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Sample records for active mothers postpartum

  1. 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…

  2. Pregnancy Problems, Postpartum Depression, and Early Mother-Infant Interactions.

    ERIC Educational Resources Information Center

    Field, Tiffany; And Others

    1985-01-01

    Mothers observed at 3 to 5 months postpartum interacting with their infants were given attitude questionnaires. Mothers who had reported preganancy problems were more depressed and anxious and expressed more punitive childrearing attitudes than mothers not reporting pregnancy problems. (Author/NH)

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

    PubMed

    Chambers, Angelina N

    2009-08-01

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

  4. Postpartum Transitions in Adolescent Mothers' Romantic and Maternal Relationships.

    ERIC Educational Resources Information Center

    Gee, Christina B.; Rhodes, Jean E.

    1999-01-01

    Interviewed adolescent mothers at prepartum or early postpartum and 1 year later regarding maternal and romantic relationships, depression, and negative life events. Responses indicated that over time male partner support became more important than maternal support. (LBT)

  5. Postpartum depression, suicidality, and mother-infant interactions.

    PubMed

    Paris, Ruth; Bolton, Rendelle E; Weinberg, M Katherine

    2009-10-01

    To date, few studies have examined suicidality in women with postpartum depression. Reports of suicidal ideation in postpartum women have varied (Lindahl et al. Arch Womens Ment Health 8:77-87, 2005), and no known studies have examined the relationship between suicidality and mother-infant interactions. This study utilizes baseline data from a multi-method evaluation of a home-based psychotherapy for women with postpartum depression and their infants to examine the phenomenon of suicidality and its relationship to maternal mood, perceptions, and mother-infant interactions. Overall, women in this clinical sample (n = 32) had wide ranging levels of suicidal thinking. When divided into low and high groups, the mothers with high suicidality experienced greater mood disturbances, cognitive distortions, and severity of postpartum symptomotology. They also had lower maternal self-esteem, more negative perceptions of the mother-infant relationship, and greater parenting stress. During observer-rated mother-infant interactions, women with high suicidality were less sensitive and responsive to their infants' cues, and their infants demonstrated less positive affect and involvement with their mothers. Implications for clinical practice and future research directions are discussed.

  6. Postpartum factors related to mother's attraction to newborn infant odors.

    PubMed

    Fleming, A S; Corter, C; Franks, P; Surbey, M; Schneider, B; Steiner, M

    1993-03-01

    Hedonic responses to a variety of infant (general body, urine, and feces) and noninfant (lotion, cheese, and spice) odorants were compared in four groups of subjects: new mothers, mothers a 1-month postpartum, and female and male nonparents. Using standard scaling procedures, subjects rated each of the odorants twice on a scale from extremely unpleasant (-20.5) to extremely pleasant (+20.5). In addition, all subjects completed a set of attitude questionnaires, and mothers also answered a childbirth questionnaire and were observed while feeding their infants.

  7. The other mother: a narrative analysis of the postpartum experiences of nonbirth lesbian mothers.

    PubMed

    McKelvey, Michele M

    2014-01-01

    The purpose of this study was to develop a metastory of nonbiological lesbian mothers' postpartum experiences utilizing Riessman's structural approach to thematic analysis. Ten nonbirth lesbian mothers were interviewed. Each shared a unique story of her first year of motherhood. Themes were individually analyzed within each story. The metastory of the postpartum experiences of nonbirth lesbian mothers revealed 6 themes including the following: At the mercy of health care providers, Nursing is the major difference between us, Defined by who I am not, Fighting for every piece of motherhood: The world can take them away, What's in a name?, and Epilogue: The new normal.

  8. 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).

  9. Body Image and Body Satisfaction Differ by Race in Overweight Postpartum Mothers

    PubMed Central

    Bastian, Lori A.; Revels, Jessica; Durham, Holiday; Lokhnygina, Yuliya; Amamoo, M. Ahinee; Ostbye, Truls

    2010-01-01

    Abstract Background Body image (BI) and body satisfaction may be important in understanding weight loss behaviors, particularly during the postpartum period. We assessed these constructs among African American and white overweight postpartum women. Methods The sample included 162 women (73 African American and 89 white) in the intervention arm 6 months into the Active Mothers Postpartum (AMP) Study, a nutritional and physical activity weight loss intervention. BIs, self-reported using the Stunkard figure rating scale, were compared assessing mean values by race. Body satisfaction was measured using body discrepancy (BD), calculated as perceived current image minus ideal image (BD<0: desire to be heavier; BD>0: desire to be lighter). BD was assessed by race for: BDIdeal (current image minus the ideal image) and BDIdeal Mother (current image minus ideal mother image). Results Compared with white women, African American women were younger and were less likely to report being married, having any college education, or residing in households with annual incomes >$30,000 (all p < 0.01). They also had a higher mean body mass index (BMI) (p = 0.04), although perceived current BI did not differ by race (p = 0.21). African Americans had higher mean ideal (p = 0.07) and ideal mother (p = 0.001) BIs compared with whites. African Americans' mean BDs (adjusting for age, BMI, education, income, marital status, and interaction terms) were significantly lower than those of whites, indicating greater body satisfaction among African Americans (BDIdeal: 1.7 vs. 2.3, p = 0.005; BDIdeal Mother: 1.1 vs. 1.8, p = 0.0002). Conclusions Racial differences exist in postpartum weight, ideal images, and body satisfaction. Healthcare providers should consider tailored messaging that accounts for these racially different perceptions and factors when designing weight loss programs for overweight mothers. PMID:20113143

  10. Clinically Identified Postpartum Depression in Asian American Mothers

    PubMed Central

    Goyal, Deepika; Wang, Elsie J.; Shen, Jeremy; Wong, Eric C.; Palaniappan, Latha P.

    2015-01-01

    Objective To identify the clinical diagnosis rate of postpartum depression (PPD) in Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) compared to non-Hispanic Whites. Design Cross-sectional study using electronic health records (EHR). Setting A large, outpatient, multiservice clinic in Northern California. Participants A diverse clinical population of non-Hispanic White (N = 4582), Asian Indian (N = 1264), Chinese (N = 1160), Filipino (N = 347), Japanese (N = 124), Korean (N = 183), and Vietnamese (N = 147) mothers. Methods Cases of PPD were identified from EHRs using physician diagnosis codes, medication usage, and age standardized for comparison. The relationship between PPD and other demographic variables (race/ethnicity, maternal age, delivery type, marital status, and infant gender) were examined in a multivariate logistic regression model. Results The PPD diagnosis rate for all Asian American mothers in aggregate was significantly lower than the diagnosis rate in non-Hispanic White mothers. Moreover, of the six Asian American subgroups, PPD diagnosis rates for Asian Indian, Chinese, and Filipino mothers were significantly lower than non-Hispanic White mothers. In multivariate analyses, race/ethnicity, age, and cesarean were significant predictors of PPD. Conclusion In this insured population, PPD diagnosis rates were lower among Asian Americans, with variability in rates across the individual Asian American subgroups. It is unclear whether these lower rates are due to underreporting, underdiagnosis, or underutilization of mental health care in this setting. PMID:22536783

  11. Postpartum depression in adolescent mothers: an integrative review of the literature.

    PubMed

    Reid, Vanessa; Meadows-Oliver, Mikki

    2007-01-01

    Research on adolescent mothers has revealed increasing rates of depressive symptoms in the postpartum period. This review integrated 12 research-based articles to provide a better understanding of depression among adolescent mothers in the first year postpartum. The results revealed that more family conflict, fewer social supports, and low self-esteem all were associated with increased rates of depressive symptoms in adolescent mothers during the first postpartum year. To prevent adverse outcomes associated with depression, it is important that nurse practitioners working with these families screen adolescent mothers for depression and refer them for treatment as needed.

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

    PubMed

    Trautmann-Villalba, P; Hornstein, C

    2007-11-01

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

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

    PubMed

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

    2013-08-01

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

  14. Early School Outcomes for Children of Postpartum Depressed Mothers: Comparison with a Community Sample

    ERIC Educational Resources Information Center

    Kersten-Alvarez, Laura E.; Hosman, Clemens M. H.; Riksen-Walraven, J. Marianne; van Doesum, Karin T. M.; Smeekens, Sanny; Hoefnagels, Cees

    2012-01-01

    Previous studies of the long-term effects of maternal postpartum depression (PPD) on child development have mostly focused on a limited set of outcomes, and have often not controlled for risk factors associated with maternal depression. The present study compared children of postpartum depressed mothers (n = 29) with children from a community…

  15. Factors associated with breastfeeding duration and exclusivity in mothers returning to paid employment postpartum.

    PubMed

    Bai, Dorothy Li; Fong, Daniel Yee Tak; Tarrant, Marie

    2015-05-01

    Mothers who are employed postpartum are less likely to continue breastfeeding than mothers who are not formally employed. However, as postpartum employment is increasingly necessary for the majority of new mothers, it is important to investigate factors that influence the continuation of breastfeeding in employed mothers. A sample of 1,738 mothers who returned to paid employment postpartum were recruited from the obstetric units of four public hospitals in Hong Kong, and prospectively followed for 12 months or until their infant was weaned. More than 85 % of participants returned to formal employment within 10 weeks postpartum, with over 90 % of these employed full-time. About one-third of the participants (32 %) were able to combine breastfeeding and employment, with breastfeeding defined as continuing for more than 2 weeks after returning to work postpartum. Later return to work and higher maternal education were associated with new mothers being able to combine breastfeeding and employment. Later return to work, shorter working hours, parental childcare, and higher maternal education were also associated with less likelihood of weaning from any or exclusive breastfeeding. Improvements in employment-related conditions for mothers and additional support for lower educated mothers may be effective strategies to enable employed women to continue breastfeeding after their return to work.

  16. Postpartum Intimate Partner Violence and Health Risks Among Young Mothers in the United States: A Prospective Study

    PubMed Central

    Ickovics, Jeannette; Lewis, Jessica B.; Magriples, Urania; Kershaw, Trace S.

    2014-01-01

    The study assessed the relationship between postpartum intimate partner violence (IPV) and postpartum health risks among young mothers over time. Data were collected from 2001 to 2005 on young women aged 14–25 attending obstetrics and gynecology clinics in two US cities. Postpartum IPV (i.e., emotional, physical, sexual) was assessed at 6 and 12 months after childbirth (n = 734). Four types of postpartum IPV patterns were examined: emerged IPV, dissipated IPV, repeated IPV, and no IPV. Emerged IPV occurred at 12 months postpartum, not 6 months postpartum. Dissipated IPV occurred at 6 months postpartum, not 12 months postpartum. Repeated IPV was reported at 6 months and 12 months postpartum. Postpartum health risks studied at both time points were perceived stress, depression, fear of condom negotiation, condom use, infant sleeping problems, and parental stress. Repeated measures analysis of covariance was used. The proportion of young mothers reporting IPV after childbirth increased from 17.9 % at 6 months postpartum to 25.3 % at 12 months postpartum (P < 0.001). Emerged and/or repeated postpartum IPV were associated with increased perceived stress, depression, fear of condom negotiation, and infant sleeping problems as well as decreased condom use (P < 0.05). Dissipated postpartum IPV was associated with decreased depression (P < 0.05). IPV screening and prevention programs for young mothers may reduce health risks observed in this group during the postpartum period. PMID:24562504

  17. 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…

  18. Perceptions and Satisfaction with Father Involvement and Adolescent Mothers' Postpartum Depressive Symptoms

    ERIC Educational Resources Information Center

    Fagan, Jay; Lee, Yookyong

    2010-01-01

    This study examined the associations between adolescent mothers' postpartum depressive symptoms and their perceptions of amount of father care giving and satisfaction with father involvement with the baby. The sample included 100 adolescent mothers (ages 13-19; mainly African-American and Latina) whose partners were recruited for a randomized…

  19. The psychological effects of aromatherapy-massage in healthy postpartum mothers.

    PubMed

    Imura, Masumi; Misao, Hanako; Ushijima, Hiroshi

    2006-01-01

    This study examined the effect of aromatherapy-massage in healthy postpartum mothers. A quasi-experimental between-groups design was used. Mothers who received aromatherapy-massage were compared with a control group who received standard postpartum care. Thirty-six healthy, first-time mothers with vaginal delivery of a full-term, healthy infant participated in this study. Sixteen mothers received a 30-minute aromatherapy-massage on the second postpartum day; 20 mothers were in the control group. All mothers completed the following four standardized questionnaires before and after the intervention: 1) Maternity Blues Scale; 2) State-Trait Anxiety Inventory; 3) Profile of Mood States (POMS); and 4) Feeling toward Baby Scale. In the aromatherapy-massage group, posttreatment scores significantly decreased for the Maternity Blues Scale, the State-Anxiety Inventory, and all but one of the Profile of Mood States subscales. Posttreatment scores in the intervention group significantly increased in Profile of Mood States-Vigor subscale and the Approach Feeling toward Baby subscale. Scores in the intervention group significantly decreased in Conflict Index of Avoidance/Approach Feeling toward Baby subscale. Our results suggest that aromatherapy-massage might be an effective intervention for postpartum mothers to improve physical and mental status and to facilitate mother-infant interaction.

  20. Social Support, Postpartum Depression, and Professional Assistance: A Survey of Mothers in the Midwestern United States

    PubMed Central

    Corrigan, Catherine P.; Kwasky, Andrea N.; Groh, Carla J.

