% CI: 1.34-6.90; p=0.0079). Although a self-report measure of adherence based on only 3 days may lead to overestimation of actual adherence over time, women with perfect adherence had lower viral loads and higher CD4 counts. Adherence to antiretrovirals decreased significantly postpartum. Interventions should target women at high risk for lower adherence during pregnancy and postpartum, including tobacco and alcohol users.

  1. Antiretroviral Adherence During Pregnancy and Postpartum in Latin America

    PubMed Central

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

    2012-01-01

    Abstract Adherence to antiretrovirals by pregnant women (and postpartum women if breastfeeding) is crucial to effectively decrease maternal viral load and decrease the risk of mother-to-child transmission of HIV. Our objectives were to describe self-reported adherence to antiretrovirals during the antepartum (after 22 weeks of pregnancy) and postpartum periods (6–12 weeks and 6 months), and identify predictors of adherence among HIV-infected women enrolled and followed in a prospective cohort study from June 2008 to June 2010 at multiple sites in Latin America. Adherence was evaluated using the number of missed and expected doses during the 3 days before the study visit. At the pre-delivery visit, 340 of 376 women (90%) reported perfect adherence. This rate significantly decreased by 6–12 weeks (171/214 [80%]) and 6 months postpartum (163/199 [82%], p<0.01). The odds for less than perfect adherence at the pre-delivery visit was significantly higher for pregnant women with current tobacco use (odds ratio [OR]=2.9, 95% confidence interval [CI]: 1.46–6.14; p=0.0029). At 6–12 weeks postpartum, the probability of non-perfect adherence increased by 6% for each 1 year increase in age (OR=1.06, 95% CI: 1.00–1.12, p=0.0497). At 6 months postpartum, the odds of nonperfect adherence was higher for those who were currently using alcohol (OR=3.04, 95% CI: 1.34–6.90; p=0.0079). Although a self-report measure of adherence based on only 3 days may lead to overestimation of actual adherence over time, women with perfect adherence had lower viral loads and higher CD4 counts. Adherence to antiretrovirals decreased significantly postpartum. Interventions should target women at high risk for lower adherence during pregnancy and postpartum, including tobacco and alcohol users. PMID:22663185

  2. Postpartum autoimmune thyroid syndrome: a model of aggravation of autoimmune disease.

    PubMed

    Amino, N; Tada, H; Hidaka, Y

    1999-07-01

    Postpartum thyroid dysfunction is rather a common problem during the postpartum period being found in approximately 5% of mothers in the general population. It occurs from subclinical autoimmune thyroiditis that is aggravated after parturition and causes various types of thyroid dysfunction. Immune activity is physiologically suppressed during pregnancy so that the fetus is not rejected, and rebounds above the normal level after parturition. Graves' disease and Hashimoto's thyroiditis also spontaneously ameliorate during pregnancy, and are often aggravated after parturition. The high-risk mothers for postpartum thyroid dysfunction are well screened by antithyroid microsomal antibody (MCAb) and 60% to 70% of MCAb-positive mothers develop postpartum thyroid dysfunction, which is transient in most cases. New onset of Graves' disease may be screened by thyroid-stimulating antibody (TSAb) and 70% of TSAb-positive mothers develop either transient or persistent postpartum Graves' disease that usually occurs 3 to 6 months postpartum. Immune rebound after parturition may cause not only autoimmune thyroid diseases but other autoimmune diseases, which may be investigated with similar strategies to those in postpartum autoimmune thyroid disease. Thus, we found that postpartum onset of rheumatoid arthritis was found in 0.08% of women in the general population and could be partially predicted by measuring rheumatoid factors in early pregnancy. There are several case reports of other autoimmune diseases that develop after delivery; postpartum renal failure or postdelivery hemolytic-uremic syndrome, postpartum idiopathic polymyositis, postpartum syndrome with antiphospholipid antibodies, postpartum autoimmune myocarditis. Many other possible postpartum autoimmune diseases are still unexplored. Puerperal diseases should be carefully examined in relation to autoimmune abnormalities in the affected organs.

  3. Prenatal predictors of postpartum depression and postpartum depressive symptoms in Mexican mothers: a longitudinal study.

    PubMed

    Lara, María Asunción; Navarrete, Laura; Nieto, Lourdes

    2016-10-01

    Prospective studies on the predictors of postpartum depression (PPD) in Latin America are scarce, which is a matter of importance, since the significance of PPD risk factors may vary according to the level of development of a country, the types of measurement and the time periods assessed. This study identifies the prenatal predictors for PPD (diagnostic interview) and postpartum depressive symptoms (PPDS) (self-report scale) in Mexican mothers at 6 weeks and 6 months postpartum. Two hundred and ten women were interviewed using the Structured Clinical Interview (SCID-I), Patient Health Questionnaire (PHQ-9) and various risk factor scales. Univariate logistic regressions showed that social support, marital satisfaction, life events, a history of psychopathology, anxiety symptoms, depressive symptoms, the traditional female role, previous miscarriages/termination of pregnancy and unplanned/unwanted pregnancy were significant predictors for both PPD and PPDS at both assessment times in the postpartum. Education, age, marital status, income, occupation, parity, C-section and resilience were significant for only one of the measurements and/or at just one assessment time. General findings replicate a high- and low-income country observed psychosocial risk profile and confirm a sociodemographic and obstetric profile of vulnerability that is more prevalent in resource-constrained countries. PPD constitutes a high burden for new mothers, particularly for those living in low-middle-income countries who face social disadvantages (such as low educational attainment and income).

  4. The Relationship Between Intuitive Eating and Postpartum Weight Loss.

    PubMed

    Leahy, Katie; Berlin, Kristoffer S; Banks, Gabrielle G; Bachman, Jessica

    2017-02-07

    Objective Postpartum weight loss is challenging for new mothers who report limited time and difficulties following traditional weight loss methods. Intuitive eating (IE) is a behavior that includes eating based on physical hunger and fullness and may have a role in encouraging weight loss. The purpose of this study was to examine the relationship between IE and postpartum weight loss. Methods Women 12-18 months postpartum completed a questionnaire regarding weight changes surrounding pregnancy, exercise, breastfeeding and intuitive eating using the Intuitive Eating Scale. Latent growth curve modeling was utilized to determine the relationship between IE, breastfeeding, weight gain during pregnancy, and postpartum weight trajectories. Results Participants (n = 50) were 28.5 ± 4.9 years old, had an average pre-pregnancy BMI of 26.4 ± 6.8 and the majority were married, and non-Hispanic white. The conditional model revealed that more intuitive eating practices predicted greater postpartum BMI decreases (Est. = -0.10, p < .05) when controlling for breastfeeding duration, exercise duration, and initial BMI and pregnancy BMI changes. Greater pregnancy BMI increases were associated with more rapid postpartum BMI decreases (Est. = -0.34, p < .001) while breastfeeding duration, exercise and initial BMI were not related. Conclusions for Practice Postpartum weight retention is a challenge for many women. Following a more intuitive eating approach to food consumption may encourage postpartum weight loss without the required weighing, measuring, recording and assessing dietary intake that is required of traditional weight loss programs. IE could offer an alternative approach that may be less arduous for new mothers.

  5. Infectious Postpartum Sacroiliitis: The Importance and Difficulty of Early Diagnosis.

    PubMed

    Vale-Fernandes, Emídio; Rodrigues, Fedra; Monteiro, Carla; Carvalho, Luís

    2016-08-01

    The sacroiliitis accounts for about 1.5% - 10% of all cases of septic arthritis and it is strongly associated with gynaecological infections, pelvic trauma or drug abuse (3.4% - 12.8% of cases occur during the postpartum period). Early diagnosis is difficult because the symptoms are nonspecific in pregnancy and in the postpartum period, making the delay of treatment a serious risk of irreversible damage to the joint and development of post-infectious complications. The authors describe the case of a 37-year-old puerperal woman presented to hospital, weeks after urgent caesarean section, with endometritis, post-anesthetic epidural hematoma and secondary infectious postpartum sacroiliitis. The diagnosis of sacroiliac joints pathology during pregnancy and puerperium is challenging. The pathogenesis of infectious sacroiliitis results from local contamination by contiguous infection or hematogenous spread of bacterial infections. The prognosis is usually favorable and depends on early diagnosis and treatment.

  6. Postpartum amenorrhoea and breast-feeding in a Danish sample.

    PubMed

    Vestermark, V; Høgdall, C K; Plenov, G; Birch, M

    1994-01-01

    The duration of postpartum amenorrhoea was studied in a Danish sample of 361 women. The median duration of amenorrhoea was 17 weeks. The 25th and 75th percentiles were 10 and 30 weeks, respectively. A significant correlation was found between the duration of postpartum amenorrhoea and of breast-feeding. However, lactation for more than 9 months did not extend the duration of amenorrhoea. Menstruation before weaning occurred in 57% of the women, and 43% terminated breast-feeding before the first menstruation. Four weeks after weaning menstruation had returned in 79% and by 8 weeks after in 93% of the mothers. At 6 months postpartum, frequency of breast-feeding, and of night-time feeding were determinants of amenorrhoea.

  7. Recurrent post-partum coronary artery dissection

    PubMed Central

    2010-01-01

    Coronary artery dissection is a rare but well-described cause for myocardial infarction during the post-partum period. Dissection of multiple coronary arteries is even less frequent. Here we present a case of recurrent post-partum coronary artery dissections. This unusual presentation poses unique problems for management. A 35 year-old female, gravida 3 para 2, presented with myocardial infarction 9 weeks and 3 days post-partum. Cardiac catheterization demonstrated left anterior descending (LAD) dissection but an otherwise normal coronary anatomy. The lesion was treated with four everolimus eluting stents. Initially the patient made an unremarkable recovery until ventricular fibrillation arrest occurred on the following day. Unsynchronized cardioversion restored a normal sinus rhythm and repeat catheterization revealed new right coronary artery (RCA) dissection. A wire was passed distally, but it was unclear whether this was through the true or false lumen and no stents could be placed. However, improvement of distal RCA perfusion was noted on angiogram. Despite failure of interventional therapy the patient was therefore treated conservatively. Early operation after myocardial infarction has a significantly elevated risk of mortality and the initial dissection had occurred within 24 hours. This strategy proved successful as follow-up transthoracic echocardiography after four months demonstrated a preserved left ventricular ejection fraction of 55-60% without regional wall motion abnormalities. The patient remained asymptomatic from a cardiac point of view. PMID:20932332

  8. Recurrent post-partum coronary artery dissection.

    PubMed

    Rajab, Taufiek K; Khalpey, Zain; Kraemer, Bernhard; Resnic, Frederic S; Gallegos, Robert P

    2010-10-09

    Coronary artery dissection is a rare but well-described cause for myocardial infarction during the post-partum period. Dissection of multiple coronary arteries is even less frequent. Here we present a case of recurrent post-partum coronary artery dissections. This unusual presentation poses unique problems for management. A 35 year-old female, gravida 3 para 2, presented with myocardial infarction 9 weeks and 3 days post-partum. Cardiac catheterization demonstrated left anterior descending (LAD) dissection but an otherwise normal coronary anatomy. The lesion was treated with four everolimus eluting stents. Initially the patient made an unremarkable recovery until ventricular fibrillation arrest occurred on the following day. Unsynchronized cardioversion restored a normal sinus rhythm and repeat catheterization revealed new right coronary artery (RCA) dissection. A wire was passed distally, but it was unclear whether this was through the true or false lumen and no stents could be placed. However, improvement of distal RCA perfusion was noted on angiogram. Despite failure of interventional therapy the patient was therefore treated conservatively. Early operation after myocardial infarction has a significantly elevated risk of mortality and the initial dissection had occurred within 24 hours. This strategy proved successful as follow-up transthoracic echocardiography after four months demonstrated a preserved left ventricular ejection fraction of 55-60% without regional wall motion abnormalities. The patient remained asymptomatic from a cardiac point of view.

  9. Sexual function in the postpartum period: effects of maternal depression and interpersonal psychotherapy treatment.

    PubMed

    Moel, Joy E; Buttner, Melissa M; O'Hara, Michael W; Stuart, Scott; Gorman, Laura

    2010-12-01

    Women's sexual functioning in the postpartum period is understudied given its potential impact on women's mental health and their relationships with their partners. The sexual functioning of women with postpartum depression (PPD) in particular is not well characterized. The goals of this study were to examine factors associated with the sexual functioning of postpartum women and to compare the long-term sexual functioning of depressed postpartum women treated with interpersonal psychotherapy with a group of postpartum women who had never been depressed. Depressed (120) and never depressed (56) postpartum women were enrolled. Self-report questionnaires and clinician-rated measures were completed at initial entry to study, immediately post-treatment, and at 6, 12, and 18 months post-treatment. Analyses revealed significant differences in sexual interest between depressed and never depressed postpartum women (t (171) = 11.82, p <0.001). Although sexual interest improved significantly following treatment for depression (t (104) = -3.18, p < 0.01), those women who fully recovered continued to experience less interest (F (2, 140) = 32.24, p < 0.0001) and less sexual satisfaction through 2 years postpartum than never depressed women. These findings suggest that differences in sexual functioning exist between depressed and never depressed postpartum women, even after depressed women are treated and have recovered from their depression. Clinicians should inquire about changes in sexual functioning when treating women with PPD.

  10. Early Interactions between Infants and Their Postpartum Depressed Mothers.

    ERIC Educational Resources Information Center

    Field, Tiffany

    The present study investigated whether infants of mothers who were depressed postpartum would behave like infants of non-depressed mothers who simulated depression. A total of 24 mothers and their 3-month-old infants were videotaped during face-to-face interactions. All mothers were given the Beck Depression Inventory (BDI) and the State-Trait…

  11. Rates and risk factors associated with depressive symptoms during pregnancy and with postpartum onset.

    PubMed

    Verreault, Nancy; Da Costa, Deborah; Marchand, André; Ireland, Kierla; Dritsa, Maria; Khalifé, Samir

    2014-09-01

    The objectives of this study were to evaluate the prevalence of depressive symptoms in the third trimester of pregnancy and at 3 months postpartum and to prospectively identify risk factors associated with elevated depressive symptoms during pregnancy and with postpartum onset. About 364 women attending antenatal clinics or at the time of their ultrasound were recruited and completed questionnaires in pregnancy and 226 returned their questionnaires at 3 months postpartum. Depressed mood was assessed by the Edinburgh Postnatal Depression Scale (EPDS; score of ≥ 10). The rate of depressed mood during pregnancy was 28.3% and 16.4% at 3 months postpartum. Among women with postpartum depressed mood, 6.6% were new postpartum cases. In the present study, belonging to a non-Caucasian ethnic group, a history of emotional problems (e.g. anxiety and depression) or of sexual abuse, comorbid anxiety, higher anxiety sensitivity and having experienced stressful events were associated with elevated depressed mood during pregnancy. Four risk factors emerged as predictors of new onset elevated depressed mood at 3 months postpartum: higher depressive symptomatology during pregnancy, a history of emotional problems, lower social support during pregnancy and a delivery that was more difficult than expected. The importance of identifying women at risk of depressed mood early in pregnancy and clinical implications are discussed.

  12. 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

  13. [Postpartum hemorrhage--an update].

    PubMed

    Gogarten, Wiebke

    2011-07-01

    Postpartum hemorrhage remains a major cause of maternal morbidity and mortality. The incidence of postpartum hemorrhage appears to be increasing in developed countries due to an increased number of placenta accreta or percreta after previous Cesarean deliveries. The initial therapy of postpartum hemorrhage consists of uterotonic drugs and inspection of the uterine cavum. At the same time, optimization of the clotting potential should be initiated early. Tranexamic acid may be considered as a first line choice, followed by fibrinogen if necessary. If bleeding continues, fresh frozen plasma and packed red cells should be ordered in a ratio of 1:1, as this ratio has been shown to improve survival in trauma victims. All labor and delivery suites should have standard operating procedures for the management of postpartum hemorrhage in place with regular drills.

  14. 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.

  15. 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…

  16. [Paternal postpartum depression: a review].

    PubMed

    Gressier, Florence; Tabat-Bouher, Myriam; Cazas, Odile; Hardy, Patrick

    2015-04-01

    Postpartum depression affects 1 in 10 fathers worldwide. Paternal PPD tends to develop gradually during the first year. Maternal depression is one of the most important risk factors for depression in fathers. Changes in hormones during the postpartum period in fathers are biological risk factors for PPD. Paternal PPD has negative impacts on family. Paternal PPD has negative effects on the infant's development, independently of maternal PPD. It is essential to identify paternal PPD at early stage.

  17. 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.

  18. Postpartum domperidone use in British Columbia: a retrospective cohort study

    PubMed Central

    Smolina, Kate; Morgan, Steven G.; Hanley, Gillian E.; Oberlander, Tim F.; Mintzes, Barbara

    2016-01-01

    Background: Domperidone is commonly used off-label to stimulate milk production in mothers who have low milk supply. The aim of this study was to describe trends, patterns and determinants of postpartum domperidone use. Methods: This is a retrospective, population-based study involving all women with a live birth between Jan. 1, 2002, and Dec. 31, 2011, in the province of British Columbia. We examined administrative data sets containing person-specific information on filled prescriptions and use of medical services, and we used logistic regression to examine associations between domperidone use and maternal characteristics. Results: The study population consisted of 225 532 women with 320 351 live births. The prevalence of postpartum domperidone use more than doubled between 2002 and 2011. In 2011, 1 in 3 women with a preterm birth and 1 in 5 women with a full-term birth were prescribed domperidone in the first 6 months postpartum. Women who were older, had a higher body mass index, had a chronic disease, were first-time mothers, delivered more than 1 baby (multiple pregnancy), had a preterm birth or had a cesarian delivery were more likely to fill a postpartum domperidone prescription. Interpretation: We found an increase in postpartum domperidone use over a 10-year period. More research is needed on maternal and infant health outcomes. PMID:27280111

  19. 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

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

    PubMed

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

    2015-03-01

    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 9 months postpartum. 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 4 months postpartum and 9 months postpartum and we used logistic regression to assess the correlates of IPV during this time. 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 9 months postpartum. Psychological IPV was the most prevalent type of IPV during pregnancy and the first 4 months postpartum. Age and previous violence within the relationship were associated with IPV during pregnancy and IPV during the postpartum period. 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.

  1. 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.

  2. Childbirth and symptoms of postpartum depression and anxiety: a prospective birth cohort study.

    PubMed

    Bell, A F; Carter, C S; Davis, J M; Golding, J; Adejumo, O; Pyra, M; Connelly, J J; Rubin, L H

    2016-04-01

    We investigated associations between aspects of childbirth and elevated postpartum symptoms of depression and anxiety. We employed secondary analysis of perinatal data (N = 4657-4946) from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Multivariable logistic regression models (adjusted for covariates) examined predictors of elevated symptoms of postpartum depression and anxiety. Predictors included the following: type of delivery (normal physiological vs. interventive non-physiological), immediate postpartum complications, and maternal perception of the recent birth experience. The Edinburgh Postnatal Depression Scale assessed elevated symptoms of depression (score ≥ 13), and the Crown-Crisp Experiential Index assessed elevated symptoms of anxiety (score ≥ 9) at 2 and 8 months after delivery. A more negative perception of the recent birth experience was associated with elevated symptoms of anxiety at 2 months [odds ratio (OR) 1.52, 95 % confidence interval (CI) 1.25-1.85] and 8 months (OR 1.30, 95 % CI 1.06-1.60) postpartum but was not associated with elevated symptoms of depression at either time point. Type of delivery (physiological vs. non-physiological) and immediate postpartum complications were not associated with elevated symptoms of depression or anxiety. Our findings suggest that improving women's childbirth experience may decrease the likelihood of postpartum anxiety, but not postpartum depression.

  3. Menstrual pattern, sexual behaviors, and contraceptive use among postpartum women in Nairobi urban slums.

    PubMed

    Ndugwa, Robert P; Cleland, John; Madise, Nyovani J; Fotso, Jean-Christophe; Zulu, Eliya M

    2011-06-01

    Postpartum months provide a challenging period for poor women. This study examined patterns of menstrual resumption, sexual behaviors and contraceptive use among urban poor postpartum women. Women were eligible for this study if they had a birth after the period September 2006 and were residents of two Nairobi slums of Korogocho and Viwandani. The two communities are under continuous demographic surveillance. A monthly calendar type questionnaire was administered retrospectively to cover the period since birth to the interview date and data on sexual behavior, menstrual resumption, breastfeeding patterns, and contraception were collected. The results show that sexual resumption occurs earlier than menses and postpartum contraceptive use. Out of all postpartum months where women were exposed to the risk of another pregnancy, about 28% were months where no contraceptive method was used. Menstrual resumption acts as a trigger for initiating contraceptive use with a peak of contraceptive initiation occurring shortly after the first month when menses are reported. There was no variation in contraceptive method choice between women who initiate use before and after menstrual resumption. Overall, poor postpartum women in marginalized areas such as slums experience an appreciable risk of unintended pregnancy. Postnatal visits and other subsequent health system contacts provide opportunities for reaching postpartum women with a need for family planning services.

  4. 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

  5. Social support during the postpartum period: mothers' views on needs, expectations, and mobilization of support.

    PubMed

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

    2013-05-01

    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. 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 6-12 months postpartum. Data transcripts were reviewed and analyzed for themes. 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. 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.

  6. 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

  7. Postpartum maternal morbidity requiring hospital admission in Lusaka, Zambia – a descriptive study

    PubMed Central

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

    2005-01-01

    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 Depression Affects New Dads, Too

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_163092.html Postpartum Depression Affects New Dads, Too Certain men at greater ... HealthDay News) -- Men can also suffer from postpartum depression after their baby is born. "Dads want to ...

  9. Postpartum Depression - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Are Here: Home → Multiple Languages → All Health Topics → Postpartum Depression URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Postpartum Depression - Multiple Languages To use the sharing features on ...

  10. [The status of postpartum weight retention and its associated factors among Chinese lactating women in 2013].

    PubMed

    Wang, J; Yang, Z Y; Pang, X H; Duan, Y F; Jiang, S; Zhao, L Y; Yin, S A; Lai, J Q

    2016-12-06

    Objective: To analyze the status of postpartum weight retention and its associated factors among Chinese lactating women in 2013. Methods: This study was based on the databank of Chinese National Nutrition and Health Surveillance in 2013. Using the multi-stage stratified cluster sampling method, we enrolled 12 514 women, at 0-24 months postpartum, from 55 sites in 30 provinces of China (excluding the Tibet Autonomous Region). Questionnaires were used to collect data on basic characteristics, physical activity, lifestyle, food intake, pre-pregnancy weight, weight before delivery, disease history during pregnancy, delivery date, delivery mode, parity and breastfeeding information. Current body weight and height of each subject were measured. Postpartum weight retention in each subject was calculated as the difference between pre-pregnancy and current weights. High postpartum weight retention was defined as ≥5 kg. Survey sample weights were calculated according to the sampling design and number of children under 2 years old from 2010 population census data of China. Associated factors of high postpartum weight retention were identified by multiple logistic regression analysis. Results: A total of 9 972 women were included in this study. P50 (P25-P75) of weight retention for participants was 3.6 (0.2-7.3) kg and high weight retention accounted for 41.5% of the subjects (4 134/9 972). The weighted means (SE) of weight retention was 3.5 (0.1) kg, and it was at 0 to <3, 3 to <6, 6 to <9, 9 to <12, 12 to <18 and 18 to <24 months postpartum were 5.3 (0.2), 4.5 (0.2), 3.8 (0.2), 3.1 (0.2), 2.8 (0.2) and 3.0 (0.2) kg, respectively. The weighted proportion of high postpartum weight retention was 37.4% (95%CI: 36.0%-38.9%). Compared with women aged under 25 years old, the odds ratio of high postpartum weight retention was 1.31 for women over 30 years old. Compared with women at 18 to <24 months postpartum, the odds ratio of high postpartum weight retention was 2.67, 1.61 and

  11. Weight during the postpartum period: what can health care workers do?

    PubMed

    Biesmans, Kathleen; Franck, Erik; Ceulemans, Christine; Jacquemyn, Yves; Van Bogaert, Peter

    2013-08-01

    To describe the gestational month-to-month weight change, obstetric and lifestyle factors influencing postpartum weight retention (PPWR) and to suggest possible interventions to prevent PPWR. This study was part of a larger research project concerning maternal weight change after childbirth. 343 women were recruited on five maternity wards in the Antwerp region, Belgium. Weight and height were assessed by the researchers during two home visits at 3 and 14 months postpartum and participants completed a questionnaire investigating obstetric and lifestyle factors during the first home visit. The monthly weights in between the home visits were self-reported by the participants. Full data were available for 75 women. One year after childbirth 52.0 % of the women faced postpartum weight retention. The different monthly weight points within the changes differed significantly from each other up to sixth months postpartum. Prepregnancy weight, exceeding the recommendations from the Institute of Medicine (IOM) concerning weight gain during pregnancy, smoking behaviour and exercising during pregnancy significantly influenced the postpartum weight change. The amount of weight gained during pregnancy, breastfeeding, possible postpartum depression and experiencing a shortage of information concerning the weight change after childbirth significantly influenced postpartum weight retention. Weight gain during pregnancy, exceeding IOM-criteria, breastfeeding, depression and lack of information determine PPWR and can be modulated by interventions such as routine weighing or screening of pregnant women. Several of these influencing factors can be preventively influenced by health care workers. Overall, we believe women could benefit from more guidance before, during and after pregnancy. Moreover, we recommend to reintroduce routine weighing of pregnant women as weight gain during pregnancy seems one of the most important factors involved in PPWR.

  12. 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

  13. 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…

  14. 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…

  15. The dialectic in becoming a mother: experiencing a postpartum phenomenon.

    PubMed

    Sethi, S

    1995-01-01

    In this study of the phenomenon of the postpartum period grounded theory methodology was used to investigate the experiences of first-time mothers during the first three months following their deliveries. The sample consisted of 12 primipara women and 3 multipara women. The data were generated by using unstructured interviews and field notes. Each woman was interviewed twice, the first time between 2 and 3 weeks postpartum, and the second time between 10 and 12 weeks postpartum. The final data for analysis consisted of: data generated through interviews, field notes, and the narratives of four mothers found in the non-fiction literature. Constant comparative analysis resulted in the generation of four categories and corresponding subcategories. These were: (1) Giving of Self; (2) Redefining Self; (3) Redefining Relationships; and (4) Redefining Professional Goals. The categories were not mutually exclusive. All the categories converged to provide support for the core variable 'Dialectic in Becoming a Mother'. The dialectic perspective demonstrated that, in becoming mothers, the women experienced transition, contradictions, tensions and transformations. A theoretical model was developed to show relationships among these major concepts. The findings of this study will be useful in effecting change in the provision of care to postpartum women and their families.

  16. The Association Between Postpartum Depression and Pica During Pregnancy

    PubMed Central

    Ezzeddin, Neda; Zavoshy, Roza; Noroozi, Mostafa; Sarichloo, Mohammad Ebrahim; Jahanihashemi, Hassan

    2016-01-01

    Introduction and Objectives: Postpartum depression (PPD) is a common disorder and social debilitating that has adverse effects on the mother, child and family. Pica is an eating disorder characterized by persistent ingestion of substances that the consumer does not define as food. The aim of this study was to investigate the association of postpartum depression with pica during pregnancy. Method: This is case-control study was carried out in health centers in west Tehran. 152 depressed women (case group) and 148 non-depressed women (control group) were selected randomly from these health care centers. In addition to collecting demographic and pica data, the Edinburgh Depression Scale was used. The data was analyzed by both descriptive and analytic analyses such as chi-squared and logistic regression in SPSS version 16. Result: In this study, there wasn’t a significant association between PPD and pica during pregnancy (P=0.153, OR=2.043, CI=0.767, 5.438), but, postpartum depression has a significant association with type (clay) (P= 0.024) and duration (more than 2 months) (P= 0.023) of pica practice. Conclusions: In the present study, pregnancy pica was not important risk factor for PPD but there were similar risk factors such as iron supplementation during and postpartum pregnancy with pica and PPD. PMID:26573027

  17. Rapunzel Syndrome: A Rare Postpartum Case

    PubMed Central

    Tegene, Teshome; Foda, Yahia; Hussain, Omar; Manikonda, Geeta

    2013-01-01

    The Rapunzel syndrome describes a disorder in which a significant amount of hair is swallowed, forming a trichobezoar that extends past the stomach into the small intestines. Given the indigestible nature of hair, it subsequently leads to obstruction within the gastrointestinal system. Clinically, patients may present with symptoms of gastrointestinal obstruction, including abdominal complaints such as pain, nausea, vomiting, and diarrhea. However, due to its broad and nonspecific presenting symptoms, the diagnosis of Rapunzel syndrome warrants consideration once other common etiologies have been excluded. Surgical intervention is often required to remove the abdominal mass. This unusual syndrome is often associated with psychiatric disorders, affecting young women most commonly. In this report, we will discuss a unique case of Rapunzel syndrome in a one-month postpartum woman. PMID:24171124

  18. Rapunzel syndrome: a rare postpartum case.

    PubMed

    Tegene, Teshome; Foda, Yahia; Hussain, Omar; Oloniyo, Kolawole; Ha, Ngoc-Tram; Manikonda, Geeta

    2013-01-01

    The Rapunzel syndrome describes a disorder in which a significant amount of hair is swallowed, forming a trichobezoar that extends past the stomach into the small intestines. Given the indigestible nature of hair, it subsequently leads to obstruction within the gastrointestinal system. Clinically, patients may present with symptoms of gastrointestinal obstruction, including abdominal complaints such as pain, nausea, vomiting, and diarrhea. However, due to its broad and nonspecific presenting symptoms, the diagnosis of Rapunzel syndrome warrants consideration once other common etiologies have been excluded. Surgical intervention is often required to remove the abdominal mass. This unusual syndrome is often associated with psychiatric disorders, affecting young women most commonly. In this report, we will discuss a unique case of Rapunzel syndrome in a one-month postpartum woman.

  19. The Relationship Between Parental Stress and Postpartum Depression Among Adolescent Mothers Enrolled in a Randomized Controlled Prevention Trial

    PubMed Central

    Phipps, Maureen G.; Triche, Elizabeth W.; Zlotnick, Caron

    2015-01-01

    Given the high co-occurrence of depression and parental stress among adolescent mothers, we evaluated the relationship between parental stress and postpartum depression among primiparous adolescent mothers. We conducted an observational analysis among a cohort of 106 adolescent mothers at 289 postpartum visits who were enrolled in a randomized controlled trial to prevent postpartum depression. Parental stress was measured using the Parenting Stress Index, short form. The Structured Clinical Interview for DSM-IV Childhood Diagnoses was administered to assess for postpartum depression; subthreshold depression was assessed using the Children's Depression Rating Scale, revised version. Generalized estimating equations were utilized to assess the relationship of parental stress on postpartum depression during the first 6 months postpartum. We present adjusted odds ratios (AOR) controlling for study arm, age, born in the United States, prior history of depression, and number of study visits. The median age was 16 years, 53 % were Latina, and 16 % reported a past history of depression. Nineteen adolescents (19 %) were diagnosed with postpartum depression and 25 % experienced high levels of parental stress through 6 months postpartum. Adolescent mothers who reported higher levels of parental stress were at significantly increased risk for postpartum depression [AOR 1.06 (95 % CI 1.04–1.09); p < 0.0001]. High levels of parental stress predicted subsequent postpartum depression when assessing parental stress at visits prior to a depression diagnosis to determine whether we could establish a temporal association [AOR 1.06 (95 % CI 1.02– 1.09); p < 0.01]. Parental stress was also a risk factor for subthreshold depression [AOR 1.04 (95 % CI 1.01– 1.07); p < 0.01]. Parental stress was a significant risk factor for developing both postpartum depression as well as subthreshold depression among adolescent mothers. Interventions that target a reduction in parental stress may

  20. Relationship between social support during pregnancy and postpartum depressive state: a prospective cohort study.

    PubMed

    Morikawa, Mako; Okada, Takashi; Ando, Masahiko; Aleksic, Branko; Kunimoto, Shohko; Nakamura, Yukako; Kubota, Chika; Uno, Yota; Tamaji, Ai; Hayakawa, Norika; Furumura, Kaori; Shiino, Tomoko; Morita, Tokiko; Ishikawa, Naoko; Ohoka, Harue; Usui, Hinako; Banno, Naomi; Murase, Satomi; Goto, Setsuko; Kanai, Atsuko; Masuda, Tomoko; Ozaki, Norio

    2015-05-29

    Although the association between social support and postpartum depression has been previously investigated, its causal relationship remains unclear. Therefore, we examined prospectively whether social support during pregnancy affected postpartum depression. Social support and depressive symptoms were assessed by Japanese version of Social Support Questionnaire (J-SSQ) and Edinburgh Postnatal Depression Scale (EPDS), among 877 pregnant women in early pregnancy and at one month postpartum. First, J-SSQ was standardized among peripartum women. The J-SSQ was found to have a two-factor structure, with Number and Satisfaction subscales, by exploratory and confirmatory factor analyses. Analysis of covariance was performed to examine how EPDS and J-SSQ scores during pregnancy affected the EPDS score at postpartum. Significant associations were found between postpartum EPDS score and both EPDS and total scores on the Number subscales during pregnancy (β = 0.488 and -0.054, ps < 0.001). Specifically, this negative correlation was stronger in depressive than non-depressive groups. Meanwhile, total score on Satisfaction subscales was not significantly associated with postpartum EPDS score. These results suggest that having a larger number of supportive persons during pregnancy helps protect against postpartum depression, and that this effect is greater in depressive than non-depressive pregnant women. This finding is expected to be vitally important in preventive interventions.

  1. Self-Help Booklets for Preventing Postpartum Smoking Relapse: A Randomized Trial

    PubMed Central

    Simmons, Vani Nath; Meade, Cathy D.; Quinn, Gwendolyn P.; Lopez Khoury, Elena N.; Sutton, Steven K.; Lee, Ji-Hyun

    2012-01-01

    Objectives. We tested a series of self-help booklets designed to prevent postpartum smoking relapse. Methods. We recruited 700 women in months 4 through 8 of pregnancy, who quit smoking for their pregnancy. We randomized the women to receive either (1) 10 Forever Free for Baby and Me (FFB) relapse prevention booklets, mailed until 8 months postpartum, or (2) 2 existing smoking cessation materials, as a usual care control (UCC). Assessments were completed at baseline and at 1, 8, and 12 months postpartum. Results. We received baseline questionnaires from 504 women meeting inclusion criteria. We found a main effect for treatment at 8 months, with FFB yielding higher abstinence rates (69.6%) than UCC (58.5%). Treatment effect was moderated by annual household income and age. Among lower income women (< $30 000), treatment effects were found at 8 and 12 months postpartum, with respective abstinence rates of 72.2% and 72.1% for FFB and 53.6% and 50.5% for UCC. No effects were found for higher income women. Conclusions. Self-help booklets appeared to be efficacious and offered a low-cost modality for providing relapse-prevention assistance to low-income pregnant and postpartum women. PMID:22994170

  2. A longitudinal study of human milk composition in the second year postpartum: implications for human milk banking.

    PubMed

    Perrin, Maryanne T; Fogleman, April D; Newburg, David S; Allen, Jonathan C

    2017-01-01

    While the composition of human milk has been studied extensively in the first year of lactation, there is a paucity of data regarding human milk composition beyond one year postpartum. Policies vary at milk banks around the world regarding how long lactating women are eligible to donate their milk. The primary purpose of this study is to describe longitudinal changes in human milk composition in the second year postpartum to support the development of evidence based guidelines regarding how long lactating women can donate human milk to a milk bank. Nineteen lactating women in North Carolina provided monthly milk samples from 11 months to 17 months postpartum (N = 131), and two non-profit milk banks provided (N = 33) pooled, unpasteurized milk samples from 51 approved donors less than one year postpartum. There was a significant increase (P < 0.05) in the concentration of total protein, lactoferrin, lysozyme, Immunoglobulin A, oligosaccharides and sodium in longitudinal samples of mother's milk between 11 and 17 months postpartum, while zinc and calcium concentrations declined, and no changes were observed in lactose, fat, iron and potassium. Human milk in the second year postpartum contained significantly higher concentrations of total protein, lactoferrin, lysozyme and Immunoglobulin A, than milk bank samples, and significantly lower concentrations of zinc, calcium, iron and oligosaccharides. Accepting milk bank donations beyond one year postpartum is a potential strategy for increasing the supply of donor milk, but may require mineral fortification.

  3. Differentials of post-partum amenorrhea: a survival analysis.

    PubMed

    Aryal, T R

    2007-01-01

    Post-partum amenorrhea is an important event for females' reproductive life and their health. It is the time period between the end of pregnancy and the resumption of menstruation after delivery, and it is considered to be the temporary infecundable period of women's reproductive life-span. The main aim of this article is to examine the differentials of post-partum amenorrhea by using current status reporting data according to the characteristics of the mother and her child. The data are utilized from a sample survey of Palpa and Rupandehi districts of western rural Nepal. A life-table based technique of survival analysis has been used. Important summary measures have been computed in order to see the differentials of duration of post-partum amenorrhea. The study revealed that parity of mothers, age of mothers, breast-feeding practices and survival status of the child were found to be the main differentials of the duration of post-partum amenorrhea. Amenorrhea period was found shorter for lower parity and younger mothers. Amenorrheic period was found to be increased with increased birth-interval and duration of breast-feeding practices. A strong positive association was found between the duration of post-partum amenorrhea and breast-feeding. The study also revealed that an inverse association was found between the duration of post-partum amenorrhea and socio-economic status of mothers. The survival status of the child showed a strong effect for the timing of amenorrhea. This study investigated the important differentials of amenorrhea by using current status reporting data according to the characteristics of mother and her child. The estimated values of mean, median and trimean duration of amenorrhea were compared. For instance, trimean of amenorrheic period was found to be 9.6 months while median was 8.4 months and mean was 10.4 months. This finding indicates that the trimean provided the most consistent and best estimates of the duration of amenorrhea than other

  4. Postpartum amenorrhea in selected developing countries: estimates from contraceptive prevalence surveys.

    PubMed

    Knodel, J; Lewis, G

    1984-01-01

    Data collected in contraceptive prevalence surveys for Korea, Sri Lanka, Thailand, Barbados, Colombia, Costa Rica, and Peru on how soon following childbirth menstruation returned provide the basis for national level estimates of the duration of postpartum amenorrhea. 2 somewhat different techniques are used for estimating median and mean durations of postpartum amenorrhea. The results are compared with information indicating patterns of breastfeeding. The analysis indicates considerable cross-national variation in the mean and median duration of postpartum amenorrhea and suggests that estimating postpartum amenorrhea from information on breastfeeding alone could be misleading. What is most striking about the results is how quickly postpartum amenorrhea appears to terminate in most of the countries. Only for Korean women is the median duration substantially above 1/2 a year. The results suggest that at least for most of the limited number of developing countries for which Westinghouse Contraceptive Prevalence Survey data are available, postpartum nonsusceptibility is providing protection against a new pregnancy for only a relatively short period following a birth for the majority of women. In all the countries with available data except Costa Rica, breastfeeding is close to universal, involving at least 90% of all children; in Costa Rica, only about 3/4 of children are ever breastfed. The average duration of breastfeeding is noticeably longer in the 3 Asian countries than in the Latin American ones.

  5. Heart rate variability biofeedback intervention for reduction of psychological stress during the early postpartum period.

    PubMed

    Kudo, Naoko; Shinohara, Hitomi; Kodama, Hideya

    2014-12-01

    This study examined the effectiveness of heart rate variability (HRV) biofeedback intervention for reduction of psychological stress in women in the early postpartum period. On postpartum day 4, 55 healthy subjects received a brief explanation about HRV biofeedback using a portable device. Among them, 25 mothers who agreed to implement HRV biofeedback at home were grouped as the biofeedback group, and other 30 mothers were grouped as the control group. At 1 month postpartum, there was a significant decrease in total Edinburgh Postnatal Depression Scale score (P < 0.001) in the biofeedback group; this change was brought about mainly by decreases in items related to anxiety or difficulty sleeping. There was also a significant increase in standard deviation of the normal heartbeat interval (P < 0.01) of the resting HRV measures in the biofeedback group after adjusting for potential covariates. In conclusion, postpartum women who implemented HRV biofeedback after delivery were relatively free from anxiety and complained less of difficulties sleeping at 1 month postpartum. Although the positive effects of HRV biofeedback may be partly attributable to intervention effects, due to its clinical outcome, HRV biofeedback appears to be recommendable for many postpartum women as a feasible health-promoting measure after childbirth.

  6. The Effect of Mode of Delivery on Postpartum Sexual Functioning in Primiparous Women

    PubMed Central

    Dabiri, Fatemeh; Yabandeh, Asieh Pormehr; Shahi, Arefeh; Kamjoo, Azita; Teshnizi, Saeed Hosseini

    2014-01-01

    Objective To evaluate the effect of mode of delivery on postpartum sexual functioning in primiparous women. Methods In this cross-sectional descriptive study, 150 primiparous women in postpartum period, who attended the family planning or vaccination clinics, were enrolled for the study. Eighty-one had vaginal delivery with episiotomy and 69 had experienced cesarean section. Sexual function was evaluated by the Female Sexual Function Index within 3 and 6 months postpartum. Results About 29% in vaginal delivery group and 37% in cesarean delivery group had resumed their sexual intercourses four weeks after delivery (p=0.280).There were no significant differences between mode of delivery and sexual functioning, including desire, arousal, lubrication, orgasm, satisfaction and pain. Conclusion The present study showed that postpartum sexual functioning was not associated with the type of delivery. PMID:25170409

  7. [Misoprostol for treating postpartum hemorrhages].

    PubMed

    Godard, Clémence; Berhoune, Malik; Bertrand, Eric; Schlatter, Joël; Chiadmi, Fouad; Toledano, Audrey; Cisternino, Salvatore; Fontan, Jean-Eudes

    2008-03-01

    Postpartum hemorrhage is defined by bleeding > 500 mL through the vagina. It is one of the obstetrical complications that obstetricians fear most. It is the leading cause of maternal mortality in the world, especially in developing countries. The reference treatments in France are parenteral oxytocin and sulprostone. Sulprostone involves sometimes fatal side effects, and must be administered only in appropriate health care facilities. It also has the major disadvantage of requiring refrigeration. Misoprostol has uterotonic properties that have led to its occasional off-label use in the treatment of postpartum hemorrhage, by rectal or sublingual administration, as an alternative to sulprostone. A careful review of the literature on this particular use of misoprostol is essential.

  8. 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.

  9. TRIPPD: A Practice-Based Network Effectiveness Study of Postpartum Depression Screening and Management

    PubMed Central

    Yawn, Barbara P.; Dietrich, Allen J.; Wollan, Peter; Bertram, Susan; Graham, Debbie; Huff, Jessica; Kurland, Margary; Madison, Suzanne; Pace, Wilson D.

    2012-01-01

    PURPOSE Postpartum depression is common but inadequately recognized and undertreated. Continuing depressive symptoms are associated with adverse outcomes for the woman, her infant, and family. We wanted to determine the effect of a practice-based training program for screening, diagnosis, and management of depression in postpartum mothers. METHODS In this practice-based effectiveness study, 28 practices were randomized to usual care (n = 14) or intervention (n = 14), and 2,343 women were enrolled between 5 and 12 weeks’ postpartum. The intervention sites received education and tools for postpartum depression screening, diagnosis, initiation of therapy, and follow-up within their practices. Usual-care practices received a 30-minute presentation about postpartum depression. Screening information for the usual care was obtained from baseline surveys sent directly to the central site but was not available for patient care. Outcomes were based on patient-reported outcomes (level of depressive symptoms) from surveys at 6 and 12 months, plus medical record review (diagnosis and therapy initiation). RESULTS Among the 2,343 women enrolled, 1,897 (80.1%) provided outcome information, and were included in the analysis. Overall, 654 (34.5% of 1,897) women had elevated screening scores indicative of depression, with comparable rates in the intervention and usual-care groups. Among the 654 women with elevated postpartum depression screening scores, those in the intervention practices were more likely to receive a diagnosis (P = .0006) and therapy for postpartum depression (P = .002). They also had lower depressive symptom levels at 6 (P = .07) and 12 months’ (P=.001) postpartum. CONCLUSIONS Primary care–based screening, diagnosis, and management improved mother’s depression outcomes at 12 months. This practical approach could be implemented widely with modest resources. PMID:22778120

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

    PubMed

    Yıldız, Hatice

    2015-01-01

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

  11. The psychoneuroimmunology of postpartum depression.

    PubMed

    Corwin, Elizabeth J; Pajer, Kathleen

    2008-11-01

    Postpartum depression (PPD) is a potentially debilitating disorder that develops in a significant percentage of women during the first year after giving birth. Women afflicted with PPD experience long-term consequences, including sadness, guilt, and despair. Offspring may be affected as well. Several investigators have tested psychosocial risk factors for the development of PPD; however, substantial amounts of variance in PPD have gone unexplained with regression on psychosocial variables alone. Likewise, interventions for PPD that have focused on psychosocial risk factors alone have been largely unsuccessful. The unexplained variance and disappointing treatment success could well be due to investigators' failure to address relevant biological changes occurring during the postpartum period. Two biological systems that are affected significantly and remain in flux during the postpartum period are the innate immune system and the hypothalamic-pituitary-adrenal (HPA) axis. Bidirectional interactions between these two systems are well established, and it is generally acknowledged that dysfunction in either system can lead to depression in nonpregnant, nonpostpartum populations. To date, little research has pursued the contribution of these interacting systems to the development of PPD. The purpose of this paper is to review the psychoneuroimmunology of PPD. The central hypothesis presented is that dysregulation in either system individually or in their bidirectional interaction is associated with the development of PPD.

  12. Measuring women's fatigue during the postpartum period.

    PubMed

    Milligan, R A; Parks, P L; Kitzman, H; Lenz, E R

    1997-01-01

    The Fatigue Symptom Checklist (FSC) (Yoshitake, 1978), developed in Japan, was selected to measure postpartum fatigue among American women. Minor wording changes and a change in the reference time frame were made. Reliability and validity of this modification of the FSC were tested in this reanalysis of data from a longitudinal study of 285 mothers. Internal consistency reliability for the total 30-item FSC was acceptable. Evidence for criterion-related and construct validity was found. Original FSC subscales were not confirmed in these analyses. Using factor analysis, a shortened 10-item postpartum scale and two postpartum subscales, physical and mental fatigue, were identified. LISRAEL confirmatory factor analysis supported the subscales. Results support appropriateness of the total 30-item FSC, the shortened 10-item postpartum scale, and postpartum subscales for measuring postpartum fatigue in American women.

  13. The Effect of Brief Alcohol Intervention on Postpartum Depression

    PubMed Central

    Wilton, Georgiana; Moberg, D. Paul; Fleming, Michael F.

    2009-01-01

    Purpose This paper reports on secondary results from the Healthy Moms Study, a clinical trial to test the efficacy of brief intervention on reducing alcohol use and alcohol-related harms in postpartum women. Study Design and Methods Data from a randomized clinical trial conducted between 2002 and 2005 with a sample of Wisconsin women was analyzed. This report presents comparison data on depressive symptomatology between postpartum women drinking above recommended levels who received a brief alcohol intervention and those who received no intervention. Results At six month follow-up, there was a significant reduction in mean depression scores compared to baseline in the women who received the alcohol intervention (p <.001). There was not a significant reduction in depressive symptomatology in the control group. Mean level of depression at six months was significantly predicted by baseline depression and the intervention (p=.018). Alcohol use at either baseline or follow-up was not a predictive factor in determining mean depressive symptomatology. Clinical Implications The results of the Healthy Moms Study support the importance of both alcohol and depression screening during the postpartum period. Brief alcohol intervention during this time may also positively affect depressive symptomatology. PMID:19713798

  14. 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.

  15. [IPPF declaration on breast feeding, fertility and postpartum contraception].

    PubMed

    1997-01-01

    Mother's milk protects the newborn against various infections, especially against gastrointestinal infections, as well as strengthening the mother-child bond. Breast-feeding is also associated with birth spacing and plays an important role in the regulation of fertility in countries where the rate of use of contraceptives is low. In breast-feeding women amenorrhea may last several months or even a year, while in women who do not breast-feed menstruation returns 35-40 days postpartum. The risk of getting pregnant in women who rely on amenorrhea for contraception increases with the appearance of the first postpartum menstruation (spotting), with the introduction of food supplement into the diet of the infant, and approximately 6 months after childbirth. Family planning programs have to collaborate with maternal health programs with respect to the need for contraception, including postpartum contraception, which involves the training of nurse-midwives or traditional birth attendants. The choice of contraceptives includes the IUD, with a high degree of efficacy, which is particularly advantageous during breast-feeding. Tubal ligation has no negative effect on breast-feeding, but it also requires proper counseling. Other methods are vasectomy, implants and injectables containing progestational hormones, and estrogen-progesterone containing pills, which should not be used for 6 weeks after childbirth.

  16. Sexual Function 6 Months After First Delivery

    PubMed Central

    Brubaker, Linda; Handa, Victoria L.; Bradley, Catherine S.; Connolly, AnnaMarie; Moalli, Pamela; Brown, Morton B.; Weber, Anne

    2008-01-01

    OBJECTIVE To explore the association of anal sphincter laceration and sexual function 6 months postpartum in the Childbirth and Pelvic Symptoms (CAPS) cohort. METHODS The primary CAPS study, a prospective cohort study, was designed to estimate the postpartum prevalence and incidence of urinary and fecal incontinence. Three cohorts of new mothers (vaginal delivery with a third- or fourth-degree anal sphincter tear, vaginal delivery without a third- or fourth-degree anal sphincter tear, and cesarean delivery without labor) were compared at 6 months postpartum. Sexual function was assessed with the Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12). Urinary and fecal incontinence were assessed using the Medical Epidemiological and Social Aspects of Aging questionnaire and the Fecal Incontinence Severity Index, which is embedded within the Modified Manchester Health Questionnaire. RESULTS Most women (459 [90%]) of those with partners reported sexual activity at the 6-month visit. Fewer women whose delivery was complicated by anal sphincter laceration reported sexual activity when compared with those who delivered vaginally without sphincter laceration (88 compared with 94%, P=.028). The mean PISQ-12 score (39±4) did not differ between delivery groups (P=.92). Pain (responses of “sometimes,” “usually,” or “always”) during sex affected one of three sexually active women (164 [36%]). CONCLUSION At 6 months postpartum, primiparous women who delivered with anal sphincter laceration are less likely to report sexual activity. PMID:18448733

  17. The postpartum period in women with epilepsy.

    PubMed

    Klein, Autumn

    2012-08-01

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

  18. Plan Turbines 3 & 4, Side View Turbines ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Plan - Turbines 3 & 4, Side View - Turbines 3 & 4, Section A-A - American Falls Water, Power & Light Company, Island Power Plant, Snake River, below American Falls Dam, American Falls, Power County, ID

  19. Cluster Sampling with Referral to Improve the Efficiency of Estimating Unmet Needs among Pregnant and Postpartum Women after Disasters

    PubMed Central

    Horney, Jennifer; Zotti, Marianne E.; Williams, Amy; Hsia, Jason

    2015-01-01

    Introduction and Background Women of reproductive age, in particular women who are pregnant or fewer than 6 months postpartum, are uniquely vulnerable to the effects of natural disasters, which may create stressors for caregivers, limit access to prenatal/postpartum care, or interrupt contraception. Traditional approaches (e.g., newborn records, community surveys) to survey women of reproductive age about unmet needs may not be practical after disasters. Finding pregnant or postpartum women is especially challenging because fewer than 5% of women of reproductive age are pregnant or postpartum at any time. Methods From 2009 to 2011, we conducted three pilots of a sampling strategy that aimed to increase the proportion of pregnant and postpartum women of reproductive age who were included in postdisaster reproductive health assessments in Johnston County, North Carolina, after tornadoes, Cobb/Douglas Counties, Georgia, after flooding, and Bertie County, North Carolina, after hurricane-related flooding. Results Using this method, the percentage of pregnant and postpartum women interviewed in each pilot increased from 0.06% to 21%, 8% to 19%, and 9% to 17%, respectively. Conclusion and Discussion Two-stage cluster sampling with referral can be used to increase the proportion of pregnant and postpartum women included in a postdisaster assessment. This strategy may be a promising way to assess unmet needs of pregnant and postpartum women in disaster-affected communities. PMID:22365134

  20. Postpartum Maternal Sleep and Mothers' Perceptions of Their Attachment Relationship with the Infant among Women with a History of Depression during Pregnancy

    ERIC Educational Resources Information Center

    Tikotzky, Liat; Chambers, Andrea S.; Kent, Jamie; Gaylor, Erika; Manber, Rachel

    2012-01-01

    This study assessed the links between maternal sleep and mothers' perceptions of their attachment relationship with their infant among women at risk for postpartum depression by virtue of having been depressed during pregnancy. Sixty-two mothers completed sleep diaries and questionnaires at 3 and 6 months postpartum. Regression analyses,…

  1. Accidental ingestion of 'Ecstasy' (3,4-methylenedioxymethylamphetamine).

    PubMed Central

    Bedford Russell, A R; Schwartz, R H; Dawling, S

    1992-01-01

    There is no report of the effects of 'Ecstasy' (3,4-methylenedioxymethylamphetamine) poisoning in childhood. The case of a 13 month old boy who ingested one capsule of Ecstasy is reported. Neurological and cardiovascular side effects predominated, which responded well to treatment with a chlormethiazole infusion. PMID:1358033

  2. A MULTIRISK APPROACH TO PREDICTING CHRONICITY OF POSTPARTUM DEPRESSION SYMPTOMS

    PubMed Central

    Klier, Claudia M.; Rosenblum, Katherine L.; Zeller, Maria; Steinhardt, Kornelia; Bergemann, Niels; Muzik, Maria

    2011-01-01

    Background Persistence of postpartum depression (PPD) carries potential adverse implications for the emerging mother–child relationship and for child development. Methods This study was designed to investigate factors related to the onset and persistence of PPD; in particular, we examined the cumulative effect of a range of psychosocial risk factors in predicting chronic PPD symptoms. One hundred and five women were interviewed at three assessment periods: within the first days after childbirth, at 6 months, and at 18 months postpartum. Results Depressive symptoms at 6 months predicted 18 months depressive symptoms, even when controlling for the contribution of maternal depression at birth. Psychosocial risk had a moderating influence on the stability of depressive symptomatology. Women with two or more risk factors at birth were more likely to have stable depressive symptomatology across the infants’ first 18 months of life. Conclusion To prevent a chronic course of PPD it may be necessary to identify both depressive symptoms and relevant psychosocial risk factors. PMID:18729148

  3. 32 CFR 3.4 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Definitions. 3.4 Section 3.4 National Defense..., GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.4 Definitions. Agency point of contact (POC... organization reporting directly to a home office, usually identified with responsibility for profit...

  4. 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

  5. How Postpartum Women With Depressive Symptoms Manage Sleep Disruption and Fatigue.

    PubMed

    Doering, Jennifer J; Sims, Dauphne A; Miller, Donald D

    2017-04-01

    Postpartum sleep and fatigue have bidirectional relationships with depressive symptoms and challenge women's everyday functioning. The everyday process of managing postpartum sleep and fatigue in the context of depressive symptoms remains unexplored. We conducted a grounded theory study with a sample of 19 women who screened positive on the Postpartum Depression Screening Scale (PDSS™) Short Form at 3 weeks postpartum. Women completed semi-structured in-home interviews and the full PDSS and Modified Fatigue Symptoms Checklist at 1, 3, and 6 months postpartum. The sample was on average 27 years old, with 2.8 children, and 63% were African-American. They described a basic social process of Finding a Routine Together, during which women's experiences with their infants progressed from Retreating at month 1 toward Finding a New Normal at month 6. In their work to Find a Routine Together, mothers' patterns of change over time were continuous, gradual, or prolonged. Their progress was influenced by depressive symptoms, social support, work and daycare, stability in social circumstances, and underlying stressors. This study's findings suggest the need to allocate resources and tailor interventions to meet the needs of women who are most vulnerable to the health effects of ongoing persistent severe fatigue, disordered sleep, and sub-clinical and clinical levels of depressive symptoms. © 2017 Wiley Periodicals, Inc.

  6. Association of postpartum maternal morbidities with children's mental, psychomotor and language development in rural Bangladesh.

    PubMed

    Hamadani, J D; Tofail, F; Hilaly, A; Mehrin, F; Shiraji, S; Banu, S; Huda, S N

    2012-06-01

    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.

  7. The BDI-II factor structure in pregnancy and postpartum: Two or three factors?

    PubMed

    Carvalho Bos, Sandra; Pereira, Ana Telma; Marques, Mariana; Maia, Berta; Soares, Maria João; Valente, José; Gomes, Ana; Macedo, António; Azevedo, Maria Helena

    2009-06-01

    The purpose of the present study was to investigate the factor structure of the Beck Depression Inventory-II (BDI-II) in pregnancy and postpartum. Women were asked to fill in the BDI-II in their last trimester of pregnancy and at 3 months after delivery. A total of 331 pregnant women, with a mean age of 29.7 years (SD=4.6), and 354 mothers, aged 30.6 years (SD=4.6 years), answered the BDI-II. The first group was mainly nulliparas (65.6%) and the second group was mostly primiparas (57.4%). Factor analyses with principal components solution and varimax rotation were performed. Based on the scree test of Cattell a 2-factor solution and a 3-factor solution were explored. The 2-factor solution was identical in pregnancy and postpartum. Items loading in the Cognitive-Affective factor and in the Somatic-Anxiety factor were almost the same, though the Cognitive-Affective factor explained more of the BDI-II total variance in pregnancy, whereas in postpartum both factors explained similar total variances. The 3-factor solution of the BDI-II in pregnancy and postpartum slightly diverged. Besides the Cognitive-Affective and the Somatic-Anxiety factors, a third factor, Fatigue, was obtained in pregnancy while Guilt was the third factor identified in postpartum. This study reveals that the BDI-II 3-factor solution might be more appropriate to assess depressive symptoms in pregnancy and postpartum.

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

    PubMed

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

    2013-12-01

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

  9. 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

  10. Bidirectional psychoneuroimmune interactions in the early postpartum period influence risk of postpartum depression.

    PubMed

    Corwin, Elizabeth J; Pajer, Kathleen; Paul, Sudeshna; Lowe, Nancy; Weber, Mary; McCarthy, Donna O

    2015-10-01

    More than 500,000 U.S. women develop postpartum depression (PPD) annually. Although psychosocial risks are known, the underlying biology remains unclear. Dysregulation of the immune inflammatory response and the hypothalamic-pituitary-adrenal (HPA) axis are associated with depression in other populations. While significant research on the contribution of these systems to the development of PPD has been conducted, results have been inconclusive. This is partly because few studies have focused on whether disruption in the bidirectional and dynamic interaction between the inflammatory response and the HPA axis together influence PPD. In this study, we tested the hypothesis that disruption in the inflammatory-HPA axis bidirectional relationship would increase the risk of PPD. Plasma pro- and anti-inflammatory cytokines were measured in women during the 3rd trimester of pregnancy and on Days 7 and 14, and Months 1, 2, 3, and 6 after childbirth. Saliva was collected 5 times the day preceding blood draws for determination of cortisol area under the curve (AUC) and depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS). Of the 152 women who completed the EPDS, 18% were depressed according to EDPS criteria within the 6months postpartum. Cortisol AUC was higher in symptomatic women on Day 14 (p=.017). To consider the combined effects of cytokines and cortisol on predicting symptoms of PPD, a multiple logistic regression model was developed that included predictors identified in bivariate analyses to have an effect on depressive symptoms. Results indicated that family history of depression, day 14 cortisol AUC, and the day 14 IL8/IL10 ratio were significant predictors of PPD symptoms. One unit increase each in the IL8/IL10 ratio and cortisol AUC resulted in 1.50 (p=0.06) and 2.16 (p=0.02) fold increases respectively in the development of PPD. Overall, this model correctly classified 84.2% of individuals in their respective groups. Findings

  11. Sigmoid Volvulus Complicating Postpartum Period

    PubMed Central

    Blake, Erin; Gonzalez, Eduardo; Pieracci, Frederic

    2017-01-01

    Background. Sigmoid volvulus is a rare complication of pregnancy and the puerperium. Case. A 19-year-old patient, gravida 1 para 0 at 41 0/7 weeks of gestation, admitted for late-term induction of labor underwent an uncomplicated primary low transverse cesarean delivery for arrest of descent. Her postoperative period was complicated by sudden onset of abdominal pain and the ultimate diagnosis of sigmoid volvulus. Conclusion. Prompt surgical evaluation of an acute abdomen in the postpartum period is essential; delayed diagnosis and treatment can lead to significant maternal morbidity and mortality. PMID:28251004

  12. 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.

  13. Paternal Psychopathology and Maternal Depressive Symptom Trajectory During the First Year Postpartum

    PubMed Central

    Zerbe, Gary O.; Hunter, Sharon K.; Ross, Randal G.

    2013-01-01

    Understanding parental psychopathology interaction is important in preventing negative family outcomes. This study investigated the effect of paternal psychiatric history on maternal depressive symptom trajectory from birth to 12 months postpartum. Maternal Edinburgh Postpartum Depression screens were collected at 1, 6 and 12 months and fathers’ psychiatric diagnoses were assessed with the Structured Clinical Interview for DSM-IV from 64 families. There was not a significant difference in the trajectory of maternal depressive symptoms between mothers with partners with history of or a current psychiatric condition or those without a condition. However, mothers with partners with substance abuse history had higher levels of depressive symptoms relative to those affected by mood/anxiety disorders or those without a disorder. Our results call for a closer look at paternal history of substance abuse when treating postpartum maternal depression. PMID:25478124

  14. Postpartum ovarian follicular dynamics in primiparous and pluriparous Mediterranean Italian buffaloes (Bubalus bubalis).

    PubMed

    Presicce, Giorgio Antonio; Bella, Antonino; Terzano, Giuseppina Maria; De Santis, Giuseppe; Senatore, Elena Maria

    2005-03-15

    The objective of this study was to monitor ovarian function in postpartum primiparous and pluriparous Mediterranean Italian buffaloes (Bubalus bubalis) during months of increasing daylength. Ovarian ultrasound monitoring was carried out for a total of 60 days from calving in 10 primiparous and 10 pluriparous buffaloes. Progesterone was determined from calving until a week after first postpartum ovulation. The study was undertaken during months of increasing day length. Time required for complete postpartum uterine involution was 31 +/- 1.0 and 33 +/- 1.3 days in primiparous and pluriparous buffaloes respectively (P = 0.1). The first postpartum ovulation was recorded on 4 primiparous and 8 pluriparous buffaloes (P = 0.16). Time for first postpartum ovulation to occur was 25.5 +/- 6.9 and 15.5 +/- 1.3 days in primiparous and pluriparous buffaloes, respectively (P = 0.07). Overall, 8 of the 12 first postpartum ovulations (66.6%) occurred in the ovary contra-lateral to the one bearing the gravidic CL, one out of 4 in primiparous and 3 out of 8 in pluriparous buffaloes (P = 1.0). Following a first postpartum ovulation, 3 primiparous and 4 pluriparous buffaloes displayed a complete wave of follicular development leading to a new ovulation. Ovulation following parturition was not recorded in 6 primiparous and two pluriparous buffaloes for the 60 days of ultrasound monitoring. Growth rate (mm/d) and largest size (mm) of first postpartum ovulating follicle was 0.95 +/- 0.18 and 1.07 +/- 0.07 (P = 0.4), and 13.5 +/- 0.8 and 14.1 +/- 0.4 (P = 0.4) in primiparous and pluriparous buffaloes, respectively. Following calving, the total number of available antral follicles (> or =2 mm) declined gradually towards the end of the study period. Follicles greater or equal to 3 mm in diameter on the contrary showed a prominent increase in the first 2 weeks from calving. The number of follicles greater or equal to 3 mm in diameter was significantly higher in the ovary contra-lateral to

  15. A Patient with Postpartum Hypopituitarism (Sheehan's Syndrome) Developed Postpartum Autoimmune Thyroiditis (Transient Thyrotoxicosis and Hypothyroidism): A Case Report and Review of the Literature.

    PubMed

    Takasu, Nobuyuki; Nakayama, Yoshirou

    2011-01-01

    A 36-year-old woman with postpartum hypopituitarism (Sheehan's syndrome: SS) developed postpartum autoimmune thyroiditis (PPAT). She delivered a baby by Caesarean section (620 mL blood loss). At 1 month post partum, she developed thyrotoxicosis due to painless thyroiditis (autoimmune destructive thyroiditis). She was positive for antithyroid antibodies. Postpartum and hypoadrenalism-induced exacerbation of autoimmune thyroiditis caused the thyrotoxicosis due to autoimmune destructive thyroiditis. ACTH was undetectable. She had ACTH deficiency and secondary hypoadrenalism. Hydrocortisone was started. At 6 months post partum, she was referred to us with hypothyroidism. Thyroxine was administered. She had thyrotoxicosis at 1-2 months post partum and then hypothyroidism. She was diagnosed with PPAT. She had hypopituitarism, ACTH deficiency (secondary hypoadrenalism), low prolactin with agalactia, and low LH with failure to resume regular menses. She had empty sella on MRI. She was diagnosed with SS. Three cases with SS have been reported to develop PPAT. Postpartum immunological rebounds and hypoadrenalism-induced immunological alterations (or a combination of the two) might have been responsible for the PPAT.

  16. The relationship between attachment style and postpartum depression.

    PubMed

    Ikeda, Mari; Hayashi, Momoko; Kamibeppu, Kiyoko

    2014-01-01

    Although an increasing number of studies show an association between adult attachment style and mood disorders, the relationship between adult attachment style and depression associated with childbirth is largely unknown. This study investigated the association between women's attachment style, postpartum depression (PPD), and other risk factors. During the 32nd week of pregnancy, 84 women were interviewed using the Attachment Style Interview. Participants also completed self-report questionnaires about reaction to pregnancy, family relationships, current life stresses, and symptoms of depression and anxiety. At one-month postpartum, they were evaluated for postpartum depressive symptoms using the Mini-International Neuropsychiatric Interview. Eighty-two women completed the second self-report questionnaires and were evaluated for PPD. The data of 76 women were eligible for analysis. PPD was present in 21%. An insecure attachment style was significantly related to depression. A multiple logistic regression analysis showed significant effects for insecure attachment, social economic status, and antenatal depression on PPD. Adding the insecure attachment style factor to the logistic model that predicted PPD increased the area under the curve to 0.87 (95% CI .77-.98; p < .05). The inclusion of attachment styles in assessments of perinatal depressive disorders could improve screening and the design of interventions.

  17. Breast-feeding and post-partum amenorrhoea in Indonesia.

    PubMed

    Jones, R E

    1989-01-01

    The association between breast-feeding patterns and resumption of menses post-partum was examined in a prospective study in Indonesia. In order to examine these relationships directly in a longitudinal study, it was first necessary to distinguish among women who experienced infant mortality before menses resumed, women who weaned before menses resumed, and women who had return to menses while breast-feeding. Information on suckling patterns and menstrual status was collected by recall for 444 women at monthly visits for 2 years. Three main breast-feeding variables, minutes per episode, number of episodes per day, number of episodes per night, and other breast-feeding variables were derived for each woman, to give the average nursing pattern up to menses or the end of the study, which-ever came first. While high levels of nursing for each of these three main variables were found to be significantly related to delay in return of menses post-partum, the interactions between more minutes per episode, and more frequent day- and night-time feeds, were found to be the most important factors in the delay in onset of post-partum menstruation in those women whose menses resumed while still nursing or who remained amenorrhoeic and nursing at the end of the study.

  18. Changes in interleukin-6 concentration in peripheral blood of pre- and post-partum dairy cattle and its relationship to postpartum reproductive diseases.

    PubMed

    Ishikawa, Yukikazu; Nakada, Ken; Hagiwara, Katsuro; Kirisawa, Rikio; Iwai, Hiroshi; Moriyoshi, Masaharu; Sawamukai, Yutaka

    2004-11-01

    Reproductive diseases after parturition are a serious problem in dairy cattle. It is important to predict postpartum reproductive diseases early and to develop prophylaxis. The objectives of this study were to demonstrate changes in the peripheral blood concentration of interleukin-6 (IL-6) before parturition, which was mainly produced by T helper 2 type (Th2) cells, and to investigate a correlation between the IL-6 concentration and the occurrence of the postpartum retained placenta, endometritis and/or follicular cyst in dairy cattle. Twenty-seven Holstein-Friesian cows were used for this study. Thirteen had no clinical disease, 8 had retained placenta, 4 were diagnosed with endometritis by vaginal inspection, and 2 were diagnosed with follicular cyst by rectal palpation at 1 and 2 months after parturition. Blood samples were collected 60 days pre- and post-partum. They used for IL-6, progesterone (P(4)) and estradiol-17beta (E(2)) concentration determination. This study showed that the IL-6 concentration prepartum was higher than postpartum. Low levels of IL-6 and P(4) in peripheral blood prepartum tended to affect retained placenta and a high level of IL-6 prepartum tended to affect endometritis. These results indicate that measurement of change in the IL-6 concentration during pregnancy is one useful tool for predicting crisis in postpartum reproductive diseases in dairy cattle.

  19. Dietary patterns during pregnancy and the risk of postpartum depression in Japan: the Osaka Maternal and Child Health Study.

    PubMed

    Okubo, Hitomi; Miyake, Yoshihiro; Sasaki, Satoshi; Tanaka, Keiko; Murakami, Kentaro; Hirota, Yoshio

    2011-04-01

    Although several nutrients and foods are suggested to be preventive against postpartum depression, all previous studies have primarily focused on single nutrients or foods. In contrast, studies on dietary patterns, namely the measurement of overall diet by considering the cumulative effects of nutrient, may provide new insights into the influence of diet on postpartum depression. We prospectively examined the association between dietary patterns during pregnancy and the risk of postpartum depression among 865 Japanese women. Diet was assessed with a validated, self-administered diet history questionnaire. Dietary patterns from thirty-three predefined food groups (energy-adjusted food (g/d)) were extracted by factor analysis. Postpartum depression was defined as present when the subjects had an Edinburgh Postnatal Depression Scale score of ≥ 9 at 2-9 months postpartum. A total of 121 women (14·0 %) were classified as having postpartum depression. Three dietary patterns were identified: 'Healthy', 'Western' and 'Japanese' patterns. After adjustment for potential confounders, neither the 'Healthy' nor the 'Japanese' pattern was related to the risk of postpartum depression. Compared with the first quartile of the 'Western' pattern, only the second quartile was independently related to a decreased risk of postpartum depression (multivariate OR 0·52, 95 % CI 0·30, 0·93), although no evident exposure-response associations were observed (P for trend = 0·36). The present study failed to substantiate clear associations between dietary patterns and the risk of postpartum depression. Further studies with more accurate measurements are warranted to confirm the relationship between dietary patterns and the risk of postpartum depression.

  20. The impact of group prenatal care on pregnancy and postpartum weight trajectories

    PubMed Central

    Magriples, Urania; Boynton, Marcella H.; Kershaw, Trace S.; Lewis, Jessica; Rising, Sharon Schindler; Tobin, Jonathan N.; Epel, Elissa; Ickovics, Jeannette R.

    2016-01-01

    OBJECTIVE The objective of the study was to investigate whether group prenatal care (Centering Pregnancy Plus [CP+]) has an impact on pregnancy weight gain and postpartum weight loss trajectories and to determine whether prenatal depression and distress might moderate these trajectories. STUDY DESIGN This was a secondary analysis of a cluster-randomized trial of CP+ in 14 Community Health Centers and hospitals in New York City. Participants were pregnant women aged 14–21 years (n = 984). Medical record review and 4 structured interviews were conducted: in the second and third trimesters and 6 and 12 months postpartum. Longitudinal mixed modeling was utilized to evaluate the weight change trajectories in the control and intervention groups. Prenatal distress and depression were also assessed to examine their impact on weight change. RESULTS There were no significant differences between the intervention and control groups in baseline demographics. Thirty-five percent of the participants were overweight or obese, and more than 50% had excessive weight gain by Institute of Medicine standards. CP+ was associated with improved weight trajectories compared with controls (P < .0001): women at clinical sites randomized to group prenatal care gained less weight during pregnancy and lost more weight postpartum. This effect was sustained among women who were categorized as obese based on prepregnancy body mass index (P < .01). Prenatal depression and distress were significantly associated with higher antepartum weight gain and postpartum weight retention. Women with the highest levels of depression and prenatal distress exhibited the greatest positive impact of group prenatal care on weight trajectories during pregnancy and through 12 months postpartum. CONCLUSION Group prenatal care has a significant impact on weight gain trajectories in pregnancy and postpartum. The intervention also appeared to mitigate the effects of depression and prenatal distress on antepartum weight

  1. All-Cause Mortality in Women With Severe Postpartum Psychiatric Disorders

    PubMed Central

    Johannsen, Benedicte Marie Winther; Larsen, Janne Tidselbak; Laursen, Thomas Munk; Bergink, Veerle; Meltzer-Brody, Samantha; Munk-Olsen, Trine

    2017-01-01

    Objective The postpartum period is associated with a high risk of psychiatric episodes. The authors studied mortality in women with first-onset severe psychiatric disorders following childbirth and compared their mortality rates with those in women from the background population including other female psychiatric patients (mothers and childless women). Method In a register-based cohort study with linked information from Danish population registers, the authors identified women with first psychiatric inpatient or outpatient contacts 0–3 months postpartum. The main outcome measure was mortality rate ratios (MRRs): deaths from natural causes (diseases and medical conditions) or unnatural causes (suicides, accidents, and homicides). The cohort included 1,545,857 women representing 68,473,423 person-years at risk. Results In total, 2,699 women had first-onset psychiatric disorders 0–3 months postpartum, and 96 of these died during follow-up. Women with postpartum psychiatric disorders had a higher MRR (3.74; 95% CI=3.06–4.57) than non-postpartum-onset mothers (MRR=2.73; 95% CI=2.67–2.79) when compared with mothers with no psychiatric history. However, childless women with psychiatric diagnoses had the highest MRR (6.15; 95% CI=5.94–6.38). Unnatural cause of death represented 40.6% of fatalities among women with postpartum psychiatric disorders, and within the first year after diagnosis, suicide risk was drastically increased (MRR=289.42; 95% CI=144.02–581.62) when compared with mothers with no psychiatric history. Conclusions Women with severe postpartum psychiatric disorders had increased MRRs compared with mothers without psychiatric diagnoses, and the first year after diagnosis represents a time of particularly high relative risk for suicide in this vulnerable group. PMID:26940804

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

    PubMed Central

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

    2015-01-01

    Introduction: In developing countries, hemorrhage accounts for 30% of the maternal deaths. Postpartum hemorrhage has been defined as blood loss of around 500 ml or more, after completing the third phase of labor. Most cases of postpartum hemorrhage occur during the first hour after birth. The most common reason for bleeding in the early hours after childbirth is uterine atony. Bleeding during delivery is usually a visual estimate that is measured by the midwife. It has a high error rate. However, studies have shown that the use of a standard can improve the estimation. The aim of the research is to compare the estimation of postpartum hemorrhage using the weighting method and the National Guideline for postpartum hemorrhage estimation. Materials and Methods: This descriptive study was conducted on 112 females in the Omolbanin Maternity Department of Mashhad, for a six-month period, from November 2012 to May 2013. The accessible method was used for sampling. The data collection tools were case selection, observation and interview forms. For postpartum hemorrhage estimation, after the third section of labor was complete, the quantity of bleeding was estimated in the first and second hours after delivery, by the midwife in charge, using the National Guideline for vaginal delivery, provided by the Maternal Health Office. Also, after visual estimation by using the National Guideline, the sheets under parturient in first and second hours after delivery were exchanged and weighted. The data were analyzed using descriptive statistics and the t-test. Results: According to the results, a significant difference was found between the estimated blood loss based on the weighting methods and that using the National Guideline (weighting method 62.68 ± 16.858 cc vs. National Guideline 45.31 ± 13.484 cc in the first hour after delivery) (P = 0.000) and (weighting method 41.26 ± 10.518 vs. National Guideline 30.24 ± 8.439 in second hour after delivery) (P = 0.000). Conclusions

  3. Postpartum amenorrhoea in Ethiopia: the role of weaning, child death, and socioeconomic factors.

    PubMed

    Berhanu, B; Hogan, D

    1998-01-01

    Using data from the 1990 National Family and Fertility Survey (NFFS) and employing discrete-time hazards models, we examine the effect of weaning, child death, and socioeconomic factors on postpartum amenorrhoea in Ethiopia. The results show that 91 in every 100 mothers breastfed their child for at least 6 months. The median duration of breastfeeding stands at 18 months, and amenorrhoea lasts for a median duration of 12 months. Significant variations in breastfeeding and amenorrhoea duration are also observed among the different categories of breastfeeding women. The median duration of breastfeeding for lactating women is 24 months, 6 months for those who weaned, and 2 months for those whose child died. The median duration of postpartum amenorrhoea is 14 months for breastfeeding women, 12 months for those who weaned, and 6 months for those whose child died. Discrete-time hazard models reveal that child death has the strongest effect on the resumption of menses. Net of other factors, the risk of returning to menses increased 3 times for mothers whose child died. The effect of child death, however, decreases over time. Weaning also has a significant positive effect; and, like child death, its effect diminishes as time passes. The study further shows significant differences in the risk of returning to postpartum menses by socioeconomic characteristics of the women, even though they are breastfeeding.

  4. Postpartum uterine health in cattle.

    PubMed

    Sheldon, I M; Dobson, H

    2004-07-01

    Uterine health is often compromised in cattle because postpartum contamination of the uterine lumen by bacteria is ubiquitous, and pathogenic bacteria frequently persist causing clinical disease. The subfertility associated with uterine infection involves perturbation of the hypothalamus, pituitary and ovary, in addition to the direct effects on the uterus, and appears to persist even after clinical resolution of the disease. Absorption of bacterial components from the uterus can prevent the follicular phase LH surge and ovulation. In addition, the first postpartum dominant follicle has a slower growth rate and secretes less estradiol at the end of the growth phase. There are also localised ovarian effects of high uterine bacterial growth density, because fewer first dominant follicles are selected in the ovary ipsilateral than contralateral to the previously gravid uterine horn. Thus, it is important to diagnose and treat uterine disease promptly and effectively. Examination of the contents of the vagina for the presence of pus is the most useful method for diagnosis of endometritis. The character and odor of the vaginal mucus can be scored and this endometritis score is correlated with the growth density of pathogenic bacteria in the uterus, and is prognostic for the likely success of treatment. The challenge for the future is to design prevention and control programs to reduce the incidence of disease, and understand how the immune and endocrine systems are integrated.

  5. Barriers to Postpartum Contraception in Texas and Pregnancy Within 2 Years of Delivery

    PubMed Central

    Potter, Joseph E.; Hubert, Celia; Stevenson, Amanda Jean; Hopkins, Kristine; Aiken, Abigail R. A.; White, Kari; Grossman, Daniel

    2015-01-01

    Objectives To assess pregnancies that could have been averted through improved access to contraceptive methods in the 2 years after delivery. Methods In this cohort study, we interviewed 403 postpartum women in a hospital in Austin, Texas who wanted to delay childbearing for at least 2 years. Follow-up interviews were completed at 3, 6, 9, 12, 18, and 24 months after delivery; retention at 24 months was 83%. At each interview, participants reported their pregnancy status and contraceptive method. At the 3- and 6-month interviews participants were also asked about their preferred contraceptive method 3 months in the future. We identified types of barriers among women unable to access their preferred method, and used Cox models to analyze the risk of pregnancy from 6 to 24 months after delivery. Results Among women interviewed 6 months postpartum (n=377), two thirds experienced a barrier to accessing their preferred method of contraception. By 24 months postpartum, 89 women had reported a pregnancy; 71 were unintended. Between 6 months postpartum and 24 months after delivery, 77 of 377 became pregnant (20.4%) with 56 (14.9%) lost to follow-up. Women who encountered a barrier obtaining their preferred method were more likely to become pregnant <24 months after delivery. They had a cumulative risk of pregnancy of 34% (95% CI: 0.25, 0.43) as compared to 12% (95% CI: 0.05, 0.18) for women with no barrier. All but three of the women reporting an unintended pregnancy had earlier expressed interest in using LARC or a permanent method. Conclusion In this study, most unintended pregnancies <24 months after delivery could have been prevented or postponed had women been able to access their desired long-acting and permanent methods. PMID:26942356

  6. 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

  7. Latent transition models to study women's changing of dietary patterns from pregnancy to 1 year postpartum.

    PubMed

    Sotres-Alvarez, Daniela; Herring, Amy H; Siega-Riz, Anna-Maria

    2013-04-15

    Latent class models are useful for classifying subjects by dietary patterns. Our goals were to use latent transition models to identify dietary patterns during pregnancy and postpartum, to estimate the prevalence of these dietary patterns, and to model transition probabilities between dietary patterns as a function of covariates. Women who were enrolled in the Pregnancy, Infection, and Nutrition Study (University of North Carolina, 2000-2005) were followed for 1 year postpartum, and their diets were assessed in the second trimester and at 3 and 12 months postpartum (n = 519, 484, and 374, respectively) by using a food frequency questionnaire. After adjusting for energy intake, parity, smoking status, race, and education, we identified 3 dietary patterns and named them "prudent," "health conscious Western," and "Western." Nulliparas were 2.9 and 2.1 times more likely to be in the "prudent" class than the "health conscious Western" or the "Western" class, respectively. The 3 dietary patterns were very stable, with the "health conscious Western" class being the least stable; the probability for staying in the same class was 0.74 and 0.87 at 3 and 12 months postpartum, respectively. Breastfeeding mothers were more likely than nonbreastfeeding mothers to switch dietary pattern class (P = 0.0286). Except for breastfeeding mothers, most women did not switch dietary patterns from pregnancy to postpartum.

  8. 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

  9. 38 CFR 3.4 - Compensation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Compensation. 3.4 Section..., Compensation, and Dependency and Indemnity Compensation General § 3.4 Compensation. (a) Compensation. This term...) Disability compensation. (1) Basic entitlement for a veteran exists if the veteran is disabled as the...

  10. 38 CFR 3.4 - Compensation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Compensation. 3.4 Section..., Compensation, and Dependency and Indemnity Compensation General § 3.4 Compensation. (a) Compensation. This term...) Disability compensation. (1) Basic entitlement for a veteran exists if the veteran is disabled as the...

  11. 38 CFR 3.4 - Compensation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Compensation. 3.4 Section..., Compensation, and Dependency and Indemnity Compensation General § 3.4 Compensation. (a) Compensation. This term...) Disability compensation. (1) Basic entitlement for a veteran exists if the veteran is disabled as the...

  12. 38 CFR 3.4 - Compensation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Compensation. 3.4 Section..., Compensation, and Dependency and Indemnity Compensation General § 3.4 Compensation. (a) Compensation. This term...) Disability compensation. (1) Basic entitlement for a veteran exists if the veteran is disabled as the...

  13. 38 CFR 3.4 - Compensation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Compensation. 3.4 Section..., Compensation, and Dependency and Indemnity Compensation General § 3.4 Compensation. (a) Compensation. This term...) Disability compensation. (1) Basic entitlement for a veteran exists if the veteran is disabled as the...

  14. Postpartum and postabortal insertion of intrauterine contraceptive devices.

    PubMed

    Martorella, L A; Esposito, J M

    1975-04-01

    One hundred forty-four patients are studied over an 18 month period. Postpartum and postabortal insertions of intrauterine contraceptive devices using the Lippes Loop and the Dalkon Shield are compared. The age, parity, previous methods of contraception, and marital status of the study group indicated a poorly motivated patient population. Although accidental pregnancy rates and expulsion rates are higher, the technique is considered worth-while in the population studied. Future research should be directed toward improved devices in order to decrease side effects and to increase appeal of the technique to those who will benefit most.

  15. Diagnosis and treatment of postpartum bipolar depression.

    PubMed

    Kelly, Erin; Sharma, Verinder

    2010-07-01

    The postpartum period is a time of increased risk of new-onset psychiatric illness, hospital admissions and out-patient psychiatric care for new mothers. Research into postpartum mood disorders has focused primarily on major depressive disorder, and has overlooked the study of bipolar disorder, particularly bipolar II disorder and bipolar disorder not otherwise specified. Failure to properly diagnose postpartum bipolar disorder may delay the initiation of appropriate treatment, lead to inappropriate treatment - thereby precipitating (hypo)mania, rapid cycling or a mixed episode - or result in polypharmacy and treatment refractoriness. The most serious consequence, however, is the high risk of infanticide and suicide among women with postpartum bipolar disorder. While no specific screening tools have been validated for postpartum mania or bipolar depression, symptoms of hypomania, atypical depression, a family history of bipolar disorder and a rapid onset of depressive symptoms following delivery may suggest a bipolar diathesis. In the absence of any pharmacological or psychotherapeutic treatments to guide clinical decision-making, it is recommended that the treatment of postpartum bipolar depression follow the same guidelines as the treatment of non-postpartum bipolar depression, using medications that are compatible with lactation.

  16. Childhood Sexual Abuse as a Predictor of Birth-Related Posttraumatic Stress and Postpartum Posttraumatic Stress

    ERIC Educational Resources Information Center

    Lev-Wiesel, Rachel; Daphna-Tekoah, Shir; Hallak, Mordechai

    2009-01-01

    Objective: To investigate the extent to which childbirth may function as a retraumatization of childhood sexual abuse, and may exacerbate postpartum posttraumatic stress reactions. Methods: Data was obtained from a convenience sample of 837 women in mid-pregnancy, at 2 and 6 months following childbirth. Three groups were drawn from this sample:…

  17. What is new in postpartum hemorrhage? Best articles from the past year.

    PubMed

    Rouse, Dwight J

    2013-09-01

    This month, we focus on current research in postpartum hemorrhage. Dr. Rouse discusses five recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts.

  18. Pathways to Violence in the Children of Mothers Who Were Depressed Postpartum

    ERIC Educational Resources Information Center

    Hay, Dale F.; Pawlby, Susan; Angold, Adrian; Harold, Gordon T.; Sharp, Deborah

    2003-01-01

    The impact of postnatal depression on a child's risk for violent behavior was evaluated in an urban British community sample (N=122 families). Mothers were interviewed during pregnancy, at 3 months postpartum, and when the child was 1, 4, and 11 years of age. Mothers, teachers, and children reported on violent symptoms at age 11. Structural…

  19. Postpartum Vascular Dysfunction in the Reduced Uteroplacental Perfusion Model of Preeclampsia

    PubMed Central

    Quon, Anita; Davidge, Sandra T.

    2016-01-01

    Preeclampsia is a disorder affecting 2–8% of all pregnancies, characterized by gestational hypertension (≥ 140/90 mmHg) and proteinuria (≥300 mg over 24 hours) diagnosed following the 20th week of pregnancy, and for which there is currently no available treatment. While the precise cause of preeclampsia is unknown, placental ischemia/hypoxia resulting from abnormal trophoblast invasion and maternal endothelial dysfunction are central characteristics. Preeclampsia is a major cause of both maternal and fetal morbidity and mortality in the perinatal period. In addition, women who have experienced preeclampsia are more likely to suffer cardiovascular disease later in life. The cause of this elevation in cardiovascular risk postpartum, however, is unknown. We hypothesize that there may be lasting vascular dysfunction following exposure to reduced uteroplacental perfusion during pregnancy that may contribute to increased cardiovascular risk postpartum. Using the rat reduced utero-placental perfusion pressure (RUPP) model of preeclampsia, blood pressure was assessed in dams at gestational day 20, one and three months postpartum. Mesenteric artery and aortic function were assessed using wire myography. We demonstrated hypertension and increased mesenteric artery responses to phenylephrine at gestational day 20, with the latter due to a decreased contribution of nitric oxide without any change in methylcholine-induced relaxation. At one month postpartum, we demonstrated a small but significant vasoconstrictive phenotype that was due to an underlying loss of basal nitric oxide contribution. At three months postpartum, endothelium-dependent relaxation of the aorta demonstrated sensitivity to oxLDL and mesenteric arteries demonstrated decreased nitric oxide bioavailability with impaired methylcholine-induced relaxation; indicative of an early development of endothelial dysfunction. In summary, we have demonstrated impaired vascular function following exposure to a RUPP

  20. [Post-partum and post-abortal use of IUDs (author's transl)].

    PubMed

    Laufe, L E

    1983-04-01

    The search for an IUD that could be safely inserted in the immediate postpartum period and retained as long as desired led the Population Council to undertake a 13-center study of Lippes loop insertion during the 1st 10 postpartum days. The expulsion rate of 20.5% in the 1st 3 months following insertion was considered too high, despite apparently lower risks of perforation and infection. In 1975 the International Fertility Research Program (IFRP) began a program to modify existing IUDs for immediate postpartum and postabortal insertion. Several approaches were explored using biodegradable materials to avoid expulsion, and a modified Lippes loop with catgut sutures gave good results. A case study undertaken by the IFRP attempted to evaluate too many factors with too little attention to the qualifications of participating physicians, resulting in highly variable experiences in different centers. A program recently initiated in 10 collaborating centers in Turkey promises to yield interesting results; preliminary indications are that success rates vary between institutions and depend partly on the enthusiasm of the program director. 1 Turkish center solved the difficult problem of follow-up by adding a clinic where the newborns received check-ups. In 1 month, with 100% follow-up, over 100 IUDs were inserted and only 1 of the last 50 was expelled. Many IUDs inserted postpartum are expelled because they are not placed sufficiently deeply in the uterine cavity. The IFRP believes that with appropriate training of personnel and a better tool for insertion, a high rate of retention can be achieved. Within 6 months the IFRP expects to begin clinical testing of a 2nd generation postpartum IUD with improved sutures. Despite variable success in the past, development of a satisfactory postpartum IUD would be a valuable addition to many national family planning programs.

  1. Hantavirus pulmonary syndrome in a postpartum woman

    PubMed Central

    Murthy, Pooja R.; Ucchil, Rajesh; Shah, Unmil; Chaudhari, Dipak

    2016-01-01

    Hantavirus infection, a rare disease diagnosed in India and carries a very high mortality. There are no reports of this infection in association with pregnancy or postpartum period in our country. We present a case of a 30-year-old female diagnosed to have hantavirus pulmonary syndrome in the postpartum period. We intend to create awareness about this infection and consider it in the differential diagnosis of patients presenting with acute respiratory distress syndrome and multiorgan dysfunction in association with pregnancy and postpartum period. PMID:27688634

  2. 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.

  3. Postpartum thyrotoxicosis in a patient with Graves' disease. Association with low radioactive iodine uptake

    SciTech Connect

    Eckel, R.H.; Green, W.L.

    1980-04-11

    A patient with previously diagnosed Graves' hyperthyroidism had a transient episode of thyrotoxicosis three months postpartum. This was associated with a diffusely enlarged thyroid gland, a rise in antithyroid microsomal antibody titer, a 24-hour radioactive iodine uptake (RAIU) of 1%, and an aspiration biopsy specimen suggestive of chronic lymphocytic thyroiditis. An alternative cause for the depressed RAIU was not discovered. This case would suggest that patients with previously diagnosed Graves' disease can have thyrotoxicosis without an enhanced RAIU and that the postpartum thyrotoxin syndrome may involve an immunologic injury causing a release of performed thyroid hormone.