    2015-01-01

    ABSTRACT Transition into motherhood is generally a joyful life event; for some women, however, it is marked by emotional turmoil. Lack of support can be associated with postpartum depression and can compromise both the mother and infant. A descriptive, cross-sectional study (N = 61) was conducted to explore the relationship between social support and postpartum depression and to determine whether mothers overwhelmed with childcare, or overwhelmed with life in general since becoming a mother, sought professional help. The results revealed that screening for depression alone may not be sufficient, that mothers are willing to contact a professional for help in the postpartum period, and that assessments after birth should include a broader assessment of life’s difficulties rather than focusing on childcare responsibilities alone. PMID:26937161

  1. Prevention of postpartum smoking relapse in mothers of infants in the neonatal intensive care unit

    PubMed Central

    Phillips, R M; Merritt, T A; Goldstein, M R; Deming, D D; Slater, L E; Angeles, D M

    2012-01-01

    Objective: Approximately 40% of women who smoke tobacco quit smoking during pregnancy, yet up to 85% relapse after delivery. Those who resume smoking often do so by 2 to 8 weeks postpartum. Smoking mothers are more than twice as likely to quit breastfeeding by 10 weeks postpartum. The hospitalization of a newborn, while stressful, is an opportunity to emphasize the importance of a smoke-free environment for babies. Supporting maternal-infant bonding may reduce maternal stress and motivate mothers to remain smoke free and continue breastfeeding. The objective of this study was to reduce postpartum smoking relapse and prolong breastfeeding duration during the first 8 weeks postpartum in mothers who quit smoking just before or during pregnancy and have newborns admitted to the Neonatal Intensive Care Unit (NICU). Study Design: This study was an Institutional Review Board-approved prospective randomized clinical trial. After informed consent, mothers of newborns admitted to the NICU were randomized to a control or intervention group. Both groups received weekly encouragement to remain smoke free and routine breastfeeding support. Mothers in the intervention group were also given enhanced support for maternal-infant bonding including information about newborn behaviors, and were encouraged to frequently hold their babies skin-to-skin. Result: More mothers were smoke free (81 vs 46%, P<0.001) and breastfeeding (86 vs 21%, P<0.001) in the intervention than in the control group at 8 weeks postpartum. Conclusion: Interventions to support mother–infant bonding during a newborn's hospitalization in the NICU are associated with reduced rates of smoking relapse and prolonged duration of breastfeeding during the first 8 weeks postpartum. PMID:21836549

  2. Postpartum cultural practices are negatively associated with depressive symptoms among Chinese and Vietnamese immigrant mothers married to Taiwanese men.

    PubMed

    Chen, Tzu-Ling; Tai, Chen-Jei; Wu, Tsai-Wei; Chiang, Ching-Ping; Chien, Li-Yin

    2012-01-01

    The objectives of researchers in this study were to examine acceptance and adherence to mainstream Taiwanese postpartum cultural practices and their association with postpartum depressive symptoms among Chinese and Vietnamese immigrant mothers married to Taiwanese men. While the postpartum cultural practices in China are similar to mainstream Taiwanese practices, those of Vietnam differ from Taiwanese practices. This cross-sectional survey was conducted in Taiwan from October 2007 through March 2008, and included190 immigrant mothers from China and Vietnam who had delivered a child within the past year. Immigrant mothers from China had higher levels of acceptance and adherence to mainstream Taiwanese postpartum cultural practices and a lower rate of postpartum depressive symptoms than immigrant mothers from Vietnam, but the association between adherence to "doing-the-month" practices and postpartum depressive symptoms did not vary significantly between Chinese and Vietnamese mothers. Adherence to these practices was negatively associated with postpartum depressive symptoms among immigrant mothers (OR = 0.93, 95% CI: 0.90-0.96) after adjustment for social support, duration between moving to Taiwan and delivery, and country of origin. Adherence to mainstream postpartum cultural practices was negatively associated with postpartum depressive symptoms for both Chinese and Vietnamese immigrant women married to Taiwanese men. PMID:22860702

  3. Postpartum cultural practices are negatively associated with depressive symptoms among Chinese and Vietnamese immigrant mothers married to Taiwanese men.

    PubMed

    Chen, Tzu-Ling; Tai, Chen-Jei; Wu, Tsai-Wei; Chiang, Ching-Ping; Chien, Li-Yin

    2012-01-01

    The objectives of researchers in this study were to examine acceptance and adherence to mainstream Taiwanese postpartum cultural practices and their association with postpartum depressive symptoms among Chinese and Vietnamese immigrant mothers married to Taiwanese men. While the postpartum cultural practices in China are similar to mainstream Taiwanese practices, those of Vietnam differ from Taiwanese practices. This cross-sectional survey was conducted in Taiwan from October 2007 through March 2008, and included190 immigrant mothers from China and Vietnam who had delivered a child within the past year. Immigrant mothers from China had higher levels of acceptance and adherence to mainstream Taiwanese postpartum cultural practices and a lower rate of postpartum depressive symptoms than immigrant mothers from Vietnam, but the association between adherence to "doing-the-month" practices and postpartum depressive symptoms did not vary significantly between Chinese and Vietnamese mothers. Adherence to these practices was negatively associated with postpartum depressive symptoms among immigrant mothers (OR = 0.93, 95% CI: 0.90-0.96) after adjustment for social support, duration between moving to Taiwan and delivery, and country of origin. Adherence to mainstream postpartum cultural practices was negatively associated with postpartum depressive symptoms for both Chinese and Vietnamese immigrant women married to Taiwanese men.

  4. [Comorbid Personality Disorders and Parenting Stress in Mothers with Postpartum Depression].

    PubMed

    Ramsauer, Brigitte

    2016-01-01

    The original peer-reviewed paper presents the results of the analysis of the effects of psychiatric comorbidities of maternal postpartum depression, anxiety disorder and personality disorder (PD) on parenting stress. In the aforementioned analysis, mothers without PD (depression/ anxiety only) were compared to mothers with Borderline PD and mothers with other PD. Depending on the maternal PD, different sources of parenting stress have been revealed as specific to the mothers’ experience of parenting stress, suggesting differential indications for psychosocial interventions to ease the burden of stress on the mother-infant system. PMID:27027218

  5. [Comorbid Personality Disorders and Parenting Stress in Mothers with Postpartum Depression].

    PubMed

    Ramsauer, Brigitte

    2016-01-01

    The original peer-reviewed paper presents the results of the analysis of the effects of psychiatric comorbidities of maternal postpartum depression, anxiety disorder and personality disorder (PD) on parenting stress. In the aforementioned analysis, mothers without PD (depression/ anxiety only) were compared to mothers with Borderline PD and mothers with other PD. Depending on the maternal PD, different sources of parenting stress have been revealed as specific to the mothers’ experience of parenting stress, suggesting differential indications for psychosocial interventions to ease the burden of stress on the mother-infant system.

  6. Young Mothers' Involvement in a Prenatal and Postpartum Support Program

    ERIC Educational Resources Information Center

    Wen, Xiaoli; Korfmacher, Jon; Hans, Sydney L.; Henson, Linda G.

    2010-01-01

    The involvement of 124 young mothers in a doula support program was measured in two dimensions--quantity of program contact and quality of mother-doula helping relationship. The study examined each dimension's differential associations with maternal outcomes, as well as the moderating effects of mother characteristics on these associations.…

  7. Functional Status Outcomes in Mothers with and without Postpartum Depression

    PubMed Central

    Posmontier, Barbara

    2008-01-01

    Objective To compare functional status between women with and without postpartum depression (PPD). Methods A two-group cross-sectional design compared functional status between 23 women with and 23 women without PPD. Participants were 6 to 26 weeks postpartum, and from obstetric practices in the Northeastern United States. Structured clinical interviews were used to establish diagnoses of PPD. Participants were matched on type of delivery, weeks postpartum, and parity. Participants compared current functioning to pre-pregnancy functioning utilizing the Inventory of Functional Status After Childbirth. The Postpartum Depression Screening Scale was used to measure PPD severity. Hierarchical multiple and logistic regression models were used to analyze data. Results Controlling for infant gender, number of nighttime infant awakenings, and income, PPD predicted lower personal (P<0.001), household (P<0.05), and social functioning (P<0.001), but no difference in infant care. Women with PPD were 12 times less likely to achieve pre-pregnancy functional levels. Conclusions Interventions are needed to address household, social, and personal functioning in women with PPD. Clinicians may find functional assessment is a useful adjunct and a less threatening way to screen and monitor treatment for PPD. PMID:18586183

  8. HIV control in postpartum mothers: a turbulent time.

    PubMed

    Loftus, Hannah; Burnett, Alexander; Naylor, Simone; Bates, Sylvia; Greig, Julia

    2016-07-01

    We conducted an audit looking at the management of HIV-positive women in the postpartum period. We found that of the women with a previous AIDS-defining condition or a CD4 count <350 cells/µL, 83% were correctly continued on antiretroviral therapy (ART) and 84.1% of these had good virological control. ART was correctly stopped in 100% of women who had always had a CD4 count >500 cells/µL. A significant finding from our audit was that all of the women who had poor virological control or stopped ART against medical advice had social issues or self-reported depression. The main recommendation was to extend the pregnancy multidisciplinary team (MDT) meeting to include the 12-month postpartum period to offer support to women to try to improve treatment outcomes. PMID:26384944

  9. Prenatal depression predicts postpartum maternal attachment in low-income Latina mothers with infants.

    PubMed

    Perry, Deborah F; Ettinger, Anna K; Mendelson, Tamar; Le, Huynh-Nhu

    2011-04-01

    Although maternal attachment is an important predictor of infant attachment security and other developmental outcomes, little is known about the formation of maternal attachment in the first few months of the infant's life, particularly among ethnic minority mothers. The current study examined the predictors of postpartum maternal attachment in a sample of 217 Latina women enrolled in a perinatal depression prevention trial. Mothers' attachment to their infants was measured at 6-8 weeks postpartum using the Maternal Postnatal Attachment Scale. A variety of predictors of early attachment were explored including: depressive symptoms during pregnancy, pregnancy intention, feelings about the pregnancy, and the quality of the partner relationship. The strongest predictor of lower maternal attachment was depressive symptoms late in pregnancy; pregnancy intention was marginally predictive of attachment, with lower scores being associated with unwanted pregnancies. The study fills a critical gap in our understanding of the role of depressive symptoms during pregnancy in shaping mothers' early attachment to their infants. PMID:21402409

  10. 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

  11. The relationship between parental stress and postpartum depression among adolescent mothers enrolled in a randomized controlled prevention trial.

    PubMed

    Venkatesh, Kartik K; Phipps, Maureen G; Triche, Elizabeth W; Zlotnick, Caron

    2014-08-01

    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 lead to less

  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. Reducing Postpartum Depressive Symptoms Among Black and Latina Mothers: A Randomized Controlled Trial

    PubMed Central

    Howell, Elizabeth A; Balbierz, Amy; Wang, Jason; Parides, Michael; Zlotnick, Caron; Leventhal, Howard

    2012-01-01

    OBJECTIVE To estimate the effectiveness of a behavioral educational intervention to reduce postpartum depressive symptoms among minority mothers. METHODS We recruited 540 self-identified black or African American and Latina or Hispanic mothers during their postpartum hospital stay and randomized them to receive a behavioral educational intervention or enhanced usual care. The intervention arm received a two-step behavioral educational intervention that prepares and educates mothers about modifiable factors associated with symptoms of postpartum depression (physical symptoms, low social support, low self-efficacy, and infant factors), bolsters social support, enhances management skills, and increases participants’ access to resources. Enhanced usual care participants received a list of community resources and received a 2-week control call. Participants were surveyed prior to randomization, 3-weeks, 3-months, and 6-months later to assess depressive symptoms. The primary outcome, depression, was assessed using the Edinburgh Postnatal Depression Scale (score of 10 or greater). RESULTS Positive depression screens were less common among intervention vs. enhanced usual care post-hospitalization: 3-weeks (8.8% vs. 15.3%, p=.03), 3-months (8.4% vs. 13.24%, p=.09) and 6-months (8.9% vs.13.7%, p=.11). An intention-to-treat repeated measures analysis for up to 6 months of follow-up demonstrated that mothers in the intervention group were less likely to screen positive for depression versus enhanced usual care (odds ratio of 0.67; 95% confidence interval [CI] 0.47–0.97; number needed to treat, 16; 95% CI: 9–112) CONCLUSION An action oriented behavioral educational intervention reduced positive depression screens among black and Latina postpartum mothers. PMID:22488220

  14. Interactive regulation of affect in postpartum depressed mothers and their infants: an overview.

    PubMed

    Reck, Corinna; Hunt, Aoife; Fuchs, Thomas; Weiss, Robert; Noon, Andrea; Moehler, Eva; Downing, George; Tronick, Edward Z; Mundt, Christoph

    2004-01-01

    Specific patterns of interaction emerging in the first months of life are related to processes regulating mutual affects in the mother-child dyad. Particularly important for the dyad are the matching and interactive repair processes. The interaction between postpartum depressed mothers and their children is characterized by a lack of responsiveness, by passivity or intrusiveness, withdrawal and avoidance, as well as a low level of positive expression of affect. Thus, an impaired capability to regulate the child's affect has been demonstrated in depressed mothers. Maternal aggression, neglect toward infants, infanticidal thoughts, as well as infanticidal behavior are mainly linked to severe postpartum depression, especially with psychotic symptoms. The findings on mother-child interaction reported in this paper are based on mothers with mild to moderate depressive disorders without psychotic symptoms. Considering the stability of interaction patterns in the course of depressive illness as well as the long-term consequences of these interactions, it seems surprising that there are still few systematic studies of depressed mothers interacting with their infants. In connection with an overview on these issues, treatment models for parent-infant psychotherapy are discussed. PMID:15539778

  15. Effect of Prepregnancy Alcohol Consumption on Postpartum Relationship Satisfaction and Divorce among Norwegian Mothers

    PubMed Central

    Mellingen, Sonja; Torsheim, Torbjørn; Thuen, Frode

    2015-01-01

    This study assessed the effect of prepregnancy level of alcohol use among mothers on relationship breakups with young children at 36 months after birth and the extent to which relationship satisfaction (RS) throughout the postpartum period could mediate any association between alcohol use and divorce. The data were part of the Norwegian Mother and Child Cohort Study, and analyses of the present article were based on a total of 69,117 mothers divided into low-, medium-, and high-risk consumption groups. All the three groups experienced a decrease in RS, but the largest effect was observed for the high-risk group. Mothers in this group had 55% higher odds for divorce as compared to the low-risk group. The findings supported a conceptual model whereby the effects of alcohol use on divorce were mediated through lowered RS. PMID:26740743