  4. A study on postpartum metritis in Iraqi buffalo cows: bacterial causes and treatment.

    PubMed

    Azawi, O I; Omran, S N; Hadad, J J

    2008-10-01

    The objectives of the present study were to determine the relationship between bacteriological findings, clinical signs and histopathological changes in postpartum metritis. Evaluation of the treatment efficiency of using systemic or intra-uterine infusion of antibiotics with some hormonal preparations for the treatment of postpartum metritis. Data were collected from 50 buffalo cows with history of calving of more than 1 month. All buffaloes were subjected to detailed clinical examination including external inspection, vaginoscopy and transrectal palpation of the cervix, uterus and ovaries. Swabs for bacteriology and biopsies for histopathology were collected from uterine lumen from each buffalo included in the present study. Bacteria identified using API systems following aerobic and anaerobic cultures. Vaginal mucus scored for character, odour and estimation of polymorphonuclear cells (PMNs). Treatment conducted using oxytetracycline in local intrauterine infusion or systemically with hormonal treatment including prostaglandin F2 alpha (PGF2 alpha) and oestradiol benzoate. Results revealed that the most predisposing factor for postpartum uterine infection was retained placenta and toxic puerperal metritis. The most prevalent bacteria in uterine lumen were Escherichia coli, Archanobacterium pyogenes, Bacteroides fragilis and Fusobacterium necrophorum the most prevalent bacteria in buffaloes with postpartum metritis. A. pyogenes and F. necrophorum were an important pathogens causing severe uterine inflammation as found in histopathological examinations. Buffaloes with postpartum metritis showed good clinical cure when oxytetracycline injected systemically with PGF2 alpha. Intrauterine infusion of oxytetracycline had no advantage for the treatment of uterine infection in buffalo cows with postpartum metritis. PGF2 alpha improved clinical cure of buffaloes with postpartum metritis.

  5. Identifying Risk for Onset of Major Depressive Episodes in Low-Income Latinas during Pregnancy and Postpartum

    ERIC Educational Resources Information Center

    Le, Huynh-Nhu; Munoz, Ricardo F.; Soto, Jose A.; Delucchi, Kevin L.; Ippen, Chandra Ghosh

    2004-01-01

    This study aimed to identify subgroups of pregnant women at imminent (1 year) risk for major depressive episodes. Participants were 84 low-income, predominantly Mexican women using public sector obstetrics services who participated in monthly interviews during pregnancy and up to 6 months postpartum. Participants were designated a priori as "more…

  6. Maternal anxiety from pregnancy to 2 years postpartum: transactional patterns of maternal early adversity and child temperament.

    PubMed

    Agrati, Daniella; Browne, Dillon; Jonas, Wibke; Meaney, Michael; Atkinson, Leslie; Steiner, Meir; Fleming, Alison S

    2015-10-01

    The aims of this study were to examine the anxiety trajectories of women from pregnancy to 2 years postpartum and to assess the influence of their early life experiences and the temperament of the child on these trajectories. We evaluated state anxiety (State-Trait Anxiety Inventory) at pregnancy and 3, 6, 12, 18, and 24 months postpartum and determined its course as a function of self-reported early adverse experiences (Childhood Trauma Questionnaire) and the temperament of the child at 18 months (Early Child Behavior Questionnaire). Based on growth curve modeling, we found that anxiety followed a general U-shape pattern from gestation to 2 years postpartum, which was modified by early life experience of women. Greater early adversity was associated with higher gestational anxiety, followed by a marked decrease once the baby was born, and subsequent increase during the later postpartum period. The temperament of the child also modulated anxiety trajectories. Thus, mothers of children high in negative affectivity and who also experienced greater early adversity had elevated and flat anxiety trajectories, while child extraversion was associated with increasing anxiety courses approaching 2 years postpartum. These results show that maternal anxiety dynamically changes through the postpartum period with a course that is affected by previous and current experiences.

  7. Implementation of a Postpartum HPV Vaccination Program in a Southeast Texas Hospital: A Qualitative Study Evaluating Health Care Provider Acceptance.

    PubMed

    Gross, Tyra T; Rahman, Mahbubur; M Wright, Abigail; M Hirth, Jacqueline; Sarpong, Kwabena O; Rupp, Richard E; D Barrett, Alan; Berenson, Abbey B

    2016-11-01

    Introduction The objective of this qualitative study was to assess healthcare providers' acceptability of an ongoing postpartum human papillomavirus (HPV) vaccination program in Southeast Texas and its integration into everyday clinical care. Methods In 2012, the Department of Obstetrics & Gynecology at the University of Texas Medical Branch (UTMB) began offering HPV vaccination as part of standard postpartum care to increase vaccination rates among young women in Galveston County. Initial vaccine doses were offered on the postpartum unit while subsequent doses were coordinated with postpartum and well-baby visits. Thirty months after project initiation, semi-structured interviews of physicians (n = 12) and nurses (n = 6) involved in postpartum and pediatric care at UTMB were conducted. Interview transcripts were analyzed using thematic analysis in Nvivo10. Results Overall, providers demonstrated "pro-vaccine" attitudes and stated the program was an effective strategy for vaccinating hard-to-reach women. Cancer prevention was the main perceived benefit while follow-up compliance was the primary perceived patient barrier. The initial challenges with integrating postpartum HPV vaccination included miscommunication between providers regarding vaccine orders and coordination issues with well-baby visits for follow-up doses. One novel finding was providers' beliefs that women's personal HPV vaccine practices may positively impact their decisions about later vaccinating their children against HPV. Providers' suggestions to improve the program included: enhancing postpartum HPV vaccine education for patients, offering more continuing education for providers, and increasing community awareness of HPV vaccination. Discussion These findings can help providers of postpartum care understand how to integrate postpartum HPV vaccination into their current practices and how to overcome perceived vaccination barriers.

  8. Prospective and Dyadic Associations between Expectant Parents’ Prenatal Hormone Changes and Postpartum Parenting Outcomes

    PubMed Central

    Edelstein, Robin S.; Chopik, William J.; Saxbe, Darby E.; Wardecker, Britney M.; Moors, Amy C.; LaBelle, Onawa P.

    2017-01-01

    During the transition to parenthood, both men and women experience hormone changes that are thought to promote parental care. Yet very few studies have explicitly tested the hypothesis that prenatal hormone changes are associated with postpartum parenting behavior. In a longitudinal study of 27 first-time expectant couples, we assessed whether prenatal hormone changes predicted self and partner-reported parenting outcomes at three months postpartum. Expectant fathers showed prenatal declines in testosterone and estradiol, and larger declines in these hormones predicted larger contributions to household and infant care tasks postpartum. Women whose partners showed larger testosterone declines also reported receiving more support and more help with household tasks. Expectant mothers showed prenatal increases in testosterone and estradiol, and larger increases predicted lower partner-rated support. Together, our findings provide some of first evidence that prenatal hormone changes may indeed be functional and that behaviors associated with these changes may be detectable by co-parents. PMID:27604815

  9. Reducing Postpartum Weight Retention and Improving Breastfeeding Outcomes in Overweight Women: A Pilot Randomised Controlled Trial

    PubMed Central

    Martin, Julia; MacDonald-Wicks, Lesley; Hure, Alexis; Smith, Roger; Collins, Clare E

    2015-01-01

    Overweight and obesity is prevalent among women of reproductive age (42% BMI > 25 kg/m2) and parity is associated with risk of weight gain. Weight gain greater than that recommended by the Institute of Medicine (IOM )is also associated with lower rates of breastfeeding initiation and duration in women. The aim of this pilot randomised controlled trial is to examine the feasibility of recruiting and maintaining a cohort of pregnant women with the view of reducing postpartum weight retention and improving breastfeeding outcomes. Women (BMI of 25–35 kg/m2 (n = 36)) were recruited from the John Hunter Hospital antenatal clinic in New South Wales, Australia. Participants were stratified by BMI and randomised to one of three groups with follow-up to six months postpartum. Women received a dietary intervention with or without breastfeeding support from a lactation consultant, or were assigned to a wait-list control group where the dietary intervention was issued at three months postpartum. Feasibility and acceptability was assessed by participation rates and questionnaire. Analysis of variance and covariance was conducted to determine any differences between groups. Sixty-nine per cent of the participants were still enrolled at six months postpartum. This pilot demonstrated some difficulties in recruiting women from antenatal clinics and retaining them in the trial. Although underpowered; the results on weight; biomarkers and breastfeeding outcomes indicated improved metabolic health. PMID:25723973

  10. The impact of migration on women’s mental health in the postpartum period

    PubMed Central

    Almeida, Lígia Moreira; Costa-Santos, Cristina; Caldas, José Peixoto; Dias, Sónia; Ayres-de-Campos, Diogo

    2016-01-01

    ABSTRACT OBJECTIVE To assess the influence of I mmigration on the psychological health of women after childbirth. METHODS In this cross-sectional study, immigrant and Portuguese-native women delivering in the four public hospitals of the metropolitan area of Porto, Portugal, were contacted by telephone between February and December 2012 during the first postpartum month to schedule a home visit and fill in a questionnaire. Most immigrant (76.1%) and Portuguese mothers (80.0%) agreed to participate and with the visits, thus a total of 89 immigrants and 188 Portuguese women were included in the study. The questionnaire included the application of four validated scales: Mental Health Inventory-5, Edinburgh Postpartum Depression Scale, Perceived Stress Scale, and Scale of Satisfaction with Social Support. Statistical analysis included t-test and Chi-square or Fisher’s test, and logistic regression models. RESULTS Immigrants had an increased risk of postpartum depression (OR = 6.444, 95%CI 1.858–22.344), and of low satisfaction with social support (OR = 6.118, 95%CI 1.991–18.798). We did not perceive any associations between migrant state, perceived stress, and impoverished mental health. CONCLUSIONS Immigrant mothers have increased vulnerabilities in the postpartum period, resulting in an increased risk of postpartum depression and lesser satisfaction with the received social support. PMID:27355463

  11. Within-woman change in regulatory T cells from pregnancy to the postpartum period.

    PubMed

    Wegienka, Ganesa; Havstad, Suzanne; Bobbitt, Kevin R; Woodcroft, Kimberley J; Zoratti, Edward M; Ownby, Dennis R; Cole Johnson, Christine

    2011-01-01

    Regulatory T cells (Treg cells) are an important area of investigation in human health and disease. In this study, the trajectory of percentage of Treg cells (defined as CD4+CD25+Foxp3+CD127--lymphocytes) was measured in the blood of 208 women during pregnancy and up to three additional times in the postpartum period (1, 6 and 12 months postpartum). Whether the trajectory was affected by gravidity, parity, neonatal sex, pet exposure, maternal atopic and asthma status, smoking, maternal race or other pregnancy factors was examined. Multilevel models were fit using full maximum likelihood methods and included both random and fixed effects. Overall, percentages of Treg cells increased from the prenatal to the postpartum period. Among women who were not atopic, nulliparous women had lower percentages of Treg cells over time compared with parous women. Atopic women with pets in the home during pregnancy had lower percentages of Treg cells than atopic women who did not have pets. The trajectory was not affected by the other factors investigated. We conclude that within-woman change in percentages of Treg cells may vary by time in relation to delivery, as well as by maternal atopic status and exposure to pets and number of prior births. The data did not indicate an overall decline in Treg cells in the postpartum period. Future work to better identify the role of Treg cells in successful pregnancy would ideally include a set of well characterized women sampled serially starting prior to pregnancy and throughout the postpartum period.

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

    PubMed Central

    2012-01-01

    Background Research has shown that exposure to interpersonal violence is associated with poorer mental health outcomes. Understanding the impact of interpersonal violence on mental health in the early postpartum period has important implications for parenting, child development, and delivery of health services. The objective of the present study was to determine the impact of interpersonal violence on depression, anxiety, stress, and parenting morale in the early postpartum. Methods Women participating in a community-based prospective cohort study (n = 1319) completed questionnaires prior to 25 weeks gestation, between 34–36 weeks gestation, and at 4 months postpartum. Women were asked about current and past abuse at the late pregnancy data collection time point. Postpartum depression, anxiety, stress, and parenting morale were assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale, the Spielberger State Anxiety Index, the Cohen Perceived Stress Scale, and the Parenting Morale Index, respectively. The relationship between interpersonal violence and postpartum psychosocial health status was examined using Chi-square analysis (p < 0.05) and multivariable logistic regression. Results Approximately 30% of women reported one or more experience of interpersonal violence. Sixteen percent of women reported exposure to child maltreatment, 12% reported intimate partner violence, and 12% reported other abuse. Multivariable logistic regression analysis found that a history of child maltreatment had an independent effect on depression in the postpartum, while both child maltreatment and intimate partner violence were associated with low parenting morale. Interpersonal violence did not have an independent effect on anxiety or stress in the postpartum. Conclusion The most robust relationships were seen for the influence of child maltreatment on postpartum depression and low parenting morale. By identifying women at risk for depression and low

  13. Patterns and trends of postpartum family planning in Ethiopia, Malawi, and Nigeria: evidence of missed opportunities for integration.

    PubMed

    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

  14. 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

  15. Contraceptive Adoption, Discontinuation, and Switching among Postpartum Women in Nairobi's Urban Slums.

    PubMed

    Mumah, Joyce N; Machiyama, Kazuyo; Mutua, Michael; Kabiru, Caroline W; Cleland, John

    2015-12-01

    Unmet need for contraception is highest within 12 months post-delivery, according to research. Using longitudinal data from the Nairobi Urban Health and Demographic Surveillance System, we assess the dynamics of contraceptive use during the postpartum period among women in Nairobi's slums. Results show that by 6 months postpartum, 83 percent of women had resumed sexual activity and 51 percent had resumed menses, yet only 49 percent had adopted a modern contraceptive method. Furthermore, almost half of women discontinued a modern method within 12 months of initiating use, with many likely to switch to another short-term method with high method-related dissatisfaction. Women who adopted a method after resumption of menses had higher discontinuation rates, though the effect was much reduced after adjusting for other variables. To reduce unmet need, effective intervention programs are essential to lower high levels of discontinuation and encourage switching to more effective methods.

  16. Breastfeeding, amenorrhea and contraceptive practice among postpartum women in Zibo, China.

    PubMed

    Zhang, L Y; Liu, Y R; Shah, I H; Tian, K W; Zhang, L H

    2002-09-01

    This paper reports a hospital-based longitudinal study that was conducted in Zibo, China, in June 1996. The objective was to investigate the existing patterns of breastfeeding, amenorrhea and contraceptive use among postpartum women in urban areas of China. Information was obtained from 492 newly parturient women. Follow-up interviews were done at 42 days. 4 months and 1 year after delivery. The results showed that the full breastfeeding rate (including exclusive and almost exclusive breastfeeding) was 78% and 43% at 42 days and 4 months after delivery, respectively. The mean reported length of abstinence from sexual intercourse after delivery was 71 days. The mean reported time to menses resumption was 184 days. Ninety-three per cent of women had resumed sexual intercourse at 4 months after delivery. Seventy-three per cent of women were using contraceptive methods when they resumed sexual activity after delivery. After childbirth, the majority ofthe women interviewed used condoms within 3 months. Thereafter, most of them switched to intrauterine device (IUD)). Life table analysis shows that the continuation rates of full breastfeeding and amenorrhea at 4 months after delivery were 35% and 68%, respectively. This implies that if the full breastfeeding rate can be prolonged, it is feasible to use the lactational amenorrhea method (LAM) among Chinese postpartum women. The policy implications of this study are that quality care on contraceptive services and information for postpartum women in urban areas need to be improved further.

  17. Paternal and Maternal Transition to Parenthood: The Risk of Postpartum Depression and Parenting Stress

    PubMed Central

    Epifanio, Maria Stella; Genna, Vitalba; De Luca, Caterina; Roccella, Michele; La Grutta, Sabina

    2015-01-01

    Transition to parenthood represents an important life event increasing vulnerability to psychological disorders. Postpartum depression and parenting distress are the most common psychological disturbances and a growing scientific evidence suggests that both mothers and fathers are involved in this developmental crisis. This paper aims to explore maternal and paternal experience of transition to parenthood in terms of parenting distress and risk of postpartum depression. Seventy-five couples of first-time parents were invited to compile the Edinburgh Postnatal Depression Scale and the Parenting Stress Index-Short Form in the first month of children life. Study sample reported very high levels of parenting distress and a risk of postpartum depression in 20.8% of mothers and 5.7% of fathers. No significant correlation between parenting distress and the risk of postpartum depression emerged, both in mothers than in fathers group while maternal distress levels are related to paternal one. The first month after partum represents a critical phase of parents life and it could be considered a developmental crisis characterized by anxiety, stress and mood alterations that could have important repercussions on the child psycho-physical development. PMID:26266033

  18. Paternal and Maternal Transition to Parenthood: The Risk of Postpartum Depression and Parenting Stress.

    PubMed

    Epifanio, Maria Stella; Genna, Vitalba; De Luca, Caterina; Roccella, Michele; La Grutta, Sabina

    2015-05-25

    Transition to parenthood represents an important life event increasing vulnerability to psychological disorders. Postpartum depression and parenting distress are the most common psychological disturbances and a growing scientific evidence suggests that both mothers and fathers are involved in this developmental crisis. This paper aims to explore maternal and paternal experience of transition to parenthood in terms of parenting distress and risk of postpartum depression. Seventy-five couples of first-time parents were invited to compile the Edinburgh Postnatal Depression Scale and the Parenting Stress Index-Short Form in the first month of children life. Study sample reported very high levels of parenting distress and a risk of postpartum depression in 20.8% of mothers and 5.7% of fathers. No significant correlation between parenting distress and the risk of postpartum depression emerged, both in mothers than in fathers group while maternal distress levels are related to paternal one. The first month after partum represents a critical phase of parents life and it could be considered a developmental crisis characterized by anxiety, stress and mood alterations that could have important repercussions on the child psycho-physical development.

  19. 2,3,4,6-Tetrachlorophenol

    Integrated Risk Information System (IRIS)

    2,3,4,6 - Tetrachlorophenol ; CASRN 58 - 90 - 2 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for Noncar

  20. Post-partum acute kidney injury.

    PubMed

    Pahwa, Naresh; Bharani, Rajesh; Kumar, Ravindra

    2014-11-01

    To determine the risk factors, course of hospital stay and mortality rate among women with post-partum acute kidney injury (AKI), we studied (of 752 patients with AKI admitted to a tertiary care center during the study period between November 2009 and August 2012) 27 (3.59%) women with post-partum AKI. The data regarding age, parity, cause of renal failure, course of hospital stay and requirement of dialysis were recorded. Sepsis was the major cause (70.3%) of post-partum AKI. Other causes included disseminated intravascular coagulation (55.5%), pre-eclampsia/eclampsia (40.7%), ante- and post-partum hemorrhage (40.7% and 22.2%) and hemolytic anemia and elevated liver enzymes and low platelet count syndrome (29.6%); most patients had more than one cause of AKI. We found a very high prevalence (18.5%) of cortical necrosis in our study patients. A significant correlation was also found between the creatinine level on admission and the period of onset of disease after delivery. In conclusion, several factors are involved in causing post-partum AKI in our population, and sepsis was the most common of them.

  1. Postpartum Health Information Seeking Using Mobile Phones: Experiences of Low-Income Mothers.

    PubMed

    Guerra-Reyes, Lucia; Christie, Vanessa M; Prabhakar, Annu; Harris, Asia L; Siek, Katie A

    2016-11-01

    Objectives To assess low-income mothers' perceptions of their postpartum information needs; describe their information seeking behavior; explore their use of mobile technology to address those needs; and to contribute to the sparse literature on postpartum health and wellness. Methods Exploratory community-based qualitative approach. Interviewees were recruited among clients of community partners and had children aged 48 months and under. A survey assessing demographics was used to identify low-income mothers. 10 low-income mothers were recruited from survey participants to complete in-depth interviews regarding postpartum information needs, information seeking, and technology use. Interviews were transcribed verbatim and coded by three researchers independently. Narratives were analyzed along predetermined (etic) and emergent (emic) categories. Results Establishing breastfeeding and solving breastfeeding problems were central postpartum concerns leading to information seeking. Interviewees reported almost exclusive use of mobile phones to access the Internet. Mobile applications were widely used during pregnancy, but were not valuable postpartum. Face-to-face information from medical professionals was found to be repetitive. Online information seeking was mediated by default mobile phone search engines, and occurred over short, fragmented time periods. College graduates reported searching for authoritative knowledge sources; non-graduates preferred forums. Conclusions for Practice Low-income postpartum women rely on their smartphones to find online infant care and self-care health information. Websites replace pregnancy-related mobile applications and complement face-to-face information. Changes in searching behavior and multitasking mean information must be easily accessible and readily understood. Knowledge of page-rank systems and use of current and emergent social media will allow health-related organizations to better engage with low-income mothers online and

  2. Levels and trends in post-partum amenorrhoea, breast-feeding and birth intervals in Matlab, Bangladesh: 1978-1989.

    PubMed

    Salway, S; Roy, N C; Koenig, M A; Cleland, J

    1993-06-01

    This study examines the trends in and determinants of length of postpartum amenorrhea during 1978-90 in Bangladesh. Data are obtained from the Matlab project. The sample comprises 6000 women per cohort for cohorts born in two year periods during 1978-80 and 1988-89. Reproductive and lactation records are available for up to 36 months following the birth of the index child. Findings indicate that the duration of postpartum amenorrhea is around 13 months for births during 1978-83. The median duration is 13.5 months for the birth cohort for 1982-83 and 9.4 months for the birth cohort for 1988-89. For 1989 alone the median duration is a further decline to 8.6 months. The seven year decline amounts to a 36% reduction. Findings indicate that age and duration of postpartum amenorrhea are positively related. All age groups show a decline in median duration. The shorter median durations occur among women with fewer than two living children and higher levels of education. Duration of breast feeding peaks in 1984-85 at 34.3 months and then declines to 30.7 months in 1986-87. Full breast feeding duration declines from around 6 months for cohorts 1978-79 to cohorts 1982-88 to 5.2 months in 1986-87 and lags behind durations of postpartum amenorrhea. Full breast feeding declines occur after the 1982-83 cohort among mothers with higher education and after the 1984-85 cohort for uneducated and less educated women. Age patterns of breast feeding women are inconsistent. The oldest mothers have the shortest breast feeding durations. The youngest cohorts show a decreasing trend. Breast feeding durations increase with an increase in the number of living children. However another trend shows initial increases in duration and then declines regardless of the number of living children. The suggestion is that full breast feeding may be important in determining the length of postpartum amenorrhea duration. Contraceptive use increases from 24% in 1977 to 39% in 1984. Median birth intervals

  3. [Hypertension and pregnancy: Post-partum period].

    PubMed

    Hugon-Rodin, Justine; Plu-Bureau, Geneviève

    2016-01-01

    Post-partum period is associated with specific characteristics in women with gestational disorders or preeclampsia. For breastfeeding women, the choice of antihypertensive treatment should take into account the impact on child health. The impact of breastfeeding on health mother must be also discussed. Moreover, for lactation inhibition, bromocriptine should not be used, especially in the context of gestational disorders. In post-partum period, the best contraceptive strategy is only-progestin contraception or non-hormonal contraceptives use. However, this choice will depend on the stabilization or normalization of blood pressure in early post-partum period. Finally, several consultations should be suggested: an information and announcement to explain the consequences of these gestational disorders and organize their multidisciplinary management and follow-up. A preconceptional consultation takes its place to anticipate potential recurrent preeclampsia or gestational hypertension and to schedule a future pregnancy in optimal conditions.

  4. Idiopathic intracranial hypertension presenting as postpartum headache

    PubMed Central

    Mathew, Mariam; Salahuddin, Ayesha; Mathew, Namitha R.; Nandhagopal, Ramachandiran

    2016-01-01

    Postpartum headache is described as headache and neck or shoulder pain during the first 6 weeks after delivery. Common causes of headache in the puerperium are migraine headache and tension headache; other causes include pre-eclampsia/eclampsia, post-dural puncture headache, cortical vein thrombosis, subarachnoid hemorrhage, posterior reversible leukoencephalopathy syndrome, brain tumor, cerebral ischemia, meningitis, and so forth. Idiopathic intracranial hypertension (IIH) is a rare cause of postpartum headache. It is usually associated with papilledema, headache, and elevated intracranial pressure without any focal neurologic abnormality in an otherwise healthy person. It is more commonly seen in obese women of reproductive age group, but rare during pregnancy and postpartum. We present a case of IIH who presented to us 18 days after cesarean section with severe headache and was successfully managed. PMID:26818168

  5. Psychiatric Disorders in Pregnant and Postpartum Women in the United States

    PubMed Central

    Vesga-Lopez, Oriana; Blanco, Carlos; Keyes, Katherine; Olfson, Mark; Grant, Bridget F.; Hasin, Deborah S.

    2009-01-01

    CONTEXT Psychiatric disorders and substance use during pregnancy are associated with adverse outcomes for mothers and their offspring. Information about the epidemiology of psychiatric disorders and substance use in this population is lacking. OBJECTIVE To examine sociodemographic correlates, rates of DSM-IV Axis I psychiatric disorders, substance use and treatment-seeking among past-year pregnant and postpartum women in the United States. DESIGN, SETTING, AND PARTICIPANTS Face-to-face interviews were conducted in the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093). MAIN OUTCOME MEASURES Prevalence of 12-month DSM-IV Axis I psychiatric disorders, substance use, and treatment seeking. RESULTS There were no significant differences in the 12-month prevalence of psychiatric disorders between past-year pregnant (25.3%), postpartum women (27.5%), and non-pregnant women of child-bearing age (30.1%), except for the significantly higher prevalence of major depressive disorder in postpartum women (9.3%) than in non-pregnant women (8.1%) (OR 1.59, 95% CI=1.15–2.20). Past-year pregnant and postpartum women had significantly lower rates of alcohol use disorders, and any substance use, except illicit drug use, than non-pregnant women. Age, marital status, health status, stressful life events, and history of traumatic experiences were all significantly associated with higher risk of psychopathology in pregnant and postpartum women. Most women with a current psychiatric disorder did not receive any mental health care in the 12-months prior to the survey regardless of pregnancy status. CONCLUSIONS Pregnancy per se is not associated with increased risk of mental disorders, though the risk of major depressive disorder may be increased during the postpartum period. Young, unmarried women with recent stressful life events, complicated pregnancies, and poor overall health were at significantly increased risk of mental disorders during pregnancy

  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. LiHo(PO3)4

    PubMed Central

    Ben Zarkouna, Emna; Driss, Ahmed; Férid, Mokhtar

    2009-01-01

    Lithium holmium(III) polyphosphate(V), LiHo(PO3)4, belongs to the type I of polyphosphates with general formula ALn(PO3)4, where A is a monovalent cation and Ln is a trivalent rare earth cation. In the crystal structure, the polyphosphate chains spread along the b-axis direction, with a repeat period of four tetra­hedra and 21 inter­nal symmetry. The Li and Ho atoms are both located on twofold rotation axes and are surrounded by four and eight O atoms, leading to a distorted tetra­hedral and dodeca­hedral coordination, respectively. The HoO8 polyhedra are isolated from each other, the closest Ho⋯Ho distance being 5.570 (1) Å. PMID:21581738

  8. 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.

  9. Obesity epidemic: impact from preconception to postpartum

    PubMed Central

    Moussa, Hind N; Alrais, Mesk A; Leon, Mateo G; Abbas, Elizabeth L; Sibai, Baha M

    2016-01-01

    The obesity epidemic is on the rise throughout the USA and the world. Not only does it affect the general population but it also specifically poses unique threats to a woman’s life in the antepartum, peripartum and postpartum periods. An increased BMI is associated with worse perinatal outcomes, including higher rates of preeclampsia (and other hypertensive disorders), macrosomia, other neonatal morbidities and gestational diabetes. Isolated maternal obesity and additional maternal diabetes predispose the infant to potential adult disease through fetal programming. This review of the literature examines the effects of obesity on a woman’s life, outlining complications beginning with preconception through the postpartum period. PMID:28031980

  10. Patient Satisfaction With Postpartum Teaching Methods

    PubMed Central

    Wagner, Debra L.; Washington, Cynthia

    2016-01-01

    ABSTRACT Postpartum discharge instructions are a crucial part of a mother’s birth experience. Finding the method to provide those discharge instructions in a manner that increases the mother’s satisfaction with her hospital experience is important. This quasi-experimental study examined the relationship between new mothers’ interaction with nurses providing postpartum instructions by the traditional and class methods and their satisfaction with discharge teaching. The results indicated new mothers were satisfied with both methods of discharge teaching; however, they were more likely to report stronger agreement with overall satisfaction with the traditional method of discharge teaching than with attending the discharge class. PMID:27445450

  11. Patient Satisfaction With Postpartum Teaching Methods.

    PubMed

    Wagner, Debra L; Washington, Cynthia

    2016-01-01

    Postpartum discharge instructions are a crucial part of a mother's birth experience. Finding the method to provide those discharge instructions in a manner that increases the mother's satisfaction with her hospital experience is important. This quasi-experimental study examined the relationship between new mothers' interaction with nurses providing postpartum instructions by the traditional and class methods and their satisfaction with discharge teaching. The results indicated new mothers were satisfied with both methods of discharge teaching; however, they were more likely to report stronger agreement with overall satisfaction with the traditional method of discharge teaching than with attending the discharge class.

  12. Pre-eclampsia and first-onset postpartum psychiatric episodes: a Danish population-based cohort study

    PubMed Central

    Bergink, V.; Laursen, T. M.; Johannsen, B. M. W.; Kushner, S. A.; Meltzer-Brody, S.; Munk-Olsen, T.

    2016-01-01

    Background Recent evidence suggests that postpartum psychiatric episodes may share similar etiological mechanisms with immune-related disorders. Pre-eclampsia is one of the most prevalent immune-related disorders of pregnancy. Multiple clinical features are shared between pre-eclampsia and postpartum psychiatric disorders, most prominently a strong link to first pregnancies. Therefore, we aimed to study if pre-eclampsia is a risk factor for first-onset postpartum psychiatric episodes. Method We conducted a cohort study using the Danish population registry, with a total of 400 717 primiparous women with a singleton delivery between 1995 and 2011. First-lifetime childbirth was the main exposure variable and the outcome of interest was first-onset postpartum psychiatric episodes. The main outcome measures were monthly incidence rate ratios (IRRs), with the period 11–12 months after birth as the reference category. Adjustments were made for age, calendar period, reproductive history, and perinatal maternal health including somatic and obstetric co-morbidity. Results Primiparous women were at particularly high risk of first-onset psychiatric episodes during the first month postpartum [IRR 2.93, 95% confidence interval (CI) 2.53–3.40] and pre-eclampsia added to that risk (IRR 4.21, 95% CI 2.89–6.13). Having both pre-eclampsia and a somatic co-morbidity resulted in the highest risk of psychiatric episodes during the 3-month period after childbirth (IRR 4.81, 95% CI 2.72–8.50). Conclusions We confirmed an association between pre-eclampsia and postpartum psychiatric episodes. The possible explanations for this association, which are not mutually exclusive, include the psychological impact of a serious medical condition such as pre-eclampsia and the neurobiological impact of pre-eclampsia-related vascular pathology and inflammation. PMID:26243040

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

    PubMed Central

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

    2015-01-01

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

  14. Epidural analgesia and cesarean delivery in multiple sclerosis post-partum relapses: the Italian cohort study

    PubMed Central

    2012-01-01

    Background Few studies have systematically addressed the role of epidural analgesia and caesarean delivery in predicting the post-partum disease activity in women with Multiple Sclerosis (MS). The objective of this study was to assess the impact of epidural analgesia (EA) and caesarean delivery (CD) on the risk of post-partum relapses and disability in women with MS. Methods In the context of an Italian prospective study on the safety of immunomodulators in pregnancy, we included pregnancies occurred between 2002 and 2008 in women with MS regularly followed-up in 21 Italian MS centers. Data were gathered through a standardized, semi-structured interview, dealing with pregnancy outcomes, breastfeeding, type of delivery (vaginal or caesarean) and EA. The risk of post-partum relapses and disability progression (1 point on the Expanded Disability Status Sclae, EDSS, point, confirmed after six months) was assessed through a logistic multivariate regression analysis. Results We collected data on 423 pregnancies in 415 women. Among these, 349 pregnancies resulted in full term deliveries, with a post-partum follow-up of at least one year (mean follow-up period 5.5±3.1 years). One hundred and fifty-five patients (44.4%) underwent CD and 65 (18.5%) EA. In the multivariate analysis neither CD, nor EA were associated with a higher risk of post-partum relapses. Post-partum relapses were related to a higher EDSS score at conception (OR=1.42; 95% CI 1.11-1.82; p=0.005), a higher number of relapses in the year before pregnancy (OR=1.62; 95% CI 1.15-2.29; p=0.006) and during pregnancy (OR=3.07; 95% CI 1.40-6.72; p=0.005). Likewise, CD and EA were not associated with disability progression on the EDSS after delivery. The only significant predictor of disability progression was the occurrence of relapses in the year after delivery (disability progression in the year after delivery: OR= 4.00; 95% CI 2.0-8.2; p<0.001; disability progression over the whole follow-up period: OR= 2.0; 95

  15. Predicting changes in depressive symptoms from pregnancy to postpartum: the role of brooding rumination and negative inferential styles.

    PubMed

    Barnum, Sarah E; Woody, Mary L; Gibb, Brandon E

    2013-02-01

    The current study examined the role of cognitive factors in the development and maintenance of depressive symptoms from pregnancy into the postpartum period. One hundred and one women were assessed for levels of rumination (brooding and reflection), negative inferential styles, and depressive symptoms in their third trimester of pregnancy and depressive symptom levels again at four and eight weeks postpartum. We found that, although none of the three cognitive variables predicted women's initial depressive reactions following childbirth (from pregnancy to one month postpartum), brooding rumination and negative inferential styles predicted longer-term depressive symptom changes (from pregnancy to two months postpartum). However, the predictive validity of women's negative inferential styles was limited to women already exhibiting relatively high depressive symptom levels during pregnancy, suggesting that it was more strongly related to the maintenance of depressive symptoms into the postpartum period rather than increases in depressive symptoms following childbirth. Modifying cognitive risk factors, therefore, may be an important focus of intervention for depression during pregnancy.

  16. Predicting Changes in Depressive Symptoms from Pregnancy to Postpartum: The Role of Brooding Rumination and Negative Inferential Styles

    PubMed Central

    Barnum, Sarah E.; Woody, Mary L.; Gibb, Brandon E.

    2014-01-01

    The current study examined the role of cognitive factors in the development and maintenance of depressive symptoms from pregnancy into the postpartum period. One hundred and one women were assessed for levels of rumination (brooding and reflection), negative inferential styles, and depressive symptoms in their third trimester of pregnancy and depressive symptom levels again at four and eight weeks postpartum. We found that, although none of the three cognitive variables predicted women’s initial depressive reactions following childbirth (from pregnancy to one month postpartum), brooding rumination and negative inferential styles predicted longer-term depressive symptom changes (from pregnancy to two months postpartum). However, the predictive validity of women’s negative inferential styles was limited to women already exhibiting relatively high depressive symptom levels during pregnancy, suggesting that it was more strongly related to the maintenance of depressive symptoms into the postpartum period rather than increases in depressive symptoms following childbirth. Modifying cognitive risk factors, therefore, may be an important focus of intervention for depression during pregnancy. PMID:25401383

  17. Maternal Antenatal Depression and Infant Disorganized Attachment at 12 months

    PubMed Central

    Hayes, Lisa J.; Goodman, Sherryl H.; Carlson, Elizabeth

    2012-01-01

    Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal parenting quality as potential moderators of this predicted association. Among women with histories of major depressive episodes, maternal depressive symptoms were assessed at multiple times during pregnancy and the first year postpartum, maternal parenting quality was measured at 3 months postpartum, and attachment disorganization was assessed at 12 months postpartum. Results revealed that infants classified as disorganized had mothers with higher levels of depressive symptoms during pregnancy compared to infants classified as organized. Maternal parenting quality moderated this association, as exposure to higher levels of maternal depressive symptoms during pregnancy was only associated with higher rates of infant disorganized attachment when maternal parenting at 3 months was less optimal. These findings suggest that enhancing maternal parenting behaviors during this early period in development has the potential to alter pathways to disorganized attachment among infants exposed to antenatal maternal depressive symptoms, which could have enduring consequences for child wellbeing. PMID:23216358

  18. Postpartum Contraception: a Comparative Study of Berlin Women with and without Immigration Background.

    PubMed

    David, M; Brenne, S; Breckenkamp, J; Razum, O; Borde, T

    2015-09-01

    Research Questions: Are there differences in postpartum contraceptive use between women with and without immigration background? Do women more commonly use contraception following a high-risk pregnancy or caesarean section? What role does current breastfeeding play and, amongst immigrants, what is the effect of acculturation level on the frequency of contraceptive use? Study Population and Methods: Data collection was carried out as part of a larger study in three Berlin delivery units using standardised interviews (questionnaires covering e.g. sociodemographics, immigration history/acculturation and use of antenatal care); telephone interviews comprising 6 questions on postpartum contraception, breastfeeding and postpartum complications were conducted on a sample of the study population six months after delivery. Results: 247 women with, and 358 women without a background of immigration were included in the study (total study population n = 605, response rate 81.1 %). 68 % of 1st generation immigrants, 87 % of 2nd/3rd generation women and 73 % of women without immigration background (non-immigrants) used contraception. In the logistical regression analysis 1st generation immigrants were less likely than non-immigrants to be using contraception six months postpartum, and 1st generation immigrants with low acculturation level were significantly less likely to use contraception than 2nd/3rd generation women with low acculturation level. Conclusion: In the extended postpartum period there was no major difference in contraceptive use between immigrants in general and non-immigrants. It remains unclear whether the differing contraceptive behaviour of 1st generation immigrants is the result of less access to information, sociocultural factors or differing contraceptive requirements and further targeted, qualitative study is required.

  19. Postpartum Contraception: a Comparative Study of Berlin Women with and without Immigration Background

    PubMed Central

    David, M.; Brenne, S.; Breckenkamp, J.; Razum, O.; Borde, T.

    2015-01-01

    Research Questions: Are there differences in postpartum contraceptive use between women with and without immigration background? Do women more commonly use contraception following a high-risk pregnancy or caesarean section? What role does current breastfeeding play and, amongst immigrants, what is the effect of acculturation level on the frequency of contraceptive use? Study Population and Methods: Data collection was carried out as part of a larger study in three Berlin delivery units using standardised interviews (questionnaires covering e.g. sociodemographics, immigration history/acculturation and use of antenatal care); telephone interviews comprising 6 questions on postpartum contraception, breastfeeding and postpartum complications were conducted on a sample of the study population six months after delivery. Results: 247 women with, and 358 women without a background of immigration were included in the study (total study population n = 605, response rate 81.1 %). 68 % of 1st generation immigrants, 87 % of 2nd/3rd generation women and 73 % of women without immigration background (non-immigrants) used contraception. In the logistical regression analysis 1st generation immigrants were less likely than non-immigrants to be using contraception six months postpartum, and 1st generation immigrants with low acculturation level were significantly less likely to use contraception than 2nd/3rd generation women with low acculturation level. Conclusion: In the extended postpartum period there was no major difference in contraceptive use between immigrants in general and non-immigrants. It remains unclear whether the differing contraceptive behaviour of 1st generation immigrants is the result of less access to information, sociocultural factors or differing contraceptive requirements and further targeted, qualitative study is required. PMID:26500367

  20. LiDy(PO3)4

    PubMed Central

    Chehimi-Moumen, Fathia; Férid, Mokhtar

    2008-01-01

    Single crystals of lithium dysprosium polyphosphate, LiDy(PO3)4, were prepared by the flux method. The atomic arrangement is built up by infinite (PO3)n chains extending along the b axis. Dy3+ and Li+ cations alternate in the middle of four such chains, with Dy⋯Li distances of 3.54 (1) and 3.48 (1) Å. The DyO8 dodeca­hedra and LiO4 tetra­hedra deviate significantly from the ideal geometry. Both Dy and Li occupy special positions (Wyckoff position 4e, site symmetry 2). PMID:21202729

  1. STARS Proceedings (3-4 December 1991)

    DTIC Science & Technology

    1991-12-04

    SUBTITLE S FUNDING NUMBERS STARS 󈨟 Proceedings 3-4 December, 1991 F19628-88-D-0031 6. AUTHOR (S) Paramax Corporation 7. PERFORMING ORGANIZATION NAME...See authorities . Block 4. Title and Subtitle. A title is taken from NASA - See Handbook NH8 2200.2. ,he part of the report that provides the most NTIS...numbers shown in the Authors Index found at the back of these proceedings include a coded prefix (P, 1, 2, 3, or 4) to indicate the part of the

  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.

  4. REO Monthly

    SciTech Connect

    Walker, Howard Andrew

    2010-12-31

    A spreadsheet written in Microsoft Excel that evaluates combinations of renewable energy technologies at a site and identifies the combination that minimizes life cycle cost. Constraints on the optimization such as percent of energy from renewable, available land area; available investment capital, etc make the optimization more useful. Inputs to the model include building location, number of square feet and floors; monthly energy use and cost for electric and any other fuels. Outputs include size of each RE technology total investment, utility costs, O&M costs; percent renewable; life cycle cost; rate of return; CO2 savings.

  5. 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

  6. Postpartum consultation: Occurrence, requirements and expectations

    PubMed Central

    Carlgren, Ingrid; Berg, Marie

    2008-01-01

    Background As a matter of routine, midwives in Sweden have spoken with women about their experiences of labour in a so-called 'postpartum consultation'. However, the possibility of offering women this kind of consultation today is reduced due to shortage of both time and resources. The aim of this study was to explore the occurrence, women's requirements of, and experiences of a postpartum consultation, and to identify expectations from women who wanted but did not have a consultation with the midwife assisting during labour. Methods All Swedish speaking women who gave birth to a live born child at a University Hospital in western Sweden were consecutively included for a phone interview over a three-week period. An additional phone interview was conducted with the women who did not have a postpartum consultation, but who wanted to talk with the midwife assisting during labour. Data from the interviews were analysed using qualitative content analysis. Results Of the 150 interviewed women, 56% (n = 84) had a postpartum consultation of which 61.9% (n = 52) had this with the midwife assisting during labour. Twenty of the 28 women who did not have a consultation with anyone still desired to talk with the midwife assisting during labour. Of these, 19 were interviewed. The content the women wanted to talk about was summarized in four categories: to understand the course of events during labour; to put into words, feelings about undignified management; to describe own behaviour and feelings, and to describe own fear. Conclusion The survey shows that the frequency of postpartum consultation is decreasing, that the majority of women who give birth today still require it, but only about half of them receive it. It is crucial to develop a plan for these consultations that meets both the women's needs and the organization within current maternity care. PMID:18651967

  7. Pharmacokinetics of Tenofovir During Pregnancy and Postpartum

    PubMed Central

    Best, Brookie M.; Burchett, Sandra; Li, Hong; Stek, Alice; Hu, Chengcheng; Wang, Jiajia; Hawkins, Elizabeth; Byroads, Mark; Watts, D. Heather; Smith, Elizabeth; Fletcher, Courtney V.; Capparelli, Edmund V.; Mirochnick, Mark

    2016-01-01

    Objectives Tenofovir disoproxol fumarate (TDF) is increasingly used in HAART regimens of pregnant women, but limited data exist on pregnancy pharmacokinetics of chronically-dosed TDF. This study described tenofovir pharmacokinetics during pregnancy and postpartum. Methods IMPAACT P1026s is a prospective, non-blinded pharmacokinetic study of HIV-infected pregnant women that included a cohort receiving 300 mg TDF once daily. Steady-state 24-hour pharmacokinetic profiles were measured at 2nd and 3rd trimester and postpartum, with maternal and umbilical cord samples at delivery. Tenofovir was measured by LC-MS. The target AUC was ≥ 1.99 mcg•hr/mL (non-pregnant historical control 10th percentile). Results Median tenofovir AUC was decreased during the 2nd (1.9 mcg•hr/mL) and 3rd (2.4 mcg•hr/mL, p=0.005) trimesters versus postpartum (3.0 mcg•hr/mL). Tenofovir AUC exceeded the target for 2/4 (50%) 2nd trimester; 27/37 (73%; 95% CI: 56%, 86%) 3rd trimester; and 27/32 (84%; 95% CI: 67%, 95%) postpartum women (p>0.05). Median 2nd/3rd trimester troughs were lower (39/54 ng/mL) than postpartum (61 ng/mL). Median 3rd trimester weight was heavier for subjects below target AUC versus those above target (97.9 vs. 74.2 kg, p = 0.006). Median ratio of cord blood to maternal concentrations was 0.88. No infants were HIV infected. Conclusions This study found lower tenofovir AUC and troughs during pregnancy. Transplacental passage with chronic TDF use during pregnancy was high. Standard TDF doses appear appropriate for most HIV-infected pregnant women but therapeutic drug monitoring with dose adjustment should be considered in pregnant women with high weight (> 90kg) or inadequate HIV RNA response. PMID:25959631

  8. Baseline Results from Hawaii's Nā Mikiniiki Project: A Physical Activity Intervention Tailored to Multiethnic Postpartum Women

    PubMed Central

    Albright, Cheryl L.; Steffen, Alana D.; Novotny, Rachel; Nigg, Claudio R.; Wilkens, Lynne R.; Saiki, Kara; Yamada, Paulette; Hedemark, Brooke; Maddock, Jason E.; Dunn, Andrea L.; Brown, Wendy J.