  16. WIC mothers' social environment and postpartum health on breastfeeding initiation and duration.

    PubMed

    Darfour-Oduro, Sandra Asantewaa; Kim, Juhee

    2014-12-01

    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

  17. 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

  18. Screening for postpartum depression among low-income mothers using an interactive voice response system.

    PubMed

    Kim, Helen G; Geppert, Joni; Quan, Tu; Bracha, Yiscah; Lupo, Virginia; Cutts, Diana B

    2012-05-01

    This study tested the feasibility of using an interactive voice response (IVR) phone system to screen for postpartum depression among low-income, English- and Spanish-speaking mothers. Newly delivered mothers were interviewed in the hospital. Consenting subjects completed a background questionnaire and were asked to call an automated phone system 7 days postpartum to complete an IVR version of the Edinburgh Postnatal Depression Screen (EPDS). During the phone screen, subjects were branched to different closing narratives based on their depression scores which were later posted to a password protected website. Logistic regression was used to assess relationships between demographic and psychosocial factors, IVR participation, and depression scores. Among 838 ethnically diverse, low income, postpartum mothers, 324 (39%) called into the automated phone screening system. Those who called were more likely to have at least a high school education (OR = 1.63, 95%CI: 1.23, 2.16), be employed (OR = 1.48, 95%CI: 1.08, 2.03) and have food secure households (OR = 1.50, 95%CI: 1.06, 2.13). There was no statistically significant difference between callers and non-callers in terms of marital status, race/ethnicity, parity, or self-reported history of depression. Postpartum depression symptoms were present in 17% (n = 55) and were associated with being single (AOR = 2.41, 95% CI: 1.29, 4.50), first time mother status (AOR = 2.43, 95% CI: 1.34, 4.40), temporary housing (AOR = 2.35, 95% CI: 1.30, 4.26), history of anxiety (AOR = 2.79, 95% CI: 1.69, 6.67), and history of self-harm (AOR = 2.66, 95% C: 1.01, 6.99). Automated phone screening for postpartum depression is feasible among disadvantaged mothers but those with the highest psychosocial risk factors may not choose or be able to access it. IVR could be used to supplement office- and home visit-based screening protocols and to educate patients about mental health resources. PMID:21584791

  19. Screening for postpartum depression among low-income mothers using an interactive voice response system.

    PubMed

    Kim, Helen G; Geppert, Joni; Quan, Tu; Bracha, Yiscah; Lupo, Virginia; Cutts, Diana B

    2012-05-01

    This study tested the feasibility of using an interactive voice response (IVR) phone system to screen for postpartum depression among low-income, English- and Spanish-speaking mothers. Newly delivered mothers were interviewed in the hospital. Consenting subjects completed a background questionnaire and were asked to call an automated phone system 7 days postpartum to complete an IVR version of the Edinburgh Postnatal Depression Screen (EPDS). During the phone screen, subjects were branched to different closing narratives based on their depression scores which were later posted to a password protected website. Logistic regression was used to assess relationships between demographic and psychosocial factors, IVR participation, and depression scores. Among 838 ethnically diverse, low income, postpartum mothers, 324 (39%) called into the automated phone screening system. Those who called were more likely to have at least a high school education (OR = 1.63, 95%CI: 1.23, 2.16), be employed (OR = 1.48, 95%CI: 1.08, 2.03) and have food secure households (OR = 1.50, 95%CI: 1.06, 2.13). There was no statistically significant difference between callers and non-callers in terms of marital status, race/ethnicity, parity, or self-reported history of depression. Postpartum depression symptoms were present in 17% (n = 55) and were associated with being single (AOR = 2.41, 95% CI: 1.29, 4.50), first time mother status (AOR = 2.43, 95% CI: 1.34, 4.40), temporary housing (AOR = 2.35, 95% CI: 1.30, 4.26), history of anxiety (AOR = 2.79, 95% CI: 1.69, 6.67), and history of self-harm (AOR = 2.66, 95% C: 1.01, 6.99). Automated phone screening for postpartum depression is feasible among disadvantaged mothers but those with the highest psychosocial risk factors may not choose or be able to access it. IVR could be used to supplement office- and home visit-based screening protocols and to educate patients about mental health resources.

  20. 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…

  1. Relationship between fatigue and sleepiness with general health of mothers in the postpartum period

    PubMed Central

    Khayamim, Nafiseh; Bahadoran, Parvin; Mehrabi, Tayebeh

    2016-01-01

    Background: Fatigue and changes in sleep patterns are one of the impressive features in the first year after birth, which have negative effects on work, family life, and social relationships. Therefore, the objective of this research was to investigate the relationship between fatigue and Stanford sleepiness with the general health of mothers in the postpartum period. Materials and Methods: The current research is a descriptive correlational study which was performed on 190 mothers between 2 and 24 postpartum weeks, referring to the health centers of Isfahan in 2014. All mothers meeting the inclusion criteria were selected through cluster purposive sampling. Data were collected by use of four questionnaires including profile and fertility, fatigue, Stanford sleepiness, and general health. Data were analyzed by statistical tests at a significance level of ≤0.05. Results: The results showed that 5.3%, 59.5%, and 35.3% of subjects had mild, moderate, and severe fatigue, respectively. In addition, 26.3% of women showed a public health disorder, and according to Stanford sleepiness, 20.5% of subjects had sleepiness. The statistical results indicated that there were significant relationships between fatigue (P ≤ 0.001, r = 0.52) and Stanford sleepiness (P = 0.04, r = 0.14), and mothers’ general health. Conclusions: According to prevalence of fatigue and sleepiness in the postpartum period and its relationship with maternal health, application of sleep health education and appropriate counseling during pregnancy and after delivery is recommended to prevent mothers’ mental complications in order to achieve a safe pregnancy. PMID:27563322

  2. Randomized Trial of Psychological Interventions to Preventing Postpartum Depression among Iranian First-time Mothers

    PubMed Central

    Fathi-Ashtiani, Ali; Ahmadi, Ahmad; Ghobari-Bonab, Bagher; Azizi, Mohammed Parsa; Saheb-Alzamani, Sayeh Moosavi

    2015-01-01

    Background: The current study was conducted to examine the effect of cognitive behavior therapy on the reduction postpartum mood disorder and increasing the self-esteem of at-risk Iranian mothers. Methods: In this quasi-experimental study, 135 at-risk mothers were selected from the population by means of cluster sampling and randomly assigned into one of two groups: Intervention (n = 64), or control (n = 71). The control group received usual medical care, and the intervention group received an eight sessions’ cognitive behavior program during pregnancy. Assessments were administered at two time points (pretest at the beginning of the third trimester and posttest at 2 weeks postpartum). Beck anxiety, beck depression, Edinburgh postpartum depression, (PPD) Coopersmith self-esteem, and religious attitude questionnaire were used to collect data. Results: The mean age of participants was 25.8 ± 3.7 years. One-third of them had either bachelor or higher degrees in education (33%). About two-third of participants were unemployment with similar distribution in both the groups (intervention = 80%, control = 83%). The majority (70%) of the participants had cesarean section deliveries. There were no statistically significant differences respects to sociodemographic characteristics between the control and intervention groups (P > 0.05). The multivariate analysis of covariance results showed that the average scores of PPD were reduced significantly in the intervention group (P < 0.001). Also while the mean score of anxiety in the intervention group decreased from 23.31 (standard error [SE] =12.11) to 16.64 (SE = 8.33) and self-esteem increased from 29.09 (SE = 3.51) to 31.81 (SE = 2.76), no change was statistically significant in comparison to the control group. Conclusions: According to the findings of the present study, cognitive behavior intervention is effective in reducing PPD in at-risk mothers. PMID:26682030

  3. How much does Low Socioeconomic Status Increase the Risk of Prenatal and Postpartum Depressive Symptoms in First Time Mothers?

    PubMed Central

    Goyal, Deepika; Gay, Caryl; Lee, Kathryn A.

    2009-01-01

    Objective To examine socioeconomic status (SES) as a risk factor for depressive symptoms in late pregnancy and the early postpartum period. A secondary objective was to determine whether SES was a specific risk factor for elevated postpartum depressive symptoms beyond its contribution to prenatal depressive symptoms. Design Quantitative, secondary analysis, repeated measures, descriptive design. Setting Participants were recruited from paid childbirth classes serving upper middle class women and Medicaid-funded hospitals serving low-income clients in Northern California. Participants A sample of 198 first time mothers was assessed for depressive symptoms in their third trimester of pregnancy and at one, two, and three months postpartum. Main Outcome Measure Depressive symptoms were measured with the Center for Epidemiological Studies-Depression (CES-D) Scale. Results Low SES was associated with increased depressive symptoms in late pregnancy and at 2 and 3 months, but not at 1 month postpartum. Women with four SES risk factors (low monthly income, less than a college education, unmarried, unemployed) were 11 times more likely than women with no SES risk factors to have clinically elevated depression scores at 3 months postpartum, even after controlling for the level of prenatal depressive symptoms. Conclusion Although new mothers from all SES strata are at risk for postpartum depression, SES factors including low education, low income, being unmarried, and being unemployed increased the risk of developing postpartum depressive symptoms in this sample. PMID:20133153

  4. 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

  5. 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.

  6. 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

  7. 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…

  8. 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,…

  9. Maternal patterns of postpartum alcohol consumption by age: a longitudinal analysis of adult urban mothers.

    PubMed

    Liu, Weiwei; Mumford, Elizabeth A; Petras, Hanno

    2015-04-01

    The purpose of this study is to investigate a) longitudinal patterns of maternal postpartum alcohol use as well as its variation by maternal age at child birth and b) within maternal age groups, the association between other maternal characteristics and alcohol use patterns for the purposes of informed prevention design. Study sample consists of 3397 mothers from the Fragile Families and Child Wellbeing Study representing medium and large US urban areas. Maternal drinking and binge drinking were measured at child age 1, 3, and 5 years. We conducted separate longitudinal latent class analysis within each of the three pre-determined maternal age groups (ages 20-25, n = 1717; ages 26-35, n = 1367; ages 36+, n = 313). Results revealed different class structures for maternal age groups. While two classes (NB [non-binge]-drinkers and LL [low-level]-drinkers) were identified for mothers in each age group, a third class (binge drinkers) was separately distinguished for the two older age groups. Whereas binge drinking rates appear to remain stable over the 5 years postdelivery for mothers who gave birth in their early twenties, mothers ages 26 and older increasingly engaged in binge drinking over time, surpassing the binge drinking behavior of younger mothers. Depression significantly increases the odds of being a NB-drinker for the 20-25 age group and that of being a binge drinker for the 36+ age group, whereas smoking during pregnancy is associated with subsequent binge drinking only for mothers ages 20-25. Findings highlight the importance of distinguishing risk factors by maternal age groups for drinking while parenting a young child, to inform the design of intervention strategies tailored to mothers of particular ages. PMID:25344349

  10. Maternal patterns of postpartum alcohol consumption by age: A longitudinal analysis of adult urban mothers

    PubMed Central

    Liu, Weiwei; Mumford, Elizabeth A.; Petras, Hanno

    2015-01-01

    The purpose of this study is to investigate a) longitudinal patterns of maternal postpartum alcohol use as well as its variation by maternal age at child birth; b) within maternal age groups, the association between other maternal characteristics and alcohol use patterns for the purposes of informed prevention design. Study sample consists of 3,397 mothers from the Fragile Families and Child Wellbeing Study representing medium and large U.S. urban areas. Maternal drinking and binge drinking were measured at child age one, three, and five years. We conducted separate longitudinal latent class analysis within each of the three pre-determined maternal age groups (ages 20–25: n=1,717; ages 26–35: n=1,367; ages 36+: n=313). Results revealed different class structures for maternal age groups. While two classes (NB [non-binge]-drinkers and LL [low-level]-drinkers) were identified for mothers in each age group, a third class (binge drinkers) was separately distinguished for the two older age groups. Whereas binge drinking rates appear to remain stable over the five years post-delivery for mothers who gave birth in their early twenties, mothers ages 26 and older increasingly engaged in binge drinking over time, surpassing the binge drinking behavior of younger mothers. Depression significantly increases the odds of being a NB-drinker for the 20–25 age group and that of being a binge drinker for the 36+ age group, whereas smoking during pregnancy is associated with subsequent binge drinking only for mothers ages 20–25. Findings highlight the importance of distinguishing risk factors by maternal age groups for drinking while parenting a young child, to inform the design of intervention strategies tailored to mothers of particular ages. PMID:25344349

  11. 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

  12. 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

  13. Prevention of Postpartum Depression in Low-Income Women: Development of the "Mamas y Bebes"/Mothers and Babies Course

    ERIC Educational Resources Information Center

    Munoz, Ricardo F.; Le, Huynh-Nhu; Ippen, Chandra Ghosh; Diaz, Manuela A.; Urizar, Guido G., Jr.; Soto, Jose; Mendelson, Tamar; Delucchi, Kevin; Lieberman, Alicia F.

    2007-01-01

    A prenatal intervention designed to prevent the onset of major depressive episodes (MDEs) during pregnancy and postpartum was pilot tested at a public sector women's clinic. The "Mamas y Bebes"/Mothers and Babies Course is an intervention developed in Spanish and English that uses a cognitive-behavioral mood management framework, and incorporates…

  14. Postpartum depression and infant-mother attachment security at one year: The impact of co-morbid maternal personality disorders.