    2012-01-01

    During the postpartum period, ethnic minority women have higher rates of inactivity/under-activity than white women. The Nā Mikimiki (“the active ones”) Project is designed to increase moderate-to-vigorous physical activity over 18 months among multiethnic women with infants 2–12 months old. The study was designed to test, via a randomized controlled trial, the effectiveness of a tailored telephone counseling of moderate-to-vigorous physical activity intervention compared to a print/website materials-only condition. Healthy, underactive women (mean age = 32 ± 5.6 years) with a baby (mean age = 5.7 ± 2.8 months) were enrolled from 2008–2009 (N = 278). Of the total sample, 84% were ethnic minority women, predominantly Asian–American and Native Hawaiian. Mean self-reported baseline level of moderate-to-vigorous physical activity was 40 minutes/week with no significant differences by study condition, ethnicity, infant's age, maternal body mass index, or maternal employment. Women had high scores on perceived benefits, self-efficacy, and environmental support for exercise but low scores on social support for exercise. This multiethnic sample's demographic and psychosocial characteristics and their perceived barriers to exercise were comparable to previous physical activity studies conducted largely with white postpartum women. The Nā Mikimiki Project's innovative tailored technology-based intervention and unique population are significant contributions to the literature on moderate-to-vigorous physical activity in postpartum women. PMID:22533900

  9. Coparenting Behaviors as Mediators between Postpartum Parental Depressive Symptoms and Toddler’s Symptoms

    PubMed Central

    Tissot, Hervé; Favez, Nicolas; Frascarolo, France; Despland, Jean-Nicolas

    2016-01-01

    Postpartum parental depression, even of mild intensity and short duration, has negative consequences on child development, including increased externalizing and internalizing symptoms. Studies revealed that the links between parental depression and child development are mediated by parenting difficulties. On the other hand, the mediating role of problematic family-level relationships, such as low coparenting support and high conflict between the parents, has rarely been considered, although coparenting difficulties have been linked with both increased depressive symptoms in parents and increased symptoms in toddlers. In the present study, we proposed testing a comprehensive mediation model linking parental depression, coparenting, and child symptoms. At 3 months postpartum, a convenience sample of 69 parental couples completed the Edinburgh Postnatal Depression Scale. In addition, we assessed levels of coparenting support and conflict during a mother–father–infant play situation, the Lausanne Trilogue Play. At 18 months postpartum, both parents assessed child symptoms with the Symptom Checklist Questionnaire. The results showed that coparenting support mediated the links between parental depressive symptoms and child symptoms, but only for mothers: Maternal depressive symptoms were linked with lower coparenting support, which in turn predicted increased psychofunctional symptoms and behavior problems assessed by mothers. Although coparenting conflict behaviors were not predicted by parents’ depressive symptoms, higher conflict was unexpectedly linked with fewer behavior problems assessed by both parents. The present study allowed us to unveil complex pathways between mild parental mood disturbances, family-level relationships, and child development in the first months of the child’s life. PMID:28018259

  10. 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

  11. Investigation of the effect of religious doctrines on religious knowledge and attitude and postpartum blues in primiparous women

    PubMed Central

    Akbarzadeh, Marzieh; Mokhtaryan, Tahereh; Amooee, Sedigheh; Moshfeghy, Zeinab; Zare, Najaf

    2015-01-01

    Background: Postpartum blues is a transient change of moods occurring in the first few days after delivery. The present study aimed to investigate the effect of religious doctrines on postpartum blues in primiparous women. Materials and Methods: In this randomized controlled tria1, 84 primiparous women who had average or weak religious attitude were randomly divided into intervention and control groups. In the intervention group, religious doctrines were instructed from 20th to 28th weeks of gestation through 6 weekly sessions of 60–90 min each. The control group, however, just received the routine care. Spielberger's anxiety scale and the questionnaires assessing religious knowledge and attitude were completed by both groups before, immediately after, and 1–2 months after the intervention. Also, postpartum blues were evaluated by Edinburg Postnatal Depression Scale (EPDS) 10 days after delivery. Then, the data were analyzed using Chi-square, paired t-test, independent t-test, analysis of variance (ANOVA), and Pearson correlation coefficient. Results: The results showed postpartum blues in 59.5% of the study participants. Besides, the results of independent t-test revealed a statistically significant difference between the two groups regarding the mean score of postpartum blues (P = 0.036). Although the intervention group's knowledge and attitude scores were higher than those of the control group, no significant difference was found between the two groups regarding the correlation coefficient between postpartum blues and religious knowledge (P = 0.088) and religious attitude (P = 0.7). Conclusions: The results of the study show that instruction of religious doctrines was effective in increasing the religious knowledge and attitudes and reducing the postpartum blues. PMID:26457094

  12. 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.

  13. Postpartum Depression: Is It a Condition Affecting the Mother-Infant Interaction and the Development of the Child across the First Year of Life?

    ERIC Educational Resources Information Center

    Figueiredo, B.

    Noting that maternal depression is common during a baby's first year, this study examined the interaction of depressed and non-depressed mother-child dyads. A sample of 26 first-time mothers with postpartum depression at the third month after birth and their 3-month-old infants was compared to a sample of 25 first-time mothers with no postpartum…

  14. Electron attachment to Ni(PF(3))(4) and Pt(PF(3))(4).

    PubMed

    Friedman, Jeffrey F; Miller, Thomas M; Friedman-Schaffer, Jessica K; Viggiano, A A; Rekha, G K; Stevens, Amy E

    2008-03-14

    An experimental study has been made of thermal electron attachment to the transition-metal trifluorophosphine complexes Ni(PF(3))(4) and Pt(PF(3))(4) using a flowing-afterglow Langmuir-probe apparatus. Both complexes are efficient at electron attachment, although the rate constants are somewhat less than collisional. The rate constant for electron attachment to Ni(PF(3))(4) is 1.9 x 10(-7) cm(3) s(-1) at room temperature, about a factor of 2 less than collisional. The activation energy is 39+/-5 meV for the attachment reaction. The rate constant for electron attachment to Pt(PF(3))(4) is 5.4 x 10(-8) cm(3) s(-1) at room temperature, and the activation energy is 84+/-8 meV. For both complexes, a PF(3) ligand is lost on electron attachment, and only the M(PF(3))(3)(-) ion is observed in the negative-ion mass spectrum. Density functional calculations were carried out on Ni(PF(3))(4) and various fragments in order to describe the thermochemistry of the attachment reaction.

  15. Electron attachment to Ni(PF3)4 and Pt(PF3)4

    NASA Astrophysics Data System (ADS)

    Friedman, Jeffrey F.; Miller, Thomas M.; Friedman-Schaffer, Jessica K.; Viggiano, A. A.; Rekha, G. K.; Stevens, Amy E.

    2008-03-01

    An experimental study has been made of thermal electron attachment to the transition-metal trifluorophosphine complexes Ni(PF3)4 and Pt(PF3)4 using a flowing-afterglow Langmuir-probe apparatus. Both complexes are efficient at electron attachment, although the rate constants are somewhat less than collisional. The rate constant for electron attachment to Ni(PF3)4 is 1.9×10-7cm3s-1 at room temperature, about a factor of 2 less than collisional. The activation energy is 39±5meV for the attachment reaction. The rate constant for electron attachment to Pt(PF3)4 is 5.4×10-8cm3s-1 at room temperature, and the activation energy is 84±8meV. For both complexes, a PF3 ligand is lost on electron attachment, and only the M(PF3)3- ion is observed in the negative-ion mass spectrum. Density functional calculations were carried out on Ni(PF3)4 and various fragments in order to describe the thermochemistry of the attachment reaction.

  16. 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.

  17. The Ohio Gestational Diabetes Postpartum Care Learning Collaborative: Development of a Quality Improvement Initiative to Improve Systems of Care for Women.

    PubMed

    Shellhaas, Cynthia; Conrey, Elizabeth; Crane, Dushka; Lorenz, Allison; Wapner, Andrew; Oza-Frank, Reena; Bouchard, Jo

    2016-11-01

    Objectives To improve clinical practice and increase postpartum visit Type 2 diabetes mellitus (T2DM) screening rates in women with a history of gestational diabetes mellitus (GDM). Methods We recruited clinical sites with at least half of pregnant patients enrolled in Medicaid to participate in an 18-month quality improvement (QI) project. To support clinical practice changes, we developed provider and patient toolkits with educational and clinical practice resources. Clinical subject-matter experts facilitated a learning network to train sites and promote discussion and learning among sites. Sites submitted data from patient chart reviews monthly for key measures that we used to provide rapid-cycle feedback. Providers were surveyed at completion regarding toolkit usefulness and satisfaction. Results Of fifteen practices recruited, twelve remained actively engaged. We disseminated more than 70 provider and 2345 patient toolkits. Documented delivery of patient education improved for timely GDM prenatal screening, reduction of future T2DM risk, smoking cessation, and family planning. Sites reported toolkits were useful and easy to use. Of women for whom postpartum data were available, 67 % had a documented postpartum visit and 33 % had a postpartum T2DM screen. Lack of information sharing between prenatal and postpartum care providers was are barriers to provision and documentation of care. Conclusions for Practice QI and toolkit resources may improve the quality of prenatal education. However, postpartum care did not reach optimal levels. Future work should focus on strategies to support coordination of care between obstetrical and primary care providers.

  18. Postpartum Loss to HIV Care and HIV Viral Suppression among Previously Diagnosed HIV-Infected Women with a Live Birth in New York State

    PubMed Central

    2016-01-01

    Mother-to-child-transmission of HIV in the United States has been greatly reduced, with clear benefits for the child. However, little is known about factors that predict maternal loss to HIV care in the postpartum year. This retrospective cohort study included 980 HIV-positive women, diagnosed with HIV at least one year before pregnancy, who had a live birth during 2008–2010 in New York State. Women who did not meet the following criterion in the 12 months after the delivery-related hospital discharge were considered to be lost to HIV care: two or more laboratory tests (CD4 or HIV viral load), separated by at least 90 days. Adjusted relative risks (aRR) and 95% confidence intervals (CI) for predictors of postpartum loss to HIV care were identified with Poisson regression, solved using generalized estimating equations. Having an unsuppressed (>200 copies/mL) HIV viral load in the postpartum year was also evaluated. Overall, 24% of women were loss to HIV care during the postpartum year. Women with low participation in HIV care during preconception were more likely to be lost to HIV care during the postpartum year (aRR: 2.70; 95% CI: 2.09–3.49). In contrast, having a low birth weight infant was significantly associated with a decreased likelihood of loss to HIV care (aRR: 0.72; 95% CI: 0.53–0.98). While 75% of women were virally suppressed at the last viral load before delivery only 44% were continuously suppressed in the postpartum year; 12% had no viral load test reported in the postpartum year and 44% had at least one unsuppressed viral load test. Lack of engagement in preconception HIV-related health care predicts postpartum loss to HIV care for HIV-positive parturient women. Many women had poor viral control during the postpartum period, increasing the risk of disease progression and infectivity. PMID:27513953

  19. Postpartum Loss to HIV Care and HIV Viral Suppression among Previously Diagnosed HIV-Infected Women with a Live Birth in New York State.

    PubMed

    Swain, Carol-Ann; Smith, Lou C; Nash, Denis; Pulver, Wendy P; Lazariu, Victoria; Anderson, Bridget J; Warren, Barbara L; Birkhead, Guthrie S; McNutt, Louise-Anne

    2016-01-01

    Mother-to-child-transmission of HIV in the United States has been greatly reduced, with clear benefits for the child. However, little is known about factors that predict maternal loss to HIV care in the postpartum year. This retrospective cohort study included 980 HIV-positive women, diagnosed with HIV at least one year before pregnancy, who had a live birth during 2008-2010 in New York State. Women who did not meet the following criterion in the 12 months after the delivery-related hospital discharge were considered to be lost to HIV care: two or more laboratory tests (CD4 or HIV viral load), separated by at least 90 days. Adjusted relative risks (aRR) and 95% confidence intervals (CI) for predictors of postpartum loss to HIV care were identified with Poisson regression, solved using generalized estimating equations. Having an unsuppressed (>200 copies/mL) HIV viral load in the postpartum year was also evaluated. Overall, 24% of women were loss to HIV care during the postpartum year. Women with low participation in HIV care during preconception were more likely to be lost to HIV care during the postpartum year (aRR: 2.70; 95% CI: 2.09-3.49). In contrast, having a low birth weight infant was significantly associated with a decreased likelihood of loss to HIV care (aRR: 0.72; 95% CI: 0.53-0.98). While 75% of women were virally suppressed at the last viral load before delivery only 44% were continuously suppressed in the postpartum year; 12% had no viral load test reported in the postpartum year and 44% had at least one unsuppressed viral load test. Lack of engagement in preconception HIV-related health care predicts postpartum loss to HIV care for HIV-positive parturient women. Many women had poor viral control during the postpartum period, increasing the risk of disease progression and infectivity.

  20. Type of fish consumed and thyroid autoimmunity in pregnancy and postpartum.

    PubMed

    Benvenga, Salvatore; Vigo, Maria Teresa; Metro, Daniela; Granese, Roberta; Vita, Roberto; Le Donne, Maria

    2016-04-01

    Fish consumption or supplementation with omega-3 fatty acids was reported to cure and/or prevent autoimmune and nonautoimmune disorders. Serum positivity for thyroid autoantibodies is a predictive marker of postpartum thyroiditis and postpartum depression. We hypothesized that stable consumption of the omega-3-rich oily fish was associated with a more favorable profile of serum thyroid antibodies throughout pregnancy and early postpartum compared with stable consumption of swordfish, a predator that concentrates pollutants. We prospectively measured serum thyroglobulin antibodies and thyroperoxidase antibodies in pregnancy (first, second trimesters) and postpartum (day 4), in 236 thyroid disease-free, nonsmoker Caucasian women with stable dietary habits. We did not measure thyroid autoantibodies prior to pregnancy. Women were divided into groups A (n = 48; swordfish), B (n = 52; oily fish), C (n = 68; swordfish + other fish, not necessarily oily fish), and D (n = 68; fish other than swordfish and oily fish). Major endpoints were positivity rates and serum concentrations of the two autoantibodies. We resorted to previous studies for the estimated content of fatty acids and microelements in the consumed fish. Positivity rates and serum concentrations of both antibodies were the greatest in group A and the lowest in group B (P < 0.001 and P < 0.05 to < 0.001, respectively). Relationship between monthly fish consumption and serum concentrations of either antibody was direct in group A but inverse in group B. The estimated content of omega-3 fatty acids in fish consumed by group B was the greatest (P < 0.001 vs. any other group). These data reinforce recommendations that pregnant women should avoid consuming swordfish and indicate consumption of oily fish as a favorable alternative. Because thyroid autoantibodies are markers of autoimmune-related postpartum problems, our data suggest a dietary prophylaxis of such problems.

  1. Representations of celebrities' weight and shape during pregnancy and postpartum: a content analysis of three entertainment magazine websites.

    PubMed

    Gow, Rachel W; Lydecker, Janet A; Lamanna, Jennifer D; Mazzeo, Suzanne E

    2012-01-01

    Entertainment magazine websites provide a continuous stream of celebrity news accessed by over 13 million unique viewers each month. Celebrities' experiences of pregnancy and new motherhood appear to be popular topics within these media outlets; however, little research has investigated the content of this coverage. In this study, investigators coded articles (N=387) published between August 1, 2007 and August 1, 2008 on three popular entertainment magazine websites. Relatively few articles about celebrities' pregnancies discussed weight (13%) or shape (30%), and an even smaller proportion (6.2%) included any discussion of postpartum body dissatisfaction. This suggests a gap between portrayal of celebrities' pregnancies and postpartum experiences and those of non-celebrity women. This disparity is concerning as it might lead to unrealistic expectations about pregnancy and postpartum for both pregnant readers and a more general audience. This study provides important initial information about the messages these media provide regarding pregnancy-related appearance.

  2. Increased Calcium Supplementation Postpartum Is Associated with Breastfeeding among Chinese Mothers: Finding from Two Prospective Cohort Studies

    PubMed Central

    Zhao, Jian; Zhao, Yun; Binns, Colin W.; Lee, Andy H.

    2016-01-01

    The calcium supplementation status during the postpartum period among Chinese lactating women is still unclear. The objective of this study is to utilize data from two population-based prospective cohort studies to examine the calcium supplementation status and to identify whether breastfeeding is associated with increased calcium supplementation among Chinese mothers after child birth. Information from 1540 mothers on breastfeeding and calcium supplementation measured at discharge, 1, 3, and 6 months postpartum were extracted to evaluate the association between breastfeeding and calcium supplementation postpartum. A generalized linear mixed model was applied to each study initially to account for the inherent correlation among repeated measurements, adjusting for socio-demographic, obstetric factors and calcium supplementation during pregnancy. In addition, breastfeeding status measured at different follow-up time points was treated as a time dependent variable in the longitudinal analysis. Furthermore, the effect sizes of the two cohort studies were pooled using fixed effect model. Based on the two cohort studies, the pooled likelihood of taking calcium supplementation postpartum among breastfeeding mothers was 4.02 times (95% confidence interval (2.30, 7.03)) higher than that of their non-breastfeeding counterparts. Dietary supplementation intervention programs targeting different subgroups should be promoted in Chinese women, given currently a wide shortage of dietary calcium intake and calcium supplementation postpartum. PMID:27735835

  3. Increased Calcium Supplementation Postpartum Is Associated with Breastfeeding among Chinese Mothers: Finding from Two Prospective Cohort Studies.

    PubMed

    Zhao, Jian; Zhao, Yun; Binns, Colin W; Lee, Andy H

    2016-10-09

    The calcium supplementation status during the postpartum period among Chinese lactating women is still unclear. The objective of this study is to utilize data from two population-based prospective cohort studies to examine the calcium supplementation status and to identify whether breastfeeding is associated with increased calcium supplementation among Chinese mothers after child birth. Information from 1540 mothers on breastfeeding and calcium supplementation measured at discharge, 1, 3, and 6 months postpartum were extracted to evaluate the association between breastfeeding and calcium supplementation postpartum. A generalized linear mixed model was applied to each study initially to account for the inherent correlation among repeated measurements, adjusting for socio-demographic, obstetric factors and calcium supplementation during pregnancy. In addition, breastfeeding status measured at different follow-up time points was treated as a time dependent variable in the longitudinal analysis. Furthermore, the effect sizes of the two cohort studies were pooled using fixed effect model. Based on the two cohort studies, the pooled likelihood of taking calcium supplementation postpartum among breastfeeding mothers was 4.02 times (95% confidence interval (2.30, 7.03)) higher than that of their non-breastfeeding counterparts. Dietary supplementation intervention programs targeting different subgroups should be promoted in Chinese women, given currently a wide shortage of dietary calcium intake and calcium supplementation postpartum.

  4. Temporal trends in postpartum hemorrhage and severe postpartum hemorrhage in Canada from 2003 to 2010.

    PubMed

    Mehrabadi, Azar; Liu, Shiliang; Bartholomew, Sharon; Hutcheon, Jennifer A; Kramer, Michael S; Liston, Robert M; Joseph, K S

    2014-01-01

    Objectif : Une hausse des taux d’hémorragie postpartum a été signalée dans plusieurs pays. Nous avons évalué les tendances temporelles en matière d’hémorragie postpartum et d’hémorragie postpartum grave au Canada pour la période se situant entre 2003 et 2010. Méthodes : Nous avons mené une étude de cohorte en population générale ayant porté sur tous les accouchements hospitaliers au Canada (exception faite du Québec) pour la période se situant entre 2003 et 2010 (n = 2 193 425), au moyen des données issues de l’Institut canadien d’information sur la santé. L’hémorragie postpartum a été définie comme étant une perte sanguine ≥ 500 ml à la suite d’un accouchement vaginal ou ≥ 1 000 ml à la suite d’une césarienne, ou encore conformément aux notes du fournisseur de soins. L’hémorragie postpartum grave a été définie comme étant une hémorragie postpartum s’accompagnant d’une transfusion sanguine, d’une hystérectomie ou d’autres interventions visant à juguler les saignements (y compris les sutures utérines ou la ligature / l’embolisation des artères pelviennes). Les tendances temporelles ont été évaluées au moyen d’un test du chi carré (pour ce qui est de l’évolution), des risques relatifs et d’une régression logistique. Résultats : Le taux d’hémorragie postpartum a connu une hausse de 22 % (IC à 95 %, 20 % - 25 %), soit de 5,1 % en 2003 à 6,2 % en 2010 (P < 0,001), déterminée par une hausse de 29 % (IC à 95 %, 26 % - 33 %) du taux d’hémorragie postpartum par atonie utérine (3,9 % en 2003 vs 5,0 % en 2010, P < 0,001). Le taux d’hémorragie postpartum s’accompagnant d’une transfusion sanguine est passé de 36,7 à 50,4 par 10 000 accouchements (P < 0,001), tandis que le taux d’hémorragie postpartum s’accompagnant d’une hystérectomie est passé de 4,9 à 5,8 par 10 000 accouchements (P < 0,01). Le taux d’hémorragie postpartum s

  5. KPr(PO3)4

    PubMed Central

    Oudahmane, Abdelghani; Daoud, Mohamed; Tanouti, Boumediene; Avignant, Daniel; Zambon, Daniel

    2010-01-01

    Single crystals of the title compound, potassium praseodymium(III) polyphosphate, were obtained by solid-state reaction. The monoclinic non-centrosymmetric structure is isotypic with all other KLn(PO3)4 analogues from Ln = La to Er, inclusive. The crystal structure of these long-chain polyphosphates is built up from infinite crenelated polyphosphate chains of corner-sharing PO4 tetra­hedra with a repeating unit of four tetra­hedra. These chains, running along [100], are arranged in a pseudo-tetra­gonal rod packing and are further linked by isolated PrO8 square anti­prisms [Pr—O = 2.3787 (9)–2.5091 (8) Å], forming a three-dimensional framework. The K+ ions reside in channels parallel to [010] and exhibit a highly distorted coordination sphere by eight O atoms at distances ranging from 2.7908 (9) to 3.1924 (11) Å. PMID:21588081

  6. 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.

  7. Expectant Fathers’ Intuitive Parenting: Associations with Parent Characteristics and Postpartum Positive Engagement

    PubMed Central

    Schoppe-Sullivan, Sarah J.; Altenburger, Lauren E.; Settle, Theresa A.; Kamp Dush, Claire M.; Sullivan, Jason M.; Bower, Daniel J.

    2015-01-01

    This study examined expectant fathers’ intuitive parenting behavior, its correlates, and its associations with fathers’ postpartum positive engagement. One hundred eighty-two expectant couples completed the Prenatal Lausanne Trilogue Play in the third trimester of pregnancy. Coders rated expectant fathers’ and mothers’ intuitive parenting behavior during this procedure. Expectant parents also completed surveys regarding their psychological and demographic characteristics. At 3 months postpartum, fathers completed time diaries that assessed the time they spent in developmentally appropriate positive engagement activities with their infants. Examination of correlates of expectant fathers’ intuitive parenting behavior revealed that expectant fathers showed lower levels of these behaviors than expectant mothers, that intuitive parenting behavior was moderately positively associated for mothers and fathers, and that individual differences in expectant fathers’ intuitive parenting behavior were associated with parent demographic and psychological characteristics. In particular, expectant fathers showed greater intuitive parenting behavior when they had greater human capital and more progressive beliefs about parent roles, and when their partners had lower parenting self-efficacy. Findings also indicated that expectant fathers’ greater intuitive parenting behavior was predictive of fathers’ greater subsequent engagement in developmentally appropriate activities at 3 months postpartum, but only when expectant mothers demonstrated low levels of intuitive parenting behavior. PMID:25798492

  8. Training for the Air Force fitness assessment: the experience of postpartum women.

    PubMed

    Armitage, Nicole H; Severtsen, Billie M; Vandermause, Roxanne; Smart, Denise A

    2014-07-01

    Active duty personnel in the U.S. Air Force (USAF) are required to pass periodic fitness assessments in order to facilitate and evaluate physical readiness. Pregnant women are exempt from testing but must take the fitness test 6 months after childbirth. However, evidence from prior research indicates that in the first 6 months postpartum, women may not achieve prepregnancy fitness levels and may be more vulnerable to mental and physical health problems. It is important for health care clinicians to understand how training for the USAF fitness test after childbirth may impact health and well-being. The purpose of this study was to develop a deep understanding of the experiences of postpartum USAF women as they train for their fitness assessment. Understanding was sought through a phenomenological study by interpreting the meaning of the lived experiences of 17 active duty women at two USAF bases. Two overarching patterns emerged from this analysis: "Striving to Perform under Pressure through Profound Life Transitions of Childbirth" and "Seeking Understanding from Others." These results provide insight into the challenges postpartum women encounter while training for their fitness assessments, and they can inform practices that facilitate efforts of women in returning to optimal fitness and well-being.

  9. Transdermal Estradiol Treatment for Postpartum Depression: A Pilot Randomized Trial

    PubMed Central

    Wisner, Katherine L.; Sit, Dorothy K.Y.; Moses-Kolko, Eydie L.; Driscoll, Kara E.; Prairie, Beth; Stika, Catherine S.; Eng, Heather F.; Dills, John L; Luther, James F.; Wisniewski, Stephen R.

    2015-01-01

    Postpartum depression occurs in 14.5% of women in the first three months after birth. This study was an 8 week acute phase randomized trial with three cells (transdermal estradiol (E2), sertraline, and placebo) for the treatment of postpartum major depressive disorder. However, the study was stopped after batch analysis revealed that the E2 serum concentrations were lower than pre-study projections. This paper explores our experiences that will inform future investigations of therapeutic E2 use. Explanations for the low E2 concentrations were: 1) Study patch non-adhesion, which did not explain the low concentrations across the entire sample. 2) Ineffective transdermal patch preparations, although two different patch preparations were used and no significant main effect of patch type on E2 concentrations was found. 3) Obesity, at study entry, E2-treated women had mean ± SD BMI=32.9 ±7.4. No pharmacokinetic data comparing E2 concentrations from transdermal patches in obese women vs. normal weight controls are available. 4) Induction of Cytochrome P450 (CYP450) 3A4 and other E2 elimination pathways in pregnancy. CYP4503A4 is induced in pregnancy and is a pathway for the metabolism of E2. Conversion to estrone and Phase II metabolism via glucuronidation and sulfation, which also increase in pregnancy, are routes of E2 elimination. The time required for these pathways to normalize after delivery has not been elucidated. The observation that transdermal E2 doses greater than 100 mcg/day did not increase serum concentrations was unexpected. Another hypothesis consistent with this observation is suppression of endogenous E2 secretion with increasing exogenous E2 dosing. PMID:26061609

  10. Accuracy of Depression Screening Tools for Identifying Postpartum Depression Among Urban Mothers

    PubMed Central

    Chaudron, Linda H.; Szilagyi, Peter G.; Tang, Wan; Anson, Elizabeth; Talbot, Nancy L.; Wadkins, Holly I.M.; Tu, Xin; Wisner, Katherine L.

    2011-01-01

    Objective The goal was to describe the accuracy of the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory II (BDI-II), and Postpartum Depression Screening Scale (PDSS) in identifying major depressive disorder (MDD) or minor depressive disorder (MnDD) in low-income, urban mothers attending well childcare (WCC) visits during the postpartum year. Design/Methods Mothers (N=198) attending WCC visits with their infants 0 to 14 months of age completed a psychiatric diagnostic interview (standard method) and 3 screening tools. The sensitivity and specificity of each screening tool were calculated in comparison with diagnoses of MDD or MDD/MnDD. Receiver operating characteristic curves were calculated and the areas under the curves for each tool were compared to assess accuracy for the entire sample (representing the postpartum year) and sub-samples (representing early, middle and late postpartum time frames). Optimal cut-points were calculated. Results At some point between 2 weeks and 14 months postpartum, 56% of mothers met criteria for either MDD (37%) or MnDD (19%). When used as a continuous measures, all scales performed equally well (areas under the curves of ≥ 0.8). With traditional cut-points, the measures did not perform at the expected levels of sensitivity and specificity. Optimal cut-points for the BDI-II (≥14 for MDD, ≥11 for MDD/MnDD) and EPDS (≥9 for MDD, ≥7 for MDD/MnDD) were lower than currently recommended. For the PDSS, the optimal cut-point was consistent with current guidelines for MDD (≥80) but higher than recommended for MDD/MnDD (≥ 77). Conclusions Large proportions of low-income, urban mothers attending WCC visits experience MDD or MnDD during the postpartum year. The EPDS, BDI-II and PDSS have high accuracy in identifying depression but cutoff points may need to be altered to more accurately identify depression in urban, low-income mothers. PMID:20156899

  11. Cross-sectional and longitudinal validation of a 13-item fatigue scale among Japanese postpartum mothers.

    PubMed

    Tsuchiya, Miyako; Mori, Emi; Sakajo, Akiko; Iwata, Hiroko; Maehara, Kunie; Tamakoshi, Koji

    2016-04-01

    This study examined the psychometric properties of a 13-item fatigue scale for postpartum mothers. Japanese mothers (n = 2026) from a cohort study completed questionnaires (e.g. fatigue scale, Japanese version of the Edinburgh Postnatal Depression Scale, demographics) during their hospital stay after childbirth (baseline) and at 1, 2, 4 and 6 months postpartum. Initial factor analysis of baseline data revealed that the fatigue scale had three factors or subscales (physical, emotional and cognitive). Within-group analysis across each measurement time revealed the same three-factor structure with acceptable fit. Between-group analysis also showed longitudinal factorial invariance across time. The fatigue subscales had acceptable divergent and convergent validities with the depression scale. The subscale scores differed significantly based on participant background. The Japanese Fatigue Scale is a concise and informative tool for assessing aspects of fatigue in clinical settings and in the community.

  12. Early postpartum gastric band slippage after bariatric surgery in an adolescent obese girl

    PubMed Central

    Schmitt, Françoise; Topart, Philippe; Salle, Agnès; Sentilhes, Loïc; Bouhours-Nouet, Natacha; Coutant, Régis; Weil, Dominique; Podevin, Guillaume

    2016-01-01

    We report here a case of a rarely described complication of laparoscopic adjustable gastric banding (LAGB), slippage during the postpartum period, after LAGB had been performed in an adolescent obese girl. The LAGB had been placed after one year of clinical survey initiated at the age of 16. Maximal pre-operative body mass index (BMI) was 48.5 kg.m−2 and obesity was associated with insulin resistance. Before pregnancy, there was a loss of 17 Kg (final BMI = 41.5 kg.m−2) and a resolution of insulin resistance. The patient became pregnant 21 months after LAGB, and whole pregnancy and delivery were uneventful for both mother and fetus. Six weeks after delivery, the patient suddenly complained for total food intolerance, due to a band slippage, leading to removal of the band. Slippage is now a rare complication of LAGB, but can happen during pregnancy and the postpartum period as well. PMID:27619323

  13. Postpartum anemia I: definition, prevalence, causes, and consequences.

    PubMed

    Milman, Nils

    2011-11-01

    This review provides a status on the definition, prevalence, causes, and consequences of anemia in women who have given childbirth, i.e., postpartum anemia. The diagnosis of iron deficiency anemia relies on a full blood count including hemoglobin, serum ferritin, and serum soluble transferrin receptor, which appear to be reliable indicators of anemia and iron status 1 week postpartum while serum transferrin saturation is an unreliable indicator several weeks after delivery. It is recommended that postpartum anemia should be defined by hemoglobin <110 g/L at 1 week postpartum and <120 g/L at 8 weeks postpartum. The major causes of postpartum anemia are prepartum anemia combined with acute bleeding anemia due blood losses at delivery. Normal peripartum blood losses are approximately 300 ml, but hemorrhage >500 ml occur in 5-6% of the women. In healthy women after normal delivery, the prevalence of anemia (hemoglobin <110 g/L) 1 week postpartum is 14% in iron-supplemented women and 24% in non-supplemented women. In consecutive series of European women, the prevalence of anemia 48 h after delivery is approximately 50%. In developing countries, the prevalence of postpartum anemia is in the range of 50-80%. Postpartum anemia is associated with an impaired quality of life, reduced cognitive abilities, emotional instability, and depression and constitutes a significant health problem in women of reproductive age.

  14. 3,4-methylenedioxymethamphetamine (MDMA): current perspectives

    PubMed Central

    Meyer, Jerrold S

    2013-01-01

    Ecstasy is a widely used recreational drug that usually consists primarily of 3,4-methylenedioxymethamphetamine (MDMA). Most ecstasy users consume other substances as well, which complicates the interpretation of research in this field. The positively rated effects of MDMA consumption include euphoria, arousal, enhanced mood, increased sociability, and heightened perceptions; some common adverse reactions are nausea, headache, tachycardia, bruxism, and trismus. Lowering of mood is an aftereffect that is sometimes reported from 2 to 5 days after a session of ecstasy use. The acute effects of MDMA in ecstasy users have been attributed primarily to increased release and inhibited reuptake of serotonin (5-HT) and norepinephrine, along with possible release of the neuropeptide oxytocin. Repeated or high-dose MDMA/ecstasy use has been associated with tolerance, depressive symptomatology, and persisting cognitive deficits, particularly in memory tests. Animal studies have demonstrated that high doses of MDMA can lead to long-term decreases in forebrain 5-HT concentrations, tryptophan hydroxylase activity, serotonin transporter (SERT) expression, and visualization of axons immunoreactive for 5-HT or SERT. These neurotoxic effects may reflect either a drug-induced degeneration of serotonergic fibers or a long-lasting downregulation in 5-HT and SERT biosynthesis. Possible neurotoxicity in heavy ecstasy users has been revealed by neuroimaging studies showing reduced SERT binding and increased 5-HT2A receptor binding in several cortical and/or subcortical areas. MDMA overdose or use with certain other drugs can also cause severe morbidity and even death. Repeated use of MDMA may lead to dose escalation and the development of dependence, although such dependence is usually not as profound as is seen with many other drugs of abuse. MDMA/ecstasy-dependent patients are treated with standard addiction programs, since there are no specific programs for this substance and no proven

  15. The Healthy Moms Study: The efficacy of brief alcohol intervention in postpartum women

    PubMed Central

    Fleming, Michael F.; Lund, Michael R.; Wilton, Georgiana; Landry, Mary; Scheets, Dawn

    2008-01-01

    Background: The prevention and treatment of alcohol use disorders among women of reproductive age have been well described. However, there is limited information on women specifically during the postpartum period. This period in a woman's life is a time of transition and provides an ideal opportunity for primary care providers to intervene. Purpose: The goal of this report is to present the results of a brief alcohol intervention conducted in 34 obstetrical practices in women seeking routine postpartum care. Methods: A randomized clinical trial was conducted from 2002-2005 in a diverse sample of women located in 15 Wisconsin counties. This report presents 6 month follow-up data. Results: 8,706 women were screened for high-risk alcohol use during routine postpartum care with 997 (12%) of these women testing positive for at-risk drinking. 235 women met inclusion criteria and were randomized to either “usual care” or “brief intervention”. The four session intervention was delivered by outpatient obstetrical nurses and research staff. The mean age of the women in the sample was 28, 19.3% were from minority groups, 60.8% were married, 53.2% reported current tobacco use and 17.9% had used marijuana in the previous 30 days. At the 6 month follow-up appointment, there were significant reductions in mean number of total drinks in the previous 28 days (p<.013), number of drinking days (p<.024) and heavy drinking days (p<.019). In addition to a statistical difference between groups, there was a 19% difference in the mean number of drinks and number of drinking days, and a 36% difference in the number of heavy drinking days in favor of the intervention group. Conclusion: The findings of the Healthy Moms Trial support the implementation of brief alcohol intervention during the postpartum period. PMID:18627361

  16. Overweight, Obesity, and Neighborhood Characteristics among Postpartum Latinas

    PubMed Central

    Keller, Colleen; Todd, Michael; Ainsworth, Barbara; Records, Kathryn; Vega-Lopez, Sonia; Permana, Paska; Coonrod, Dean; Nagle Williams, Allison

    2013-01-01

    Background. Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in Latinas. Design and Methods. Madres para la Salud (Mothers for Health) is a 12-month prospective, randomized controlled trial exploring a social support intervention with moderate-intensity physical activity to effect changes in body fat, systemic and fat tissue inflammation, and depression symptoms in sedentary postpartum Latinas. This paper describes the initial body composition of the sample, social support, and neighborhood contextual correlations of overweight and obese Latina mothers within the first 6 months after birth. Results. The mean body mass index was 29.68 with 38.56% bioelectrical impedence analysis for body fat. Elements of the environment (e.g., opportunities to walk) received middle or high scores. Access to healthy food was positively related to favorability of the walking environment. Waist-to-hip ratio was uncorrelated with other obesity-related indices. Conclusions. The body adiposity of these Latina mothers was coupled with low levels of social support from family and friends and neighborhood characteristics that were unfavorable to walking. PMID:23476752

  17. Longitudinal association of maternal attempt to lose weight during the postpartum period and child obesity at age 3 years.

    PubMed

    Sonneville, Kendrin R; Rifas-Shiman, Sheryl L; Oken, Emily; Peterson, Karen E; Gortmaker, Steven L; Gillman, Matthew W; Taveras, Elsie M

    2011-10-01

    The effect of maternal attempt to lose weight during the postpartum period on later child weight has not been explored. Among 1,044 mother-infant pairs in Project Viva, we estimated longitudinal associations of maternal attempt to lose weight during the postpartum period with child weight and adiposity at age 3 years and examined differences in associations by type of weight loss strategy used. Using covariate-adjusted linear and logistic regression models, we estimated associations before and after adjusting for maternal weight-related variables including prepregnancy BMI. At 6 months postpartum, 53% mothers were trying to lose weight. At age 3 years, mean (s.d.) child BMI z-score was 0.44 (1.01) and 8.9% of children were obese. Children whose mothers were trying to lose weight at 6 months postpartum had higher BMI z-scores (0.30 (95% confidence interval (CI) 0.18, 0.42)) and were more likely to be obese (3.0 (95% CI 1.6, 5.8)) at 3 years of age. Addition of maternal prepregnancy BMI to the models attenuated but did not eliminate the associations seen for BMI z-score (0.24 (95% CI 0.12, 0.36) and obesity (2.4 (95% CI 1.2, 4.7)). Attempting to lose weight by exercising alone was the only weight loss strategy that consistently predicted higher child BMI z-score (0.36 (95% CI 0.14, 0.58)) and odds of obesity (6.0 (95% CI 2.2, 16.5)) at age 3 years. In conclusion, we observed an association between maternal attempt to lose weight at 6 months postpartum, particularly through exercise alone, measured using a single item and child adiposity at age 3 years. This association should be thoroughly examined in future studies.

  18. eMoms: Electronically-Mediated Weight Interventions for Pregnant and Postpartum Women. Study Design and Baseline Characteristics

    PubMed Central

    Groth, Susan W.; Reschke, Jennifer E.; Graham, Meredith L.; Strawderman, Myla; Olson, Christine M.

    2015-01-01

    Background The influence of childbearing in the development of obesity is situated within two different but related contexts: pregnancy-related weight gain and weight gain prevention and control in young adult women. Pregnancy related weight gain contributes to long-term weight retention in childbearing women. Objective To present the study design, data collection procedures, recruitment challenges, and the baseline characteristics for the eMoms of Rochester study, a randomized clinical trial testing the effect of electronically-mediated behavioral interventions to prevent excessive gestational weight gain (GWG) and postpartum weight retention among women aged 18–35 years of diverse income and racial/ethnic backgrounds in an urban setting. Design Randomized double blind clinical trial. A total of 1,722 women at or below 20 weeks gestation were recruited primarily from obstetrics practices and randomized to 3 treatment groups: control arm; intervention arm with access to intervention during pregnancy and control at postpartum (e-intervention 1); and intervention arm with access to intervention during pregnancy and postpartum (e-intervention 2). Enrollment and consent were completed via study staff or online. Data were collected via online surveys, medical charts, and measurement of postpartum weights. The primary endpoints are gaining more weight than recommended by the Institution of Medicine guidelines and weight retained at 12 months postpartum. Conclusion This study will provide evidence on the efficacy of behavioral interventions in the prevention of excessive GWG and postpartum weight retention with potential dissemination to obstetrics practices and/or health insurances. PMID:25957183

  19. Postpartum Regression of a Presumed Cavernous Meningioma

    PubMed Central

    Phang, See Yung; Whitfield, Peter

    2016-01-01

    Meningiomas are known to be more common in females than males. They are also known in rare cases to grow in size during pregnancy, which can complicate its management. We describe a 31-year-old Caucasian woman who presented with blurring of her vision and diplopia during the third trimester of her pregnancy. Magnetic resonance imaging (MRI) showed a small left cavernous sinus meningioma. The patient was treated conservatively until her uncomplicated delivery. A postpartum MRI scan showed complete regression of the suspected meningioma. Currently the patient is contemplating a further pregnancy. PMID:27066285

  20. Challenges in Diagnosing and Treating Postpartum Blues, Depression and Psychosis

    ERIC Educational Resources Information Center

    Lewis, Carol A.; Byers, Alison Daly; Malard, Sarah Deann; Dawson, Gregory A.

    2010-01-01

    With recent media attention and a growing awareness in popular culture, the appropriate treatment for postpartum depression has taken center stage as a prevalent women's health issue. There is little agreement on the definition, existence and treatment of postpartum depression. Contributing to this factor is the lack of research that exists to…

  1. Ischemic neuropathy and rhabdomyolysis as presenting symptoms of postpartum cardiomyopathy.

    PubMed

    Helmich, Rick C G; van Laarhoven, Hanneke W M; Schoonderwaldt, Hennie C; Janssen, Mirian C H

    2009-05-01

    Rhabdomyolysis and peripheral neuropathy are two distinct disease entities which are rarely encountered in combination. We present a woman with rhabdomyolysis and peripheral neuropathy 3 weeks postpartum. Her symptoms were caused by bilateral femoral artery thrombosis due to postpartum cardiomyopathy (PPCM). This demonstrates that PPCM may present with predominantly non-cardial symptoms and underscores the importance of rapidly recognizing this disorder.

  2. 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…

  3. Women's Experiences with Postpartum Anxiety: Expectations, Relationships, and Sociocultural Influences

    ERIC Educational Resources Information Center

    Wardrop, Andrea A.; Popadiuk, Natalee E.

    2013-01-01

    Evidence about anxiety in the postpartum is sparse and contradictory. Our research expands this knowledge by using a qualitative methodology, the Feminist Biographical Method, to explore first time mothers' experiences of postpartum anxiety. Data collection included 1.5 to 2.0 hour interviews with six women about their experiences of anxiety in…

  4. Mother's stress, mood and emotional involvement with the infant: 3 months before and 3 months after childbirth.

    PubMed

    Figueiredo, Barbara; Costa, Raquel

    2009-06-01

    Adverse effects of maternal anxiety and depression are well documented, namely on the foetus/child behaviour and development, but not as much attention has been given to the mother's emotional involvement with the offspring. To study mother's prenatal and postpartum stress, mood and emotional involvement with the infant, the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale and the Mother-to-Infant Bonding Scale were filled in and cortisol levels were measured, 3 months before and 3 months after childbirth, in a sample of 91 Portuguese women. From pregnancy to the postpartum period, mother's cortisol levels, anxiety and emotional involvement toward the child decrease. No significant change was observed regarding mother's depression. Mother's depression predicted a worse emotional involvement before childbirth, while mother's anxiety predicted a worse emotional involvement with the infant after childbirth. Additionally, pregnant women with a worse emotional involvement with the offspring are at risk of poorer emotional involvement with the infant and higher anxiety and depression at 3 months postpartum. It should be given more attention to mother's poor emotional involvement with the offspring during pregnancy, as it interferes with her emotional involvement with the infant and her psychological adjustment 3 months after childbirth.

  5. Pathways Linking Socioeconomic Status and Postpartum Smoking Relapse

    PubMed Central

    Businelle, Michael S.; Kendzor, Darla E.; Reitzel, Lorraine R.; Vidrine, Jennifer Irvin; Castro, Yessenia; Mullen, Patricia Dolan; Velasquez, Mary M.; Cofta-Woerpel, Ludmila; Cinciripini, Paul M.; Greisinger, Anthony J.; Wetter, David W.

    2012-01-01

    Background Low socioeconomic status (SES) exacerbates the high rate of smoking relapse in women following childbirth. Purpose This study examined multiple models of potential mechanisms linking SES and postpartum smoking relapse among women who quit smoking due to pregnancy. Methods Participants were 251 women enrolled in a randomized clinical trial of a new postpartum smoking relapse prevention intervention. Four models of the prepartum mechanisms linking SES and postpartum smoking relapse were evaluated using a latent variable modeling approach. Results Each of the hypothesized models were a good fit for the data. As hypothesized, SES indirectly influenced postpartum smoking relapse through increased prepartum negative affect/stress, reduced sense of agency, and increased craving for cigarettes. However, the model that included craving as the sole final pathway between SES and relapse demonstrated superior fit when compared with all other models. Conclusions Findings have implications for future interventions that aim to reduce postpartum relapse. PMID:23086590

  6. Perspective of Postpartum Depression Theories: A Narrative Literature Review

    PubMed Central

    Abdollahi, Fatemeh; Lye, Munn-Sann; Zarghami, Mehran

    2016-01-01

    Postpartum depression is the most prevalent emotional problem during a women's lifespan. Untreated postpartum depression may lead to several consequences such as child, infant, fetal, and maternal effects. The main purpose of this article is to briefly describe different theoretical perspectives of postpartum depression. A literature search was conducted in Psych Info, PubMed, and Science Direct between 1950 and 2015. Additional articles and book chapters were referenced from these sources. Different theories were suggested for developing postpartum depression. Three theories, namely, biological, psychosocial, and evolutionary were discussed. One theory or combinations of psychosocial, biological, and evolutionary theories were considered for postpartum depression. The most important factor that makes clinicians’ choice of intervention is their theoretical perspectives. Healthcare providers and physicians should help women to make informed choices regarding their treatment based on related theories. PMID:27500126

  7. Perspective of Postpartum Depression Theories: A Narrative Literature Review.

    PubMed

    Abdollahi, Fatemeh; Lye, Munn-Sann; Zarghami, Mehran

    2016-06-01

    Postpartum depression is the most prevalent emotional problem during a women's lifespan. Untreated postpartum depression may lead to several consequences such as child, infant, fetal, and maternal effects. The main purpose of this article is to briefly describe different theoretical perspectives of postpartum depression. A literature search was conducted in Psych Info, PubMed, and Science Direct between 1950 and 2015. Additional articles and book chapters were referenced from these sources. Different theories were suggested for developing postpartum depression. Three theories, namely, biological, psychosocial, and evolutionary were discussed. One theory or combinations of psychosocial, biological, and evolutionary theories were considered for postpartum depression. The most important factor that makes clinicians' choice of intervention is their theoretical perspectives. Healthcare providers and physicians should help women to make informed choices regarding their treatment based on related theories.

  8. Birth Preparedness and Its Association with Skilled Birth Attendance and Postpartum Checkups among Mothers in Gibe Wereda, Hadiya Zone, South Ethiopia

    PubMed Central

    Tessema, Fasil; Hailu, Chernet

    2016-01-01

    Background. Birth preparedness program was designed to enhance skilled birth attendance and postpartum checkups of women in a developing country to reduce the three delays that lead women and neonates to death and disability. However, the relationship between birth preparedness with skilled birth attendance and postpartum checkups among mothers is not well studied. Therefore this study is intended to assess the association between birth preparedness and skilled birth attendance and postpartum checkups. Methods. A community based cross-sectional study was conducted from March to April 2014. Eight out of 22 Kebeles were selected using probability proportional to size sampling method. Seven hundred and forty-five mothers were selected randomly from the sampling frame, generated from family folders obtained from health posts. Data was collected using pretested questionnaire by face-to-face interview. Data was entered into EpiData version 3.1 database and analyzed by SPSS version 16. Result. Out of 745 sampled mothers 728 (97.7%) participated in the study. One hundred and twelve (15.4%) and 128 (17.6%) mothers got skilled birth attendance and received postpartum checkups for their last child, respectively. Birth preparedness, educational status of women and their husbands, and antenatal care visits of mothers were found to be predictor of skilled birth attendance and postpartum checkups. Mothers well prepared for child birth were 6.7 times more likely to attend skilled birth attendance [AOR = 6.7 (2.7–16.4)] and 3 times more likely to follow postpartum checkups [AOR = 3.0 (1.5–5.9)] than poorly prepared mothers, respectively. Travel time to reach the nearest health facility was found as predictor for postpartum checkups of mothers; mothers who travel ≤ 2 hours were three times more likely to follow postpartum checkups than mothers who travel > 2 hours (AOR (95% CI) = 3.4 (1.5–7.9)). Conclusion and Recommendation. Skilled birth attendance and postpartum checkups

  9. Parenting stress and depressive symptoms in postpartum mothers: bidirectional or unidirectional effects?

    PubMed

    Thomason, Elizabeth; Volling, Brenda L; Flynn, Heather A; McDonough, Susan C; Marcus, Sheila M; Lopez, Juan F; Vazquez, Delia M

    2014-08-01

    Despite the consistent link between parenting stress and postpartum depressive symptoms, few studies have explored the relationships longitudinally. The purpose of this study was to test bidirectional and unidirectional models of depressive symptoms and parenting stress. Uniquely, three specific domains of parenting stress were examined: parental distress, difficult child stress, and parent-child dysfunctional interaction (PCDI). One hundred and five women completed the Beck Depression Inventory and the Parenting Stress Index - Short Form at 3, 7, and 14 months after giving birth. Structural equation modeling revealed that total parenting stress predicted later depressive symptoms, however, there were different patterns between postpartum depressive symptoms and different types of parenting stress. A unidirectional model of parental distress predicting depressive symptoms best fit the data, with significant stability paths but non-significant cross-lagged paths. A unidirectional model of depressive symptoms predicted significant later difficult child stress. No model fit well with PCDI. Future research should continue to explore the specific nature of the associations of postpartum depression and different types of parenting stress on infant development and the infant-mother relationship.

  10. Parenting stress and depressive symptoms in postpartum mothers: Bidirectional or unidirectional effects?

    PubMed Central

    Thomason, Elizabeth; Volling, Brenda L.; Flynn, Heather A.; McDonough, Susan C.; Marcus, Sheila M.; Lopez, Juan F.; Vazquez, Delia M.

    2015-01-01

    Despite the consistent link between parenting stress and postpartum depressive symptoms, few studies have explored the relationships longitudinally. The purpose of this study was to test bidirectional and unidirectional models of depressive symptoms and parenting stress. Uniquely, three specific domains of parenting stress were examined: parental distress, difficult child stress, and parent–child dysfunctional interaction (PCDI). One hundred and five women completed the Beck Depression Inventory and the Parenting Stress Index–Short Form at 3, 7, and 14 months after giving birth. Structural equation modeling revealed that total parenting stress predicted later depressive symptoms, however, there were different patterns between postpartum depressive symptoms and different types of parenting stress. A unidirectional model of parental distress predicting depressive symptoms best fit the data, with significant stability paths but non-significant cross-lagged paths. A unidirectional model of depressive symptoms predicted significant later difficult child stress. No model fit well with PCDI. Future research should continue to explore the specific nature of the associations of postpartum depression and different types of parenting stress on infant development and the infant–mother relationship. PMID:24956500

  11. The Association between Traditional Chinese Dietary and Herbal Therapies and Uterine Involution in Postpartum Women

    PubMed Central

    Ho, Ming; Li, Tsai-Chung; Su, Shan-Yu

    2011-01-01

    Background. Traditional Chinese postpartum care is believed to help in the recovery of women after delivery. Objective. This study investigated the association of elements in dietary and herbal therapy with uterine involution. Methods. Indices of uterine involution were measured ultrasonographically in 127 postpartum women between 4-6 weeks after delivery. A self-reported retrospective questionnaire was used to query women about their frequencies of taking herbal medicines and consuming special diets during the first month after delivery. Correlation coefficients were calculated to identify the associations, then the regression models were used to identify the predictors. Result. Among the herbal medicines and diet, consumption of Eucommia ulmoides (E. ulmoides) negatively correlated with the AP diameter of the uterus and the cavity. E. ulmoides was also the only predictor of maximum AP diameter of the uterus, AP diameter of the uterus 5 cm from the fundus, and the maximum AP diameter of the cavity. Moreover, consumption of Sheng-hau-tang was significantly correlated with anteverted uterus and was a predictor of anteverted uterus. Conclusion. E. ulmoides and Sheng-hau-tang positively correlated with the degree of uterine involution after delivery, implying that both therapies might possess the pharmacological efficacy of uterine contraction in postpartum women. PMID:21584195

  12. What are postpartum women doing while the rest of the world is asleep?

    PubMed

    McBean, Amanda L; Montgomery-Downs, Hawley E

    2015-06-01

    Large individual differences characterize maternal postpartum sleep and adjustment. Our goal was to explore aspects of mothers' nocturnal environments and behaviours that may explain differences in postpartum adjustment. A total of 201 mothers of infants aged 0-6 months completed an online survey with demographics, number and duration of nocturnal awakenings, caretaking behaviours, environment and nocturnal activities during 'one typical night during the past week'. Mothers reported 2.9 [standard deviation (SD) ± 1.7] nocturnal awakenings, each lasting 33.9 (SD ± 22.5) min. Infant age was related inversely to duration but unrelated to number of awakenings. Falling asleep while feeding was less frequent among exclusively formula-feeders. Among the entire sample, mothers used a cellphone (59%), backlit tablet (25%), TV (20%) and computer (16%) during nocturnal awakenings. Watching TV and using a computer were each associated with longer nocturnal awakenings. Eighty-nine per cent of women used ≥1 extra light source during nocturnal awakenings: night light (35%), light from a cracked door (28%), desk lamp (25%), electronic device (19%) or room light (14%). Light source(s) was unrelated to number or duration of nocturnal awakenings. These data suggest that, although supplemental light sources were not associated with awakenings, TV and computer use accounted for longer awakenings. Feeding method and technology use may help to explain individual differences in postpartum adjustments and may be targets for more effective interventions.

  13. Postpartum depression screening in the Neonatal Intensive Care Unit: program development, implementation, and lessons learned

    PubMed Central

    Cherry, Amanda S; Blucker, Ryan T; Thornberry, Timothy S; Hetherington, Carla; McCaffree, Mary Anne; Gillaspy, Stephen R

    2016-01-01

    Objective The aims of this project were to describe the development of a postpartum depression screening program for mothers of infants in the Neonatal Intensive Care Unit and assess the implementation of the screening program. Methods Screening began at 14 days postpartum and was implemented as part of routine medical care. A nurse coordinator facilitated communication with mothers for increasing screen completion, review of critical self-harm items, and making mental health referrals. During the 18-month study period, 385 out of 793 eligible mothers completed the screen. Results Approximately 36% of mothers had a positive screen that resulted in a mental health referral and an additional 30% of mothers had screening results indicating significant symptoms. Conclusion Several barriers were identified, leading to adjustments in the screening process, and ultimately recommendations for future screening programs and research. Development of a postpartum depression screening process in the Neonatal Intensive Care Unit involves support, training, implementation, and coordination from administrators, medical staff, new mothers, and mental health specialists. Several predictable challenges to program development require ongoing assessment and response to these challenges. Relevance This study highlights the expanding role of the psychologist and behavioral health providers in health care to intervene as early as possible in the life of a child and family with medical complications through multidisciplinary program development and implementation, as well as key considerations for institutions initiating such a program. PMID:26937199

  14. Postpartum bonding: the impact of maternal depression and adult attachment style.

    PubMed

    Nonnenmacher, N; Noe, D; Ehrenthal, J C; Reck, C

    2016-10-01

    Maternal depression poses a risk for the developing mother-infant relationship. Similarly, maternal insecure attachment styles may limit the ability to adequately connect with the newborn during the postpartum period. The aim of this study was to investigate the effect of maternal depression and insecure attachment (insecure and dual/disorganized) on maternal bonding in a sample of n = 34 women with depression according to DSM-IV and n = 59 healthy women. Maternal depression was assessed 3 to 4 months postpartum with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), bonding with the Postpartum Bonding Questionnaire, and maternal attachment style with the Attachment Style Interview. Women with current and lifetime depression as well as women with dual/disorganized attachment style reported lower bonding. Explorative analysis revealed that depression partially mediated the link between dual/disorganized attachment style and bonding with a medium-sized mediation effect. The combination of maternal depression and dual/disorganized attachment style may pose a special risk constellation for the developing mother-infant bond that should be addressed in prevention and early intervention programs.

  15. Development and psychometric testing of the Chinese Postnatal Risk Factors Questionnaire (CPRFQ) for postpartum depression.

    PubMed

    Yan, Xiaoyu; Lu, Jun; Shi, Shenxun; Wang, Ximei; Zhao, Rui; Yan, Yuan; Chen, Gang

    2015-04-01

    This article describes the development and psychometric assessment of the Chinese Postnatal Risk Factors Questionnaire (CPRFQ). There were four phases in this process: (1) the items were generated using a literature review and a focus group, (2) content validity was evaluated by an expert panel, (3) a pilot study was conducted with 45 postpartum women to refine the scale, and (4) a convenience sample of 256 postpartum women in China was recruited to complete the questionnaire. Construct validity was established by exploratory factor analysis; a four-factor structure of the scale was accepted (social and family, personality and relationship, mother and infant, maternal feelings and 'doing the month'). These factors explained 47.46 % of the variance. Pearson's correlation coefficient was conducted to test convergent validity with the Edinburgh Postnatal Depression Scale (EPDS) (r = 0.54; p < 0.001). The Cronbach's alpha coefficient of the four subscales ranged from 0.58 to 0.71. The final 18-item version of the questionnaire is potentially a valuable tool for assessing postnatal risk factors in Chinese postpartum mothers.

  16. Physical, Sexual, Emotional and Economic Intimate Partner Violence and Controlling Behaviors during Pregnancy and Postpartum among Women in Dar es Salaam, Tanzania

    PubMed Central

    Mahenge, Bathsheba; Stöckl, Heidi; Abubakari, Abdulai; Mbwambo, Jessie; Jahn, Albrecht

    2016-01-01

    Background Intimate partner violence (IPV) during pregnancy and postpartum is a serious global health problem affecting millions of women worldwide. This study sought to determine the prevalence of different forms of IPV during pregnancy and postpartum and associated factors among women in Dar es Salaam, Tanzania. Methods We conducted a cross-sectional study among 500 women at one to nine months postpartum in three health facilities in the three districts of Dar es Salaam: Temeke, Kinondoni and Illala. Two trained research assistants administered the questionnaire, which aimed to examine sociodemographic characteristics and different forms of IPV. Results Of the 500 women who were interviewed, 18.8% experienced some physical and/or sexual violence during pregnancy. Forty-one women (9%) reported having experienced some physical and/or sexual violence at one to nine months postpartum. Physical and/or sexual IPV during pregnancy was associated with cohabiting (AOR 2.2, 95% CI 1.24–4.03) and having a partner who was 25 years old or younger (AOR 2.7, 95% CI 1.08–6.71). Postpartum, physical and/or sexual IPV was associated with having a partner who was 25 years old or younger (AOR 4.4, 95% CI 1.24–15.6). Conclusion We found that IPV is more prevalent during pregnancy than during the postpartum phase. There is also continuity and maintenance of IPV during and after pregnancy. These results call for policy and interventions to be tailored for pregnant and postpartum women. PMID:27755559

  17. Milk intake during pregnancy is inversely associated with the risk of postpartum depressive symptoms in Japan: the Kyushu Okinawa Maternal and Child Health Study.

    PubMed

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Furukawa, Shinya; Arakawa, Masashi

    2016-09-01

    Only one epidemiologic study has investigated the association between dairy product intake during pregnancy and postpartum depressive symptoms. Epidemiologic evidence on the relationships between calcium and vitamin D intake during pregnancy and postpartum depressive symptoms is also lacking. The present prospective study examined these issues in Japan. Study subjects were 1319 women. During pregnancy, dietary intake during the preceding month was assessed using a self-administered diet history questionnaire in the baseline survey. Postpartum depressive symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 9 or higher between 3 and 4 months postpartum. Adjustment was made for age, gestation at baseline, region of residence, number of children, family structure, history of depression, family history of depression, job type, education, body mass index, having smoked during pregnancy, cesarean delivery, baby's sex, baby's birth weight, and total energy intake. After adjustment for the confounding factors, compared with milk intake in the lowest quartile, intake levels in the second and fourth quartiles were independently associated with a reduced risk of postpartum depressive symptoms, although the inverse exposure-response relationship was not significant: the adjusted odds ratio between extreme quartiles was 0.51 (95% confidence interval, 0.28-0.93; P for trend = .12). No material relationships were observed between intake of total dairy products, yogurt, cheese, calcium, or vitamin D and the risk of postpartum depressive symptoms. The present prospective cohort study in Japan suggests that higher milk intake during pregnancy is associated with a reduced risk of postpartum depressive symptoms.

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

    PubMed Central

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

    2015-01-01

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

  19. Postpartum teens' perception of the food environments at home and school

    PubMed Central

    Tabak, Rachel G.; Joshu, Corinne E.; Clarke, Megan A.; Schwarz, Cynthia D.; Haire-Joshu, Debra L.

    2016-01-01

    Background An environment that supports healthy eating is one factor to prevent obesity. However, little is known about postpartum teen's perceptions of their home and school environments and how this relates to dietary behaviors. Purpose This study explores the relationship between home and school environments and dietary behaviors for postpartum teens. Design Conducted cross-sectionally during 2007-2009 across 27 states; included 889 postpartum teens enrolled in Parents as Teachers Teen Program. Data included measures of sociodemographics and perceptions of school and home food environments. A 7-day recall of snack and beverage frequency assessed dietary behaviors. Logistic regression explored associations between baseline environment measures and dietary behaviors at baseline and post-intervention (approximately 5 months after baseline) for the control group. Results Respondents reported greater access and selection (i.e., variety of choices) of healthy foods and beverages at home than school. At baseline, fruit and vegetable intake was associated with home selection (1.9, 95% CI: 1.3-2.9) and availability (1.8, 95% CI: 1.3-2.6), sweet snack consumption was associated with selection (1.5, 95% CI: 1.0-2.1), and total snack consumption and sugar-sweetened beverage intake were associated with selection (snack: 2.1, 95% CI: 1.5-3.0; beverage: 1.7, 95% CI: 1.2-2.4) and availability (snack: 2.1, 95% CI: 1.4-3.1; beverage: 1.5, 95% CI: 1.0-2.3). Water intake at baseline and at the post-intervention for control group teens was associated with selection (1.6, 95% CI: 1.1-2.2). No significant associations were identified between the school environment and dietary behaviors. Conclusions Interventions should target improvements in the home environment for high risk, postpartum teens. PMID:26272783

  20. 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.

  1. 10 CFR 960.3-4 - Environmental impacts.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Environmental impacts. 960.3-4 Section 960.3-4 Energy... REPOSITORY Implementation Guidelines § 960.3-4 Environmental impacts. Environmental impacts shall be... process. The DOE shall mitigate significant adverse environmental impacts, to the extent...

  2. 10 CFR 960.3-4 - Environmental impacts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Environmental impacts. 960.3-4 Section 960.3-4 Energy... REPOSITORY Implementation Guidelines § 960.3-4 Environmental impacts. Environmental impacts shall be... process. The DOE shall mitigate significant adverse environmental impacts, to the extent...

  3. 34 CFR 3.4 - Use of the seal.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Use of the seal. 3.4 Section 3.4 Education Office of the Secretary, Department of Education OFFICIAL SEAL § 3.4 Use of the seal. (a) Use by any person or...) Requests by any person or organization outside of the Department for permission to use the Seal must...

  4. 34 CFR 3.4 - Use of the seal.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Use of the seal. 3.4 Section 3.4 Education Office of the Secretary, Department of Education OFFICIAL SEAL § 3.4 Use of the seal. (a) Use by any person or...) Requests by any person or organization outside of the Department for permission to use the Seal must...

  5. 43 CFR 3400.3-4 - Trust protection lands.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Trust protection lands. 3400.3-4 Section 3400.3-4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND...: General § 3400.3-4 Trust protection lands. The regulations in this group do not apply to the leasing...

  6. 45 CFR 1210.3-4 - Initiation of termination.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Initiation of termination. 1210.3-4 Section 1210.3-4 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY TERMINATION PROCEDURES VISTA Volunteer Early Termination § 1210.3-4 Initiation...

  7. 34 CFR 3.4 - Use of the seal.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Use of the seal. 3.4 Section 3.4 Education Office of the Secretary, Department of Education OFFICIAL SEAL § 3.4 Use of the seal. (a) Use by any person or organization outside of the Department may be made only with the Department's prior written approval....

  8. 10 CFR 960.3-4 - Environmental impacts.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Environmental impacts. 960.3-4 Section 960.3-4 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-4 Environmental impacts. Environmental impacts shall...

  9. 10 CFR 960.3-4 - Environmental impacts.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Environmental impacts. 960.3-4 Section 960.3-4 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-4 Environmental impacts. Environmental impacts shall...

  10. 10 CFR 960.3-4 - Environmental impacts.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Environmental impacts. 960.3-4 Section 960.3-4 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-4 Environmental impacts. Environmental impacts shall...

  11. 40 CFR 257.3-4 - Ground water.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Ground water. 257.3-4 Section 257.3-4... and Practices § 257.3-4 Ground water. (a) A facility or practice shall not contaminate an underground drinking water source beyond the solid waste boundary or beyond an alternative boundary specified...

  12. 40 CFR 257.3-4 - Ground water.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Ground water. 257.3-4 Section 257.3-4... and Practices § 257.3-4 Ground water. (a) A facility or practice shall not contaminate an underground drinking water source beyond the solid waste boundary or beyond an alternative boundary specified...

  13. 40 CFR 257.3-4 - Ground water.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Ground water. 257.3-4 Section 257.3-4... and Practices § 257.3-4 Ground water. (a) A facility or practice shall not contaminate an underground drinking water source beyond the solid waste boundary or beyond an alternative boundary specified...

  14. 40 CFR 257.3-4 - Ground water.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Ground water. 257.3-4 Section 257.3-4... and Practices § 257.3-4 Ground water. (a) A facility or practice shall not contaminate an underground drinking water source beyond the solid waste boundary or beyond an alternative boundary specified...

  15. 40 CFR 257.3-4 - Ground water.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Ground water. 257.3-4 Section 257.3-4... and Practices § 257.3-4 Ground water. (a) A facility or practice shall not contaminate an underground drinking water source beyond the solid waste boundary or beyond an alternative boundary specified...

  16. Postpartum Depressive Symptoms Across Time and Place: Structural Invariance of the Self-Reporting Questionnaire Among Women from the International, Multi-Site MAL-ED Study

    PubMed Central

    Pendergast, Laura L.; Scharf, Rebecca J.; Rasmussen, Zeba A.; Seidman, Jessica C.; Schaefer, Barbara A.; Svensen, Erling; Tofail, Fahmida; Koshy, Beena; Kosek, Margaret; Rasheed, Muneera A.; Roshan, Reeba; Maphula, Angelina; Shrestha, Rita; Murray-Kolb, Laura E.

    2014-01-01

    Background The Self-Reporting Questionnaire (SRQ) is a screening instrument that has been shown to be an effective measure of depression in postpartum women and is widely used in developing nations. Methods The SRQ was administered to 2,028 mothers from eight nations at two time points: one and six months postpartum. All data were obtained from the Interactions of Malnutrition and Enteric Infections: Consequences for Child Health and Development (MAL-ED) study. The sample included women from MAL-ED sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania. This study examined three aspects of validity of SRQ scores including (a) structural validity, (b) cross-cultural invariance, and (c) invariance over time. Results A 16-item, one-factor structure with items reflecting somatic symptoms removed was deemed to be superior to the original structure in this postpartum population. Although differential item functioning (DIF) across sites was evident, the one-factor model was a good fit to the data from seven sites, and the structure was invariant across the one- and six-month time points. Limitations Findings are based on data from self-report scales. No information about the clinical status of the participants was available. Conclusions Overall, findings support the validity of a modified model of the SRQ among postpartum women. Somatic symptoms (e.g., headaches, not sleeping well) may not reflect internalizing problems in a postpartum population. Implications for researchers and practitioners are discussed. PMID:24981251

  17. Feasibility and Perception of Using Text Messages as an Adjunct Therapy for Low-Income, Minority Mothers With Postpartum Depression

    PubMed Central

    Ladley, Amy S; Rhyne, Elizabeth A; Halloran, Donna R

    2015-01-01

    Background Postpartum depression (PPD) is the most common medical problem among new mothers that can have a negative impact on infant health. Traditional treatments are often difficult for low-income mothers to complete, particularly given the numerous barriers families face. Objective Among low-income, primarily racial, and ethnic minority mothers with postpartum depression, our aim was to evaluate (1) the feasibility of sending supportive text messages, and (2) the perception of receiving private, supportive text messages for postpartum depression. Methods Mothers found to be at risk for postpartum depression received supportive text messages four times weekly for 6 months in addition to receiving access to traditional counseling services based within an academic pediatric office. Feasibility was evaluated along with cellular and text messaging use, access, and perception of the message protocol. Perception of the message protocol was evaluated at study completion via a Likert scale questionnaire and open-ended qualitative survey. Results In total, 4158/4790 (86.81%) text messages were successfully delivered to 54 mothers over a 6-month period at a low cost (US $777.60). Among the 96 scripted messages, 37 unique messages (38.54%) allowed for a response. Of all sent messages that allowed for responses, 7.30% (118/1616) were responded to, and 66.1% of those responses requested a call back; 46% (25/54) of mothers responded at least once to a text message. Mothers felt that messages were easily received and read (25/28, 89%) and relevant to them personally (23/28, 82%). Most shared texts with others (21/28, 75%). Conclusions Text messaging is feasible, well-accepted, and may serve as a simple, inexpensive adjunct therapy well-suited to cross socioeconomic boundaries and provide private support for at-risk mothers suffering from postpartum depression. PMID:26543910

  18. Childhood sexual abuse and posttraumatic stress disorder among pregnant and postpartum women: review of the literature.

    PubMed

    Wosu, Adaeze C; Gelaye, Bizu; Williams, Michelle A

    2015-02-01

    The aims of this review are (i) to summarize and evaluate current knowledge on the association between childhood sexual abuse (CSA) and posttraumatic stress disorder (PTSD) in pregnant and postpartum women, (ii) to provide suggestions for future research on this topic, and (iii) to highlight some clinical implications. Relevant publications were identified through literature searches of four databases (PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and PsycARTICLES) using keywords such as "child abuse," "posttraumatic stress," "pregnancy," and "postpartum". Five studies were included in this review. Findings across all studies were consistent with higher prevalence of PTSD diagnosis or symptomatology among women with history of CSA. However, only findings from two studies were statistically significant. One study observed higher overall PTSD scores in women with CSA history compared to women with non-CSA trauma history or no trauma history during pregnancy (mean ± SD 1.47 (0.51) vs. 1.33 (0.41) vs. 1.22 (0.29), p < 0.001), at 2 months postpartum (mean ± SD 1.43 (0.49) vs. 1.26 (0.38) vs. 1.19 (0.35), p < 0.001), and at 6 months postpartum (mean ± SD 1.36 (1.43) vs. 1.20 (0.33) vs. 1.14 (0.27), p < 0.001). Another study observed that the prevalence of PTSD during pregnancy was 4.1 % in women with no history of physical or sexual abuse, 11.4 % in women with adult physical or sexual abuse history, 16.0 % in women with childhood physical or sexual abuse history, and 39.0 % in women exposed to both childhood and adult physical or sexual abuse (p < 0.001); in a subsequent analysis, the investigators reported that pregnant women with PTSD had over 5-fold odds of having a history of childhood completed rape compared to counterparts without PTSD (OR = 5.3, 95 % CI 3.2, 8.7). Overall, available evidence suggests positive associations of CSA with clinical PTSD or PTSD symptomatology among pregnant and

  19. Understanding Factors Associated with Postpartum Visit Attendance and Contraception Choices: Listening to Low-Income Postpartum Women and Health Care Providers.

    PubMed

    Henderson, Vida; Stumbras, Katrina; Caskey, Rachel; Haider, Sadia; Rankin, Kristin; Handler, Arden

    2016-11-01

    Background While there is considerable variability with respect to attendance at the postpartum visit, not much is known about women's preferences with respect to postpartum care. Likewise, there is also limited information on providers' practices regarding the postpartum visit and care including the delivery of contraception. To understand and address deficits in the delivery and utilization of postpartum care, we examined the perceptions of low-income postpartum women with respect to barriers to and preferences for the timing and location of the postpartum visit and receipt of contraception. We also examined providers' current prenatal and postnatal care practices for promoting the use of postpartum care and their attitudes toward alternative approaches for delivering contraceptive services in the postpartum period. Methods Qualitative face-to-face interviews were completed with 20 postpartum women and in-depth qualitative phone interviews were completed with 12 health care providers who had regular contact with postpartum women. Interviews were coded using Atlas.ti software and themes were identified. Results Women believed that receiving care during the postpartum period was an important resource for monitoring physical and mental health and also strongly supported the provision of contraception earlier than the 6-week postpartum visit. Providers reported barriers to women's use of postpartum care on the patient, provider, and system levels. However, providers were receptive to exploring new clinical practices that may widen the reach of postpartum care and increase access to postpartum contraception. Conclusion Approaches that increase the flexibility and convenience of postpartum care and the delivery of postpartum contraception may increase the likelihood that women will take advantage of essential postpartum services.

  20. 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

  1. 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.

  2. A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon

    PubMed Central

    Casapía, Martín; Aguilar, Eder; Silva, Hermánn; Montresor, Antonio; Rahme, Elham; Fraser, William D.; Marquis, Grace S.; Vercruysse, Jozef; Allen, Lindsay H.; Blouin, Brittany; Razuri, Hugo; Pezo, Lidsky

    2017-01-01

    Background Nutritional interventions targeting the critical growth and development period before two years of age can have the greatest impact on health trajectories over the life course. Compelling evidence has demonstrated that interventions investing in maternal health in the first 1000 days of life are beneficial for both mothers and their children. One such potential intervention is deworming integrated into maternal postpartum care in areas where soil-transmitted helminth (STH) infections are endemic. Methodology/Principal Findings From February to August 2014, 1010 mother-infant pairs were recruited into a trial aimed at assessing the effectiveness of maternal postpartum deworming on infant and maternal health outcomes. Following delivery, mothers were randomly assigned to receive either single-dose 400 mg albendazole or placebo. Participants were followed-up at 1 and 6 months postpartum. There was no statistically significant difference in mean weight gain between infants in the experimental and control groups (mean difference: -0.02; 95% CI: -0.1, 0.08) at 6 months of age. Further, deworming had no effect on measured infant morbidity indicators. However, ad hoc analyses restricted to mothers who tested positive for STHs at baseline suggest that infants of mothers in the experimental group had greater mean length gain in cm (mean difference: 0.8; 95% CI: 0.1, 1.4) and length-for-age z-score (mean difference: 0.5; 95% CI: 0.2, 0.8) at 6 months of age. Conclusions/Significance In a study population composed of both STH-infected and uninfected mothers, maternal postpartum deworming was insufficient to impact infant growth and morbidity indicators up to 6 months postpartum. Among STH-infected mothers, however, important improvements in infant length gain and length-for-age were observed. The benefits of maternal postpartum deworming should be further investigated in study populations having higher overall prevalences and intensities of STH infections and, in

  3. Postpartum amenorrhoea among Manipuri women: a survival analysis.

    PubMed

    Singh, N Sanajaoba; Singh, N Sharat; Narendra, R K

    2012-03-01

    Among the three major components of a closed birth interval, waiting time to conception can somehow be managed with effective contraceptives while gestation is universally constant in its duration; the duration of postpartum amenorrhoea (PPA) varies in complex nature. The present study aimed to investigate the proximate factors influencing the duration of PPA. A community-based, cross-sectional study was conducted in four valley districts of Manipur, India, during 1 August-31 December 2009, to analyze the differentials and determinants of duration of PPA, applying the survival analysis technique. In total, 1,225 ever-married women were selected through two-stage cluster sampling. The median duration of PPA was 5.7 months. Among the 11 explanatory variables of interest, only three variables--place of residence (p<0.05), infant mortality from preceding pregnancy (p<0.01), and duration of breastfeeding (p<0.01)--had a significant effect on the duration of PPA. The findings may be used as baseline information for future researchers and maternal health policy-makers.

  4. Residential substance abuse treatment for pregnant and postpartum women and their children: treatment and policy implications.

    PubMed

    Clark, H W

    2001-01-01

    In FY 1993 and FY 1995, the federal government awarded 27 five-year grants that supported 35 residential treatment projects for substance-abusing pregnant and postpartum women and their children. These projects provided comprehensive culturally and gender-specific treatment. Preliminary aggregated data collected in a national cross-site evaluation of 24 of these projects are encouraging with respect to infant mortality and morbidity, treatment retention and completion rates, and behavioral changes in the participating mothers at six months postdischarge. Local evaluations reflect other benefits of treatment. Cost data are expected to demonstrate the efficiencies and benefits of these projects compared to no treatment.

  5. Contraceptive efficacy and clinical performance of Nestorone implants in postpartum women.

    PubMed

    Massai, M R; Díaz, S; Quinteros, E; Reyes, M V; Herreros, C; Zepeda, A; Croxatto, H B; Moo-Young, A J

    2001-12-01

    The objective of this study was to evaluate the contraceptive efficacy and clinical performance of a Nestorone subdermal implant (NES) in the postpartum period. NES (n = 100) and Copper T intrauterine device (T-Cu; n = 100) acceptors initiated contraception at 8 weeks postpartum and were followed at monthly intervals during the first year and at 3-month intervals thereafter. Pregnancy rates, breastfeeding performance, infant growth, bleeding pattern, and side effects were assessed. Blood and milk NES concentration were measured. No pregnancy occurred in 2195 and 2145 woman-months of NES implant and T-Cu use, respectively. No effect of NES on lactation and infant growth and no serious adverse events were observed. Lactational amenorrhea was significantly longer in NES users (353 +/- 20 days) than in T-Cu users (201 +/- 11 days). More NES users (55.8%) experienced prolonged bleedings than did T-Cu users (36.2%). Concentrations of NES in breast milk ranged between 54-135 pmol/liter. The Nestorone implant is a highly effective contraceptive, safe for breastfed infants because the steroid is inactive by the oral route.

  6. Assessment of postpartum depressive symptoms: the importance of somatic symptoms and irritability.

    PubMed

    Williamson, J Austin; O'Hara, Michael W; Stuart, Scott; Hart, Kimberly J; Watson, David

    2015-06-01

    Assessing postpartum depressive symptoms is complicated by the fact that irritability, fatigue, insomnia, and appetite disruptions are also related to normative aspects of the childbearing process. We used multigroup confirmatory factor analysis to compare symptoms in 271 postpartum women with those of 820 non-postpartum women. We found that (a) irritability, insomnia, fatigue, and appetite loss were substantially associated with depressed mood among postpartum women whereas increased appetite was not; (b) irritability, insomnia, fatigue, and appetite changes were as strongly related to depression among postpartum women as they were among non-postpartum women; and (c) after controlling for overall depressed mood, postpartum women reported more irritability, insomnia, and appetite loss than the non-postpartum women. Irritability, fatigue, insomnia, and appetite loss are valid indicators and should be used to measure postpartum depressive symptoms. However, scores on these symptoms should be adjusted downward to account for their higher baseline rates in the postpartum population.

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

    PubMed

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

    2015-10-01

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

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

    PubMed

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

    2015-04-01

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

  9. Postpartum Sexuality and the Lactational Amenorrhea Method for Contraception.

    PubMed

    Labbok, Miriam H

    2015-12-01

    This chapter reviews the literature on postpartum coital behavior, anovulatory and ovulatory bleeding episodes, and the methodology and efficacy of Lactational Amenorrhea Method and progesterone-only oral contraceptives. Of interest is the finding that breastfeeding women may resume coital behavior earlier postpartum, but report increased discomfort over time. The high efficacy of the Lactational Amenorrhea Method is confirmed and data illustrating possible relaxation of some criteria are presented. The conflicting guidance of CDC and WHO concerning immediate postpartum use of progestin-only methods is presented. The dearth of recent studies calls for new research on these topics.

  10. Dream-associated Behaviors Affecting Pregnant and Postpartum Women

    PubMed Central

    Nielsen, Tore; Paquette, Tyna

    2007-01-01

    Study objectives: Evaluate the prevalence and phenomenology of dream-associated behaviors affecting pregnant and postpartum mothers. Episodes consist of anxious dreams and nightmares about the new infant that are accompanied by complex behaviors (motor activity, speaking, expressing emotion). Design: Three-group design (postpartum, pregnant, null gravida), self-report, and repeated measures. Setting: Pregnancy and postpartum groups: completion of questionnaires in hospital room within 48 hours of giving birth and home telephone interviews; null gravida group: completion of questionnaires and interview in person or by telephone. Participants: Two hundred seventy-three women in 3 groups: postpartum: n = 202 (mean age = 29.7 ± 4.94 years; 95 primiparas, 107 multiparas); pregnant: n = 50 (mean age = 31.1 ± 5.44 years); null gravida: n = 21 (mean age = 28.5 ± 6.34 years). Interventions: Subjects completed questionnaires about pregnancy and birth factors, personality, and sleep and participated in interviews concerning the prevalence of recent infant dreams and nightmares, associated behaviors, anxiety, depression, and other psychopathologic factors. Measurements and Results: Most women in all groups recalled dreams (88%-91%). Postpartum and pregnant women recalled infant dreams and nightmares with equal prevalence, but more postpartum women reported they contained anxiety (75%) and the infant in peril (73%) than did pregnant women (59%, P < 0.05 and 42%, P < 0.0001). More postpartum (63%) than pregnant (40%) women reported dream-associated behaviors (P < 0.01), but neither group differed from null gravida women (56%). This was due to different distributions over groups of the behavior subtypes. Motor activity was present in twice as many postpartum (57%) as pregnant (24%) or null gravida (25%) women (all P < 0.0001). Expressing emotion was more prevalent among null gravida (56%) than postpartum women (27%) (P < 0.05) but was not different from pregnant women (37

  11. Postpartum depression among African-American women.

    PubMed

    Amankwaa, Linda Clark

    2003-01-01

    The purpose of this qualitative study was to describe the nature of postpartum depression (PPD) among African-American women. Twelve women, who had experienced PPD within the last three years, were interviewed for approximately one hour at two intervals. Nudist-4 software and the constant comparative method were used to analyze the data. Five themes "Stressing Out," "Feeling Down," "Losing It," "Seeking Help," and "Feeling Better" represented aspects of PPD as experienced by the participants. The last theme, "Dealing with It," represented the cultural ways in which African-American mothers managed their depression. These included Keeping the Faith, Trying to Be a Strong Black Woman, Living with Myths, and Keeping Secrets. Suggestions for future directions in nursing research are included.

  12. Stressful Events During Pregnancy and Postpartum Depressive Symptoms

    PubMed Central

    Diop, Hafsatou; Declercq, Eugene; Cabral, Howard J.; Fox, Matthew P.; Wise, Lauren A.

    2015-01-01

    Abstract Background: Understanding the influence of perinatal stressors on the prevalence of postpartum depressive symptoms (PDS) and help-seeking for PDS using surveillance data can inform service provision and improve health outcomes. Methods: We used Massachusetts Pregnancy Risk Assessment Monitoring System (MA-PRAMS) 2007–2010 data to evaluate associations between selected perinatal stressors and PDS and with subsequent help-seeking behaviors. We categorized 12 stressors into 4 groups: partner, traumatic, financial, and emotional. We defined PDS as reporting “always” or “often” to any depressive symptoms on PRAMS Phase 5, or to a composite score ≥10 on PRAMS Phase 6 depression questions, compared with women reporting “sometimes,” “rarely” or “never” to all depressive symptoms. The median response time to MA-PRAMS survey was 3.2 months (interquartile range, 2.9–4.0 months). We estimated prevalence ratios (PRs) and 95% confidence intervals (95% CIs) using modified Poisson regression models, controlling for socioeconomic status indicators, pregnancy intention and prior mental health visits. Results: Among 5,395 participants, 58% reported ≥1 stressor (partner=26%, traumatic=16%, financial=29% and emotional=30%). Reporting of ≥1 stressor was associated with increased prevalence of PDS (PR=1.68, 95% CI: 1.42–1.98). The strongest association was observed for partner stress (PR=1.90, 95% CI: 1.51–2.38). Thirty-eight percent of mothers with PDS sought help. Mothers with partner-related stressors were less likely to seek help, compared with mothers with other grouped stressors. Conclusions: Women who reported perinatal common stressors—particularly partner-related stressors—had an increased prevalence of PDS. These data suggest that women should be routinely screened during pregnancy for a range of stressors and encouraged to seek help for PDS. PMID:25751609

  13. Optimistic Outlook Regarding Maternity Protects Against Depressive Symptoms Postpartum

    PubMed Central

    Robakis, Thalia K.; Williams, Katherine E.; Crowe, Susan; Kenna, Heather; Gannon, Jamie; Rasgon, Natalie L.

    2016-01-01

    Purpose The transition to motherhood is a time of elevated risk for clinical depression. Dispositional optimism may be protective against depressive symptoms; however the arrival of a newborn presents numerous challenges that may be at odds with initially positive expectations, and which may contribute to depressed mood. We have explored the relative contributions of antenatal and postnatal optimism regarding maternity to depressive symptoms in the postnatal period. Methods 98 pregnant women underwent clinician interview in the third trimester to record psychiatric history, antenatal depressive symptoms, and administer a novel measure of optimism towards maternity. Measures of depressive symptoms, attitudes to maternity, and mother-to-infant bonding were obtained from 97 study completers at monthly intervals through three months postpartum. Results We found a positive effect of antenatal optimism, and a negative effect of postnatal disconfirmation of expectations, on depressive mood postnatally. Postnatal disconfirmation, but not antenatal optimism, was associated with more negative attitudes toward maternity postnatally. Antenatal optimism, but not postnatal disconfirmation, was associated with reduced scores on a mother-to-infant bonding measure. The relationships between antenatal optimism, postnatal disconfirmation of expectations, and postnatal depression held true among primigravidas and multigravidas, as well as among women with prior histories of mood disorders, although antenatal optimism tended to be lower among women with mental health histories. Conclusions We conclude that cautious antenatal optimism, rather than immoderate optimism or frank pessimism, is the approach that is most protective against postnatal depressive symptoms, and that this is true irrespective of either mood disorder history or parity. Factors predisposing to negative cognitive assessments and impaired mother-to-infant bonding may be substantially different than those associated

  14. Postpartum weight retention is associated with elevated ratio of oxidized LDL lipids to HDL-cholesterol.

    PubMed

    Puhkala, Jatta; Luoto, Riitta; Ahotupa, Markku; Raitanen, Jani; Vasankari, Tommi

    2013-12-01

    Oxidized LDL lipids (ox-LDL) are associated with lifestyle diseases such as cardiovascular diseases, metabolic syndrome and type 2 diabetes. The present study investigated how postpartum weight retention effects on ox-LDL and serum lipids. The study is a nested comparative research of a cluster-randomized controlled trial, NELLI (lifestyle and counselling during pregnancy). During early pregnancy (8-12 weeks) and 1 year postpartum, 141 women participated in measurements for determining of plasma lipids: total cholesterol (T-C), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triacylglycerols (TAG) and ox-LDL. Subjects were stratified into tertiles (weight loss, unaltered weight and weight gain groups) based on their weight change from baseline to follow-up. Ox-LDL was determined by baseline level of conjugated dienes in LDL lipids. Among the group of weight gainers, concentration of TAG reduced less (-0.14 vs. -0.33, p = 0.002), HDL-C reduced more (-0.31 vs. -0.16, p = 0.003) and ox-LDL/HDL-C ratio increased (3.0 vs. -0.2, p = 0.003) when compared to group of weight loss. Both T-C and LDL-C elevated more (0.14 vs. -0.21, p = 0.008; 0.31 vs. 0.07, p = 0.015) and TAG and ox-LDL reduced less (-0.33 vs. 0.20, p = 0.033; -3.33 vs. -0.68, p = 0.026) in unaltered weight group compared to weight loss group. The women who gained weight developed higher TAG and ox-LDL/HDL-C ratio as compared to those who lost weight. Postpartum weight retention of 3.4 kg or more is associated with atherogenic lipid profile.

  15. Incidence of double ovulation during the early postpartum period in lactating dairy cows.

    PubMed

    Kusaka, Hiromi; Miura, Hiroshi; Kikuchi, Motohiro; Sakaguchi, Minoru

    2017-03-15

    In lactating cattle, the incidence of twin calving has many negative impacts on production and reproduction in dairy farming. In almost all cases, natural twinning in dairy cattle is the result of double ovulation. It has been suggested that the milk production level of cows influences the number of ovulatory follicles. The objective of the present study was to investigate the incidence of double ovulations during the early postpartum period in relation to the productive and reproductive performance of dairy cows. The ovaries of 43 Holstein cows (26 primiparous and 17 multiparous) were ultrasonographically scanned throughout the three postpartum ovulation sequences. The incidence of double ovulation in the unilateral ovaries was 66.7%, with a higher incidence in the right ovary than in the left, whereas that in bilateral ovaries was 33.3%. When double ovulations were counted dividing into each side ovary in which ovulations occurred, the total frequency of ovulations deviated from a 1:1 ratio (60.3% in the right side and 39.7% in the left side, P < 0.05). In multiparous cows, double ovulation occurred more frequently than in primiparous cows (58.8% vs. 11.5% per cow and 30.0% vs. 3.8% per ovulation, respectively P < 0.01). The double ovulators experienced more anovulatory repeated waves of follicles before their first ovulations than the single ovulators, which resulted in an extension of the period from parturition to third ovulation (81.5 days vs. 64.2 days, P < 0.05). In the multiparous cows, the double ovulators exhibited higher peak milk yield (P < 0.01) with lower milk lactose concentration (P < 0.05), indicating the prevalence of a more severe negative energy balance during the postpartum 3-month compared to the multiparous single ovulators. Our results showed that, regardless of their parity, double ovulation had no impact on the reproductive performance of the cows. Two multiparous cows that experienced double ovulation during the early

  16. A Randomized Controlled Trial of Innovative Postpartum Care Model for Mother-Baby Dyads

    PubMed Central

    Laliberté, Corinne; Dunn, Sandra; Pound, Catherine; Sourial, Nadia; Yasseen, Abdool S.; Millar, David; Rennicks White, Ruth; Walker, Mark; Lacaze-Masmonteil, Thierry

    2016-01-01

    Objective To evaluate the efficacy, safety, and maternal satisfaction of a newly established integrative postpartum community-based clinic providing comprehensive support for mothers during the first month after discharge from the hospital. Our primary interests were breastfeeding rates, readmission and patient satisfaction. Methods A randomized controlled trial was conducted in Ottawa, Canada, where 472 mothers were randomized via a 1:2 ratio to either receive standard of care (n = 157) or to attend the postpartum breastfeeding clinic (n = 315). Outcome data were captured through questionnaires completed by the participants at 2, 4, 12 and 24 weeks postpartum. Unadjusted and adjusted logistic regression models were conducted to determine the effect of the intervention on exclusive breastfeeding at 12 weeks (primary outcome). Secondary outcomes included breastfeeding rate at 2, 4 and 24 weeks, breastfeeding self-efficacy scale, readmission rate, and satisfaction score. Results More mothers in the intervention group (n = 195, 66.1%) were exclusively breastfeeding at 12 weeks compared to mothers in the control group (n = 81, 60.5%), however no statistically significant difference was observed (OR = 1.28; 95% CI:0.84–1.95)). The rate of emergency room visits at 2 weeks for the intervention group was 11.4% compared to the standard of care group (15.2%) (OR = 0.69; 95% CI: 0.39–1.23). The intervention group was significantly more satisfied with the overall care they received for breastfeeding compared to the control group (OR = 1.96; 95% CI: 3.50–6.88)). Conclusion This new model of care did not significantly increase exclusive breastfeeding at 12 weeks. However, there were clinically meaningful improvements in the rate of postnatal problems and satisfaction that support this new service delivery model for postpartum care. A community-based multidisciplinary postpartum clinic is feasible to implement and can provide appropriate and highly satisfactory care to

  17. Postpartum uterine diseases and their impacts on conception and days open in dairy herds in Italy.

    PubMed

    Toni, F; Vincenti, L; Ricci, A; Schukken, Y H

    2015-10-15

    The objective of this study was to describe the incidence and the impact of postpartum uterine diseases in postpartum cows on future uterine status and reproductive performance in large Italian dairy herds. This study provides an important quantitative estimate of uterine and postpartum diseases incidence that afflict high-producing Italian dairy cows. The total number of cows included in the study was 1498 on three farms; all cows were followed from the dry period until 300 days postpartum. All farms used high-quality data collection systems and standard operating procedures: weekly herd health visits, monthly Dairy Herd Improvement Association visits, and, due to cheese-making milk quality requirements, a supplementary milk sample collected at 7 ± 3 days postpartum evaluated for milk components. Clinical metritis in primiparous cows did not change the time to the first artificial insemination (AI) or days open; conversely, clinical metritis in multiparous cows had impact on the time to first AI (hazard ratio: 0.66, P < 0.01) and resulted in a lower conception rate at first insemination and a increase in days open (odds ratio: 0.64, P < 0.05). Clinical endometritis had a strong deleterious effect on first AI conception rate (odds ratio: 0.34, P < 0.05) and days open across all lactations (hazard ratio: 0.68, P < 0.05). Persistent metritis, defined as the presence of both clinical metritis and clinical endometritis in the same animal in the same lactation, caused low conception rate both in the first-lactation and in older cows and had a strong negative effect on the proportion of pregnant cows at 300 days (P < 0.05). In conclusion, the impact of endometritis on fertility was true across lactation groups. A good management and precocious diagnosis of the pathologies is not resolutive to restore good fertility parameters, and understanding the immune response in first-lactation cows may be of value for developing alternative intervention protocols for older

  18. Postpartum osteoporosis and vertebral fractures in two patients treated with enoxaparin during pregnancy.

    PubMed

    Ozdemir, D; Tam, A A; Dirikoc, A; Ersoy, R; Cakir, B

    2015-01-01

    Postpartum osteoporosis (PPO) is a rare disease associated with pregnancy and lactation period. Here, we report severe PPO and multiple vertebral compression fractures in two patients treated with enoxaparin--low-molecular-weight heparin (LMWH)--throughout their pregnancy. A 34-year-old woman who has delivered her second baby 3 months ago presented with severe low-back pain. She was treated with enoxaparin 40 mg/day for 8 months during her pregnancy. Dual-energy X-ray absorptiometry (DEXA) showed low T- and Z-scores in lumbar (L) vertebras. In magnetic resonance imaging (MRI), severe height losses in thoracic (T) 12, L1, and L2 vertebras were detected. She was diagnosed to have severe PPO and multiple vertebral compression fractures and was prescribed risedronate 35 mg/week, calcium, and vitamin D. The other patient was a 36-year-old woman diagnosed with PPO and vertebral fractures at the third week postpartum. She was also treated with enoxaparin 60 mg/day during her pregnancy. Severe osteoporosis in L vertebras and height losses indicative for compression fractures in T5-8, T11-12, and L2-5 vertebras were detected by DEXA and MRI, respectively. She was treated with calcitonin 200 U/day, calcium, and vitamin D. These findings suggest that vertebral compression fractures and PPO may be one of the causes of severe back pain in postpartum patients. Treatment with LMWH during pregnancy might be considered as a new risk factor for this rare condition.