    PubMed

    Smith-Nielsen, Johanne; Tharner, Anne; Steele, Howard; Cordes, Katharina; Mehlhase, Heike; Vaever, Mette Skovgaard

    2016-08-01

    Previous studies on effects of postpartum depression (PPD) on infant-mother attachment have been divergent. This may be due to not taking into account the effects of stable difficulties not specific for depression, such as maternal personality disorder (PD). Mothers (N=80) were recruited for a longitudinal study either during pregnancy (comparison group) or eight weeks postpartum (clinical group). Infants of mothers with depressive symptoms only or in combination with a PD diagnosis were compared with infants of mothers with no psychopathology. Depression and PD were assessed using self-report and clinical interviews. Infant-mother attachment was assessed when infants were 13 months using Strange Situation Procedure (SSP). Attachment (in)security was calculated as a continuous score based on the four interactive behavioral scales of the SSP, and the conventional scale for attachment disorganization was used. PPD was associated with attachment insecurity only if the mother also had a PD diagnosis. Infants of PPD mothers without co-morbid PD did not differ from infants of mothers with no psychopathology. These results suggest that co-existing PD may be crucial in understanding how PPD impacts on parenting and infant social-emotional development. Stable underlying factors may magnify or buffer effects of PPD on parenting and child outcomes. PMID:27400381

  15. Parenting stress and postpartum depression/anxiety in mothers with personality disorders: indications for differential intervention priorities.

    PubMed

    Ramsauer, Brigitte; Mühlhan, Christine; Mueller, Jessica; Schulte-Markwort, Michael

    2016-06-01

    To date, parenting stress has rarely been examined in clinical samples of mothers with postpartum comorbid Axis-I disorders and Axis-II personality disorders (PD). Previous research has shown important links between maternal psychopathology and the development of child psychopathology. For these reasons, a clinical sample (N = 54) of mothers with various PD and comorbid depression/anxiety disorders were compared in this study. The clinical sample was divided into three groups based on PD: without PD, other PD, and borderline PD (BPD), and then matched according to depression/anxiety diagnoses and age. Parenting stress index (PSI, Abidin, 1995) scores were compared between these subsamples and to a nonclinical control group. No significant differences were found between mothers with various PD on global PSI scores. However, further examination of the PSI subscale scores revealed that PD were linked to an impaired sense of competence and positive reinforcement in relation to parenting. Compared to mothers with other PD, mothers with BPD had significantly more interpersonal issues. Compared to the nonclinical controls, clinically referred mothers had significantly higher PSI global and subscale scores, with notable PD-specific exceptions. These results illustrate the need for more differentiated treatment options for mothers with postpartum depression and/or anxiety disorders with PD to prevent later development of psychopathology in children of these mothers. PMID:26400074

  16. 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. PMID:12321351

  17. 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…

  18. Impact of physical activity during pregnancy and postpartum on chronic disease risk.

    PubMed

    2006-05-01

    Research over the past 20 years has focused on the safety of physical activity during pregnancy. Guidelines for health care providers and pregnant/postpartum women have been developed from the results of these studies. The overwhelming results of most studies have shown few negative effects on the pregnancy of a healthy gravida, but rather, be beneficial to the maternal-fetal unit. Recently, researchers have begun to consider the role of maternal physical activity in a more traditional chronic disease prevention model, for both mother and offspring. To address the key issues related to the role of physical activity during pregnancy and postpartum on chronic disease risk, the American College of Sports Medicine convened a Scientific Roundtable at Michigan State University in East Lansing, MI. Topics included preeclampsia, gestational diabetes, breastfeeding and weight loss, musculoskeletal disorders, mental health, and offspring health and development.

  19. Oxytocin increases VTA activation to infant and sexual stimuli in nulliparous and postpartum women.

    PubMed

    Gregory, Rebecca; Cheng, Hu; Rupp, Heather A; Sengelaub, Dale R; Heiman, Julia R

    2015-03-01

    After giving birth, women typically experience decreased sexual desire and increased responsiveness to infant stimuli. These postpartum changes may be viewed as a trade-off in reproductive interests, which could be due to alterations in brain activity including areas associated with reward. The goal of this study was to describe the roles of oxytocin and parity on reward area activation in response to reproductive stimuli, specifically infant and sexual images. Because they have been shown to be associated with reward, the ventral tegmental area (VTA) and nucleus accumbens (NAc) were targeted as areas of expected alterations in activity. Oxytocin was chosen as a potential mediator of reproductive trade-offs because of its relationship to both mother-infant interactions, including breastfeeding and bonding, and sexual responses. We predicted that postpartum women would show higher reward area activation to infant stimuli and nulliparous women would show higher activation to sexual stimuli and that oxytocin would increase activation to infant stimuli in nulliparous women. To test this, we measured VTA and NAc activation using fMRI in response to infant photos, sexual photos, and neutral photos in 29 postpartum and 30 nulliparous women. Participants completed the Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales and the Brief Index of Sexual Function for Women (BISF-W), which includes a sexual desire dimension, and received either oxytocin or placebo nasal spray before viewing crying and smiling infant and sexual images in an fMRI scanner. For both groups of women, intranasal oxytocin administration increased VTA activation to both crying infant and sexual images but not to smiling infant images. We found that postpartum women showed lower SES, higher SIS, and lower sexual desire compared to nulliparous women. Across parity groups, SES scores were correlated with VTA activation and subjective arousal ratings to sexual images. In postpartum women, sexual

  20. Oxytocin increases VTA activation to infant and sexual stimuli in nulliparous and postpartum women.

    PubMed

    Gregory, Rebecca; Cheng, Hu; Rupp, Heather A; Sengelaub, Dale R; Heiman, Julia R

    2015-03-01

    After giving birth, women typically experience decreased sexual desire and increased responsiveness to infant stimuli. These postpartum changes may be viewed as a trade-off in reproductive interests, which could be due to alterations in brain activity including areas associated with reward. The goal of this study was to describe the roles of oxytocin and parity on reward area activation in response to reproductive stimuli, specifically infant and sexual images. Because they have been shown to be associated with reward, the ventral tegmental area (VTA) and nucleus accumbens (NAc) were targeted as areas of expected alterations in activity. Oxytocin was chosen as a potential mediator of reproductive trade-offs because of its relationship to both mother-infant interactions, including breastfeeding and bonding, and sexual responses. We predicted that postpartum women would show higher reward area activation to infant stimuli and nulliparous women would show higher activation to sexual stimuli and that oxytocin would increase activation to infant stimuli in nulliparous women. To test this, we measured VTA and NAc activation using fMRI in response to infant photos, sexual photos, and neutral photos in 29 postpartum and 30 nulliparous women. Participants completed the Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales and the Brief Index of Sexual Function for Women (BISF-W), which includes a sexual desire dimension, and received either oxytocin or placebo nasal spray before viewing crying and smiling infant and sexual images in an fMRI scanner. For both groups of women, intranasal oxytocin administration increased VTA activation to both crying infant and sexual images but not to smiling infant images. We found that postpartum women showed lower SES, higher SIS, and lower sexual desire compared to nulliparous women. Across parity groups, SES scores were correlated with VTA activation and subjective arousal ratings to sexual images. In postpartum women, sexual

  1. A case study of a mother's intertwining experiences with incest and postpartum depression.

    PubMed

    Røseth, Idun; Bongaardt, Rob; Binder, Per-Einar

    2011-01-01

    The association between childhood sexual abuse (CSA) and major depression disorder (MDD) gives reason to suspect that many mothers with postpartum depression (PPD) have a history of CSA. However, few studies have investigated how CSA and PPD are related. In this case study we explore how the experience of incest intertwines with the experience of postpartum depression. We focus on participant subject "Nina," who has experienced both. We interviewed her three times and we analysed the interviews with Giorgi's phenomenological descriptive method to arrive at a contextualised meaning structure. Nina's intruding fantasies of men who abuse her children merge with her recollections of her own incest experiences. She may succeed in forcing these fantasies out of her consciousness, but they still alter her perceptions, thoughts, and emotions. She feels overwhelmed and succumbs to sadness, while she also is drawn towards information about CSA, which in turn feeds her fantasies. The psychodynamic concepts of repetition compulsion, transference, and projection may provide some explanation of Nina's actions, thoughts, and emotions through her past experiences. With our phenomenological stance, we aim to acknowledge Nina's descriptions of her everyday life here and now. With reference to Husserl, Heidegger, Merleau-Ponty, and Minkowski, we show that Nina's past is not a dated memory; rather it determines the structure of her consciousness that constitutes her past as her true present and future. Incest dominates Nina's world, and her possibilities for action are restricted by this perceived world. Any suspension of action implies anguish, and she resolves this by incest-structured action that in turn feeds and colours her expectations. Thus anxiety and depression are intertwined in the structure of this experience.

  2. Delivery and postpartum practices among new mothers in Laputta, Myanmar: intersecting traditional and modern practices and beliefs.

    PubMed

    Diamond-Smith, Nadia; Thet, May Me; Khaing, Ei Ei; Sudhinaraset, May

    2016-09-01

    Myanmar is witnessing increased access to modern maternity care, along with shifting norms and practices. Past research has documented low rates of facility-based deliveries in the country, along with adverse maternal and child health outcomes. Research has also documented diverse traditional practices in the postpartum period, related to maternity care and maternal food intake. Through 34 qualitative interviews with women who recently gave birth and their mothers-in-law in one township in Myanmar (Laputta), we explore factors influencing decision-making around postpartum care and the practices that women engage in. We find that women use both modern and traditional providers because different types of providers play particular roles in the delivery and postpartum period. Despite knowledge of about healthy foods to eat postpartum, many women restrict the intake of certain foods, and mothers-in-laws' beliefs in these practices are particularly strong. Findings suggest that women and their families are balancing two different sets of practices and beliefs, which at times come in conflict. Educational campaigns and programmes should address both modern and traditional beliefs and practices to help women be better able to access safe care and improve their own and their children's health. PMID:27212423

  3. Influence of Cultural Beliefs on Infant Feeding, Postpartum and Childcare Practices among Chinese-American Mothers in New York City.

    PubMed

    Lee, Adele; Brann, Lynn

    2015-06-01

    As one of the fastest growing communities in the United States, Chinese-Americans receive relatively little research attention on their rates of breastfeeding versus formula feeding, and what factors influence that choice. This research aims to examine the influence of elders and cultural beliefs on postpartum, infant feeding, and childcare practices. Semi-structured interviews with 22 recently postpartum mothers who met the recruiting criteria were conducted between July 2012 and February 2013. The traditional postpartum practice, zuo yuezi, presented negative physical and emotional outcomes and maternal reporting of delay in lactation. Early introduction of solids for traditional reasons was reported. The support from husbands and elders were necessary for breastfeeding success, while some mothers had to first negotiate with elders for breastfeeding. The practice of sending infants back to China to be taken care of by extended families presented cultural implications related to grandparents' involvement in raising grandchildren. With the respect and appreciation for elders and traditions, it is likely that Chinese mothers negotiate between cultural traditions and societal expectation in the western home.

  4. U.S.- and Mexico-born Hispanic teen mothers: a descriptive study of factors that relate to postpartum compliance.

    PubMed

    Weinman, M L; Smith, P B

    1994-05-01

    Compliance with postpartum visits after teenage births in the US was examined among 289 Hispanic teenagers, of whom 127 were born in Mexico or border towns, who delivered at Harris County Hospital District and scheduled postpartum appointments at the Teen Health Clinic. The mean age was 17.31 years for mothers and 21.95 years for fathers. 56.7% (164) were married. 49.8% lived with husbands, 25.8% with parents, 22.3% with friends/relatives, and 2.1% alone. 74.7% stated that they had no social supports. 88.9% had a term delivery, 8.3% a preterm delivery, and 2.8% a fetal loss. 67.5% were first births, 5.5% had a previous abortion, and 3.1% had a previous miscarriage. 23.2% had a previous child, and 0.7% had a previous preterm delivery. Some form of prenatal care was received by 85.1%. 34.3% reported no further educational plans. 17.3% (50) returned for a scheduled postpartum visit. Mothers with a prior history of a premature birth or miscarriage were more likely to return postpartum compared to mothers with a first or prior birth. The differences are marginally significant. None of the mothers with a prior abortion returned. 34.9% of the returning teen mothers were more likely to have had prenatal care. Returning mothers also were a larger percentage of those with no future educational plans. 13.4% of returning mothers had an available social support system. Country of origin was not associated with support systems, prenatal care, return status, educational plans, pregnancy history, or current birth outcome. Out of the 50 returning, 20 were Mexican-born and married. Only Mexican marital status was found to be a significant variable explaining differences. Marital status had no effect on the 26 US native-born returnees. 92% of the Mexican-born teens were married and had a support system. The most dramatic feature of this study is the high level of noncompliance among both US-born and Mexican-born adolescents. There were few distinguishing features between these two

  5. 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. PMID:23064898

  6. Postpartum ovarian activity in South Asian zebu cattle.

    PubMed

    Brar, P S; Nanda, A S

    2008-07-01

    Timely onset of postpartum ovarian activity is vital for optimal reproductive performance of dairy cows. Much depends upon genetic constitution of an animal although several factors interplay to govern the onset of postpartum ovarian activity. South Asian zebu cattle have much longer service period when compared with other exotic or crossbred cattle reared in the same Asian environment, which suggests differences in their genetic makeup. However, the cows with same genetic configuration expressed better reproductive potential when reared under different environment, such as in Brazil and Mexico, which suggests the role of extrinsic factors such as management, nutrition, environment and disease conditions. Better management of animals (provision of proper shade, water and housing, efficient oestrous detection and timely insemination), good quality nutrition supplemented with appropriate minerals and vitamins, prevention of diseases (vaccination, deworming, suitable therapeutic interventions) and application of biotechnology have helped in improving postpartum ovarian activity and, therefore, reproductive performance of zebu cattle in Asia. No comprehensive study appears to have been carried out on the various aspects of reproduction in zebu cattle reared under South Asian socio-agro-climatic conditions. This paper is a modest effort to collect what ever information available and to critically review the postpartum ovarian activity in zebu cattle with special reference to the effect of the various managemental practices and pharmacological interventions. PMID:18638125

  7. "And You're Telling Me Not to Stress?" A Grounded Theory Study of Postpartum Depression Symptoms among Low-Income Mothers

    ERIC Educational Resources Information Center

    Abrams, Laura S.; Curran, Laura

    2009-01-01

    Low-income mothers in the U.S. are more likely to experience postpartum depression (PPD) and less likely to seek treatment than their middle-class counterparts. Despite this knowledge, prior research has not provided an in-depth understanding of PPD symptoms as they are experienced by low-income mothers. Through in-depth interviews, this study…

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

    ERIC Educational Resources Information Center

    Kalita, Kamal Narayan

    2010-01-01

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

  9. Perceptions of general and parenting-specific posttraumatic change among postpartum mothers with histories of childhood maltreatment.