  19. Pertussis immunization in a high-risk postpartum population.

    PubMed

    Healy, C Mary; Rench, Marcia A; Castagnini, Luis A; Baker, Carol J

    2009-09-18

    We provided CDC recommended postpartum tetanus, diphtheria, acellular pertussis (Tdap) immunization to medically underserved, uninsured women in Houston through a standing order protocol. From January 7-April 30, 2008, 1129 of 1570 (72%) postpartum women (93% Hispanic; 11% < or = 19 years) received Tdap before hospital discharge. Tdap uptake was 96.2% in women without self-reported contraindications. Recall of immunization history was inaccurate in 32% of unimmunized women who reported receiving antepartum immunization. Black women refused Tdap more often than other ethnicities (24% versus 8%; P=0.003). Postpartum Tdap immunization was successfully implemented in a high-risk population through a standing order protocol. Barriers to postpartum immunization include inaccurate immunization history and the need for ongoing targeted education.

  20. Introducing the World Health Organization Postpartum Family Planning Compendium.

    PubMed

    Sonalkar, Sarita; Gaffield, Mary E

    2017-01-01

    The postpartum period offers multiple opportunities for healthcare providers to assist with family planning decision making. However, there are also many changing factors during the first year after delivery that can affect family planning choices. Given that several different documents have addressed WHO guidance on postpartum family planning, the electronic WHO Postpartum Family Planning Compendium (http://srhr.org/postpartumfp) has been introduced. This resource integrates essential guidance on postpartum family planning for clinicians, program managers, and policy makers. The development of the Compendium included consultations with family planning experts, key international stakeholders, and web developers. Once the website had been created, user testing by family planning experts allowed for improvements to be made before the official launch. Future directions are adaptation of the website into a mobile application that can be more easily integrated to low-resource settings, and translation of the content into French and Spanish.

  1. Gestational Diabetes a Risk Factor for Postpartum Depression

    MedlinePlus

    ... html Gestational Diabetes a Risk Factor for Postpartum Depression: Study It found chances increased even more if woman had suffered an earlier bout of depression To use the sharing features on this page, ...

  2. A content analysis of attributions for resuming smoking or maintaining abstinence in the post-partum period.

    PubMed

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

    2015-03-01

    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. 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. 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. 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.

  3. [[The duration of postpartum amenorrhea in a Sundanese village

    PubMed

    Takasaka, K

    1988-06-01

    "The duration of postpartum amenorrhea of women in a Sundanese agricultural village [in Indonesia] whose last pregnancy resulted in live birth in the past six years was studied. Data were collected from 197 women from September through November 1983....[The] results suggest that the duration of postpartum amenorrhea of women in a Sundanese agricultural village although relatively long, has recently become shorter." (SUMMARY IN ENG)

  4. Dispelling myths to support breastfeeding in women with postpartum depression.

    PubMed

    Olson, Tonia; Bowen, Angela

    2014-01-01

    Increasing attention is being paid to the possible connection between infant feeding practices and postpartum depression. Nurses caring for women and their families in the postpartum period might wonder how to best support the breastfeeding relationship if a woman has a history of depression. Using evidence from the scientific literature, this article dispels some myths regarding breastfeeding and depression, and provides suggested dialogue nurses can use when counseling women about depression and breastfeeding.

  5. [Anemia and its treatment with peroral anti-anemia agents in women during the postpartum period].

    PubMed

    Mára, M; Eretová, V; Zivný, J; Kvasnicka, J; Umlaufová, A; Márová, E

    1999-06-01

    proved that laboratory and clinical indicators of post-partum anaemia reached more quickly normal values in women treated with iron preparations. The authors did not detect a single and supreme marker of sideropenic anaemia in the early post-partum period. This is one of the reasons why the authors recommend iron administration to all women after spontaneous delivery. In the authors' opinion examination of the blood count on the fourth day and assessment of the serum ferritin concentration one month after a spontaneous delivery in selected mothers (e.g. after an above average peripartal blood loss) is desirable. Addition of folic acid to iron is of no special value during the post-partum period. Iron substitution in women after spontaneous delivery should be, with regard to the long persisting sideropenia, administered at least for three months. The dose of 80 mg elemental iron per day is sufficient for mild or medium post-partum anaemia. Addition of mucoprotease and ascorbic acid to iron preparations is useful because it increases the compliance of the patients and thus also its effectiveness. The preparation Tardyferon meets the above criteria and is therefore a good choice for the treatment of post-partum anaemia.

  6. Mothers who are securely attached in pregnancy show more attuned infant mirroring 7 months postpartum

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study contrasted two forms of mother–infant mirroring: the mother's imitation of the infant's facial, gestural, or vocal behavior (i.e., "direct mirroring") and the mother's ostensive verbalization of the infant's internal state, marked as distinct from the infant's own experience (i.e., "inten...

  7. Examination of a telephone-based exercise intervention for the prevention of postpartum depression: design, methodology, and baseline data from The Healthy Mom study.

    PubMed

    Lewis, Beth A; Gjerdingen, Dwenda K; Avery, Melissa D; Guo, Hongfei; Sirard, John R; Bonikowske, Amanda R; Marcus, Bess H

    2012-11-01

    Research indicates that exercise is an efficacious intervention for depression among adults; however, little is known regarding its efficacy for preventing postpartum depression. The Healthy Mom study was a randomized controlled trial examining the efficacy of an exercise intervention for the prevention of postpartum depression. Specifically, postpartum women with a history of depression or a maternal family history of depression (n=130) were randomly assigned to a telephone-based exercise intervention or a wellness/support contact control condition each lasting six months. The exercise intervention was designed to motivate postpartum women to exercise based on Social Cognitive Theory and the Transtheoretical Model. The primary dependent variable was depression based on the Structured Clinical Diagnostic Interview (SCID). Secondary dependent variables included scores on the Edinburgh Postnatal Depression Scale, the PHQ-9, and the Perceived Stress Scale. The purpose of this paper is to describe the study design, methodology, and baseline data for this trial. Upon completion of the trial, the results will yield important information about the efficacy of exercise in preventing postpartum depression.

  8. Maternal depression from pregnancy to 4 years postpartum and emotional/behavioural difficulties in children: results from a prospective pregnancy cohort study.

    PubMed

    Woolhouse, Hannah; Gartland, Deirdre; Mensah, Fiona; Giallo, Rebecca; Brown, Stephanie

    2016-02-01

    Considerable attention has been focused on women's mental health in the perinatal period and the subsequent impacts on children. Comparatively, we know much less about maternal depression at later time points and the potential implications for child mental health. The objective of this paper was to explore the association between maternal depression and child emotional/behavioural difficulties at 4 years postpartum, taking into account earlier episodes of perinatal depression. The Maternal Health Study is a prospective cohort study of 1,507 nulliparous women. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy and at 3, 6 and 12 months postpartum and again at 4 years postpartum. Maternal depressive symptoms at 4 years postpartum were associated with significantly increased odds of child emotional/behavioural difficulties (odds ratio (OR) = 3.46, 95 % confidence interval (CI) = 2.21-5.43). This remained significant after adjusting for earlier episodes of perinatal depression and socio-demographic characteristics (OR = 2.07, 95 % CI = 1.18-3.63). We also observed a robust association between child difficulties at age 4 and measures of socio-economic disadvantage. Our findings suggest a pressing need to rethink current paradigms of maternal health surveillance and extend mental health surveillance and support to at least 4 years postpartum.

  9. Postpartum Sexual Functioning and Its Predicting Factors among Iranian Women

    PubMed Central

    Rezaei, Nazanin; Azadi, Arman; Sayehmiri, Kourosh; Valizadeh, Reza

    2017-01-01

    Background Many women experience sexual dysfunction following childbirth but this has not been well investigated in Iran. The aim of this study was to evaluate women’s sexual function in the postpartum period in Iran. It also sought to determine predicting factors associated with their sexual function. Methods This was a cross-sectional study among 380 postpartum women attending 10 urban health centers in Ilam province in southwestern Iran. Participants were selected using random cluster sampling. Data was collected using the female sexual function index (FSFI) and a checklist of socio-demographic and maternal status for each of the women. Sexual dysfunction was classified according to an FSFI score of ≤ 28. Data were analysed using SPSS version 22. Results The majority of participants (76.3%) had sexual dysfunction. Primiparity (adjusted odds ratio (aOR): 1.78 (95% Confidence Interval (CI): 1.11, 2.94); P = 0.006) and exclusive breastfeeding (aOR: 2.47 (95% CI: 1.21, 5.03); P = 0.012) were associated with increased odds of experiencing sexual dysfunction in the postpartum period. Other factors such as age, type of delivery, education, time since delivery and family income did not predict women’s postpartum sexual function. Conclusion This study confirmed findings of previous studies on factors that may have an adverse effect on new mothers’ sexual function in the postpartum period. However the effect of type of delivery on postpartum sexual function remains unclear. PMID:28381932

  10. Bipolar II postpartum depression: Detection, diagnosis, and treatment.

    PubMed

    Sharma, Verinder; Burt, Vivien K; Ritchie, Hendrica L

    2009-11-01

    Research on postpartum mood disorders has focused primarily on major depressive disorder, bipolar I disorder, and puerperal psychosis and has largely ignored or neglected bipolar II disorder. Hypomanic symptoms are common after delivery but frequently unrecognized. DSM-IV does not consider early postpartum hypomania as a significant diagnostic feature. Although postpartum hypomania may not cause marked impairment in social or occupational functioning, it is often associated with subsequent, often disabling depression. Preliminary evidence suggests that bipolar II depression arising in the postpartum period is often misdiagnosed as unipolar major depressive disorder. The consequences of the misdiagnosis can be particularly serious because of delayed initiation of appropriate treatment and the inappropriate prescription of antidepressants. Moreover, no pharmacological or psychotherapeutic studies of bipolar postpartum depression are available to guide clinical decision making. Also lacking are screening instruments designed specifically for use before or after delivery in women with suspected bipolar depression. It is recommended that the treatment of postpartum bipolar depression follow the same guidelines as the treatment of nonpuerperal bipolar II depression, using medications that are compatible with lactation.

  11. Creating New Strategies to Enhance Postpartum Health and Wellness.

    PubMed

    Cornell, Andria; McCoy, Carolyn; Stampfel, Caroline; Bonzon, Erin; Verbiest, Sarah

    2016-11-01

    Over the past 5 years there have been a number of new initiatives focused on improving birth outcomes and reducing infant mortality, including a renewed focus on the complex interactions between motherhood and infancy that influence lifelong health trajectories. Beginning in 2012, the Association of Maternal & Child Health Programs (AMCHP) facilitated a series of meetings to enhance coordination across initiatives. Emerging from these conversations was a shared desire across stakeholders to reimagine the postpartum visit and improve postpartum care and wellness. AMCHP convened a Postpartum Think-Tank Meeting in 2014 to map the system of postpartum care and identify levers for its transformation. The meeting findings are presented in an infographic which frames the challenges and proposed solutions from the woman's perspective. The infographic describes maternal issues and concerns along with a concise summary of the recommended solutions. Strategies include creating integrated services and seamless care transitions from preconception through postpartum and well-baby; business, community, and government support, including paid parental leave, health insurance and spaces for new parents to meet each other; and mother-centered care, including quality visits on her schedule with complete and culturally appropriate information. These solutions catalyze a postpartum system of care that supports women, children, and families by infusing new ideas and capitalizing on existing opportunities and resources.

  12. Night Waking in 6-Month-Old Infants and Maternal Depressive Symptoms

    ERIC Educational Resources Information Center

    Karraker, Katherine Hildebrandt; Young, Marion

    2007-01-01

    Relations between night waking in infants and depressive symptoms in their mothers at 6 months postpartum were examined using the data from the National Institute for Child Health and Human Development Study of Early Child Care. Although more depressive symptoms were only weakly correlated with a higher frequency of infant waking, longer wake…

  13. 43 CFR 9269.3-4 - Range management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Range management. 9269.3-4 Section 9269.3-4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... Range management. (a) Grazing administration—exclusive of Alaska—(1) Unlawful enclosures or...

  14. 43 CFR 9269.3-4 - Range management.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Range management. 9269.3-4 Section 9269.3-4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... Range management. (a) Grazing administration—exclusive of Alaska—(1) Unlawful enclosures or...

  15. 43 CFR 9269.3-4 - Range management.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Range management. 9269.3-4 Section 9269.3-4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... Range management. (a) Grazing administration—exclusive of Alaska—(1) Unlawful enclosures or...

  16. 43 CFR 9269.3-4 - Range management.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Range management. 9269.3-4 Section 9269.3-4 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... Range management. (a) Grazing administration—exclusive of Alaska—(1) Unlawful enclosures or...

  17. 21 CFR 3.4 - Designated agency component.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Designated agency component. 3.4 Section 3.4 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PRODUCT.... Where the primary mode of action is that of: (1) A drug (other than a biological product), the...

  18. 21 CFR 3.4 - Designated agency component.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Designated agency component. 3.4 Section 3.4 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PRODUCT.... Where the primary mode of action is that of: (1) A drug (other than a biological product), the...

  19. 43 CFR 3162.3-4 - Well abandonment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Well abandonment. 3162.3-4 Section 3162.3... Operating Rights Owners and Operators § 3162.3-4 Well abandonment. (a) The operator shall promptly plug and... newly completed or recompleted well in which oil or gas is not encountered in paying quantities or...

  20. 43 CFR 3162.3-4 - Well abandonment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Well abandonment. 3162.3-4 Section 3162.3... Operating Rights Owners and Operators § 3162.3-4 Well abandonment. (a) The operator shall promptly plug and... newly completed or recompleted well in which oil or gas is not encountered in paying quantities or...

  1. 43 CFR 3162.3-4 - Well abandonment.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Well abandonment. 3162.3-4 Section 3162.3... Operating Rights Owners and Operators § 3162.3-4 Well abandonment. (a) The operator shall promptly plug and... newly completed or recompleted well in which oil or gas is not encountered in paying quantities or...

  2. 43 CFR 3162.3-4 - Well abandonment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Well abandonment. 3162.3-4 Section 3162.3... Operating Rights Owners and Operators § 3162.3-4 Well abandonment. (a) The operator shall promptly plug and... newly completed or recompleted well in which oil or gas is not encountered in paying quantities or...

  3. Serum 25-Hydroxyvitamin D and Parathyroid Hormone Levels in Non-Lactating Women with Post-Partum Thyroiditis: The Effect of L-Thyroxine Treatment.

    PubMed

    Krysiak, Robert; Kowalska, Beata; Okopien, Bogusław

    2015-06-01

    Vitamin D deficiency seems to be implicated in the onset and progression of some autoimmune disorders. No previous study has investigated vitamin D homeostasis in post-partum thyroiditis. We compared 25-hydroxyvitamin D and parathyroid hormone (PTH) levels between four groups of non-lactating women who gave birth within 12 months before the beginning of the study: hypothyroid women with post-partum thyroiditis (group A; n = 14), euthyroid females with post-partum thyroiditis (group B; n = 14), women with non-autoimmune hypothyroidism (group C; n = 16) and healthy euthyroid females without thyroid autoimmunity (group D; n = 15). In the second part of the study, groups A and C were treated for 6 months with L-thyroxine. Serum levels of 25-hydroxyvitamin D were lower, while PTH higher in patients with post-partum thyroiditis than in patients without thyroid autoimmunity. They were also lower (25-hydroxyvitamin D) or higher (PTH) in group A than in group B, as well as in group C in comparison with group D. L-thyroxine treatment increased 25-hydroxyvitamin D and reduced PTH levels only in hypothyroid women with post-partum thyroiditis. Baseline levels of 25-hydroxyvitamin D correlated with thyroid antibody titres, thyroid function and circulating PTH levels, while the effect of L-thyroxine on serum levels of this vitamin correlated with the changes in thyroid antibody titres and PTH levels. The results of our study suggest the association of vitamin D status with post-partum thyroiditis and L-thyroxine treatment of this disorder.

  4. Randomized controlled trial to prevent postpartum depression in mothers on public assistance

    PubMed Central

    Zlotnick, Caron; Tzilos, Golfo; Miller, Ivan; Seifer, Ronald; Stout, Robert

    2015-01-01

    Introduction Postpartum depression (PPD) is a significant and common public health problem for women. Aims To examine the efficacy of an intervention based on the principles of interpersonal therapy (IPT) in reducing the risk of PPD in pregnant women. Methods Randomized controlled trial of 205 pregnant women who were 18 years old or older, on public assistance, and at risk for PPD. Participants (mean age=23; 38% Hispanic and 23% Black) were randomized to either the IPT group intervention (n=104) or the treatment as usual control (TAU) program (n=101). Results At 6 months, the overall depression rate in the intervention group (16%) was lower than the control group (31%) and the effect of the intervention was statistically significant at p<0.05. Limitations It is unknown if findings will generalize to a more heterogeneous sample of women than the current study, such as women from a range of socio-economic and cultural backgrounds, or marital status. There was a differential amount of contact between TAU and intervention conditions. Conclusions An IPT based intervention during the prenatal period has the potential to reduce cases of PPD within 6 months postpartum in at risk mothers on public assistance. PMID:26454186

  5. Content Analysis of Motivational Counseling Calls Targeting Obesity-Related Behaviors Among Postpartum Women

    PubMed Central

    McDonald, Julia; Oken, Emily; Haines, Jess; Gillman, Matthew W.; Taveras, Elsie M.

    2011-01-01

    Our objective was to examine mothers’ perspectives of obesity-related health behavior recommendations for themselves and their 0–6 month old infants. A health educator conducted 4 motivational counseling calls with 60 mothers of infants during the first 6 months postpartum. Calls addressed 5 behaviors for infants (breastfeeding, introduction of solid foods, sleep, TV, hunger cues), and 4 for mothers (eating, physical activity, sleep, TV). We recorded detailed notes from each call, capturing responsiveness to recommendations and barriers to change. Two independent coders analyzed the notes to identify themes. Mothers in our study were more interested in focusing on their infants’ health behaviors than on their own. While most were receptive to eliminating their infants’ TV exposure, they resisted limiting TV for themselves. There was some resistance to following infant feeding guidelines, and contrary to advice to avoid nursing or rocking babies to sleep, mothers commonly relied on these techniques. Return to work emerged as a barrier to breastfeeding, yet facilitated healthier eating, increased activity, and reduced TV time for mothers. The early postpartum period is a challenging time for mothers to focus on their own health behaviors, but returning to work appears to offer an opportunity for positive changes in this regard. To improve weight-related infant behaviors, interventions should consider mothers’ perceptions of nutrition and physical activity recommendations and barriers to adherence. PMID:21258960

  6. Body temperature in early postpartum dairy cows.

    PubMed

    Burfeind, O; Suthar, V S; Voigtsberger, R; Bonk, S; Heuwieser, W

    2014-07-01

    A strategy widely adopted in the modern dairy industry is the introduction of postpartum health monitoring programs by trained farm personnel. Within these fresh cow protocols, various parameters (e.g., rectal temperature, attitude, milk production, uterine discharge, ketones) are evaluated during the first 5 to 14 days in milk (DIMs) to diagnose relevant diseases. It is well documented that 14% to 66% of healthy cows exhibit at least one temperature of 39.5 °C or greater within the first 10 DIM. Although widely adopted, data on diagnostic performance of body temperature (BT) measurement to diagnose infectious diseases (e.g., metritis, mastitis) are lacking. Therefore, the objective of this study was to identify possible factors associated with BT in postpartum dairy cows. A study was conducted on a commercial dairy farm including 251 cows. In a total of 217 cows, a vaginal temperature logger was inserted from DIM 2 to 10, whereas 34 cows did not receive a temperature logger as control. Temperature loggers measured vaginal temperature every 10 minutes. Rectal temperature was measured twice daily in all cows. On DIM 2, 5, and 10, cows underwent a clinical examination. Body temperature was influenced by various parameters. Primiparous cows had 0.2 °C higher BT than multiparous cows. Multiparous cows that calved during June and July had higher BT than those that calved in May. In primiparous cows, this effect was only evident from DIM 7 to 10. Furthermore, abnormal calving conditions (i.e., assisted calving, dead calf, retained placenta, twins) affected BT in cows. This effect was more pronounced in multiparous cows. Abnormal vaginal discharge did increase BT in primiparous and multiparous cows. Primiparous cows suffering from hyperketonemia (beta-hydroxybutyrat ≥ 1.4 mmol/L) had higher BT than those not affected. In multiparous cows, there was no association between hyperketonemia and BT. The results of this study clearly demonstrate that BT is influenced

  7. Husband's Alcohol Use, Intimate Partner Violence, and Family Maltreatment of Low-Income Postpartum Women in Mumbai, India.

    PubMed

    Wagman, Jennifer A; Donta, Balaiah; Ritter, Julie; Naik, D D; Nair, Saritha; Saggurti, Niranjan; Raj, Anita; Silverman, Jay G

    2016-01-21

    Husbands' alcohol use has been associated with family-level stress and intimate partner violence (IPV) against women in India. Joint family systems are common in India and IPV often co-occurs with non-violent family maltreatment of wives (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care). Alcohol use increases for some parents following the birth of a child. This study examined 1,038 postpartum women's reports of their husbands' alcohol use and their own experiences of IPV (by husband) and non-violent maltreatment from husbands and/or in-laws. We analyzed cross-sectional, quantitative data collected in 2008, from women (ages 15-35) seeking immunizations for their infants <6 months at three large urban health centers in Mumbai, India. Crude and adjusted logistic regression models estimated associations between the independent variable (husbands' past month use of alcohol) and two dependent variables (postpartum IPV and maltreatment). Overall, 15% of husbands used alcohol, ranging from daily drinkers (10%) to those who drank one to two times per week (54%). Prevalence of postpartum IPV and family maltreatment was 18% and 42%, respectively. Prevalence of IPV among women married to alcohol users was 27%. Most abused women's husbands always (27%) or sometimes (37%) drank during violent episodes. Risk for IPV increased with a man's increasing frequency of consumption. Women who lived with a husband who drank alcohol, relative to non-drinkers, were more likely to report postpartum IPV, aOR = 2.0, 95% confidence interval (CI) = [1.3, 3.1]. Husbands' drinking was marginally associated with increased risk for family maltreatment, aOR = 1.4, 95% CI = [1.0, 2.1]. Our findings suggest that men's alcohol use is an important risk factor for postpartum IPV and maltreatment. Targeted services for Indian women contending with these issues are implicated. Postpartum care offers an ideal opportunity to screen for IPV, household maltreatment, and

  8. Childhood sexual abuse and posttraumatic stress disorder among pregnant and postpartum women: Review of the literature

    PubMed Central

    Wosu, Adaeze C.; Gelaye, Bizu; Williams, Michelle A.

    2014-01-01

    Purpose The aims of this review are i) to summarize and evaluate current knowledge on the association between childhood sexual abuse (CSA) and posttraumatic stress disorder (PTSD) in pregnant and postpartum women, ii) to provide suggestions for future research on this topic, and iii) to highlight some clinical implications. Methods Relevant publications were identified through literature searches of four databases (PubMed, CINAHL, PsycINFO, and PsycARTICLES) using keywords such as “child abuse,” “posttraumatic stress,” “pregnancy” and “postpartum”. Results Five studies were included in this review. Findings across all studies were consistent with higher prevalence of PTSD diagnosis or symptomatology among women with history of CSA. However, only findings from two studies were statistically significant. One study observed higher overall PTSD scores in women with CSA history compared to women with non-CSA trauma history or no trauma history during pregnancy (mean±SD 1.47 (0.51) vs. 1.33 (0.41) vs. 1.22 (0.29), p<0.001), at 2 months postpartum (mean±SD 1.43 (0.49) vs. 1.26 (0.38) vs. 1.19 (0.35), p<0.001), and at 6 months postpartum (mean±SD 1.36 (1.43) vs. 1.20 (0.33) vs. 1.14 (0.27), p<0.001). Another study observed that the prevalence of PTSD during pregnancy was 4.1 % in women with no history of physical or sexual abuse, 11.4 % in women with adult physical or sexual abuse history, 16.0 % in women with childhood physical or sexual abuse history, and 39.0 % in women exposed to both childhood and adult physical or sexual abuse (p<0.001); in a subsequent analysis, the investigators reported that pregnant women with PTSD had over 5-fold odds of having a history of childhood completed rape compared to counterparts without PTSD (OR = 5.3, 95 % CI 3.2, 8.7). Conclusions Overall, available evidence suggests positive associations of CSA with clinical PTSD or PTSD symptomatology among pregnant and postpartum women. PMID:25380784

  9. Prevalence of use study for amphetamine (AMP), methamphetamine (MAMP), 3,4-methylenedioxy-amphetamine (MDA), 3,4-methylenedioxy-methamphetamine (MDMA), and 3,4-methylenedioxy-ethylamphetamine (MDEA) in military entrance processing stations (MEPS) specimens.

    PubMed

    Klette, Kevin L; Kettle, Aaron R; Jamerson, Matthew H

    2006-06-01

    The Roche Abuscreen Onlinetrade mark Amphetamine immunoassay (IA), modified to include sodium periodate, and the Microgenics DRI Ecstasy IA were used to determine the prevalence of amphetamine (AMP), methamphetamine (MAMP), 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxymethamphetamine (MDMA), and 3,4-methylenedioxyethylamphetamine (MDEA) in urine specimens from applicants seeking to join the United States Armed Forces. Over a 4-month period, a total of 85,658 specimens were IA screened using the Department of Defense 500 ng/mL administrative cutoff level for AMP and MDMA. All presumptively positive specimens were confirmed using a solid-phase extraction procedure coupled with simultaneous analysis of AMP, MAMP, MDA, MDMA, and MDEA by fast gas chromatography-mass spectrometry using the same cutoff levels as the IA. The Roche Online Amphetamine IA identified 216 specimens as presumptively positive; of these, 70 specimens confirmed positive for AMP and 87 specimens confirmed positive for AMP and/or MAMP, resulting in a confirmation rate of 73%. The Microgenics DRI Ecstasy IA identified eight specimens as presumptively positive; of these, five specimens confirmed positive for MDMA and/or MDA, resulting in a confirmation rate of 63%. The total use prevalence for AMP, MAMP, MDA, MDMA, and/or MDEA in military entrance processing stations specimens over the testing period was determined to be 0.19%.

  10. Synthesis and pharmacological properties of benzothiazole, 1,3-4-oxadiazole and 1,3,4-thiadiazole derivatives.

    PubMed

    Santagati, M; Modica, M; Santagati, A; Russo, F; Caruso, A; Cutuli, V; Di Pietro, E; Amico-Roxas, M

    1994-12-01

    The reaction of the 2-amino-substituted 1,3,4-oxadiazoles 9, 10 and the benzothiazoles 11, 12 with ethyl cyanoacetate is described. The obtained cyanoacetamide derivatives 13-16 gave the benzylidene derivatives 18-21 by condensation with benzaldehyde. 2-Phenyl-5-amino-1,3,4-oxadiazolo[3,2-a]pyrimidin-7-one (17) was also obtained. Moreover, the preparation of 6,7,8,9-tetraydro-5H-1,3,4-thiadiazolo[2,3-b]quinazolin++ +-5-thio-derivatives 22-25 and N-(1,3,4-thiadiazol-2-yl-5-substituted)-3,4-5,6-tetrahydro-anthran ilic acids 26-29 is also described. All above compounds and compounds, related to them, 1-8 were tested for their analgesic and antiinflammatory activities and the pharmacological screening results are reported and discussed.

  11. A case of taeniasis diagnosed postpartum.

    PubMed

    Noss, Matthew R; Gilmore, Katherine; Wittich, Arthur C

    2013-04-01

    A case of postpartum taeniasis will be discussed along with the pathophysiology, proper treatment, potential risks, and prevention of taeniasis infections to the pregnant mother, her infant, and her family members. Taenia spp. infections are relatively rare in developed societies. Increasing immigration to developed countries and an expanding role of medical aid in developing countries will lead to an increase in the number of taeniasis cases seen by medical providers. Taenia solium and T. saginata are the most common species and can be differentiated by proglottids (a segment of a tapeworm containing both male and female reproductive organs) or scolex (the head of a tapeworm which attaches to the intestine of the definitive host). Both carry different risks when considering autoinfection and transmission. Cystercercosis caused by T. solium is a risk for neonates and is cause for immediate treatment of the mother. A 23-year-old new mother, originally from Ethiopia, passed T. strobili shortly after giving birth. Her pregnancy was complicated by limited prenatal care. She did not experience any symptoms related to tapeworm infection. The patient received treatment with praziquantel. With a possible future increase in the number of cases seen by health care providers, understanding the risks of Taenia sp. infection is important as proper treatment and education are needed to halt the life cycle of the tapeworm before more serious infection ensues.

  12. Postpartum depression and culture: Pesado Corazon.

    PubMed

    Callister, Lynn Clark; Beckstrand, Renea L; Corbett, Cheryl

    2010-01-01

    The purpose of this article is to describe what the literature has shown about postpartum depression (PPD) in culturally diverse women. The majority of qualitative studies done with women identified as having PPD have been conducted with Western women, with the second largest group focusing on Chinese women. This article reviews the qualitative studies in the literature and discusses how the management of PPD in technocentric and ethnokinship cultures differs. Social support has been shown to be significantly related to fewer symptoms of PPD, and culturally prescribed practices may or may not be cultural mediators in decreasing the incidence of PPD. Nurses should be sensitive to the varied ways in which culturally diverse women perceive, explain, and report symptoms of PPD. Exemplary interventions for culturally diverse women suffering from PPD are examined in this article as well, although it is clear that additional research is needed to develop models for culturally competent interventions for PPD in culturally diverse women and to document the outcomes of such interventions.

  13. Nutrition and the psychoneuroimmunology of postpartum depression.

    PubMed

    Ellsworth-Bowers, E R; Corwin, E J

    2012-06-01

    Postpartum depression (PPD) is a relatively common and often severe mood disorder that develops in women after childbirth. The aetiology of PPD is unclear, although there is emerging evidence to suggest a psychoneuroimmune connection. Additionally, deficiencies in n-3 PUFA, B vitamins, vitamin D and trace minerals have been implicated. This paper reviews evidence for a link between micronutrient status and PPD, analysing the potential contribution of each micronutrient to psychoneuroimmunological mechanisms of PPD. Articles related to PPD and women's levels of n-3 PUFA, B vitamins, vitamin D and the trace minerals Zn and Se were reviewed. Findings suggest that while n-3 PUFA levels have been shown to vary inversely with PPD and link with psychoneuroimmunology, there is mixed evidence regarding the ability of n-3 PUFA to prevent or treat PPD. B vitamin status is not clearly linked to PPD, even though it seems to vary inversely with depression in non-perinatal populations and may have an impact on immunity. Vitamin D and the trace minerals Zn and Se are linked to PPD and psychoneuroimmunology by intriguing, but small, studies. Overall, evidence suggests that certain micronutrient deficiencies contribute to the development of PPD, possibly through psychoneuroimmunological mechanisms. Developing a better understanding of these mechanisms is important for guiding future research, clinical practice and health education regarding PPD.

  14. AM2 3-4 Alternate Lay Pattern Evaluation

    DTIC Science & Technology

    2014-09-01

    ER D C/ G SL T R- 14 -3 8 Airfield Damage Repair Modernization Program AM2 3-4 Alternate Lay Pattern Evaluation G eo te ch ni ca l a nd...Airfield Damage Repair Modernization Program ERDC/GSL TR-14-38 September 2014 AM2 3-4 Alternate Lay Pattern Evaluation Timothy W. Rushing, Lyan...brickwork pattern. Therefore, the 3-4 alternate lay pattern was designed to allow Marines to use any mats on hand to fill in designated portions of the

  15. Bis (4-(3,4-dimethylene-pyrrolidyl)-phenyl) methane

    NASA Technical Reports Server (NTRS)

    Ottenbrite, Raphael M. (Inventor)

    1990-01-01

    The primary objective is to prepare high temperature polymeric materials, especially linear aromatic polyimides, which maintain their integrity and toughness during long exposure times at elevated temperatures. The attained benefits are obtained by first providing the bis (exocyclodiene) bis (4-(3,4-dimethylene-pyrrolidyl)-phenyl) methane, which is a novel material formed from the monomer N-phenyl-3,4-dimethylene-pyrrolidine. This compound undergoes Diels-Alder reaction with a bismaleimide, without the evolution of gaseous by-products, to form the aromatic polyimide bis (4-(3,4-dimethylene-pyrrolidyl)-phenyl) methane.

  16. The Specific Role of Relationship Life Events in the Onset of Depression during Pregnancy and the Postpartum

    PubMed Central

    Wright, Nicola; Hill, Jonathan; Pickles, Andrew; Sharp, Helen

    2015-01-01

    Background The precipitating role of life events in the onset of depression is well-established. The present study sought to examine whether life events hypothesised to be personally salient would be more strongly associated with depression than other life events. In a sample of women making the first transition to parenthood, we hypothesised that negative events related to the partner relationship would be particularly salient and thus more strongly predictive of depression than other events. Methods A community-based sample of 316 first-time mothers stratified by psychosocial risk completed interviews at 32 weeks gestation and 29 weeks postpartum to assess dated occurrence of life events and depression onsets from conception to 29 weeks postpartum. Complete data was available from 273 (86.4%). Cox proportional hazards regression was used to examine risk for onset of depression in the 6 months following a relationship event versus other events, after accounting for past history of depression and other potential confounders. Results 52 women (19.0%) experienced an onset of depression between conception and 6 months postpartum. Both relationship events (Hazard Ratio = 2.1, p = .001) and other life events (Hazard Ratio = 1.3, p = .020) were associated with increased risk for depression onset; however, relationship events showed a significantly greater risk for depression than did other life events (p = .044). Conclusions The results are consistent with the hypothesis that personally salient events are more predictive of depression onset than other events. Further, they indicate the clinical significance of events related to the partner relationship during pregnancy and the postpartum. PMID:26645963

  17. WIC Mothers' Social Environment and Postpartum Health on Breastfeeding Initiation and Duration

    PubMed Central

    Darfour-Oduro, Sandra Asantewaa

    2014-01-01

    Abstract A low breastfeeding rate has been a consistent maternal and child health problem in the United States, especially for low-income families. Understanding mothers' social environment and overall well-being is important in determining how mothers will take care of themselves and their infants during the postnatal period in relation to the breastfeeding rate among low-income mothers. In this study, we examined the effects of the social environment of mothers enrolled in a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in eastern Illinois and their postpartum health on breastfeeding initiation (n=103) and maintaining breastfeeding for at least 3 months (n=73). Using logistic regression models, a significant positive association (adjusted odds ratio [AOR]=3.47; 95% confidence interval [CI], 1.15–10.47; p=0.03) between marital status and breastfeeding initiation and a significant negative association (AOR=0.23; 95% CI, 0.06–0.88) between receiving food stamps and breastfeeding initiation were found. WIC mothers who were married were 4.1 times as likely to maintain any breastfeeding for at least 3 months than single mothers, and the association was significant (AOR=4.08; 95% CI, 1.36–12.27; p=0.01). The breastfeeding initiation rate was 77.7%, however, the mean±standard deviation age of the child when breastfeeding stopped was 2.2±1.4 months. There was a nonsignificant association between postpartum depression and breastfeeding initiation and maintaining any breastfeeding for 3 months. This study has shown that the familial environment of mothers plays a very important role in improving breastfeeding rates among WIC mothers. In addition, there is a negative relationship between using a food assistance program and breastfeeding among low-income women. PMID:25188784

  18. Meeting Postpartum Women’s Family Planning Needs Through Integrated Family Planning and Immunization Services: Results of a Cluster-Randomized Controlled Trial in Rwanda

    PubMed Central

    Dulli, Lisa S; Eichleay, Marga; Rademacher, Kate; Sortijas, Steve; Nsengiyumva, Théophile

    2016-01-01

    ABSTRACT Objective The primary objective of this study was to test the effectiveness of integrating family planning service components into infant immunization services to increase modern contraceptive method use among postpartum women. Methods The study was a separate sample, parallel, cluster-randomized controlled trial. Fourteen randomly selected primary health facilities were equally allocated to intervention (integrated family planning and immunization services at the same time and location) and control groups (standard immunization services only). At baseline (May–June 2010), we interviewed postpartum women attending immunization services for their infant aged 6 to 12 months using a structured questionnaire. A separate sample of postpartum women was interviewed 16 months later after implementation of the experimental health service intervention. We used linear mixed regression models to test the study hypothesis that postpartum women attending immunization services for their infants aged 6–12 months in the intervention facilities will be more likely to use a modern contraceptive method than postpartum women attending immunization services for their infants aged 6–12 months in control group facilities. Results We interviewed and analyzed data for 825 women from the intervention group and 829 women from the control group. Results showed the intervention had a statistically significant, positive effect on modern contraceptive method use among intervention group participants compared with control group participants (regression coefficient, 0.15; 90% confidence interval [CI], 0.04 to 0.26). Although we conducted a 1-sided significance test, this effect was also significant at the 2-sided test with alpha = .05. Among those women who did not initiate a contraceptive method, awaiting the return of menses was the most common reason cited for non-use of a method. Women in both study groups overwhelmingly supported the concept of integrating family planning

  19. 17. BUILDING I, BAYS 3, 4 AND 5, VIEW NORTHWEST, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. BUILDING I, BAYS 3, 4 AND 5, VIEW NORTHWEST, SOUTHEAST ELEVATION - Public Service Railway Company, Newton Avenue Car Shops, Bounded by Tenth, Mount Ephraim, Border & Newton Avenue, Camden, Camden County, NJ

  20. Kv3.4 channel function and dysfunction in nociceptors

    PubMed Central

    Ritter, David M; Zemel, Benjamin M; Lepore, Angelo C; Covarrubias, Manuel

    2015-01-01

    Recently, we reported the isolation of the Kv3.4 current in dorsal root ganglion (DRG) neurons and described dysregulation of this current in a spinal cord injury (SCI) model of chronic pain. These studies strongly suggest that rat Kv3.4 channels are major regulators of excitability in DRG neurons from pups and adult females, where they help determine action potential (AP) repolarization and spiking properties. Here, we characterized the Kv3.4 current in rat DRG neurons from adult males and show that it transfers 40–70% of the total repolarizing charge during the AP across all ages and sexes. Following SCI, we also found remodeling of the repolarizing currents during the AP. In the light of these studies, homomeric Kv3.4 channels expressed in DRG nociceptors are emerging novel targets that may help develop new approaches to treat neuropathic pain. PMID:26039360

  1. Kv3.4 channel function and dysfunction in nociceptors.

    PubMed

    Ritter, David M; Zemel, Benjamin M; Lepore, Angelo C; Covarrubias, Manuel

    2015-01-01

    Recently, we reported the isolation of the Kv3.4 current in dorsal root ganglion (DRG) neurons and described dysregulation of this current in a spinal cord injury (SCI) model of chronic pain. These studies strongly suggest that rat Kv3.4 channels are major regulators of excitability in DRG neurons from pups and adult females, where they help determine action potential (AP) repolarization and spiking properties. Here, we characterized the Kv3.4 current in rat DRG neurons from adult males and show that it transfers 40-70% of the total repolarizing charge during the AP across all ages and sexes. Following SCI, we also found remodeling of the repolarizing currents during the AP. In the light of these studies, homomeric Kv3.4 channels expressed in DRG nociceptors are emerging novel targets that may help develop new approaches to treat neuropathic pain.

  2. 1. 3/4 VIEW, LOOKING NE. Philadelphia & Reading Railroad, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. 3/4 VIEW, LOOKING NE. - Philadelphia & Reading Railroad, Pedestrian Suspension Bridge, Foot of Sixth Street at Schuylkill River (formerly spanned Philadelphia & Reading main line at Reading Depot), Reading, Berks County, PA

  3. 34. DETAILS OF CAISSON FOR PIERS 2, 3, 4 AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    34. DETAILS OF CAISSON FOR PIERS 2, 3, 4 AND 5 TO BE BUILT ON SOIL OVERBURDEN - East Bloomsburg Bridge, Spanning Susquehanna River at Pennsylvania Route 487 (Legislative Route 283), Bloomsburg, Columbia County, PA

  4. 1,3,4-oxadiazole: a biologically active scaffold.

    PubMed

    Khalilullah, H; Ahsan, M J; Hedaitullah, Md; Khan, S; Ahmed, B

    2012-07-01

    There has been considerable interest in the development of novel compounds with anticonvulsant, antidepressant, analgesic, anti-inflammatory, antiallergic, antipsychotic, antimicrobial, antimycobecterial, antitumour, antiviral and antitubercular activities. 1,3,4-oxadiazoles constitute an important class of compounds for new drug development. Therefore, many researchers have synthesized these compounds as target structures and evaluated their biological activities. These observations led to the development of new 1,3,4-oxadiazole derivatives. This review article describes the various biological activities associated with 1,3,4-oxadiazole ring system and is useful in guiding the researchers across the world working on this moiety and consequently have been instrumental in the advancement of 1,3,4-oxadiazole chemistry.

  5. Prefrontal activity during response inhibition decreases over time in the postpartum period.

    PubMed

    Bannbers, Elin; Gingnell, Malin; Engman, Jonas; Morell, Arvid; Sylvén, Sara; Skalkidou, Alkistis; Kask, Kristiina; Bäckström, Torbjörn; Wikström, Johan; Poromaa, Inger Sundström

    2013-03-15

    The postpartum period is characterized by complex hormonal changes, but human imaging studies in the postpartum period have thus far predominantly focused on the neural correlates of maternal behavior or postpartum depression, whereas longitudinal studies on neural correlates of cognitive function across the postpartum period in healthy women are lacking. The aim of this study was to longitudinally examine response inhibition, as a measure of executive function, during the postpartum period and its neural correlates in healthy postpartum women and non-postpartum controls. Thirteen healthy postpartum women underwent event-related functional magnetic resonance imaging while performing a Go/NoGo task. The first assessment was made within 48 h of delivery, and the second at 4-7 weeks postpartum. In addition, 13 healthy women examined twice during the menstrual cycle were included as non-postpartum controls. In postpartum women region of interest analyses revealed task-related decreased activations in the right inferior frontal gyrus, right anterior cingulate, and bilateral precentral gyri at the late postpartum assessment. Generally, postpartum women displayed lower activity during response inhibition in the bilateral inferior frontal gyri and precentral gyri compared to non-postpartum controls. No differences in performance on the Go/NoGo task were found between time-points or between groups. In conclusion, this study has discovered that brain activity in prefrontal areas during a response inhibition task decreases throughout the course of the first postpartum weeks and is lower than in non-postpartum controls. Further studies on the normal adaptive brain activity changes that occur during the postpartum period are warranted.

  6. Factors affecting the incidence of postpartum oestrus, ovarian activity and reproductive performance in Thoroughbred mares bred at foal heat under Indian subtropical conditions.

    PubMed

    Sharma, Sumeet; Davies Morel, M C G; Dhaliwal, G S

    2010-07-01

    Decreased reproductive performance due to summer stress is a well known phenomenon in farm livestock. Whether this occurs in the mare and specifically how this might affect postpartum reproductive activity and performance, especially at Foal Heat (FH), is unknown. This study, therefore, aims to investigate this and the factors that might affect postpartum reproductive activity. Reproductive records of 228 Thoroughbred mares (694 mare years) bred in subtropical north-western India were retrospectively analysed. Overt oestrous activity occurred within 21 d postpartum in 92.94% (645/694) of mares. Significantly (p<0.001) more April foaling mares (97.37%, 185/190) expressed postpartum oestrous activity than those foaling in January (83.61%; 51/61) and February (88.49; 123/139). Similarly significantly (p<0.01) fewer multiparous mares failed to demonstrate oestrous activity than primiparous mares (6.12% vs.15.07%; 38/621 vs. 11/73, respectively). 190 of these 694 mares were additionally monitored to confirm ovulation; in these mares onset of FH (oestrus plus confirmed ovulation) occurred 8.42+/-0.17 d and first ovulation 13.64+/-0.20 d postpartum. Month, stud farm, year, and parity did not affect interval from parturition to FH onset or to first ovulation; or FH onset to ovulation. In FH bred mares Day 16 pregnancy rate and overall foaling rate were 53.76% (100/186) and 46.24% (86/186) respectively and were similar to those of mares bred later postpartum. FH pregnancy rates were not affected by stud, season, month, year, number of matings, or day of ovulation but were significantly (p<0.008) lowered by increasing mare age. Significantly (p<0.01) lower Day 16 pregnancy rates were observed in uterine treated mares compared to untreated mares (31.09% vs. 57.96%; 9/29 vs. 91/157, respectively), this difference was not evident during the rest of pregnancy. In conclusion, postpartum reproductive and ovarian activity appears to be affected by environment, i.e., delayed in

  7. Madres para la Salud: Design of a Theory-based Intervention for Postpartum Latinas

    PubMed Central

    Keller, Colleen; Records, Kathie; Ainsworth, Barbara; Belyea, Michael; Permana, Paska; Coonrod, Dean; Vega-López, Sonia; Nagle-Williams, Allison

    2011-01-01

    Background Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained. Objectives This report describes the theoretical rationale, design considerations, and cultural relevance for “Madres para la Salud” [Mothers for Health]. Design and Methods Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using “bouts” of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas. Summary The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas. PMID:21238614

  8. Spatiotemporal control of endocytosis by phosphatidylinositol-3,4-bisphosphate.

    PubMed

    Posor, York; Eichhorn-Gruenig, Marielle; Puchkov, Dmytro; Schöneberg, Johannes; Ullrich, Alexander; Lampe, André; Müller, Rainer; Zarbakhsh, Sirus; Gulluni, Federico; Hirsch, Emilio; Krauss, Michael; Schultz, Carsten; Schmoranzer, Jan; Noé, Frank; Haucke, Volker

    2013-07-11

    Phosphoinositides serve crucial roles in cell physiology, ranging from cell signalling to membrane traffic. Among the seven eukaryotic phosphoinositides the best studied species is phosphatidylinositol-4,5-bisphosphate (PI(4,5)P2), which is concentrated at the plasma membrane where, among other functions, it is required for the nucleation of endocytic clathrin-coated pits. No phosphatidylinositol other than PI(4,5)P2 has been implicated in clathrin-mediated endocytosis, whereas the subsequent endosomal stages of the endocytic pathway are dominated by phosphatidylinositol-3-phosphates(PI(3)P). How phosphatidylinositol conversion from PI(4,5)P2-positive endocytic intermediates to PI(3)P-containing endosomes is achieved is unclear. Here we show that formation of phosphatidylinositol-3,4-bisphosphate (PI(3,4)P2) by class II phosphatidylinositol-3-kinase C2α (PI(3)K C2α) spatiotemporally controls clathrin-mediated endocytosis. Depletion of PI(3,4)P2 or PI(3)K C2α impairs the maturation of late-stage clathrin-coated pits before fission. Timed formation of PI(3,4)P2 by PI(3)K C2α is required for selective enrichment of the BAR domain protein SNX9 at late-stage endocytic intermediates. These findings provide a mechanistic framework for the role of PI(3,4)P2 in endocytosis and unravel a novel discrete function of PI(3,4)P2 in a central cell physiological process.

  9. Family history, not lack of medication use, is associated with the development of postpartum depression in a high-risk sample.

    PubMed

    Kimmel, Mary; Hess, Edward; Roy, Patricia S; Palmer, Jennifer Teitelbaum; Meltzer-Brody, Samantha; Meuchel, Jennifer M; Bost-Baxter, Emily; Payne, Jennifer L

    2015-02-01

    We sought to determine clinical predictors of postpartum depression (PPD), including the role of medication, in a sample of women followed prospectively during and after pregnancy. Women with a history of mood disorder were recruited and evaluated during each trimester and 1 week, 1 month, and 3 months postpartum. DSM-IV criteria for a major depressive episode were assessed by a psychiatric interview at each time point. Sixty-three women with major depression and 30 women with bipolar disorder entered the study and 75.4 % met DSM-IV criteria for a MDE during pregnancy, postpartum, or both. We modeled depression in a given time period (second trimester, third trimester, or 1 month postpartum) as a function of medication use during the preceding period (first, second, or third trimester). The odds of being depressed for those who did not use medication in the previous period was approximately 2.8 times that of those who used medication (OR 2.79, 95 % CI 1.38-5.66, p = 0.0048). Of 38 subjects who were psychiatrically well during the third trimester, 39.5 % (N = 15) met the criteria for a MDE by 4 weeks postpartum. In women who developed PPD, there was a high rate of a family history of PPD (53.3 %) compared to women who did not develop PPD (11.8 %, p = 0.02). While the use of psychiatric medications during pregnancy reduced the odds of being depressed overall, the use of psychiatric medications during pregnancy may not protect against PPD in women at high risk, particularly those with a family history of PPD.

  10. Probable postpartum hypomania and depression in a South African cohort.

    PubMed

    Pingo, Janine; van den Heuvel, Leigh L; Vythylingum, Bavinisha; Seedat, Soraya

    2017-04-04

    The aim of this study was to evaluate the frequency of, and factors associated with, postpartum hypomania (PPH) and postpartum depression (PPD) in a South African sample. Data from 57 women were analysed as part of a larger prospective study of maternal stress in pregnancy. On day 3 postpartum, women were assessed for probable PPH using the Highs scale. On day 3 and at week 6, probable PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS), while social support was evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS). PPH was present in 49.1% of the participants at day 3 postpartum whilst PPD was present in 33.3% of participants on day 3 postpartum and in 45.6% at week 6. Participants meeting the clinical cut-off for both PPH and PPD on day 3 (17.5%) had significantly higher depression scores at week 6 than those with only PPH (p = 0.010) or only PPD (p = 0.035) on day 3. Depression scores on day 3 and lower social support scores at week 6 were predictive of PPD at week 6. Consistent with findings in other settings, early-onset PPD and poor social support were predictive of persisting PPD (i.e. at week 6). Women meeting criteria for both PPH and PPD on day 3 had greater depressive symptomatology at week 6. This may be indicative of an underlying bipolar disorder and warrants further investigation.

  11. PREPP: postpartum depression prevention through the mother-infant dyad.

    PubMed

    Werner, Elizabeth A; Gustafsson, Hanna C; Lee, Seonjoo; Feng, Tianshu; Jiang, Nan; Desai, Preeya; Monk, Catherine

    2016-04-01

    Most interventions to prevent postpartum depression (PPD) focus on the mother rather than the mother-infant dyad. As strong relationships between infant sleep and cry behavior and maternal postpartum mood have been demonstrated by previous research, interventions targeted at the dyad may reduce symptoms of PPD. The goal of the current study was to examine the effectiveness of Practical Resources for Effective Postpartum Parenting (PREPP). PREPP is a new PPD prevention protocol that aims to treat women at risk for PPD by promoting maternally mediated behavioral changes in their infants, while also including mother-focused skills. Results of this randomized control trial (RCT) (n = 54) indicate that this novel, brief intervention was well tolerated and effective in reducing maternal symptoms of anxiety and depression, particularly at 6 weeks postpartum. Additionally, this study found that infants of mothers enrolled in PREPP had fewer bouts of fussing and crying at 6 weeks postpartum than those infants whose mothers were in the Enhanced TAU group. These preliminary results indicate that PREPP has the potential to reduce the incidence of PPD in women at risk and to directly impact the developing mother-child relationship, the mother's view of her child, and child outcomes.

  12. Etiology and management of postpartum hypertension-preeclampsia.

    PubMed

    Sibai, Baha M

    2012-06-01

    Postpartum hypertension can be related to persistence of gestational hypertension, preeclampsia, or preexisting chronic hypertension, or it could develop de novo postpartum secondary to other causes. There are limited data describing the etiology, differential diagnosis, and management of postpartum hypertension-preeclampsia. The differential diagnosis is extensive, and varies from benign (mild gestational or essential hypertension) to life-threatening such as severe preeclampsia-eclampsia, pheochromocytoma, and cerebrovascular accidents. Therefore, medical providers caring for postpartum women should be educated about continued monitoring of signs and symptoms and prompt management of these women in a timely fashion. Evaluation and management should be performed in a stepwise fashion and may require a multidisciplinary approach that considers predelivery risk factors, time of onset, associated signs/symptoms, and results of selective laboratory and imaging findings. The objective of this review is to increase awareness and to provide a stepwise approach toward the diagnosis and management of women with persistent and/or new-onset hypertension-preeclampsia postpartum period.

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

    PubMed Central

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

    2003-01-01

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

  14. Impact of childhood trauma on postpartum depression: a prospective study.

    PubMed

    De Venter, Maud; Smets, Jorien; Raes, Filip; Wouters, Kristien; Franck, Erik; Hanssens, Myriam; Jacquemyn, Yves; Sabbe, Bernard G C; Van Den Eede, Filip

    2016-04-01

    Studies on the impact of childhood trauma on postpartum depression show inconsistencies and methodological limitations. The present study examines the effect of childhood trauma on depression 12 and 24 weeks after childbirth, while controlling for history of depression, depression symptoms during pregnancy and type D personality. During the third trimester of pregnancy, 210 women completed self-report questionnaires assessing depression (current and/or past episodes), childhood trauma and type D personality, of whom 187 participated in the postpartum follow-up, with depression symptoms being reassessed at 12 and 24 weeks after delivery with three depression outcome measures. Eventually, 183 participants were retained for analysis. Results indicated no predictive value of childhood trauma on postpartum depression in the univariate analyses, nor after controlling for previous depression, depression symptoms during pregnancy and type D personality. However, past depression and depression symptoms during pregnancy did independently and convincingly predict postpartum depression, especially at 12 weeks and to a lesser extent at 24 weeks following childbirth. Overall, we found no significant association between childhood trauma and postpartum depression. Past depression and depression symptoms during pregnancy are more relevant factors to assess before childbirth.

  15. Modeling postpartum depression in rats: theoretic and methodological issues

    PubMed Central

    Ming, LI; Shinn-Yi, CHOU

    2016-01-01

    The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions. PMID:27469254

  16. Food Insecurity During Pregnancy Leads to Stress, Disordered Eating, and Greater Postpartum Weight Among Overweight Women

    EPA Science Inventory

    This study examines food insecurity during and after pregnancy and how that affects postpartum weight retention. The results show that food insecurity was associated with higher levels of stress, eating behaviors, dietary fat intake, and higher postpartum weight status.

  17. Influence of IFNL3 and HLA-DPB1 genotype on postpartum control of hepatitis C virus replication and T-cell recovery

    PubMed Central

    Tedesco, Dana; Kohout, Jennifer A.; Prasad, Mona R.; Price, Aryn A.; Lindquist, Tera; Ohmer, Samantha; Moore-Clingenpeel, Melissa; Grakoui, Arash; Walker, Christopher M.

    2016-01-01

    Chronic hepatitis C virus (HCV) infection is characterized by exhaustion of virus-specific T-cells and stable viremia. Pregnancy is an exception. Viremia gradually climbs during gestation but sometimes declines sharply in the months following delivery. Here, we demonstrated that postpartum HCV control was associated with enhanced virus-specific T-cell immunity. Women with viral load declines of at least 1 log10 between the third trimester and 3-mo postpartum exhibited HCV-specific T-cell responses of greater breadth (P = 0.0052) and magnitude (P = 0.026) at 3-mo postpartum than women who failed to control viremia. Moreover, viral dynamics were consistent in women after consecutive pregnancies, suggesting genetic underpinnings. We therefore searched for genetic associations with human leukocyte antigen (HLA) alleles and IFN-λ3 gene (IFNL3) polymorphisms that influence HCV infection outcome. Postpartum viral control was associated with the IFNL3 rs12979860 genotype CC (P = 0.045 at 6 mo) that predicts a positive response to IFN-based therapy. Suppression of virus replication after pregnancy was also strongly influenced by the HLA class II DPB1 locus. HLA-DPB1 alleles are classified by high and low patterns of expression. Carriage of at least one high-expression HLA-DPB1 allele predicted resurgent virus-specific T-cell immunity and viral control at 3-mo postpartum (P = 0.0002). When considered together in multivariable analysis, IFNL3 and HLA-DPB1 independently affected viral control at 3- and 6-mo postpartum. Together, these findings support a model where spontaneous control of HCV such as sometimes follows pregnancy is governed by genetic polymorphisms that affect type III IFN signaling and virus-specific cellular immune responses. PMID:27601657

  18. The role of intimate partner violence and other health-related social factors on postpartum common mental disorders: a survey-based structural equation modeling analysis

    PubMed Central

    2014-01-01

    Background Although studies suggest the relevance of intimate partner violence (IPV) and other health-related social characteristics as risk factors for postpartum mental health, literature lacks evidence about how these are effectively connected. This study thus aims to explore how socio-economic position, maternal age, household and marital arrangements, general stressors, alcohol misuse and illicit drug abuse, and especially psychological and physical IPV relate in a framework leading to postpartum common mental disorder (CMD). Methods The study was carried out in five primary health care units of Rio de Janeiro, Brazil, and included 810 randomly selected mothers of children up to five postpartum months waiting for pediatric visits. The postulated pathways between exposures and outcome were based on literature evidence and were further examined using structural equation models. Results Direct pathways to postpartum CMD arose from a latent variable depicting socio-economic position, a general stressors score, and both IPV variables. Notably, the effect of psychological IPV on postpartum CMD ran partly through physical IPV. The effect of teenage pregnancy, conjugal instability and maternal burden apparently happens solely through substance use, be it alcohol misuse, illicit drug abuse or both in tandem. Moreover, the effect of the latter on CMD seems to be entirely mediated through both types of IPV. Conclusion Although the theoretical model underlying the analysis still requires in-depth detailing, results of this study may have shed some light on the role of both psychological and physical IPV as part of an intricate network of events leading to postpartum CMD. Health initiatives may want to make use of this knowledge when designing preventive and intervention approaches. PMID:24884951

  19. Method for preparation of 7-hydroxy-1,2,3,4-tetrahydroquinoline from 1,2,3,4-tetrahydroquinoline

    DOEpatents

    Field, George; Hammond, Peter R.

    1994-01-01

    Methods for the efficient preparation of 7-hydroxy-1,2,3,4-tetrahydroquinoline include a first method in which the acylation of m-aminophenol obtains a lactam which is reduced to give the desired quinoline and a second method in which tetrahydroquinoline is nitrated and hydrogenated and then hydrolyzed to obtain the desire quinoline. 7-hydroxy-1,2,3,4-tetrahydroquinoline is used in the efficient synthesis of four lasing dyes of the rhodamine class.

  20. Method for preparation of 7-hydroxy-1,2,3,4-tetrahydroquinoline from 1,2,3,4-tetrahydroquinoline

    DOEpatents

    Field, G.; Hammond, P.R.

    1994-02-01

    Methods for the efficient preparation of 7-hydroxy-1,2,3,4-tetrahydroquinoline include a first method in which the acylation of m-aminophenol obtains a lactam which is reduced to give the desired quinoline and a second method in which tetrahydroquinoline is nitrated and hydrogenated and then hydrolyzed to obtain the desire quinoline. 7-hydroxy-1,2,3,4-tetrahydroquinoline is used in the efficient synthesis of four lasing dyes of the rhodamine class.

  1. Spectroscopic properties of Eu 3+-doped KLa(PO 3) 4 and LiLa(PO 3) 4 powders

    NASA Astrophysics Data System (ADS)

    Ferhi, M.; Horchani-Naifer, K.; Férid, M.

    2011-11-01

    KLa(PO 3) 4 (KLP) and LiLa(PO 3) 4 (LLP) doped with different concentrations of Eu 3+ are grown by solid state reaction. The obtained powders are identified by X-ray diffraction, Raman and FT-IR spectroscopies. These polyphosphates KLa(PO 3) 4 and LiLa(PO 3) 4 crystallize in the monoclinic system but with different space groups respectively P2 1 and C2/c. The evolution of crystal lattice parameters as function of Eu 3+ concentration in these host lattices was studied. Spectroscopic properties of the Eu 3+-doped KLa(PO 3) 4 and LiLa(PO 3) 4 at room temperature (RT) are presented. The excitation spectra of the Eu 3+ ion in condensed polyphosphates along the UV-Visible domain are registered. They show that the position of the charge transfer band (CTB) depends on the host lattices. The effect of structural characteristics of condensed polyphosphates on their optical and colorimetric properties was investigated for the first time. Colorimetric parameters of the Eu 3+ ions red emission in KLP and LLP are determined and compared with other host matrices. Evolution of colorimetric properties as function of Eu 3+concentration was discussed.

  2. Can Drug Effects Explain the Recent Temporal Increase in Atonic Postpartum Haemorrhage?

    PubMed Central

    Joseph, K. S.; Sheehy, Odile; Mehrabadi, Azar; Urquia, Marcelo L.; Hutcheon, Jennifer A.; Kramer, Michael

    2015-01-01

    Abstract Background Rates of postpartum haemorrhage and atonic postpartum haemorrhage have increased in several high‐income countries. We carried out a study to examine if drug use in pregnancy, or drug and other interactions, explained this increase in postpartum haemorrhage. Methods The linked administrative and hospital databases of the Québec Pregnancy Cohort were used to define a cohort of pregnant women in Québec, Canada, from 1998 to 2009 (n = 138 704). Case–control studies on any postpartum haemorrhage and atonic postpartum haemorrhage were carried out within this population, with up to five controls randomly selected for each case after matching on index date and hospital of delivery (incidence density sampling). Conditional logistic regression was used to estimate the effects of drug use on postpartum haemorrhage and atonic postpartum haemorrhage. Results There was an unexpected non‐linear, declining temporal pattern in postpartum haemorrhage and atonic postpartum haemorrhage between 1998 and 2009. Use of antidepressants (mainly selective serotonin reuptake inhibitors) was associated with higher rates of postpartum haemorrhage [adjusted rate ratio (aRR) 1.48, 95% confidence interval (CI) 1.23, 1.77] and atonic postpartum haemorrhage [aRR 1.40, 95% CI 1.13, 1.74]. Thrombocytopenia was also associated with higher rates of postpartum haemorrhage [aRR 1.52, 95% CI 1.16, 2.00]. There were no statistically significant drug interactions. Adjustment for maternal factors and drug use had little effect on temporal trends in postpartum haemorrhage and atonic postpartum haemorrhage. Conclusions Although antidepressant use and thrombocytopenia were associated with higher rates of atonic postpartum haemorrhage, antidepressant and other drug use did not explain temporal trends in postpartum haemorrhage. PMID:25847112

  3. Postpartum uterine disease and dairy herd reproductive performance: a review.

    PubMed

    LeBlanc, Stephen J

    2008-04-01

    This paper reviews the causes, impact, treatment, and prevention of retained placenta (RP), metritis, and endometritis in dairy cows. The occurrence of each of these diseases largely depends on immune function in the transition period. Retained placenta affects 5-10% of calvings and greatly increases the risk of metritis and endometritis. More field studies are needed to validate criteria for treatment of metritis, but cows with at least two of RP, fever, dullness, and fetid uterine discharge appear to merit treatment with systemic antibiotics. Clinical endometritis affects 15-20% of cows at 4-6 weeks postpartum; an additional 30-35% have subclinical endometritis between 4 and 9 weeks postpartum. Under specific conditions, treatment of cows with endometritis improved pregnancy rate. Systematic use of prostaglandin F(2alpha) at 5 and 7 weeks postpartum may improve pregnancy rate. The economic benefit of efforts to identify and treat endometritis is herd-specific.

  4. Synthesis and reactivity of coumarin 3,4-epoxide.

    PubMed

    Born, S L; Rodriguez, P A; Eddy, C L; Lehman-McKeeman, L D

    1997-11-01

    Coumarin is used widely as a fragrance constituent and is administered clinically in the treatment of certain lymphedemas and malignancies. Although toxicity occurs only rarely in humans treated clinically with high-dose coumarin, it is well established that coumarin is hepatotoxic in the rat. This species difference in susceptibility to toxicity reflects the disparate metabolic processes occurring in humans and rodents. In humans, coumarin is converted extensively via cytochrome P450 2A6 to the nontoxic 7-hydroxycoumarin metabolite. In contrast, coumarin 3,4-epoxidation is thought to predominate in rodent species, resulting in the formation of several potentially toxic metabolites. Coumarin epoxide is thought to be highly unstable and has not been isolated synthetically or as a microsomal product. To address this issue, coumarin 3,4-epoxide was synthesized, and its stability and fate have been determined. Coumarin 3,4-epoxide was prepared by reacting coumarin with dimethyldioxirane. The epoxide was stable in organic solvents and survived conditions required for analysis by gas chromotography. Its structure was confirmed via 1H-NMR and gas chromatography-mass spectrometry-infrared spectroscopy (GC-MS-IR). In contrast, coumarin 3,4-epoxide was unstable in aqueous solution, converting within 20 sec to a ring-opened compound. Using GC-MS-IR analysis, the single coumarin 3,4-epoxide product was identified as o-hydroxyphenylacetaldehyde (o-HPA). Although other investigators have suggested that 3-hydroxycoumarin is an intermediate in o-HPA formation from coumarin 3,4-epoxide, we have demonstrated that 3-hydroxycoumarin, incubated in an aqueous system or with liver microsomal proteins, does not form o-HPA. Thus, the results of the present work establish that coumarin 3,4-epoxide can be synthesized and that o-HPA, which has previously been shown to be a prominent coumarin metabolite in rat liver microsomal incubations, is formed directly from coumarin 3,4-epoxide. These

  5. 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.

  6. 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.

  7. The Role of Emotional Intelligence in Predicting Postpartum Depression.

    PubMed

    Rode, Jennifer L

    2016-04-01

    This study examines the direct and moderating effects of emotional intelligence on postpartum depression (PPD), while taking into account social support and stressful life events. Using a prospective cohort design, 165 women were surveyed in their third trimester and again at 9 weeks postpartum. Results support the direct effects of emotional intelligence (β = -.20, p = .01), social support (β = -.17, p = .04), and stressful life events (β = .17, p = .04) on PPD. Moderating effects are also supported with significant effects on PPD: stressful life events × emotional intelligence (β = -.17, p = .04) and stressful life events × social support (β = -.21, p = .01).

  8. Postpartum ovarian vein thrombosis after cesarean delivery: a case report

    PubMed Central

    Royo, Pedro; Alonso-Burgos, Alberto; García-Manero, Manuel; Lecumberri, Ramón; Alcázar, Juan Luis

    2008-01-01

    Introduction Postpartum ovarian vein thrombosis is an uncommon complication; incidence varies between 0.002% and 0.05%. It most often occurs during the 2–15 days following delivery. Case presentation A 22-year-old pregnant woman at term presented to hospital with uterine contractions, abdominal pain, nausea and vomiting. After delivery an ovarian vein thrombosis was diagnosed. Conclusion Low-molecular weight heparin with broad-spectrum antibiotics are the accepted therapy in non-complicated cases of postpartum ovarian vein thrombosis. PMID:18400095

  9. Local anesthetic use in the pregnant and postpartum patient.

    PubMed

    Fayans, Edgar P; Stuart, Hunter R; Carsten, David; Ly, Quen; Kim, Hanna

    2010-10-01

    The use of systemically absorbed drugs in the gravid and in the lactating patient is of concern to the dentist. This article reviews concerns for the health and safety of the mother, developing fetus, and neonate involving local anesthetics. The available literature on the use of local anesthetics for dentistry in the pregnant and postpartum patient is also reviewed. In addition, the physiology of the pregnant and postpartum woman is discussed because this is essential to understanding potential interplay with local anesthesia and the stress of a dental appointment.

  10. Early postpartum hyponatremia in a patient with transient Sheehan's syndrome.

    PubMed

    Munz, W; Seufert, R; Knapstein, P-G; Pollow, K

    2004-05-01

    In modern day health care, Sheehan's syndrome is a rare disorder affecting the postpartum period. We present a case of a 33-year-old woman with atonic hemorrhage developing a transient Sheehan's syndrome associated with hyponatremia six days postpartum. Evaluation of cranial computer tomography and magnetic resonance imaging of the pituitary demonstrated normal finding. Immediate replacement therapy using sodium, chloride, hydrocortisone, fludrocortisone and levothyroxine revealed regression of the Sheehan's syndrome to complete recovery. The present report shows that Sheehan's syndrome can be associated with hyponatremia and illustrates the need to include hyponatremia as an initial symptom in the differential diagnosis of Sheehan's syndrome.

  11. Prevalence and correlates of explosive anger among pregnant and post-partum women in post-conflict Timor-Leste

    PubMed Central

    Rees, Susan; Tam, Natalino; Mohsin, Mohammed; Tay, Alvin Kuowei; Tol, Wietse

    2015-01-01

    Background Little is known about explosive anger as a response pattern among pregnant and post-partum women in conflict-affected societies. Aims To investigate the prevalence and correlates of explosive anger among this population in Timor-Leste. Method We assessed traumatic events, intimate partner violence, an index of adversity, explosive anger, psychological distress and post-traumatic stress disorder among 427 women (257 in the second trimester of pregnancy, 170 who were 3–6 months post-partum) residing in two districts of Timor-Leste (response >99%). Results Two-fifths (43.6%) had explosive anger. Levels of functional impairment were related to frequency of explosive anger episodes. Explosive anger was associated with age (>35 years), being married, low levels of education, being employed, traumatic event count, ongoing adversity and intimate partner violence. Conclusions A combination of social programmes and novel psychological therapies may assist in reducing severe anger among pregnant and post-partum women in conflict-affected countries such as Timor-Leste. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703721

  12. 1,3,4-oxadiazole derivatives as potential biological agents.

    PubMed

    Sun, Juan; Makawana, Jigar A; Zhu, Hai-Liang

    2013-10-01

    The synthesis of novel compound libraries along with screening is a rapid and effective approach for the discovery of potential chemical agents, and it becomes an important method in pharmaceutical chemistry research. 1,3,4- oxadiazole derivatives as the typical heterocyclic compounds, exhibit a broad spectrum of biological activities and vital leading compounds for the development of chemical drugs. Herein, we focus on the synthesis and screening of novel 1,3,4-oxadiazoles derivatives with antimicrobial, antitumor or antiviral activities during the past decade. In this review, we discussed the synthetic development of 1,3,4-oxadiazoles derivatives, and also the relevant bioactivity and their prospects as the potential chemical drugs.

  13. Poly(1,3,4-oxadiazoles) via aromatic nucleophilic displacement

    NASA Technical Reports Server (NTRS)

    Connell, John W. (Inventor); Hergenrother, Paul M. (Inventor); Wolf, Peter (Inventor)

    1992-01-01

    Poly(1,3,4-oxadiazoles) (POX) are prepared by the aromatic nucleophilic displacement reaction of di(hydroxyphenyl) 1,3,4-oxadiazole monomers with activated aromatic dihalides or activated aromatic dinitro compounds. The polymerizations are carried out in polar aprotic solvents such as sulfolane or diphenylsulfone using alkali metal bases such as potassium carbonate at elevated temperatures under nitrogen. The di(hydroxyphenyl) 1,3,4-oxadiazole monomers are synthesized by reacting 4-hydroxybenzoic hydrazide with phenyl 4-hydrobenzoate in the melt and also by reacting aromatic dihydrazides with two moles of phenyl 4-hydroxybenzoate in the melt. This synthetic route has provided high molecular weight POX of new chemical structure, is economically and synthetically more favorable than other routes, and allows for facile chemical structure variation due to the large variety of activated aromatic dihalides which are available.

  14. The Effect of Integrating Family Planning with a Maternal and Newborn Health Program on Postpartum Contraceptive Use and Optimal Birth Spacing in Rural Bangladesh.

    PubMed

    Ahmed, Saifuddin; Ahmed, Salahuddin; McKaig, Catharine; Begum, Nazma; Mungia, Jaime; Norton, Maureen; Baqui, Abdullah H

    2015-09-01

    Meeting postpartum contraceptive need remains a major challenge in developing countries, where the majority of women deliver at home. Using a quasi-experimental trial design, we examine the effect of integrating family planning (FP) with a community-based maternal and newborn health (MNH) program on improving postpartum contraceptive use and reducing short birth intervals <24 months. In this two-arm trial, community health workers (CHWs) provided integrated FP counseling and services during home visits along with their outreach MNH activities in the intervention arm, but provided only MNH services in the control arm. The contraceptive prevalence rate (CPR) in the intervention arm was 15 percent higher than in the control arm at 12 months, and the difference in CPRs remained statistically significant throughout the 24 months of observation. The short birth interval of less than 24 months was significantly lower in the intervention arm. The study demonstrates that it is feasible and effective to integrate FP services into a community-based MNH care program for improving postpartum contraceptive use and lengthening birth intervals.

  15. Bis(4-(3,4-dimethylenepyrrolidyl)-phenyl) methane

    NASA Technical Reports Server (NTRS)

    Ottenbrite, Raphael M. (Inventor)

    1989-01-01

    It is the primary object of the present invention to prepare high temperature polymeric materials, especially linear aromatic polyimides, which maintain their integrity and toughness during long exposure times at elevated temperatures. According to the present invention, this object is achieved, and the attending benefits are obtained, by first providing the bis(exocyclodiene) bis(4-(3,4-dinethylene pyrrolidyl) phenyl) methane, which is formed from the monomer N-phenyl 3,4-dimethylene pyrrolidine. This bis-(exocyclodiene) undergoes Diels-Alder reaction with a bismaleimide without the evolution of gaseous by-products, to form the aromatic polyimide.

  16. The prenatal and immediate postpartum periods

    PubMed Central

    1989-01-01

    A mother's nutritional status during pregnancy has important implications for both her own health and her ability to produce and breast-feed a healthy infant. Knowledge about adequate maternal nutrition during pregnancy is incomplete, however, and there is still considerable debate about the level of extra energy needed by a pregnant woman. A woman's usual nutritional requirements increase during pregnancy to meet her needs and those of the growing fetus. Additional energy is needed because of increased basal metabolism, the greater cost of physical activity, and the normal accumulation of fat as the energy reserve. The protein, vitamin and mineral requirements of the mother also increase during pregnancy, but the precise amounts for the last two are still a matter for discussion. A woman's weight increments during pregnancy vary between privileged and underprivileged communities. In addition to calcium, phosphorus and iron, a mother provides considerable amounts of protein and fat for fetal growth. Placental metabolism and placental blood flow, which are interrelated, are the most critical factors for fetal development. The nutritional requirements of healthy newborns vary widely according to their weight, gestational age, rate of growth, as well as environmental factors. However, recommendations for some components may be derived from the average composition of early human milk and the amounts consumed by healthy, mature newborns who are following a normal postpartum clinical course. The water requirements of infants are related to their caloric consumption, activity, rate of growth, and the ambient temperature. A postnatal weight loss of 5-8% of body weight is usual during the first few days of life in mature newborn infants; in contrast, infants who experienced intrauterine malnutrition lose little or no weight at all. The dynamic process of mother—newborn interaction from the first hours of life is intimately related to successful early breast-feeding. If

  17. 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.

  18. Effect of behavioural-educational intervention on sleep for primiparous women and their infants in early postpartum: multisite randomised controlled trial

    PubMed Central

    Hodnett, Ellen; Kenton, Laura; Lee, Kathryn; Weiss, Shelly; Weston, Julie; Willan, Andrew

    2013-01-01

    differences in any outcomes were noted based on the specific nurse delivering the intervention or the number of phone contacts received. Conclusion A behavioural-educational intervention delivered in the early postpartum, in hospital, and in the first weeks at home, was ineffective in improving maternal and infant sleep or other health outcomes in the first months postpartum. Trial registration ISRCT No 13501166. PMID:23516146

  19. Impact of health beliefs, social support and self-efficacy on physical activity and dietary habits during the post-partum period after gestational diabetes mellitus: study protocol

    PubMed Central

    2013-01-01

    Background Gestational diabetes mellitus (GDM) is defined as a glucose intolerance of variable severity occurring or diagnosed for the first time during pregnancy. Numerous epidemiological studies show that this disorder affects between 1 and 18% of pregnancies, depending on the ethnicity of the populations studied, the diagnostic criteria, or the body mass index (BMI). Its incidence is constantly rising worldwide. Patients with GDM have a high risk of developing type 2 diabetes in the months after delivery. For this reason, GDM patients are encouraged to practice specific health behaviors (dietary habits, physical activity) during the postpartum period. It is important to identify the factors that may impact adherence to these behaviors. Methods/Design A targeted sample size of 200 eligible pregnant women with a diagnosis of GDM will be enrolled in this prospective, cohort study. They will be recruited from 30-36 weeks of gestation as part of their diabetes consultation in Geneva University Hospital (GUH) maternity unit. Psychosocial variables that could impact adherence to health behaviors in the postpartum period (behavioral intentions, risk perceptions, general knowledge about diabetes, health beliefs, social support, self-efficacy) will be evaluated using specific tools at the end of pregnancy, at 6 weeks postpartum and at 6 months postpartum. Multiple regression analyses will be performed on SPSS. Discussion For the first time in Europe, the objective of this research is to study in women with very recent GDM the link between dietary habits, physical activity levels, and psychosocial and cognitive factors possibly involved in the adoption of health behaviors in the postpartum period. These factors have been identified in the literature, but to date have never been combined in a single study. The study will allow a predictive theoretical model of health behavior to be established and used as a basis for reflection to optimize interventions carried out on

  20. Year 3/4 Children's Forms of Justification

    ERIC Educational Resources Information Center

    Widjaja, Wanty

    2014-01-01

    Engaging children in justifying, forming conjectures and generalising is critical to develop their mathematical reasoning. Previous studies have revealed limited opportunities for primary school children to justify their thinking, form conjectures and generalise in mathematics lessons. Forms of justification of Year 3/4 children from three schools…

  1. Anxiety Self Report (ASR (1,2,3,4,). X

    ERIC Educational Resources Information Center

    Parsons, Jane S.

    The Anxiety Self Report (ASR 1,2,3,4) is provided, followed by information about the report. The ASR is discussed as to its development, description, response bias, scoring procedures, reliability, stability, validity, and correlation between the ASR and the Manifest Anxiety Scale. (For related documents, see TM 002 928, 929.) (DB)

  2. 43 CFR 4120.3-4 - Standards, design and stipulations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR RANGE MANAGEMENT (4000) GRAZING ADMINISTRATION-EXCLUSIVE OF ALASKA Grazing Management § 4120.3-4 Standards, design and stipulations. Range improvement permits and... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Standards, design and stipulations....

  3. 6. GATES 3, 4, AND 5, INTAKE CHANNEL LOOKING EAST; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. GATES 3, 4, AND 5, INTAKE CHANNEL LOOKING EAST; WATER THAT PASSED INTO PIPES ENTERED SETTLING VAULT. - Hondius Water Line, 1.6 miles Northwest of Park headquarters building & 1 mile Northwest of Beaver Meadows entrance station, Estes Park, Larimer County, CO

  4. 41 CFR 60-3.4 - Information on impact.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 3-UNIFORM GUIDELINES ON EMPLOYEE SELECTION PROCEDURES (1978) General Principles § 60-3.4 Information... records or other information which will disclose the impact which its tests and other selection procedures... selection rates. The “bottom line.” If the information called for by sections 4A and B of this section...

  5. 43 CFR 5511.3-4 - Removal by agent.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., DEPARTMENT OF THE INTERIOR FOREST MANAGEMENT (5000) FREE USE OF TIMBER Free Use Regulations § 5511.3-4 Removal by agent. A free-use permittee may procure the timber by agent. Such agent shall not, however, be paid more than fair compensation for the time, labor and money expended in procuring timber...

  6. 43 CFR 5511.3-4 - Removal by agent.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., DEPARTMENT OF THE INTERIOR FOREST MANAGEMENT (5000) FREE USE OF TIMBER Free Use Regulations § 5511.3-4 Removal by agent. A free-use permittee may procure the timber by agent. Such agent shall not, however, be paid more than fair compensation for the time, labor and money expended in procuring timber...

  7. 13. PRATT STREET BULKHEAD: SECTIONS 2, 3, 4, 5, AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. PRATT STREET BULKHEAD: SECTIONS 2, 3, 4, 5, AND 6, DRAWER 10, PLAN NO. 1, 1 IN. = 15 FT. AND 1/2 IN. = 1 FT., APRIL 25, 1906, DRAWING SHOWS DESIGN FOR PRATT STREET BULKHEAD BETWEEN PIERS - Baltimore Inner Harbor, Pier 5, South of Pratt Street between Market Place & Concord Street, Baltimore, Independent City, MD

  8. 43 CFR 4120.3-4 - Standards, design and stipulations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Standards, design and stipulations. 4120.3... ALASKA Grazing Management § 4120.3-4 Standards, design and stipulations. Range improvement permits and cooperative range improvement agreements shall specify the standards, design, construction and...

  9. 9 CFR 3.4 - Outdoor housing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Transportation of Dogs and Cats 1 Facilities and Operating Standards § 3.4 Outdoor housing facilities. (a) Restrictions. (1) The following categories of dogs or cats must not be kept in outdoor facilities, unless that practice is specifically approved by the attending veterinarian: (i) Dogs or cats that are not...

  10. 9 CFR 3.4 - Outdoor housing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Transportation of Dogs and Cats 1 Facilities and Operating Standards § 3.4 Outdoor housing facilities. (a) Restrictions. (1) The following categories of dogs or cats must not be kept in outdoor facilities, unless that practice is specifically approved by the attending veterinarian: (i) Dogs or cats that are not...

  11. 9 CFR 3.4 - Outdoor housing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Transportation of Dogs and Cats 1 Facilities and Operating Standards § 3.4 Outdoor housing facilities. (a) Restrictions. (1) The following categories of dogs or cats must not be kept in outdoor facilities, unless that practice is specifically approved by the attending veterinarian: (i) Dogs or cats that are not...

  12. 9 CFR 3.4 - Outdoor housing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Transportation of Dogs and Cats 1 Facilities and Operating Standards § 3.4 Outdoor housing facilities. (a) Restrictions. (1) The following categories of dogs or cats must not be kept in outdoor facilities, unless that practice is specifically approved by the attending veterinarian: (i) Dogs or cats that are not...

  13. 9 CFR 3.4 - Outdoor housing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Transportation of Dogs and Cats 1 Facilities and Operating Standards § 3.4 Outdoor housing facilities. (a) Restrictions. (1) The following categories of dogs or cats must not be kept in outdoor facilities, unless that practice is specifically approved by the attending veterinarian: (i) Dogs or cats that are not...

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

    PubMed

    Nash, Christopher M; Allen, Victoria M

    2015-05-01

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

  15. Rapid simultaneous determination of amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine, 3,4-methylenedioxymethamphetamine, and 3,4-methylenedioxyethylamphetamine in urine by fast gas chromatography-mass spectrometry.

    PubMed

    Klette, Kevin L; Jamerson, Matthew H; Morris-Kukoski, Cynthia L; Kettle, Aaron R; Snyder, J Jacob

    2005-10-01

    The use of fast gas chromatography-mass spectrometry (FGC-MS) was investigated to improve the efficiency of analysis of urine specimens that previously screened presumptively positive for amphetamine (AMP), methamphetamine (MAMP), 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxymethamphetamine (MDMA), and/or 3,4 methylenedioxyethylamphetamine (MDEA) by immunoassay testing. Specimens were pretreated with basic sodium periodate, extracted using a positive-pressure manifold/cation-exchange solid-phase cartridge methodology, and derivatized using 4-carbethoxyhexafluorobutyryl chloride (4-CB). The analytical method was compared to traditional GC-MS analysis and evaluated with respect to assay chromatography, linearity, sensitivity, precision, accuracy, and reproducibility. The limits of detection were 62.5 ng/mL for MDA and 31.25 ng/mL for AMP, MAMP, MDMA, and MDEA. All of the target analytes were linear to 12,000 ng/mL with the exception of MAMP which was linear to 10,000 ng/mL. The intra-assay precision of a 500 ng/mL multiconstituent control (n=15) ranged from 522.6 to 575.9 ng/mL with a coefficient of variation of less than 3.8%. Authentic human urine specimens (n=187) previously determined to contain the target analytes were re-extracted and analyzed by both FGC-MS and the currently utilized GC-MS method. No significant differences in specimen concentration were observed between these analytical methods. No interferences were seen when the performance of the FGC-MS method was challenged with ephedrine, pseudoephedrine, phenylpropanolamine, and phentermine. When compared to traditional GC-MS analysis, FGC-MS analysis provided a dramatic reduction in retention time for amphetamine (1.8 min vs. 4.12 min). For example, the FGC-MS method reduced overall run time for a batch of 56 specimens from 12.0 h to 7.25 h. This reduction in analysis time makes FGC-MS an attractive alternative to traditional GC-MS by allowing a laboratory greater flexibility in the purchase

  16. Postpartum early discharge: impact on maternal fatigue and functional ability.

    PubMed

    Smith-Hanrahan, C; Deblois, D

    1995-02-01

    The purpose of this study was to determine the impact of a postpartum early discharge program, with home follow-up by hospital nursing staff, on the maternal fatigue and functional ability of low-risk mothers with healthy neonates. A quasi-experimental design was used. Subjects were randomly assigned to one of two groups receiving the early-discharge program (hospital stay less than 60 hours plus home follow-up by hospital-based nurses; n = 35) or traditional hospital care (hospital stay more than 60 hours and no home follow-up by hospital staff; n = 17). A third group emerged from those originally assigned to traditional care but later transferred to early discharge due to bed shortages (n = 29). The Rhoten Fatigue Scale and the Inventory of Functional Status After Childbirth were used to collect the data at discharge and 1 and 6 weeks postpartum period. No significant differences between groups were found, suggesting that early discharge with adequate home follow-up does not affect the low-risk mother's fatigue and functional ability to any significantly greater extent than traditional care. It was also noted that, regardless of type of care, the proportion of subjects reporting severe fatigue was relatively large (25%, 31%, and 19% at discharge, 1 and 6 weeks postpartum period), highlighting the need for further study of maternal fatigue in the postpartum period.

  17. A Family Approach to Treatment of Postpartum Depression

    ERIC Educational Resources Information Center

    McKay, Judith; Shaver-Hast, Laura; Sharnoff, Wendy; Warren, Mary Ellen; Wright, Harry

    2009-01-01

    Postpartum depression (PPD) has an impact on the entire family. The authors describe a model of intervention that emphasizes the family system and includes mothers, fathers, and children in the treatment of PPD. The intervention is provided by a multidisciplinary team consisting of a psychiatrist, social worker, child psychologist, and therapists.…

  18. Relaxation Training and Expectation in the Treatment of Postpartum Distress.

    ERIC Educational Resources Information Center

    Halonen, Jane S.; Passman, Richard H.

    1985-01-01

    Examined the effectiveness of relaxation training in reducing postpartum distress for 48 first-time mothers-to-be via a treatment-component strategy. Compared with nonrelaxation conditions, relaxation treatments reduced reported postpartal distress. Expectations about treatment effectiveness were not significant factors in treatment outcome.…

  19. [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.

  20. Anger after Childbirth: An Overlooked Reaction to Postpartum Stressors

    ERIC Educational Resources Information Center

    Graham, Jennifer E.; Lobel, Marci; DeLuca, Robyn Stein

    2002-01-01

    Other than postpartum depression, little is known about women's emotional responses to childbirth and subsequent stressors. Anger was explored on the basis of theory and evidence that it is a likely emotional response in this context. During their third trimester of pregnancy and approximately six weeks after delivery, 163 participants completed…

  1. The prevention of postpartum hemorrhage in the community.

    PubMed

    Souza, João Paulo

    2013-10-01

    João Paulo Souza discusses the implications of a study by Cynthia Stanton and colleagues for the prevention and management of postpartum hemorrhage in the community, particularly in low-income countries, and outlines the remaining challenges. Please see later in the article for the Editors' Summary.

  2. 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…

  3. Knowledge of blood loss at delivery among postpartum patients

    PubMed Central

    Miller, Claire M.; Ramachandran, Bharathi; Hegde, Priya; Akbar, Kulsum; Goodnough, Lawrence Tim; Butwick, Alexander J.

    2016-01-01

    Background Postpartum hemorrhage (PPH) is a leading cause of obstetric morbidity. There is limited understanding of patients’ knowledge about blood loss at delivery, PPH, and PPH-related morbidities, including transfusion and anemia. Methods We surveyed 100 healthy postpartum patients who underwent vaginal or cesarean delivery about blood loss, and whether they received information about transfusion and peripartum hemoglobin (Hb) testing. Responses were compared between women undergoing vaginal delivery vs. cesarean delivery; P < 0.05 considered as statistically significant. Results In our cohort, 49 women underwent vaginal delivery and 51 women underwent cesarean delivery. Only 29 (29%) of women provided blood loss estimates for their delivery. Women who underwent cesarean delivery were more likely to receive clear information about transfusion therapy than those undergoing vaginal delivery (43.1% vs. 20.4% respectively; P = 0.04). Women who underwent vaginal delivery were more likely to receive results of postpartum Hb tests compared to those undergoing cesarean delivery (49% vs. 29.4%; P = 0.02). Conclusion Our findings suggest that women are poorly informed about the magnitude of blood loss at delivery. Hematologic information given to patients varies according to mode of delivery. Further research is needed to better understand the clinical implications of patients’ knowledge gaps about PPH, transfusion and postpartum anemia. PMID:27635332

  4. 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.