    PubMed

    Fava, Nicole M; Simon, Valerie A; Smith, Erin; Khan, Maria; Kovacevic, Merdijana; Rosenblum, Katherine L; Menke, Rena; Muzik, Maria

    2016-06-01

    Although adaptive meanings of childhood maltreatment (CM) are critical to posttraumatic adaptation, little is known about perceptions of posttraumatic change (PTC) during the vulnerable postpartum period. PTC may be positive or negative as well as global or situational. This study examined general and parenting-specific PTC among 100 postpartum women with CM histories (Mage=29.5 years). All reported general and 83% reported parenting PTC. General PTC were more likely to include negative and positive changes; parenting PTC were more likely to be exclusively positive. Indicators of more severe CM (parent perpetrator, more CM experiences) were related to parenting but not general PTC. Concurrent demographic risk moderated associations between number of CM experiences and positive parenting PTC such that among mothers with more CM experiences, demographic risk was associated with stronger positive parenting PTC. Results highlight the significance of valence and specificity of PTC for understanding meanings made of CM experiences. PMID:27131270

  10. Barriers to access to treatment for mothers with postpartum depression in primary health care centers: a predictive model1

    PubMed Central

    Martínez, Pablo; Vöhringer, Paul A.; Rojas, Graciela

    2016-01-01

    Objective to develop a predictive model to evaluate the factors that modify the access to treatment for Postpartum Depression (PPD). Methods prospective study with mothers who participated in the monitoring of child health in primary care centers. For the initial assessment and during 3 months, it was considered: sociodemographic data, gyneco-obstetric data, data on the services provided, depressive symptoms according to the Edinburgh Postpartum Depression Scale (EPDS) and quality of life according to the Short Form-36 Health Status Questionnaire (SF-36). The diagnosis of depression was made based on MINI. Mothers diagnosed with PPD in the initial evaluation, were followed-up. Results a statistical model was constructed to determine the factors that prevented access to treatment, which consisted of: item 2 of EPDS (OR 0.43, 95%CI: 0.20-0.93) and item 5 (OR 0.48, 95%CI: 0.21-1.09), and previous history of depression treatment (OR 0.26, 95%CI: 0.61-1.06). Area under the ROC curve for the model=0.79; p-value for the Hosmer-Lemershow=0.73. Conclusion it was elaborated a simple, well standardized and accurate profile, which advises that nurses should pay attention to those mothers diagnosed with PPD, presenting low/no anhedonia (item 2 of EPDS), scarce/no panic/fear (item 5 of EPDS), and no history of depression, as it is likely that these women do not initiate treatment. PMID:27027674

  11. Factors associated with early postpartum maternity blues and depression tendency among Japanese mothers with full-term healthy infants.

    PubMed

    Takahashi, Yuki; Tamakoshi, Koji

    2014-02-01

    Maternity blues and postpartum depression are common mental health problems during the early postpartum period. However, few studies have examined the factors associated with maternity blues and postpartum depression in healthy mothers with spontaneous births of healthy full-term infants. This study aimed to determine the demographic and obstetric factors, various feelings during pregnancy, and psychological factors by using the Maternity Blues Scale (MBS) and Edinburgh Postnatal Depression scale (EPDS) among healthy Japanese mothers. We distributed the MBS and EPDS self-administered questionnaires to 100 Japanese mothers during their 4-5 day hospitalization and at a health check-up 1-month after delivery, respectively. Multiple regression analyses were performed including the above-mentioned variables as independent variables and the maximum MBS or EPDS scores as dependent variables. The answers "Having a friend I can talk to about maternity life or child rearing" [beta (95% confidence interval) = -1.53 (-2.68 - -0.378)] and "Satogaeri bunben", a Japanese traditional support system wherein a postnatal woman lives with her husband/parents [-2.82 (-4.73 - -0.898)] were significantly associated with MBS scores. The answer "Having a friend I can talk to about maternity life or child rearing" [-2.83 (-4.76 - -0.903)] was also significantly associated with EPDS scores, although the association between the partner's age and these scores was marginally significant [-0.106 (-0.008 - 0.221)]. This study shows that it is important to provide support for healthy women without delivery complications, both at home and in the community.

  12. Levels of innate immune factors in preterm and term mothers' breast milk during the 1st month postpartum.

    PubMed

    Trend, Stephanie; Strunk, Tobias; Lloyd, Megan L; Kok, Chooi Heen; Metcalfe, Jessica; Geddes, Donna T; Lai, Ching Tat; Richmond, Peter; Doherty, Dorota A; Simmer, Karen; Currie, Andrew

    2016-04-14

    There is a paucity of data on the effect of preterm birth on the immunological composition of breast milk throughout the different stages of lactation. We aimed to characterise the effects of preterm birth on the levels of immune factors in milk during the 1st month postpartum, to determine whether preterm milk is deficient in antimicrobial factors. Colostrum (days 2-5 postpartum), transitional milk (days 8-12) and mature milk (days 26-30) were collected from mothers of extremely preterm (<28 weeks of gestation, n 15), very preterm (28-<32 weeks of gestation, n 15), moderately preterm (32-<37 weeks of gestation, n 15) and term infants (37-41 weeks of gestation, n 15). Total protein, lactoferrin, secretory IgA, soluble CD14 receptor (sCD14), transforming growth factor-β2 (TGF-β2), α defensin 5 (HD5), β defensins 1 (HBD1) and 2, IL-6, IL-10, IL-13, interferon-γ, TNF-α and lysozyme (LZ) were quantified in milk. We examined the effects of lactation stage, gestational age, volume of milk expressed, mode of delivery, parity and maternal infection on milk immune factor concentrations using repeated-measures regression analysis. The concentrations of all factors except LZ and HD5 decreased over the 1st month postpartum. Extremely preterm mothers had significantly higher concentrations of HBD1 and TGF-β2 in colostrum than term mothers did. After controlling for other variables in regression analyses, preterm birth was associated with higher concentrations of HBD1, LZ and sCD14 in milk samples. In conclusion, preterm breast milk contains significantly higher concentrations of some immune proteins than term breast milk.

  13. Improving postpartum care for mothers and newborns in Niger and Mali: a case study of an integrated maternal and newborn improvement programme

    PubMed Central

    Boucar, M; Hill, K; Coly, A; Djibrina, S; Saley, Z; Sangare, K; Kamgang, E; Hiltebeitel, S

    2014-01-01

    Despite appropriate guidelines, healthcare services worldwide often fail to deliver high-impact evidence-based care. This case study describes a large-scale programme to improve integrated postpartum care for mothers and newborns in Niger and Mali. As a result of an improvement effort based on common objectives, local ownership and shared learning to accelerate implementation of best practices, 78 facilities demonstrated rapid improvement in compliance with standards for post-partum haemorrhage prevention and Essential Newborn Care as well as a reduction in estimated postpartum haemorrhage. This approach yields rapid results and can be efficiently spread to improve care in low-resource settings. PMID:25236646

  14. Evidence for a neuroendocrinological foundation of human affiliation: plasma oxytocin levels across pregnancy and the postpartum period predict mother-infant bonding.

    PubMed

    Feldman, Ruth; Weller, Aron; Zagoory-Sharon, Orna; Levine, Ari

    2007-11-01

    Although research on the neurobiological foundation of social affiliation has implicated the neuropeptide oxytocin in processes of maternal bonding in mammals, there is little evidence to support such links in humans. Plasma oxytocin and cortisol of 62 pregnant women were sampled during the first trimester, last trimester, and first postpartum month. Oxytocin was assayed using enzyme immunoassay, and free cortisol was calculated. After the infants were born, their interactions with their mothers were observed, and the mothers were interviewed regarding their infant-related thoughts and behaviors. Oxytocin was stable across time, and oxytocin levels at early pregnancy and the postpartum period were related to a clearly defined set of maternal bonding behaviors, including gaze, vocalizations, positive affect, and affectionate touch; to attachment-related thoughts; and to frequent checking of the infant. Across pregnancy and the postpartum period, oxytocin may play a role in the emergence of behaviors and mental representations typical of bonding in the human mother.

  15. Intra-individual stability and developmental change in hair cortisol among postpartum mothers and infants: Implications for understanding chronic stress.

    PubMed

    Liu, Cindy H; Snidman, Nancy; Leonard, Alexandra; Meyer, Jerrold; Tronick, Ed

    2016-05-01

    The study goal was to determine the intra-individual stability, developmental change, and maternal-reported correlates (socio-demographic, stress experiences, hair characteristics, and care) of hair cortisol in mothers and their infants. To assess cortisol deposition in hair during the periods of 6-to-9 months and 9-to-12 months of age, 3 cm segments of hair samples deemed to represent approximately 3 months of retrospective hair cortisol were sampled longitudinally at 9- and 12-months in 41 mothers and infants. Bivariate correlations and mean level comparisons of log-transformed hair cortisol levels at 9- (T1) and 12-months (T2) in mothers and infants were examined. Hair cortisol values were positively correlated from T1 to T2 for mothers (r = .41, p < .05) and infants (r = .39, p < .05). Hair cortisol values did not significantly differ from T1 to T2 in infants but decreased for mothers (F(1,34) = 9.2, p < .01). Maternal and infant hair cortisol was not associated with each other at either time point. Self-reported measures of stress, and hair characteristics and care were not associated with hair cortisol. This is the first study to obtain hair cortisol from more than one time point within the first year after birth in mothers and infants. The intra-individual stability of hair cortisol suggests that it may be a possible biomarker for detecting change in chronic stress experiences within the first year of life and in the postpartum period. PMID:26806857

  16. Predicting Postpartum Depressive Symptoms in New Mothers: The Role of Optimism and Stress Frequency during Pregnancy

    ERIC Educational Resources Information Center

    Grote, Nancy K.; Bledsoe, Sarah E.

    2007-01-01

    During the transition to motherhood, women typically show favorable psychological adjustment after the first child is born, whereas 10 percent to 26 percent of women are at risk of developing clinically significant postpartum depressive symptoms. Little is known about which individuals are especially protected against the emergence of postpartum…

  17. Incident HIV during Pregnancy and Postpartum and Risk of Mother-to-Child HIV Transmission: A Systematic Review and Meta-Analysis

    PubMed Central

    Drake, Alison L.; Wagner, Anjuli; Richardson, Barbra; John-Stewart, Grace

    2014-01-01

    Background Women may have persistent risk of HIV acquisition during pregnancy and postpartum. Estimating risk of HIV during these periods is important to inform optimal prevention approaches. We performed a systematic review and meta-analysis to estimate maternal HIV incidence during pregnancy/postpartum and to compare mother-to-child HIV transmission (MTCT) risk among women with incident versus chronic infection. Methods and Findings We searched PubMed, Embase, and AIDS-related conference abstracts between January 1, 1980, and October 31, 2013, for articles and abstracts describing HIV acquisition during pregnancy/postpartum. The inclusion criterion was studies with data on recent HIV during pregnancy/postpartum. Random effects models were constructed to pool HIV incidence rates, cumulative HIV incidence, hazard ratios (HRs), or odds ratios (ORs) summarizing the association between pregnancy/postpartum status and HIV incidence, and MTCT risk and rates. Overall, 1,176 studies met the search criteria, of which 78 met the inclusion criterion, and 47 contributed data. Using data from 19 cohorts representing 22,803 total person-years, the pooled HIV incidence rate during pregnancy/postpartum was 3.8/100 person-years (95% CI 3.0–4.6): 4.7/100 person-years during pregnancy and 2.9/100 person-years postpartum (p = 0.18). Pooled cumulative HIV incidence was significantly higher in African than non-African countries (3.6% versus 0.3%, respectively; p<0.001). Risk of HIV was not significantly higher among pregnant (HR 1.3, 95% CI 0.5–2.1) or postpartum women (HR 1.1, 95% CI 0.6–1.6) than among non-pregnant/non-postpartum women in five studies with available data. In African cohorts, MTCT risk was significantly higher among women with incident versus chronic HIV infection in the postpartum period (OR 2.9, 95% CI 2.2–3.9) or in pregnancy/postpartum periods combined (OR 2.3, 95% CI 1.2–4.4). However, the small number of studies limited power to detect associations

  18. Post-partum blues among Korean mothers: a structural equation modelling approach.

    PubMed

    Chung, Sung Suk; Yoo, Il Young; Joung, Kyoung Hwa

    2013-08-01

    The objective of this study was to propose the post-partum blues (PPB) model and to estimate the effects of self-esteem, social support, antenatal depression, and stressful events during pregnancy on PPB. Data were collected from 249 women post-partum during their stay in the maternity units of three hospitals in Korea using a self-administered questionnaire. A structural equation modelling approach using the Analysis of Moments Structure program was used to identify the direct and indirect effects of the variables on PPB. The full model had a good fit and accounted for 70.3% of the variance of PPB. Antenatal depression and stressful events during pregnancy had strong direct effects on PPB. Household income showed indirect effects on PPB via self-esteem and antenatal depression. Social support indirectly affected PPB via self-esteem, antenatal depression, and stressful events during pregnancy.

  19. The experience of labor, maternal perception of the infant, and the mother's postpartum mood in a low-risk community cohort.