  5. 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…

  6. Trajectories of Postpartum Maternal Depressive Symptoms and Children's Social Skills

    ERIC Educational Resources Information Center

    Wu, Yelena P.; Selig, James P.; Roberts, Michael C.; Steele, Ric G.

    2011-01-01

    The vast majority of new mothers experience at least some depressive symptoms. Postpartum maternal depressive symptoms can greatly influence children's outcomes (e.g., emotional, cognitive, language, and social development). However, there have been relatively few longitudinal studies of how maternal depressive symptoms may influence children's…

  7. The Structure of Women's Mood in the Early Postpartum

    ERIC Educational Resources Information Center

    Buttner, Melissa M.; O'Hara, Michael W.; Watson, David

    2012-01-01

    The "postpartum blues" is a mild, predictable mood disturbance occurring within the first several days following childbirth. Previous analyses of the "blues" symptom structure yielded inconclusive findings, making reliable assessment a significant methodological limitation. The current study aimed to explicate the symptom…

  8. Reply: Omega-3 polyunsaturated fatty acids for postpartum depression

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To the Editors: We appreciate the interest and the comments of Chiu et al. concerning our recently published study investigating the effect of maternal docosahexaenoic acid (DHA) supplementation to prevent postpartum depression (PPD). We agree with many of their criticisms and, in fact, discussed th...

  9. Predicting Change in Postpartum Depression: An Individual Growth Curve Approach.

    ERIC Educational Resources Information Center

    Buchanan, Trey

    Recently, methodologists interested in examining problems associated with measuring change have suggested that developmental researchers should focus upon assessing change at both intra-individual and inter-individual levels. This study used an application of individual growth curve analysis to the problem of maternal postpartum depression.…

  10. Is sleep disruption a trigger for postpartum psychosis?

    PubMed

    Lewis, Katie J S; Foster, Russell G; Jones, Ian R

    2016-05-01

    An episode of postpartum psychosis can be devastating for a woman and her family, and it is vital we understand the factors involved in the aetiology of this condition. Sleep and circadian rhythm disruption is a plausible candidate but further research is needed that builds on the latest advances in chronobiology and neuroscience.

  11. An Unusual Cause of Postpartum Heart Failure

    PubMed Central

    Khaddash, Ibrahim; Hawatmeh, Amer; Altheeb, Zaid; Hamdan, Aiman; Shamoon, Fayez

    2017-01-01

    Peripartum cardiomyopathy is a weakness of the heart muscle. It is an idiopathic cardiomyopathy that presents with heart failure secondary to left ventricular systolic dysfunction toward the end of pregnancy or in the months after delivery, in the absence of any other cause of heart failure. It is a rare condition that can carry mild or severe symptoms. PMID:28074806

  12. Postpartum Maternal Sleep, Maternal Depressive Symptoms and Self-Perceived Mother-Infant Emotional Relationship.

    PubMed

    Tikotzky, Liat

    2016-01-01

    This study examined the links between maternal sleep, maternal depressive symptoms, and mothers' perceptions of their emotional relationship with their infant in a self-recruited sample of mothers. Eighty mothers of infants 3-18 months old completed sleep diaries for 5 consecutive nights, and questionnaires assessing sleep (Insomnia Severity Index [ISI]), depressive symptom severity (Edinburgh Postnatal Depression Scale [EPDS]), and perceived mother-infant relationship (Postpartum Bonding Questionnaire [PBQ] and Maternal Postnatal Attachment Questionnaire [MPAQ]). Significant correlations, controlling for depression severity, were found between more disturbed maternal sleep and more negative maternal perceptions of the mother-infant relationship. Regression analyses revealed that EPDS showed the strongest association with PBQ, whereas ISI demonstrated the strongest association with MPAQ. The present study highlights the importance of deepening and expanding our understanding of the negative implications of maternal sleep problems.

  13. Description of breastfeeding practices among poorer sections in Calcutta Metropolitan Area and its impact on postpartum infecundity.

    PubMed

    Dihidar, S; Bhattacharya, B N; Mukherjee, K L

    2002-09-01

    Descriptions of breastfeeding practices among residents in slum areas of Kolkata and the influence of breastfeeding on postpartum amenorrhoea is the focus of this study. Three out of four women initiate breastfeeding after one hour of birth and three out of five women squeeze the first milk from the breast before breastfeeding. Though the median duration of breastfeeding is long, the duration of exclusive breastfeeding is much shorter. Breastfeeding during the first six months has a significant negative influence on the rate of return to menses.

  14. Ferrocyanide Safety Project: Subtask 3. 4, Aging Studies

    SciTech Connect

    Lilga, M.A.; Lumetta, M.R.; Riemath, W.F.; Romine, R.A.; Schiefelbein, G.F.

    1992-11-01

    The Hanford Ferrocyanide Task Team is addressing issues involving ferrocyanide precipitates in single-shell waste storage tanks (SSTs), in particular the storage of waste in a safe manner. This Task Team, composed of researchers from Westinghouse Hanford Company (WHC), Pacific Northwest Laboratory (PNL), and outside consultants, was formed in response to the need for an updated analysis of safety questions about the Hanford ferrocyanide tanks. This annual report gives the results of the work conducted by PNL in FY 1992 on Subtask 3.4, Aging Studies, which is part of Task 3, Chemical Nature of Feffocyanide in Wastes. Subtask 3.4 deals with the aging behavior and solubilization of ferrocyanide tank waste sludges in a basic aqueous environment. Investigated were the effects of pH variation, ionic strength, salts present in SSTS, and gamma radiation on solubilization of vendor-prepared Na[sub 2]NiFe(CN)[sub 6].

  15. Neurotoxicity of methamphetamine and 3,4-methylenedioxymethamphetamine.

    PubMed

    Halpin, Laura E; Collins, Stuart A; Yamamoto, Bryan K

    2014-02-27

    Amphetamines are a class of psychostimulant drugs that are widely abused for their stimulant, euphoric, empathogenic and hallucinogenic properties. Many of these effects result from acute increases in dopamine and serotonin neurotransmission. Subsequent to these acute effects, methamphetamine and 3,4 methylenedioxymethamphetamine (MDMA) produce persistent damage to dopamine and serotonin nerve terminals. This review summarizes the numerous interdependent mechanisms including excitotoxicity, mitochondrial damage and oxidative stress that have been demonstrated to contribute to this damage. Emerging non-neuronal mechanisms by which the drugs may contribute to monoaminergic terminal damage, as well as the neuropsychiatric consequences of this terminal damage are also presented. Methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) have similar chemical structures and pharmacologic properties compared to other abused substances including cathinone (khat), as well as a relatively new class of novel synthetic amphetamines known as 'bath salts' that have gained popularity among drug abusers.

  16. A monoclinic polymorph of KY(PO(3))(4).

    PubMed

    Horchani-Naifer, Karima; Jouini, Anis; Férid, Mokhtar

    2008-05-17

    The title compound, potassium yttrium polyphosphate, KY(PO(3))(4), was synthesized using the flux method. The atomic arrangement consists of an infinite long-chain polyphosphate organization. Chains, with a period of four PO(4) tetra-hedra, run along the a-axis direction. Two other polymorphs of this phosphate are known, in space groups P21/n and C2/c.

  17. A monoclinic polymorph of KY(PO3)4

    PubMed Central

    Horchani-Naifer, Karima; Jouini, Anis; Férid, Mokhtar

    2008-01-01

    The title compound, potassium yttrium polyphosphate, KY(PO3)4, was synthesized using the flux method. The atomic arrangement consists of an infinite long-chain polyphosphate organization. Chains, with a period of four PO4 tetra­hedra, run along the a-axis direction. Two other polymorphs of this phosphate are known, in space groups P21/n and C2/c. PMID:21202436

  18. Hispanic Heritage Month

    NASA Video Gallery

    Hispanic-themed music and Salsa dance performances helped kick off the Johnson Space Center celebration of Hispanic Heritage Month, commemorating the histories, cultures and contributions of Hispan...

  19. Birth Month Affects Longevity

    ERIC Educational Resources Information Center

    Abel, Ernest L.; Kruger, Michael L.

    2010-01-01

    The authors examined the association between birth month and longevity for major league baseball players. Players born in the month of November had the greatest longevities whereas those born in June had the shortest life spans. These differences remained after controlling for covariates such as birth year, career length, age at debut, height, and…

  20. (3R,4S)-3,4-Isopropylidenedioxy-5-phenylsulfonylmethyl-3,4-dihydro-2H-pyrrole 1-oxide

    PubMed Central

    Flores, Mari Fe; Garcia, P.; M. Garrido, Narciso; Sanz, Francisca; Diez, David

    2011-01-01

    The title compound, C14H17NO5S, was prepared by oxidation of (2R,3S,4R)-2-phenyl­sulfonyl­methyl-1-hy­droxy-3,4-iso­pro­pyl­idene­dioxy­pyrrolidine. Its crystal structure confirms unequivocally its configuration. Two inter­molecular C—H⋯O inter­actions help to establish the packing. PMID:21754431

  1. Violence against women and postpartum depression: the experience of Chilean women.

    PubMed

    Quelopana, Ana M

    2012-01-01

    This article is based on the findings from a cross-sectional study of women (N = 163) who were at least two weeks postpartum and attending primary care clinics in Arica, Chile. The researcher in this study examined the prevalence of history of violence and its association with postpartum depression. The Women Abuse Screen and the Postpartum Depression Screening Scale-Spanish version were used to assess interpersonal violence and postpartum depression. A history of violence was reported by 64% of the women. Of those who experienced abuse, 44% reported ongoing abuse during their pregnancy. Women who experienced violence screened positive for elevated symptoms categories of postpartum depression such as anxiety/insecurity, emotional lability, and mental confusion compared to women who had not experienced violence. Postpartum depression symptom reporting decreased with increasing number of pregnancies (OR = 0.70, 95% CI 0.54-0.97) and greater social support (OR = 0.64, 95% CI 0.46-0.88). Postpartum depression symptom reporting increased with smoking (OR = 1.71, 95% CI 1.00-2.86), and with reporting history of violence (OR = 1.79, 95% CI 1.24-2.34). Acknowledgment of the strong association between domestic violence and postpartum depression should lead to routine screening during prenatal and postpartum periods as a way to isolate risk for postpartum depression.

  2. Type of delivery and self-reported postpartum symptoms among Iranian women.

    PubMed

    Nikpour, M; Delavar, M A; Abedian, Z

    2013-01-01

    The aim of the present study was to examine the association between mode of delivery and self-reported postpartum among women eight weeks postpartum. A cross-sectional study was conducted on postpartum women with symptoms. A total of 300 individuals over 16 years (155 with normal vaginal delivery and 145 with elective cesarean section) from ten primary healthcare centers in an urban area of Amol, Mazandaran, Iran were selected using a clustering random sampling technique. A standard questionnaire named Edinburgh postnatal depression scale (EPDS) was used to assess depressive symptom. Most women (98.3%) reported at least one postpartum symptom at eight weeks postpartum. The most prevalent postpartum symptoms were excessive tiredness or fatigue (72.2%), pain (65.7%) and backache (61.3%). There was a decrease in percentage of occurrence of sexual problems (p = 0.009) with elective cesarean section at postpartum was founded. Compared with women having vaginal delivery, cesarean delivery women were more likely to report headaches (OR = 2.5; CI = 1.493, 4.289) and less to report sexual problems (OR = 0.594; CI = 0.362, 0.975) during postpartum. It would be useful to provide a defined standard for postpartum care and apply regular postpartum visits in primary health care centers, hospital, and home visits and restricting mediolateral episiotomy.

  3. 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.

  4. The impact of maternal diet fortification with lipid-based nutrient supplements on postpartum depression in rural Malawi: a randomised-controlled trial.

    PubMed

    Stewart, Robert C; Ashorn, Per; Umar, Eric; Dewey, Kathryn G; Ashorn, Ulla; Creed, Francis; Rahman, Atif; Tomenson, Barbara; Prado, Elizabeth L; Maleta, Ken

    2017-04-01

    Perinatal depression is highly prevalent in low-and-middle-income countries and has been linked to poor child health. Suboptimal maternal nutrition may be a risk factor for perinatal depression. In this randomised-controlled trial conducted in rural Malawi, we set out to test the hypothesis that women taking a fatty acid-rich lipid-based nutrient supplement (LNS) would have fewer depressive symptoms postpartum than those taking iron-folate (IFA) or multiple-micronutrient (MMN) capsules. Women were recruited from antenatal clinics and randomised to receive LNS or MMN during pregnancy and for 6 months postpartum, or IFA during pregnancy only. Maternal depressive symptoms were measured using validated translations of the Self Reporting Questionnaire (SRQ) and Edinburgh Postnatal Depression Scale (EPDS), antenatally (SRQ only) and at 6 months postpartum (SRQ and EPDS). Analysis was by modified intention to treat. One thousand three hundred and ninety one women were randomised (LNS = 462, MMN = 466, IFA = 463). The groups were similar across a range of baseline variables. At 6 months postpartum, 1078 (77.5%) had SRQ completed; mean (SD) scores were LNS 1.76(2.73), MMN 1.92(2.75), IFA 1.71(2.66), P = 0.541. One thousand and fifty seven (76.0%) had EPDS completed; mean (SD) scores were LNS 5.77(5.53), MMN 5.43(4.97), IFA 5.52(5.18), P = 0.676. There were no statistically significant differences between the groups on SRQ or EPDS scores (continuous or dichotomised) in unadjusted or adjusted models. In conclusion, fortification of maternal diet with LNS compared with MMN or IFA did not reduce postnatal depressive symptoms in this study.

  5. Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil - ECCAGE study

    PubMed Central

    2010-01-01

    Background Woman's nutritional status, before and during pregnancy, is a strong determinant of health outcomes in the mother and newborn. Gestational weight gain and postpartum weight retention increases risk of overweight or obesity in the future and they depend on the pregestational nutritional status and on food consumption and eating behavior during pregnancy. Eating behavior during pregnancy may be the cause or consequence of mood changes during pregnancy, especially depression, which increases likelihood of postpartum depression. In Brazil, a study carried out in the immediate postpartum period found that one in three women experienced some type of violence during pregnancy. Violence and depression are strongly associated and both exposures during pregnancy are associated with increased maternal stress and subsequent harm to the infant. The main objectives of this study are: to identify food intake and eating behaviors patterns; to estimate the prevalence of common mental disorders and the experience of violence during and after pregnancy; and to estimate the association between these exposures and infant's health and development. Methods/Design This is a cohort study of 780 pregnant women receiving care in 18 primary care units in two cities in Southern Brazil. Pregnant women were first evaluated between the 16th and 36th week of pregnancy at a prenatal visit. Follow-up included immediate postpartum assessment and around the fifth month postpartum. Information was obtained on sociodemographic characteristics, living circumstances, food intake, eating behaviors, mental health and exposure to violence, and on infant's development and anthropometrics measurements. Discussion This project will bring relevant information for a better understanding of the relationship between exposures during pregnancy and how they might affect child development, which can be useful for a better planning of health actions aiming to enhance available resources in primary health

  6. AGR 3/4 Irradiation Test Final As Run Report

    SciTech Connect

    Collin, Blaise P.

    2015-06-01

    Several fuel and material irradiation experiments have been planned for the Idaho National Laboratory Advanced Reactor Technologies Technology Development Office Advanced Gas Reactor Fuel Development and Qualification Program (referred to as the INL ART TDO/AGR fuel program hereafter), which supports the development and qualification of tristructural-isotropic (TRISO) coated particle fuel for use in HTGRs. The goals of these experiments are to provide irradiation performance data to support fuel process development, qualify fuel for normal operating conditions, support development and validation of fuel performance and fission product transport models and codes, and provide irradiated fuel and materials for post irradiation examination and safety testing (INL 05/2015). AGR-3/4 combined the third and fourth in this series of planned experiments to test TRISO coated low enriched uranium (LEU) oxycarbide fuel. This combined experiment was intended to support the refinement of fission product transport models and to assess the effects of sweep gas impurities on fuel performance and fission product transport by irradiating designed-to-fail fuel particles and by measuring subsequent fission metal transport in fuel-compact matrix material and fuel-element graphite. The AGR 3/4 fuel test was successful in irradiating the fuel compacts to the burnup and fast fluence target ranges, considering the experiment was terminated short of its initial 400 EFPD target (Collin 2015). Out of the 48 AGR-3/4 compacts, 42 achieved the specified burnup of at least 6% fissions per initial heavy-metal atom (FIMA). Three capsules had a maximum fuel compact average burnup < 10% FIMA, one more than originally specified, and the maximum fuel compact average burnup was <19% FIMA for the remaining capsules, as specified. Fast neutron fluence fell in the expected range of 1.0 to 5.5×1025 n/m2 (E >0.18 MeV) for all compacts. In addition, the AGR-3/4 experiment was globally successful in keeping the

  7. Diastereoselective synthesis of 2,3,4,5,6-pentafluoroheptanes.

    PubMed

    Farran, Daniel; Slawin, Alexandra M Z; Kirsch, Peer; O'Hagan, David

    2009-09-18

    A stereocontrolled synthesis of alkanes containing five contiguous fluorine atoms is presented. The compounds were prepared by sequential fluorination of diastereoisomeric alcohol-diepoxides. The chemistry involved epoxide ring-opening with HF.NEt(3) and deshydroxyfluorination reactions of free alcohols with Deoxo-Fluor. The fluorination reactions were all highly stereospecific, with all five fluorines being incorporated in three sequential steps. Three different diastereoisomers of the 2,3,4,5,6-pentafluoroheptyl motif were prepared as heptane-1,7-diol derivatives, a structural format amenable for incorporation of the vicinal pentafluoro scaffold into larger molecular architectures.

  8. Loss of Resources and Hurricane Experience as Predictors of Postpartum Depression Among Women in Southern Louisiana

    PubMed Central

    Ehrlich, Matthew; Xiong, Xu; Buekens, Pierre; Pridjian, Gabriella; Elkind-Hirsch, Karen

    2010-01-01

    Abstract Background After a natural disaster, mental disorders often become a long-term public health concern. Previous studies under smaller-scale natural disaster conditions suggest loss of psychosocial resources is associated with psychological distress. Methods We examined the occurrence of depression 6 and 12 months postpartum among 208 women residing in New Orleans and Baton Rouge, Louisiana, who were pregnant during or immediately after Hurricane Katrina's landfall. Based on the Conservation of Resources (COR) theory, we explored the contribution of both tangible/financial and nontangible (psychosocial) loss of resources (LOR) on the outcome of depression, measured using the Edinburgh Postnatal Depression Scale (EPDS). We also investigated the influence on depression of individuals' hurricane experience through a Hurricane Experience Score (HES) that includes such factors as witnessing death, contact with flood waters, and injury to self or family members. Results Both tangible and nontangible LOR were associated with depression cross-sectionally and prospectively. Severe hurricane exposure (high HES) was also associated with depression. Regression analysis showed LOR-associated depression was explained almost entirely by nontangible rather than tangible factors. Consistent with COR theory, however, nontangible LOR explained some of the association between severe hurricane exposure and depression in our models. A similar result was seen prospectively for depression at 12 months, even controlling for depression symptoms at 6 months. Conclusions These results suggest the need for preventive measures aimed at preserving psychosocial resources to reduce the long-term effects of disasters. PMID:20438305

  9. Paternal postpartum depression: what health care providers should know.

    PubMed

    Musser, Anna K; Ahmed, Azza H; Foli, Karen J; Coddington, Jennifer A

    2013-01-01

    Paternal postpartum depression (PPD) is a clinically significant problem for families that is currently underscreened, underdiagnosed, and undertreated. Maternal PPD is a well-known condition and has been extensively researched. In comparison, PPD in fathers and its potential effects on the family are not widely recognized. Studies have shown the importance of optimal mental health in fathers during the postpartum period. Negative effects of paternal PPD affect marital/partner relationships, infant bonding, and child development. To promote optimal health for parents and children, pediatric nurse practitioners must stay up to date on this topic. This article discusses the relationship of paternal PPD to maternal PPD; the consequences, signs, and symptoms; and the pediatric nurse practitioner's role in assessing and managing paternal PPD.

  10. Bottle feeding simulates child loss: postpartum depression and evolutionary medicine.

    PubMed

    Gallup, Gordon G; Nathan Pipitone, R; Carrone, Kelly J; Leadholm, Kevin L

    2010-01-01

    At the level of a mother's basic biology, the decision to bottle feed unwittingly mimics conditions associated with the death of an infant. Child loss is a well documented trigger for depression particularly in mothers, and growing evidence shows that bottle feeding is a risk factor for postpartum depression. The implications of this hypothesis for infant feeding practices, hospital procedures that lead to intermittent separation between mothers and infants during the immediate postpartum period, parallels between an increased desire to hold infants by mothers who bottle feed and responses to infant death among nonhuman primates, and the relationship between weaning and depression are discussed in the context of an emerging discipline known as evolutionary medicine.

  11. 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

  12. Complicated Postpartum Type B Aortic Dissection and Endovascular Repair

    PubMed Central

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

    2012-01-01

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

  13. Postpartum spontaneous subcapsular hepatic hematoma related to preeclampsia.

    PubMed

    Anyfantakis, Dimitrios; Kastanakis, Miltiades; Fragiadakis, Georgios; Karona, Paraskevi; Katsougris, Nikolaos; Bobolakis, Emmanouil

    2014-01-01

    Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Here we report a case of a 32-year-old primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. The woman underwent an emergency caesarean section with the extraction of an alive foetus. A few hours after delivery, she was transferred to the emergency department of our institution complaining of severe epigastric pain. Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively. Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus. For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum.

  14. 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.

  15. Functional end-capped conducting poly (3,4-ethylenedioxythiophene)

    NASA Astrophysics Data System (ADS)

    Sabatini, V.; Farina, H.; Ortenzi, Marco A.

    2016-05-01

    Methacrylate-terminated Poly(3,4-Ethylenedioxythiophene) (PEDOT) polymers with controlled degree of polymerization were successfully prepared by direct oxidative polycondensation between Ethylenedioxythiophene (EDOT) and a cross-linkable methacrylate end-capper monomer, obtained via Friedel Crafts acylation starting from EDOT and Methacryloyl chloride. The new polymer was synthesized in order to overcome the well-known technical problems of PEDOT, i.e. difficult processability and patterning, due to its poor solubility in common organic and inorganic solvents. The chemical structure and the degree of polymerization of the end-capped polymers were determined by 1H NMR spectra. A new synthesis of Methacrylate end-capped PEDOT with controlled degree of polymerization, soluble in common organic and chlorinated solvents and with improved conductivity, 210 S/cm, was performed. This method includes: direct oxidative polycondensation of 3,4-Ethylenedioxythiophene (EDOT) in the presence of a cross-linkable end-capper, i.e. Methacrylate end-capped EDOT prepared via Friedel Crafts acylation with Methacryloyl chloride and oxidant species, i.e. ferric sulfate. Furthermore, the oxidative polycondensation of EDOT monomer and Methacrylate end-capped EDOT in the presence of Sulfonated Polyethersulfone (SPES)- characterized by different degree of Sulfonation (DS)- as dopant agent was performed, leading to functional end-capped conducting PEDOT, easy to process and pattern, with conductivity of 210 S/cm, 50 S/cm higher than the one of commercial PEDOT.

  16. SW LW MONTHLY

    Atmospheric Science Data Center

    2014-07-09

    ... 06/30/1991 Temporal Resolution:  Monthly average Tools:  Contact User Services ... Water Radiative Forcing Shortwave Radiation Surface Temperature Order Data:  Contact User Services: Order Data ...

  17. Natural Gas Monthly

    EIA Publications

    2017-01-01

    Highlights activities, events, and analyses associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer related activities and underground storage data are also reported.

  18. Weekly bull exchange shortens postpartum anestrus in suckled beef cows.

    PubMed

    Miller, V; Ungerfeld, R

    2008-05-01

    The duration of anestrus in cattle was usually shortened when cows were exposed to bulls. The objective of the present experiment was to determine if weekly bull exchange accelerated the resumption of cyclicity in postpartum suckled beef cows. We tested the hypothesis that exposure of postpartum, anestrous, suckled beef cows (extensively managed) to weekly exchange of bulls, accelerates the resumption of cyclicity, compared to continuous exposure to the same bulls. Ninety-one multiparous suckled Hereford and Hereford x Angus cows, <60d postpartum, were assigned to two homogeneous groups. Beginning on December 1st (late spring), the control group (C, n=45) remained with one pair of bulls throughout the breeding period (7 weeks), whereas in the "exchanged" (E, n=46) group two pairs of bulls were exchanged weekly. Based on weekly ultrasonographic examinations of all cows, none had a CL at the start of the experiment and for 2 weeks after the start of bull exposure. However, the accumulated frequency of cows with a CL was greater in group E than in group C cows on week 4 (P=0.024), as well as on weeks 5-7 (P<0.001) after the start of bull exposure. Furthermore, in group E versus group C, there was a higher pregnancy rate 30d after the end of bull exposure (26 of 46, 56.2% vs. 16 of 45, 35.6%; P=0.045). In conclusion, weekly exchange of two pairs of bulls shortened postpartum anestrus in suckled multiparous cows, compared to continuous exposure to a single pair of bulls.

  19. 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

  20. Postpartum live virus vaccination: lessons from veterinary medicine.

    PubMed

    Yazbak, F Edward; Diodati, Catherine J M

    2002-09-01

    Pregnant rubella-susceptible women are often revaccinated during the postpartum period with the Measles, Mumps, and Rubella vaccine (MMR). It is known that the rubella virus from vaccine is secreted in breast milk and persists in the nose and throat for up to 28 days but it is not known whether the measles and mumps viruses are similarly secreted. It is probable the measles virus from vaccine is.

  1. Consumption of the Placenta in the Postpartum Period.

    PubMed

    Hayes, Emily Hart

    2016-01-01

    Postpartum women are consuming their placentas to achieve claimed health benefits, including improved mood, energy, and lactation. Strong scientific evidence to substantiate these claims is lacking. Self-reported benefits from some women include improved mood and lactation; animal models suggest there may be an analgesic effect. Possible risks include infection, thromboembolism from estrogens in placental tissue, and accumulation of environmental toxins. Women's health care providers should be aware of this practice to help women make informed decisions.

  2. Safety pin suture for management of atonic postpartum hemorrhage.

    PubMed

    Mostfa, Ali Abdelhamed M; Zaitoun, Mostafa M

    2012-01-01

    Objective. To assess the efficacy of a new suture technique in controlling severe resistant uterine atonic postpartum hemorrhage. Patients and Methods. This is a retrospective observational study that included thirteen women with uterine atony and postpartum bleeding that did not react to usual medical management. All these women underwent compressing vertical suture technique in which the anterior and posterior walls of the uterus were attached so as to compress the uterus. The suture is transfixed at the uterine fundus, thus eliminating the risk of sutures sliding off at the uterine fundus (safety pin suture). Results. safety pin uterine compression suture was a sufficient procedure to stop the bleeding immediately in 92.2% of the women. None of the women developed complications related to the procedure. Conclusion. A new safety pin suture is a simple and effective procedure to control bleeding in patients with treatment-resistant, life-threatening atonic postpartum hemorrhage with the advantage of eliminating the risk of the sutures sliding off at the uterine fundus.

  3. Sleep Quality in Women with and without Postpartum Depression

    PubMed Central

    Posmontier, Bobbie

    2008-01-01

    Objective To compare and measure the effects of sleep quality on women with and without postpartum depression (PPD). Design A case-control repeated measures matched pairs design. Setting Home and obstetric office. Participants Forty-six women who were 6 to 26 weeks postpartum. Two participants were dropped from the final analysis because they were outliers. Methods Participants underwent wrist actigraphy at home for 7 consecutive days to measure sleep quality (sleep latency, wake after sleep onset, sleep efficiency, wake episodes). The Postpartum Depression Screening Scale measured depression severity. Psychosocial variables were collected during a screening interview. A structured clinical interview was used to diagnose PPD. Correlations, t-tests, and hierarchical multiple regressions were run to analyze data. Results With the exception of wake episodes, sleep latency (B = 1.80, S.E. = 0.73, P<0.05), wake after sleep onset (B = 6.85, S.E. = 2.85, P<0.05), and thus sleep efficiency (B = −6.31, S.E. = 3.13, P<0.05) predicted PPD symptom severity. Conclusions Women with PPD experienced poorer sleep quality than women without PPD, and sleep quality worsened with increasing PPD symptom severity. Clinicians need to address measures to improve sleep quality in depressed mothers to decrease symptom severity, and researchers need to develop interventions to facilitate better sleep quality in women with PPD. PMID:19012723

  4. Uterine artery impedance during the first eight postpartum weeks

    PubMed Central

    Guedes-Martins, L.; Gaio, A. R.; Saraiva, J.; Cunha, A.; Macedo, F.; Almeida, H.

    2015-01-01

    The aim of this study was to construct reference ranges for the uterine artery (UtA) mean pulsatility (PI) and resistance (RI) indices from 1–8 weeks postpartum. A prospective, cross-sectional, and observational study was performed with 320 healthy women from week 1 through week 8 postpartum. UtAs were examined transvaginally using colour and pulsed Doppler imaging, and the means of the right and left values of the PI and RI, as well as the presence or absence of a bilateral protodiastolic notch, were recorded. The 5th, 50th and 95th reference percentile curves for the UtA-PI and UtA-RI were derived using regression models. The adjusted reference intervals uncovered a convergence trend at the week 8 time-point, although impedance was lower at the week 1 time-point in multiparous women compared with primiparous women. The notching prevalence was 22.5% (9/40) at week 1 and 95.0% (38/40) at week 8. The study revealed consistent evidence of a progressive increase of postpartum uterine impedance and provided new average UtA-PI and UtA-RI reference charts for weeks 1 through 8. Multiparity does not change the trend but does impart a lower rate of increase, likely as a consequence of previous vascular structural and functional differences. PMID:25739463

  5. Driving through: postpartum care during World War II.

    PubMed Central

    Temkin, E

    1999-01-01

    In 1996, public outcry over shortened hospital stays for new mothers and their infants led to the passage of a federal law banning "drive-through deliveries." This recent round of brief postpartum stays is not unprecedented. During World War II, a baby boom overwhelmed maternity facilities in American hospitals. Hospital births became more popular and accessible as the Emergency Maternal and Infant Care program subsidized obstetric care for servicemen's wives. Although protocols before the war had called for prolonged bed rest in the puerperium, medical theory was quickly revised as crowded hospitals were forced to discharge mothers after 24 hours. To compensate for short inpatient stays, community-based services such as visiting nursing care, postnatal homes, and prenatal classes evolved to support new mothers. Fueled by rhetoric that identified maternal-child health as a critical factor in military morale, postpartum care during the war years remained comprehensive despite short hospital stays. The wartime experience offers a model of alternatives to legislation for ensuring adequate care of postpartum women. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 PMID:10191809

  6. Conceptualizations of postpartum depression by public-sector health care providers in Mexico.

    PubMed

    Place, Jean Marie S; Billings, Deborah L; Blake, Christine E; Frongillo, Edward A; Mann, Joshua R; deCastro, Filipa

    2015-04-01

    In this article we describe the knowledge frameworks that 61 physicians, nurses, social workers, and psychologists from five public-sector health care facilities in Mexico used to conceptualize postpartum depression. We also demonstrate how providers applied social and behavioral antecedents in their conceptualizations of postpartum depression. Using grounded theory, we identify two frameworks that providers used to conceptualize postpartum depression: biochemical and adjustment. We highlight an emerging model of the function of social and behavioral antecedents within the frameworks, as well as the representation of postpartum depression by symptoms of distress and the perception among providers that these symptoms affected responsibilities associated with motherhood. The results provide a foundation for future study of how providers' conceptualizations of postpartum depression might affect detection and treatment practices and might be useful in the development of training materials to enhance the quality of care for women who experience any form of distress in the postpartum period.

  7. The effects of bromocriptine treatment during early pregnancy on postpartum maternal behaviors in rats.

    PubMed

    Price, Anya K; Bridges, Robert S

    2014-09-01

    Prolactin, a hormone of the anterior pituitary, is involved in initiating maternal behavior, alleviating postpartum anxiety, and stimulating lactogenesis. Bromocriptine, a dopamine D2 receptor agonist, inhibits prolactin secretion. Bromocriptine administration represses postpartum maternal behaviors (pup retrieval) in mice, and causes elevated anxiety in the elevated plus maze [Larsen & Grattan (2010). Endocrinology 151(8): 3805-3814]. Whether similar effects exist in other species is unknown. The present study examined the possible involvement of prolactin during early gestation on maternal behavior and anxiety in rats. Bromocriptine given on days 2-4 of pregnancy resulted in impaired postpartum maternal behaviors in a novel environment during early lactation. However, compared to controls, bromocriptine-treated subjects did not exhibit increased postpartum anxiety in the elevated plus maze. These findings support work in mice that bromocriptine treatment during early gestation impedes postpartum maternal care, and indicate that early gestational hormonal status affects postpartum behavior more broadly in other mammals.

  8. Preparedness of pregnant women for childbirth and the postpartum period: their knowledge and fear.

    PubMed

    Tugut, N; Tirkes, D; Demirel, G

    2015-05-01

    The aim of the study was to identify knowledge and fear related to childbirth and the postpartum period in pregnant women. The sample consisted of 114 pregnant women. It was determined that pregnant women had insufficient levels of knowledge related to childbirth and the postpartum period. The Fear of Childbirth and Postpartum Anxiety Scale score for childbirth and the postpartum period related to 'fear regarding the action of childbirth', was found to be the highest. The highest causes for concern were determined to be 'infant-related anxiety' and 'fear regarding infant and puerperal health'. No statistically significant correlation was observed between the perceived sufficiency of the knowledge of pregnant women in terms of maintaining their own health and care, and their mean childbirth and postpartum period concern score. These findings indicate that the level of concern among pregnant women with relation to the postpartum period and childbirth is rather high.

  9. Depression During Pregnancy and the Postpartum Among HIV-Infected Women on Antiretroviral Therapy in Uganda

    PubMed Central

    Matthews, Lynn T.; Ashaba, Scholastic; Tsai, Alexander C.; Kanters, Steve; Robak, Magdalena; Psaros, Christina; Kabakyenga, Jerome; Boum, Yap; Haberer, Jessica E.; Martin, Jeffrey N.; Hunt, Peter W.; Bangsberg, David R.

    2014-01-01

    Background: Among HIV-infected women, perinatal depression compromises clinical, maternal, and child health outcomes. Antiretroviral therapy (ART) is associated with lower depression symptom severity but the uniformity of effect through pregnancy and postpartum periods is unknown. Methods: We analyzed prospective data from 447 HIV-infected women (18–49 years) initiating ART in rural Uganda (2005–2012). Participants completed blood work and comprehensive questionnaires quarterly. Pregnancy status was assessed by self-report. Analysis time periods were defined as currently pregnant, postpartum (0–12 months post-pregnancy outcome), or non–pregnancy-related. Depression symptom severity was measured using a modified Hopkins Symptom Checklist 15, with scores ranging from 1 to 4. Probable depression was defined as >1.75. Linear regression with generalized estimating equations was used to compare mean depression scores over the 3 periods. Results: At enrollment, median age was 32 years (interquartile range: 27–37), median CD4 count was 160 cells per cubic millimeter (interquartile range: 95–245), and mean depression score was 1.75 (s = 0.58) (39% with probable depression). Over 4.1 median years of follow-up, 104 women experienced 151 pregnancies. Mean depression scores did not differ across the time periods (P = 0.75). Multivariable models yielded similar findings. Increasing time on ART, viral suppression, better physical health, and “never married” were independently associated with lower mean depression scores. Findings were consistent when assessing probable depression. Conclusions: Although the lack of association between depression and perinatal periods is reassuring, high depression prevalence at treatment initiation and continued incidence across pregnancy and non–pregnancy-related periods of follow-up highlight the critical need for mental health services for HIV-infected women to optimize both maternal and perinatal health. PMID:25436816

  10. 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 52 weeks 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 (β = -0.5161, p = .0378). Cesarean section was associated with increased OCSs in the postpartum period compared to vaginal delivery (β = 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 (χ (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.

  11. Effect of subclinical uterine infection on cervical and uterine involution, estrous activity and fertility in postpartum buffaloes.

    PubMed

    Usmani, R H; Ahmad, N; Shafiq, P; Mirza, M A

    2001-01-15

    Nili-Ravi buffaloes (n=29) that calved normally between August and November and did not develop any clinical reproductive disorder after calving were studied for the incidence of sub-clinical bacterial infection of the uterus and its effects on postpartum reproductive efficiency. The incidence of subclinical uterine infection was 24% (7/29). Involution of the cervix and uterus was slower (P < 0.01) in the infected group than in the normal group (45.6 vs 31.1 days and 46.3 vs 35.8 days), respectively. The mean diameters of cervix and gravid horn on Day 12 post partum and on completion of involution did not differ between buffaloes of the two groups. However, the rate of involution of the cervix and the gravid horn was lower in buffaloes of the infected group (2.2 vs. 2.7 mm/day and 2.6 vs. 3.2 mm/day). The mean interval to first post partum ovulation was similar in buffaloes in the infected (35.5 days) and the normal group (33.8 days). The life span of corpus luteum formed after first ovulation was shorter (11 days) in buffaloes of both groups than that of a normal estrous cycle (15 to 17 days). The incidence of silent ovulation was apparently higher in buffaloes of the infected group (83 vs. 60%) but the difference was not significant. For the first four months after calving, the mean interval to first postpartum estrus was longer in buffaloes of the infected group (73.0 vs. 47.7 days; P < 0.01). Similarly, the average service period was longer in buffaloes of the infected group (91.0 vs. 64.8 days; P < 0.05). The overall pregnancy rate for the first four months after calving did not differ between buffaloes of the two groups. We conclude that subclinical bacterial infection of the postpartum uterus delays the cervical and uterine involution which can, in turn, delay the occurrence of first postpartum estrus and prolong the service period in buffaloes.

  12. 3,4-methylenedioxyamfetamine (ecstasy) use reduces cognition.

    PubMed

    Chummun, Harry; Tilley, Victoria; Ibe, Jude

    3,4-methylenedioxyamfetamine (MDMA, ecstasy) use reduces cognition by reducing levels of dopamine and serotonin in the central nervous system. This results in dose-related cognition impairment, particularly in complex cognitive skills, as well as causing disorders such as mood changes, hallucinations, altered perception amd memory loss. MDMA reduces the level of these neurotransmitters within the neural synapses by reducing the number of intraneural transporters to the synaptic clefts, increasing deactivation with the synapse and/ or increasing degradation with the pre- and postsynaptic neurons. Users may have varied reasons for MDMA use and therefore require help and support from their families or friends, and knowledgeable and well-skilled healthcare professionals for successful abstinence, avoidance of further psychological damage and a reversal of adverse health effects or reduction in their severity.

  13. Determinants of breast-feeding and post-partum amenorrhoea in Orissa.

    PubMed

    Srinivasan, K; Pathak, K B; Pandey, A

    1989-07-01

    A life table analysis is made of the duration of breast-feeding and post-partum amenorrhoea in Orissa, India, taking one variable at a time using data from a baseline survey of fertility and mortality (BSFM) conducted on the lines of the World Fertility Survey. Then a multivariate (proportional hazard) analysis showed that socioeconomic factors including residence, caste status and education influence the breast-feeding and post-partum amenorrhoea periods. There was no effect of maternal age on the length of breast-feeding, but mean length of post-partum amenorrhoea varied with age. The durations of breast-feeding and post-partum amenorrhoea are strongly related.

  14. Emotional anticipation after delivery - a longitudinal neuroimaging study of the postpartum period.

    PubMed

    Gingnell, Malin; Toffoletto, Simone; Wikström, Johan; Engman, Jonas; Bannbers, Elin; Comasco, Erika; Sundström-Poromaa, Inger

    2017-12-01

    Neuroimaging research has begun to unveil the mechanisms behind emotion processing during the postpartum period, which, in turn, may be of relevance for the development of postpartum depression. The present study sought to longitudinally investigate the neural correlates of emotion anticipation during the postpartum period in healthy women. Functional magnetic resonance imaging was employed to measure the blood oxygen level-dependent signal in the brain in response to anticipation of negative emotional stimuli and during processing of images with positive or negative valence. The participating women were scanned twice: the first scan occurred during the first 48 hours after delivery, and the second was performed 4-6 weeks after delivery. The early postpartum period was characterized by higher anterior cingulate cortex reactivity during anticipation of negative emotional stimuli than the late postpartum period. This was accompanied by a negative relationship with insular reactivity during the early postpartum period and a trend towards an increase in insular reactivity in the late postpartum period. Thus, during the first four weeks of the postpartum period, a diminished top-down regulatory feedback on emotion-related areas of the brain was noted. This finding suggests a physiologically important adaptation during the healthy postpartum period.

  15. Postpartum Pyomyoma, a Rare Complication of Sepsis Associated with Chorioamnionitis and Massive Postpartum Haemorrhage Treated with an Intrauterine Balloon

    PubMed Central

    Kaler, Mandeep; Gailer, Ruth; Iskaros, Joseph; David, Anna L.

    2015-01-01

    We report the successful treatment of a postpartum pyomyoma, a rare but serious complication of uterine leiomyomata in a 28-year-old primigravida. The patient was treated for an Escherichia Coli (E. Coli) urinary tract infection (UTI) at 16 weeks of gestation. She had asymptomatic short cervical length on ultrasound scan at 20 weeks that was managed conservatively due to the presence of further UTI and received antibiotics. She was known to have a left sided intramural leiomyoma. She presented with abdominal pain and vaginal bleeding at 23+1 weeks of gestation and the next day she had spontaneous vaginal delivery and collapsed with E. Coli septic shock, massive postpartum haemorrhage, and disseminated intravascular coagulation and was successfully treated with oxytocic drugs, a Rusch intrauterine balloon, and intravenous antibiotics. Eleven days postnatally she re-presented with systemic sepsis and was treated for retained products of conception. Sepsis persisted and investigations showed a postpartum pyomyoma that was initially managed with intravenous antibiotics to avoid surgery. Ultimately she required laparotomy, drainage of pyomyoma, and myomectomy. Postoperative recovery was good and the patient had a successful pregnancy two years later. PMID:26199774

  16. Synthesis and antimicrobial activity of styryl/pyrrolyl/pyrazolyl sulfonylmethyl-1,3,4-oxadiazolyl amines and styryl/pyrrolyl/pyrazolyl sulfonylmethyl-1,3,4-thiadiazolyl amines.

    PubMed

    Sravya, G; Yamini, G; Padmavathi, V; Padmaja, A

    2016-10-21

    A new class of mono and bis heterocycles - styryl sulfonylmethyl-1,3,4-oxadiazolyl/1,3,4-thiadiazolyl amines, pyrrolyl sulfonylmethyl-1,3,4-oxadiazolyl/1,3,4-thiadiazolyl amines and pyrazolyl sulfonylmethyl-1,3,4-oxadiazolyl/1,3,4-thiadiazolyl amines were prepared from the synthetic intermediate Z-styrylsulfonylacetic acid adopting simple and well versed synthetic methodologies and studied their antimicrobial activity. Amongst all the tested compounds styryl thiadiazole 5c exhibited promising antimicrobial activity against Pseudomonas aeruginosa and Penicillium chrysogenum.

  17. Estradiol Modulates Anhedonia and Behavioral Despair in Rats and Negative Affect in a Subgroup of Women at High Risk for Postpartum Depression

    PubMed Central

    Schiller, Crystal Edler; O’Hara, Michael W.; Rubinow, David R.; Johnson, Alan Kim

    2013-01-01

    In an effort to address inconsistencies in the literature, we tested a cross-species estrogen withdrawal model of postpartum depression (PPD) with a series of rodent experiments and a prospective, naturalistic human study. All rats were ovariectomized prior to experimentation. The first rat experiment examined the effects of low- and high-dose estradiol administration and withdrawal on lateral-hypothalamic self-stimulation, a behavioral index of anhedonia, in experimental (n=7) and vehicle-only control animals (n=7). The second rat experiment examined the effects of high-dose estradiol withdrawal on activity and immobility during the forced swim test, an index of behavioral despair, in a separate group of experimental (n=8) and vehicle-only control animals (n=8). In the human study, women with (n=8) and without (n=12) a history of PPD completed mood ratings and collected saliva samples (to assess estradiol levels) daily during the third trimester of pregnancy through 10 days postpartum. The presence of PPD was assessed at one month postpartum. In the animal studies, rats in the estradiol withdrawal group demonstrated significantly greater immobility and less swimming than controls. Estradiol withdrawal resulted in reduced responding for electrical stimulation (multiple intensities) relative to estradiol administration. In the human study, there was no significant association between estradiol and negative affect among women with or without a history of PPD. However, there was a correlation between daily estradiol levels and negative affect in the women with incident PPD at one month postpartum. Despite important cross-species differences, both the rat and human studies provided evidence of the effects of estradiol on perinatal depressive symptoms. PMID:23770328

  18. Developmental milestones record - 6 months

    MedlinePlus

    Normal childhood growth milestones - 6 months; Childhood growth milestones - 6 months; Growth milestones for children - 6 months ... the weight on hands (often occurs by 4 months) Able to pick up a dropped object Able ...

  19. Developmental milestones record - 12 months

    MedlinePlus

    Normal childhood growth milestones - 12 months; Growth milestones for children - 12 months; Childhood growth milestones - 12 months ... care provider. PHYSICAL AND MOTOR SKILLS A 12-month-old child is expected to: Be 3 times ...

  20. Developmental milestones record - 18 months

    MedlinePlus

    Growth milestones for children - 18 months; Normal childhood growth milestones - 18 months; Childhood growth milestones - 18 months ... PHYSICAL AND MOTOR SKILL MARKERS The typical 18-month-old: Has a closed soft spot on the ...