    PubMed

    Weisman, Omri; Granat, Adi; Gilboa-Schechtman, Eva; Singer, Magi; Gordon, Ilanit; Azulay, Hila; Kuint, Jacob; Feldman, Ruth

    2010-12-01

    Postpartum negative mood interferes with maternal-infant bonding and carries long-term negative consequences for infant growth. We examined the effects of birth-related risks on mother's postpartum anxiety and depression. A community cohort of 1,844 low-risk women who delivered a singleton term baby completed measures assessing delivery, emotions during labor, attitudes toward pregnancy and infant, mood regulation, and postpartum anxiety and depression. Under conditions of low risk, 20.5% of parturient women reported high levels of depressive symptoms. Following Cesarean Section Delivery (CSD), 23% reported high depressive symptoms, compared to 19% following Vaginal Delivery (VGD), and 21% after Assisted Vaginal Delivery (AVGD). State anxiety was highest in CSD and lowest in VGD. Mothers undergoing CSD experienced labor as most negative, reported highest somatic symptoms during the last trimester, and were least efficient in regulating negative mood. Postpartum depression was independently associated with higher maternal age, CSD, labor pain, lower negative and higher positive emotions during labor, inefficient mood regulation, somatic symptoms, and more negative and less positive perception of fetus during last trimester. Results demonstrate that elevated depressive symptoms are prevalent in the postpartum even under optimal socioeconomic and health conditions and increase following CSD. Interventions to increase positive infant-related perceptions and emotions may be especially important for promoting bond formation following CSD.

  20. Stress in the City: Influence of Urban Social Stress and Violence on Pregnancy and Postpartum Quality of Life among Adolescent and Young Mothers.

    PubMed

    Willie, Tiara C; Powell, Adeya; Kershaw, Trace

    2016-02-01

    Adolescent and young mothers transitioning from pregnancy to postpartum need to maintain an optimal quality of life. Stress and exposure to violence (e.g., intimate partner violence (IPV), nonpartner violence) are predictors of poor quality of life for adult women; however, these associations remain understudied among adolescent and young mothers in urban areas. Guided by the social ecological model, the current study created a latent variable, urban social stress, to examine the impact of the urban social environment (i.e., stressful life events, discrimination, family stress, and neighborhood problems) on the quality of life of adolescent and young mothers during both pregnancy and postpartum. The current study is a secondary data analysis of a prospective cohort study of 296 expectant young mothers recruited at obstetrics and gynecology clinics. Results from structural equation and multigroup models found that higher urban social stress predicted lower mental and physical quality of life during pregnancy, but these associations were significantly stronger for IPV-exposed and nonpartner violence-exposed mothers. In the postpartum period, higher urban social stress predicted lower mental and physical quality of life, but these associations were significantly stronger for IPV-unexposed and nonpartner violence-exposed mothers. Stress reduction programs need to help adolescent and young mothers in urban areas develop stress management skills specific to urban social stress. Pregnancy and parenting programs need to be tailored to the specific needs of young mothers in urban areas by becoming sensitive to the role of IPV and nonpartner violence in these young women's lives.

  1. Postpartum Depression and Child Development.

    ERIC Educational Resources Information Center

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

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

  2. The relationship between maternal attitudes and symptoms of depression and anxiety among pregnant and postpartum first-time mothers

    PubMed Central

    Epperson, C. Neill; Barber, Jacques P.

    2014-01-01

    Two studies examined the relationship between maternal attitudes and symptoms of depression and anxiety during pregnancy and the early postpartum period. In the first study, a measure of maternal attitudes, the Attitudes Toward Motherhood Scale (AToM), was developed and validated in a sample of first-time mothers. The AToM was found to have good internal reliability and convergent validity with cognitive biases and an existing measure of maternal attitudes. Exploratory and confirmatory factor analyses determined that the measure comprises three correlated factors: beliefs about others’ judgments, beliefs about maternal responsibility, and maternal role idealization. In the second study, we used the AToM to assess the relationship between maternal attitudes and other psychological variables. The factor structure of the measure was confirmed. Maternal attitudes predicted symptoms of depression and anxiety, and these attitudes had incremental predictive validity over general cognitive biases and interpersonal risk factors. Overall, the results of these studies suggest that maternal attitudes are related to psychological distress among first-time mothers during the transition to parenthood and may provide a useful means of identifying women who may benefit from intervention during the perinatal period. PMID:24643422

  3. Experiences of mothers with antenatal, delivery and postpartum care in rural Gambia.

    PubMed

    Telfer, Michelle L; Rowley, Jane T; Walraven, Gijs E L

    2002-04-01

    Over the last two decades, the maternal mortality ratio appears to have fallen by up to 50% in the Farafenni, a rural area of The Gambia. This reduction almost certainly reflects improvements in access to essential obstetric services. The ratio, however, is still 50 times higher than in Western and Northern Europe or North America. This paper provides information from a community-based study of 623 women who had recently given birth in the Farafenni area. Information on how, when, and why care was accessed, and what type of care and information were provided were obtained from traditional and western methods of health care were during visits. Women were asked about their experiences during prenatal, delivery and postpartum periods. Results from this study highlight a number of opportunities for improving the quality of maternal health services that could be implemented relatively easily with existing resources.

  4. SCREENING FOR SYMPTOMS OF POSTPARTUM TRAUMATIC STRESS IN A SAMPLE OF MOTHERS WITH PRETERM INFANTS

    PubMed Central

    Shaw, Richard J.; Lilo, Emily; Benitz, William; Storfer-Isser, Amy; Ball, M. Bethany; Proud, Melinda; Vierhaus, Nancy S.; Huntsberry, Audrey; Mitchell, Kelley; Adams, Marian M.; Horwitz, Sarah M.

    2014-01-01

    Objective There are no established screening criteria to help identify mothers of premature infants who at risk for symptoms of emotional distress. The current study, using data obtained from recruitment and screening in preparation for a randomized controlled trial, aimed to identify potential risk factors associated with symptoms of depression, anxiety and posttraumatic stress in a sample of mothers with premature infants hospitalized in a neonatal intensive care unit. Method 135 mothers of preterm infants born at 26-34 weeks of gestation completed three self-report measures, the Stanford Acute Stress Reaction Questionnaire, the Beck Depression Inventory, Second Edition and the Beck Anxiety Inventory to determine their eligibility for inclusion in a treatment intervention study based on clinical cut-off scores for each measure. Results Maternal sociodemographic measures, including race, ethnicity and age, maternal pregnancy history and measures of infant medical severity were not helpful in differentiating mothers who screened positive on one or more of the measures from those who screened negative. Conclusions Programs to screen parents of premature infants for the presence of symptoms of posttraumatic stress, anxiety and depression will need to adopt universal screening rather than profiling of potential high risk parents based on their sociodemographic characteristics or measures of their infant’s medical severity. PMID:24597585

  5. Screening for symptoms of postpartum traumatic stress in a sample of mothers with preterm infants.

    PubMed

    Shaw, Richard J; Lilo, Emily A; Storfer-Isser, Amy; Ball, M Bethany; Proud, Melinda S; Vierhaus, Nancy S; Huntsberry, Audrey; Mitchell, Kelley; Adams, Marian M; Horwitz, Sarah M

    2014-03-01

    There are no established screening criteria to help identify mothers of premature infants who are at risk for symptoms of emotional distress. The current study, using data obtained from recruitment and screening in preparation for a randomized controlled trial, aimed to identify potential risk factors associated with symptoms of depression, anxiety and posttraumatic stress in a sample of mothers with premature infants hospitalized in a neonatal intensive care unit. One hundred, thirty-five mothers of preterm infants born at 26-34 weeks of gestation completed three self-report measures: the Stanford Acute Stress Reaction Questionnaire, the Beck Depression Inventory (2nd ed.), and the Beck Anxiety Inventory to determine their eligibility for inclusion in a treatment intervention study based on clinical cut-off scores for each measure. Maternal sociodemographic measures, including race, ethnicity, age, maternal pregnancy history, and measures of infant medical severity were not helpful in differentiating mothers who screened positive on one or more of the measures from those who screened negative. Programs to screen parents of premature infants for the presence of symptoms of posttraumatic stress, anxiety, and depression will need to adopt universal screening rather than profiling of potential high risk parents based on their sociodemographic characteristics or measures of their infant's medical severity.

  6. Calcium supplementation, bone mineral density and bone mineral content. Predictors of bone mass changes in adolescent mothers during the 6-month postpartum period.

    PubMed

    Malpeli, Agustina; Apezteguia, María; Mansur, José L; Armanini, Alicia; Macías Couret, Melisa; Villalobos, Rosa; Kuzminczuk, Marta; Gonzalez, Horacio F

    2012-03-01

    We determined the effect of calcium supplementation on bone mineral density (BMD) and bone mineral content (BMC) and identified predictors of bone mass changes in adolescent mothers 6 months postpartum. A prospective, analytical, clinical study was performed in adolescent mothers (< or = 19 years old; n = 37) from La Plata, Argentina. At 15 days postpartum, mothers were randomly assigned into one of two groups and started with calcium supplementation; one group received dairy products (932 mg Ca; n = 19) and the other calcium citrate tablets (1000 mg calcium/day; n = 18). Weight, height and dietary intake were measured and BMD was determined by DEXA at 15 days (baseline) and 6 months postpartum. BMC, total body BMD and BMD were assessed in lumbar spine, femoral neck, trochanter and total hip. Regression models were used to identify the relationship of total body BMD and BMC with independent variables (calcium supplementation, months of lactation, weight at 6 months, percent weight change, lean mass at 6 months, percent lean mass change, total calcium intake). Results showed that changes in BMD and BMC at the different sites were similar in both groups, and changes in percent body weight and total calcium intake were the main predictive factors. In conclusion, the effect of calcium was similar with either form of supplementation, i.e., dairy products or tablets, and changes in percent body weight and total calcium intake were predictors of total body BMD and BMC changes. PMID:23477205

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

    PubMed Central

    Evenson, Kelly R.

    2010-01-01

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

  8. Steam sauna and mother roasting in Lao PDR: practices and chemical constituents of essential oils of plant species used in postpartum recovery

    PubMed Central

    2011-01-01

    Background Fundamental in traditional postpartum recovery in Lao PDR is the use of hotbeds, mother roasting, steam sauna and steam baths. During these treatments medicinal plants play a crucial role, but little has been published about how the treatments are carried out precisely, which species are used, the medicinal properties of these species, and the medicinal efficacy of their chemical constituents. Methods Sixty-five interviews, in 15 rural villages, with women of 4 different ethnic groups were conducted to survey confinement rituals, and postpartum plant use and salience. Essential oils from the main species used were extracted using steam distillation and the main chemical constituents characterized using gas chromatography-mass spectrometry (GC-MS). Results A total of 10 different species were used by three or more of the ethnic groups included in this study. All species were used in steam sauna and bath, but only 3 species were used in hotbed and mother roasting. Essential oils of Amomum villosum, Amomum microcarpum and Blumea balsamifera were found to contain significant amounts of the following terpenes: β-pinene, camphor, bornyl acetate, borneol, linalool, D-limonene, fenchone, terpinen-4-ol and α-terpinene. Conclusions Many of these terpenes have documented antimicrobial and analgesic properties, and some have also synergistic interactions with other terpenes. The mode of application in hotbed and mother roasting differs from the documented mechanisms of action of these terpenes. Plants in these two practices are likely to serve mainly hygienic purposes, by segregating the mother from infection sources such as beds, mats, stools, cloth and towels. Steam sauna medicinal plant use through inhalation of essential oils vapors can possibly have medicinal efficacy, but is unlikely to alleviate the ailments commonly encountered during postpartum convalescence. Steam sauna medicinal plant use through dermal condensation of essential oils, and steam bath

  9. Effects of Online Self-Regulation Activities on Physical Activity Among Pregnant and Early Postpartum Women.

    PubMed

    Kim, Hye Kyung; Niederdeppe, Jeff; Graham, Meredith; Olson, Christine; Gay, Geri

    2015-01-01

    Physical and psychological changes that occur during pregnancy present a unique challenge for women's physical activity. Using a theory-based prospective design, this study examines the effects of pregnant women's (a) physical activity cognitions (self-efficacy, outcome expectancy, and safety beliefs) and (b) online self-regulation activities (goal-setting and self-monitoring) on subsequent changes in their physical activity intentions and behavior during pregnancy and immediately postpartum. The authors used data from three panel surveys administered to pregnant women enrolled in a web-based intervention to promote healthy pregnancy and postpartum weight, as well as log data on their use of self-regulatory features on the intervention website. Perceived self-efficacy and perceived safety of physical activity in pregnancy enhanced subsequent intentions to be physically active. Repeated goal-setting and monitoring of those goals helped to maintain positive intentions during pregnancy, but only repeated self-monitoring transferred positive intentions into actual behavior. Theoretically, this study offers a better understanding of the roles of self-regulation activities in the processes of goal-striving. The authors also discuss practical implications for encouraging physical activity among pregnant and early postpartum women.

  10. Using Young Mothers' Clubs to Improve Knowledge of Postpartum Hemorrhage and Family Planning in Informal Settlements in Nairobi, Kenya.

    PubMed

    Ndirangu, Gathari; Gichangi, Anthony; Kanyuuru, Lynn; Otai, Jane; Mulindi, Rose; Lynam, Pamela; Koskei, Nancy; Tappis, Hannah; Archer, Linda

    2015-08-01

    Women living in Nairobi's informal settlements face a higher risk of maternal death than those living elsewhere in the country, and have limited knowledge of actions they can take to improve their chances of survival during pregnancy and childbirth. As one strategy to reach this high risk group, Jhpiego has implemented young mothers' clubs (YMCs). These clubs comprise mothers aged 18-30 who come together on a weekly basis to share experiences and solutions to their challenges while receiving health education from health facility staff and community health workers (CHWs). The aim of this study was to assess whether the YMC strategy could be used to improve participants' knowledge of postpartum hemorrhage (PPH), positive behavior around childbirth, and family planning. Participants in nine YMCs (n = 193) across four informal settlements were interviewed to assess their knowledge of safe motherhood topics before and after a series of eight health education sessions. Data were analyzed with the McNemar test to determine significance of change in knowledge pre- and post-intervention. The largest improvements were observed in knowledge about what to include in a birth plan, with correct responses increasing from 32 to 73% (p < 0.001), 58-93% (p < 0.001), 36-66% (p < 0.001), 58-85% (p < 0.001), and 64-88% (p < 0.001) for identifying a birth companion, budget, skilled birth attendant, emergency supplies, and place of birth, respectively. Less substantial improvements were observed in knowledge of danger signs of PPH (up 10% from 77%, p = 0.003). Although knowledge of actions to take in the event of bleeding after delivery did significantly improve, final knowledge scores remained low--knowledge to urinate increased from 14 to 28% (p < 0.001) and to breastfeed from 12 to 24% (p = 0.005). Even though the vast majority of respondents (84%) knew before the intervention that a woman should space pregnancy by at least 2 years after delivery, there was an increase to 94% after

  11. Can't a mother sing the blues? Postpartum depression and the construction of motherhood in late 20th-century America.

    PubMed

    Held, Lisa; Rutherford, Alexandra

    2012-05-01

    Popular depictions of 20th-century American motherhood have typically emphasized the joy and fulfillment that a new mother can expect to experience on her child's arrival. But starting in the 1950s, discussions of the "baby blues" began to appear in the popular press. How did articles about the baby blues, and then postpartum depression, challenge these rosy depictions? In this article, we examine portrayals of postpartum distress in popular magazines and advice books during the second half of the 20th century to examine how the unsettling pairing of distress and motherhood was culturally negotiated in these decades. We show that these portrayals revealed a persistent reluctance to situate motherhood itself as the cause of serious emotional distress and a consistent focus on changing mothers to adapt to their role rather than changing the parameters of the role itself. Regardless of whether these messages actually helped or hindered new mothers themselves, we suggest that they reflected the rarely challenged assumption that motherhood and distress should not mix.

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

    PubMed Central

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

    2014-01-01

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

  13. Postpartum Bonding Disorder: Factor Structure, Validity, Reliability and a Model Comparison of the Postnatal Bonding Questionnaire in Japanese Mothers of Infants

    PubMed Central

    Ohashi, Yukiko; Kitamura, Toshinori; Sakanashi, Kyoko; Tanaka, Tomoko

    2016-01-01

    Negative attitudes of mothers towards their infant is conceptualized as postpartum bonding disorder, which leads to serious health problems in perinatal health care. However, its measurement still remains to be standardized. Our aim was to examine and confirm the psychometric properties of the Postnatal Bonding Questionnaire (PBQ) in Japanese mothers. We distributed a set of questionnaires to community mothers and studied 392 mothers who returned the questionnaires at 1 month after childbirth. Our model was compared with three other models derived from previous studies. In a randomly halved sample, an exploratory factor analysis yielded a three-factor structure: Anger and Restrictedness, Lack of Affection, and Rejection and Fear. This factor structure was cross-validated by a confirmatory factor analysis using the other halved sample. The three subscales showed satisfactory internal consistency. The three PBQ subscale scores were correlated with depression and psychological abuse scores. Their test–retest reliability between day 5 and 1 month after childbirth was measured by intraclass correlation coefficients between 0.76 and 0.83. The Akaike Information Criteria of our model was better than the original four-factor model of Brockington. The present study indicates that the PBQ is a reliable and valid measure of bonding difficulties of Japanese mothers with neonates. PMID:27490583

  14. Postpartum Bonding Disorder: Factor Structure, Validity, Reliability and a Model Comparison of the Postnatal Bonding Questionnaire in Japanese Mothers of Infants.

    PubMed

    Ohashi, Yukiko; Kitamura, Toshinori; Sakanashi, Kyoko; Tanaka, Tomoko

    2016-01-01

    Negative attitudes of mothers towards their infant is conceptualized as postpartum bonding disorder, which leads to serious health problems in perinatal health care. However, its measurement still remains to be standardized. Our aim was to examine and confirm the psychometric properties of the Postnatal Bonding Questionnaire (PBQ) in Japanese mothers. We distributed a set of questionnaires to community mothers and studied 392 mothers who returned the questionnaires at 1 month after childbirth. Our model was compared with three other models derived from previous studies. In a randomly halved sample, an exploratory factor analysis yielded a three-factor structure: Anger and Restrictedness, Lack of Affection, and Rejection and Fear. This factor structure was cross-validated by a confirmatory factor analysis using the other halved sample. The three subscales showed satisfactory internal consistency. The three PBQ subscale scores were correlated with depression and psychological abuse scores. Their test-retest reliability between day 5 and 1 month after childbirth was measured by intraclass correlation coefficients between 0.76 and 0.83. The Akaike Information Criteria of our model was better than the original four-factor model of Brockington. The present study indicates that the PBQ is a reliable and valid measure of bonding difficulties of Japanese mothers with neonates. PMID:27490583

  15. Activities for Infant Stimulation or Mother-Infant Games.

    ERIC Educational Resources Information Center

    Badger, Earladeen

    Specific suggestions are offered for mother-infant activities, sequenced according to developmental levels, which foster the physical and mental development of the infant and the socio-emotional relationship between mother and infant. The activities are intended for use by professionals, paraprofessionals, and mother-teacher aides who work with…

  16. Oxytocin increases VTA activation to infant and sexual stimuli in nulliparous and postpartum women

    PubMed Central

    Gregory, Rebecca; Cheng, Hu; Rupp, Heather A.; Sengelaub, Dale R.; Heiman, Julia R.

    2015-01-01

    After giving birth, women typically experience decreased sexual desire and increased responsiveness to infant stimuli. These postpartum changes may be viewed as a trade-off in reproductive interests, which could be due to alterations in brain activity including areas associated with reward. The goal of this study was to describe the roles of oxytocin and parity on reward area activation in response to reproductive stimuli, specifically infant and sexual images. Because they have been shown to be associated with reward, the ventral tegmental area (VTA) and nucleus accumbens (NAc) were targeted as areas of expected alterations in activity. Oxytocin was chosen as a potential mediator of reproductive trade-offs because of its relationship to both mother–infant interactions, including breastfeeding and bonding, and sexual responses. We predicted that postpartum women would show higher reward area activation to infant stimuli and nulliparous women would show higher activation to sexual stimuli and that oxytocin would increase activation to infant stimuli in nulliparous women. To test this, we measured VTA and NAc activation using fMRI in response to infant photos, sexual photos, and neutral photos in 29 postpartum and 30 nulliparous women. Participants completed the Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales and the Brief Index of Sexual Function for Women (BISF-W), which includes a sexual desire dimension, and received either oxytocin or placebo nasal spray before viewing crying and smiling infant and sexual images in an fMRI scanner. For both groups of women, intranasal oxytocin administration increased VTA activation to both crying infant and sexual images but not to smiling infant images. We found that postpartum women showed lower SES, higher SIS, and lower sexual desire compared to nulliparous women. Across parity groups, SES scores were correlated with VTA activation and subjective arousal ratings to sexual images. In postpartum women, sexual

  17. Postpartum depression

    PubMed Central

    Pearlstein, Teri; Howard, Margaret; Salisbury, Amy; Zlotnick, Caron

    2014-01-01

    Postpartum depression (PPD) affects up to 15% of mothers. Recent research has identified several psychosocial and biologic risk factors for PPD. The negative short-term and long-term effects on child development are well-established. PPD is under recognized and under treated. The obstetrician and pediatrician can serve important roles in screening for and treating PPD. Treatment options include psychotherapy and antidepressant medication. Obstacles to compliance with treatment recommendations include access to psychotherapists and concerns of breastfeeding mothers about exposure of the infant to antidepressant medication. Further research is needed to examine systematically the short-term and long-term effect of medication exposure through breastmilk on infant and child development. PMID:19318144

  18. 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

  19. Effects of Online Self-Regulation Activitieson Physical Activity among Pregnant and Early Postpartum Women

    PubMed Central

    Niederdeppe, Jeff; Graham, Meredith; Olson, Christine; Gay, Geri

    2015-01-01

    Physical and psychological changes that occur during pregnancy present a unique challenge for women’s physical activity. Using a theory-based prospective design, this study examines effects of pregnant women’s (1) physical activity cognitions (self-efficacy, outcome expectancy, and safety beliefs) and (2) online self-regulation activities (goal-setting and self-monitoring) on subsequent changes in their physical activity intentions and behavior during pregnancy and immediately postpartum. We used data from three panel surveys administered to pregnant women enrolled in a web-based intervention to promote healthy pregnancy and postpartum weight, as well as log data on their use of self-regulatory features on the intervention website. Perceived self-efficacy and perceived safety of physical activity in pregnancy enhanced subsequent intentions to be physically active. Repeated goal-setting and monitoring of those goals helped to maintain positive intentions during pregnancy, but only repeated self-monitoring transferred positive intentions into actual behavior. Theoretically, this study offers a better understanding of the roles of self-regulation activities in the processes of goal-striving. We also discuss practical implications for encouraging physical activity among pregnant and early postpartum women. PMID:26132887

  20. 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 ...

  1. Interpersonal Psychotherapy for Postpartum Depression

    PubMed Central

    Stuart, Scott

    2014-01-01

    Perinatal depression is prevalent and has a great impact on both mother and infant. There are empirically validated treatments for both postpartum depression and depression during pregnancy. Primary among these is interpersonal psychotherapy, which has been shown to be effective for postpartum women across the spectrum from mild to severe depression. At present, interpersonal psychotherapy is the best validated treatment for postpartum depression and should be considered first-line treatment, especially for depressed breastfeeding women. PMID:22473762

  2. Acceptability and feasibility of a mobile phone-based case management intervention to retain mothers and infants from an Option B+ program in postpartum HIV care

    PubMed Central

    SCHWARTZ, Sheree R; CLOUSE, Kate; YENDE, Nompumelelo; VAN RIE, Annelies; BASSETT, Jean; RATSHEFOLA, Mamothe; PETTIFOR, Audrey

    2016-01-01

    Objective To assess the acceptability and feasibility of a cell-phone based case manager intervention targeting HIV-infected pregnant women on highly-active antiretroviral therapy (HAART). Methods Pregnant women ≥36 weeks gestation attending antenatal care and receiving HAART through the Option B+ program at a primary care clinic in South Africa were enrolled into a prospective pilot intervention to receive text messages and telephone calls from a case manager through six weeks postpartum. Acceptability and feasibility of the intervention were assessed along with infant HIV testing rates and 10-week and 12-month postpartum maternal retention in care. Retention outcomes were compared to women of similar eligibility receiving care prior to the intervention. Results Fifty women were enrolled into the pilot from May-July 2013. Most (70%) were HAART-naive at time of conception and started HAART during antenatal care. During the intervention, the case manager sent 482 text messages and completed 202 telephone calls, for a median of 10 text messages and 4 calls/woman. Ninety-six percent completed the postpartum interview and 47/48 (98%) endorsed the utility of the intervention. Engagement in 10-week postpartum maternal HIV care was >90% in the pre-intervention (n=50) and intervention (n=50) periods; by 12-months retention fell to 72% and was the same across periods. More infants received HIV-testing by 10-weeks in the intervention period as compared to pre-intervention (90.0% vs. 63.3%, p<0.01). Conclusions Maternal support through a cell-phone based case manager approach was highly acceptable among South African HIV infected women on HAART and feasible, warranting further assessment of effectiveness. PMID:25656728

  3. Internet confessions of postpartum depression.

    PubMed

    Kantrowitz-Gordon, Ira

    2013-12-01

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

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

    PubMed

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

    2015-02-01

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

  5. Risk of vaginal bleeding and postpartum hemorrhage after use of antidepressants in pregnancy: a study from the Norwegian Mother and Child Cohort Study.

    PubMed

    Lupattelli, Angela; Spigset, Olav; Koren, Gideon; Nordeng, Hedvig

    2014-02-01

    This study aimed to examine obstetric bleeding outcomes after exposure during pregnancy to selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic (TCAs), and other antidepressants (OADs).The Norwegian Mother and Child Cohort Study and the Medical Birth Registry of Norway constituted the data source for the present study. We included 57,279 pregnant women, of which 1.02% reported use of antidepressants during pregnancy, mostly SSRIs/SNRIs (0.92%). We categorized exposure according to antidepressant use in pregnancy (SSRIs/SNRIs, n = 527; TCAs/OADs, n = 59; nonexposed, nondepressed, n = 55,411) with inclusion of a disease comparison group (nonexposed, depressed, n = 1282). We used logistic regression to estimate adjusted odds ratio (aOR) and 95% confidence interval (CI) for vaginal bleeding outcomes in pregnancy and postpartum hemorrhage.Compared with nonexposed subjects, first trimester exposure to SSRIs/SNRIs or TCAs/OADs did not confer any increased risk of vaginal bleeding in early pregnancy (aOR, 0.91; 95% CI, 0.72-1.16 and aOR, 0.83; 95% CI, 0.36-1.92, respectively). No increased risk for vaginal bleeding in midpregnancy was observed among users of SSRIs/SNRIs (aOR, 0.81; 95% CI, 0.50-1.31) or TCAs/OADs (aOR, 0.96; 95% CI, 0.26-3.53) in second trimester. Exposure to SSRIs/SNRIs during gestational week 30 to childbirth did not confer any increased risk of postpartum hemorrhage after vaginal (aOR, 0.90; 95% CI, 0.47-1.74) or cesarean (aOR, 1.47; 95% CI, 0.51-4.22) delivery. Women in the disease comparison group presented a significant moderate increased risk of vaginal bleeding in early pregnancy (aOR, 1.22; 95% CI, 1.06-1.39) and midpregnancy (aOR, 1.28; 95% CI, 1.07-1.55) but not postpartum.Among this Norwegian cohort of pregnant women, use of antidepressants in pregnancy was not associated with any obstetrical bleeding outcome.

  6. Evaluation of the effects of ice massage applied to large intestine 4 (hegu) on postpartum pain during the active phase of labor

    PubMed Central

    Can, Hafize Ozturk; Saruhan, Aynur

    2015-01-01

    Background: The uterus continues to contract after childbirth. The pain caused by the contractions of the uterus can be as severe as labor pain. The study was aimed to evaluate the effects of ice massage applied to the large intestine 4 (LI4) on postpartum pain during the active phase of labor. Materials and Methods: The study was designed as a randomized controlled trial with three groups and carried out in two stages. The study sample comprised of 150 pregnant women, who were referred to a maternity hospital. In the experimental group, ice massage was applied to LI4 during four contractions within the active phase of labor. In the placebo group, pressure was applied to LI4 using silicone balloons and the third group was the control group. The Visual Analog Scale (VAS) and The McGill (Melzack) Pain Questionnaire (MPQ) were compared among the experimental, placebo, and control groups. Results: The mothers in the ice application group had the lowest mean VAS score. It was determined that ice massage applied to LI4 during the active phase of labor did not lead to any statistical differences in mothers in the first 24 hours postpartum in terms of the characteristics of the pain with MPQ and VAS. Conclusions: In the study, the perception of pain was tried to be minimized by applying pressure with ice balloons to LI4. However, although the application was determined to have made no difference in the pain intensity, the mothers’ statements in the ice application group suggested that they felt more comfortable than did the mothers in the other groups. PMID:25709702

  7. Long-term postpartum anxiety and depression-like behavior in mother rats subjected to maternal separation are ameliorated by palatable high fat diet.

    PubMed

    Maniam, Jayanthi; Morris, Margaret J

    2010-03-17

    While the effects of maternal separation on pups are well studied, the impact on dams has attracted little attention. The consumption of palatable food is known to dampen stress responses in animals, and emotions influence food choice in humans. Here we examined the early- and long-term impacts of maternal separation on behavioral profile of the dams, and the effects of palatable cafeteria high-fat diet (HFD). After littering, Sprague-Dawley female rats were subjected to prolonged separation, S180 (180 min) or brief separation, S15 (15 min/day) from postnatal days (PND) 2-14. At 4 weeks postpartum, half the dams were assigned to HFD. Anxiety and depression-like behaviors were assessed pre- and post-diet. Compared to S15 dams, S180 dams consuming chow demonstrated increased anxiety and depression-like behaviors assessed by elevated plus maze (EPM) and forced swim (FST) tests, respectively. These behavioral deficits were observed at 4 weeks, and persisted until 17 weeks postpartum. The S180 dams also had increased plasma corticosterone concentration compared to S15 dams, which coincided with increased hypothalamic CRH mRNA and reduced hippocampal GR mRNA expression, suggesting possible dysregulation of hypothalamic-pituitary-adrenal axis activity. Interestingly, continuous provision of HFD improved the behavioral deficits observed in S180 dams with significant reduction of hypothalamic CRH mRNA expression. These data are the first to describe long-term detrimental behavioral impacts of separation in dams, suggesting this may provide a model of postpartum depression. Moreover, they support the notion of long-term beneficial effects of 'comfort food' on stress responses.

  8. What Do Mothers Say? Korean Mothers' Perceptions of Children's Participation in Extra-Curricular Musical Activities

    ERIC Educational Resources Information Center

    Cho, Eun

    2015-01-01

    A recent study of Korean middle-class mothers' perceptions and parenting practices associated with children's participation in musical activities reported unique forms of musical parenting, which closely correspond with previous studies of concerted cultivation in Western middle-class families. Are these unique patterns exclusive to middle-class…

  9. 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…

  10. 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

  11. 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 ...

  12. 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 ...

  13. Postpartum Blood Clots

    MedlinePlus

    ... Breast Infection Postpartum Blood Clots Postpartum Thyroid Disorders Postpartum Depression The risk of developing blood clots (thrombophlebitis) is ... Breast Infection Postpartum Blood Clots Postpartum Thyroid Disorders Postpartum Depression NOTE: This is the Consumer Version. CONSUMERS: Click ...

  14. Breast Milk Concentration of Rubidium in Lactating Mothers by Instrumental Neutron Activation Analysis Method

    PubMed Central

    Khatami, Seyedeh-Fatemeh; Parvaresh, Pouya; Parvaresh, Parviz; Madani Kouchak, Sara Sadat; Khorsandi, Jamshid

    2014-01-01

    Objective: Relatively little is known about the trace elements content of human milk from different countries. This has not been fully investigated especially among Iranian women. This study aimed to assess the concentration of Rubidium (Rb) as a poisonous trace element in transitional breast milk of lactating mothers living in Mashhad. Methods: Forty nursing mothers in early lactation 3 days to 15 days postpartum, free from any medical disorder and/or medication were randomly selected. We have applied Instrumental Neutron Activation Analysis (INAA) to assess the long-lived isotope trace element Rb in transitional milk of these economically moderate 18–39 year old Iranian women. Findings: The average concentration level of Rb was 32.176 ppm dry weight (min 8.660, max 107.210 ppm). No significant correlation was observed between Rb concentration and maternal weight and age (P=0.06, P=0.05 respectively) and newborns’ weight, age and sex (P=0.07, P=0.2, P=0.2 respectively). Conclusion: Although the Rubidium concentration found in this study is among the highest reported in the literature, it could not be compared to other studies because of differences in analytical performance, state of lactation, and unavailable reference ranges, so this finding needs further investigations. PMID:26019773

  15. The postpartum triathlete.

    PubMed

    Thein-Nissenbaum, Jill

    2016-09-01

    The postpartum period in a woman's life is filled with numerous changes, including physical changes, changes in sleep habits, and learning how to best care for a newborn. A common goal among postpartum women is to either begin or resume an active lifestyle, which often includes physical activity such as running, biking and swimming. The postpartum athlete may discover barriers that prevent her from returning to or beginning an exercise routine. These obstacles include muscle weakness, fatigue, depression and physical changes that require exercise modification. The physical therapist is well-suited to properly assess, treat and manage the care of the postpartum athlete. Postpartum athletes wishing to begin or resume training for triathlons require special consideration, as the triathlete must balance training to compete in three different sports. The purpose of the paper is to identify the unique physical and physiological changes that occur to the female during the postpartum period. In addition, injuries that are more commonly seen during the postpartum period will be discussed. Recommendations for beginning or resuming an exercise program will be reviewed. Lastly, sport-specific training for the postpartum triathlete, including challenges presented with each triathlon component, will be discussed. PMID:27497835

  16. Postpartum Infections

    MedlinePlus

    ... Drug Interactions Pill Identifier Commonly searched drugs Aspirin Metformin Warfarin Tramadol Lactulose Ranitidine News & Commentary Recent News ... Muscle Disorders Brain, Spinal Cord, and Nerve Disorders Cancer Children's Health Issues ... Bladder and Kidney Infections Breast Infection Postpartum Blood Clots Postpartum Thyroid Disorders Postpartum ...

  17. Postpartum hemorrhage.

    PubMed

    Su, Cindy W

    2012-03-01

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

  18. Healthy Mothers Healthy Babies: awareness and perceptions of existing breastfeeding and postpartum depression support among parents and perinatal health care providers in Hawai'i.

    PubMed

    Kimura, Lisa J; McGee, Amelia; Baird, Shelagh; Viloria, Joanne; Nagatsuka, Melissa

    2015-03-01

    Healthy Mothers, Healthy Babies Coalition of Hawai'i (HMHB) is a local nonprofit organization dedicated to eliminating health disparities and improving Hawai'i's maternal, child, and family health though collaborative efforts in public education, advocacy, and partner development. A review of HMHB services revealed overwhelming requests for both breastfeeding and postpartum depression (PPD) support. The purpose of this article is to present the findings of two surveys that highlight the awareness of existing breastfeeding and PPD resources based on both parents and health care providers; perceptions of where and how care is accessed; and whether mothers throughout Hawai'i have equitable access to support. Results helped assess gaps in resources and determine barriers to care, as well as provide suggestions for new services or resources. Web-based surveys were sent to 450 providers and 2,955 parents with response rates of 8.9% and 4.0%, respectively. Less than half of parent participants reported that their health provider discussed PPD with them. Participants identified a number of barriers to increasing access and utilization of PPD support resources, including: not feeling like symptoms were server enough, feeling embarrassed to seek help, not knowing where to find support/information, and not able to afford or insurance wouldn't cover PPD support. Only 40% of providers reported screening for PPD and 33% felt they had not received adequate training. Barriers identified by providers were a lack of trained providers, lack of PPD specific support groups, cultural stigma, and lack of PPD awareness among providers. Of the women who did not exclusively breastfeed for the full six-month recommendation, the most common breastfeeding concerns included: perceptions of low milk supply; lack of lactation support; medical reasons; and pain. Providers described an environment of uneven distribution of resources, general lack of awareness of available resources, along with a

  19. Healthy Mothers Healthy Babies: awareness and perceptions of existing breastfeeding and postpartum depression support among parents and perinatal health care providers in Hawai'i.

    PubMed

    Kimura, Lisa J; McGee, Amelia; Baird, Shelagh; Viloria, Joanne; Nagatsuka, Melissa

    2015-03-01

    Healthy Mothers, Healthy Babies Coalition of Hawai'i (HMHB) is a local nonprofit organization dedicated to eliminating health disparities and improving Hawai'i's maternal, child, and family health though collaborative efforts in public education, advocacy, and partner development. A review of HMHB services revealed overwhelming requests for both breastfeeding and postpartum depression (PPD) support. The purpose of this article is to present the findings of two surveys that highlight the awareness of existing breastfeeding and PPD resources based on both parents and health care providers; perceptions of where and how care is accessed; and whether mothers throughout Hawai'i have equitable access to support. Results helped assess gaps in resources and determine barriers to care, as well as provide suggestions for new services or resources. Web-based surveys were sent to 450 providers and 2,955 parents with response rates of 8.9% and 4.0%, respectively. Less than half of parent participants reported that their health provider discussed PPD with them. Participants identified a number of barriers to increasing access and utilization of PPD support resources, including: not feeling like symptoms were server enough, feeling embarrassed to seek help, not knowing where to find support/information, and not able to afford or insurance wouldn't cover PPD support. Only 40% of providers reported screening for PPD and 33% felt they had not received adequate training. Barriers identified by providers were a lack of trained providers, lack of PPD specific support groups, cultural stigma, and lack of PPD awareness among providers. Of the women who did not exclusively breastfeed for the full six-month recommendation, the most common breastfeeding concerns included: perceptions of low milk supply; lack of lactation support; medical reasons; and pain. Providers described an environment of uneven distribution of resources, general lack of awareness of available resources, along with a

  20. Relationship between participation in leisure activities and constraints on Taiwanese breastfeeding mothers during leisure activities

    PubMed Central

    2013-01-01

    Background Participation in leisure activities strongly associates with health and well-being. Little research has explored the relationship between participation in leisure activities and constraints on breastfeeding mothers during leisure activities. The purposes of this study are: 1) to investigate constraints on breastfeeding mothers during leisure activities and participation in leisure activities; 2) to investigate the differences between preferences for leisure activities and actual participation by breastfeeding mothers; 3) to segment breastfeeding mothers with similar patterns, using a cluster analysis based on the delineated participation in leisure activities and leisure preferences; 4) to explore any differences between clusters of breastfeeding mothers with respect to socio-demographic characteristics, breastfeeding behaviours and leisure constraints. Methods This study has a cross-sectional design using an online survey conducted among mothers having breastfeeding experiences of more than four months. The questionnaire includes demographic variables, breastfeeding behaviours, preferences for leisure activities participation, and constraints on leisure activities. Collection of data occurred between March and July 2011, producing 415 valid responses for analysis. Results For breastfeeding mothers, this study identifies constraints on breastfeeding related to leisure activities in addition to the three traditional factors for constraints in the model. This study demonstrates that reports of constraints related to children, family, and nursing environments are the most frequent. Breastfeeding mothers in Taiwan participate regularly in family activities or activities related to their children. Cluster analysis classified breastfeeding mothers into Action and Contemplation groups, and found that mothers within the latter group participate less in leisure activities and experienced more constraints related to breastfeeding. Conclusions Implications provide

  1. Postpartum depression in a military sample.

    PubMed

    Appolonio, Kathryn Kanzler; Fingerhut, Randy

    2008-11-01

    Postpartum depression (PPD) affects nearly 1 in 8 mothers and has many negative implications. Studies show particular risk factors are linked with PPD. There are nearly 200,000 women serving in the U.S. Armed Forces, but little is known regarding PPD and active duty (AD) mothers. This study examined rates and risk factors for AD mothers and found that 19.5% were positive for PPD symptoms. Ten significant psychosocial factors were associated with PPD, including low self-esteem, prenatal anxiety, prenatal depression, history of previous depression, social support, poor marital satisfaction, life stress, child care stress, difficult infant temperament, and maternity blues. This study has implications for prevention, identification, and treatment of AD military women with PPD.

  2. Postpartum Tuberculosis: A Diagnostic and Therapeutic Challenge

    PubMed Central

    Gudeta, Alemeshet; Zerihun, Aklilu; Lewis, Odene; Ahmed, Sohail; Gajjala, Jhansi; Thomas, Alicia

    2016-01-01

    Tuberculosis (TB) infection in pregnant women and newborn babies is always challenging. Appropriate treatment is pivotal to curtail morbidity and mortality. TB diagnosis or exposure to active TB can be emotionally distressing to the mother. Circumstances can become more challenging for the physician if the mother's TB status is unclear. Effective management of TB during pregnancy and the postpartum period requires a multidisciplinary approach including pulmonologist, obstetrician, neonatologist, infectious disease specialist, and TB public health department. Current guidelines recommend primary Isoniazid prophylaxis in TB exposed pregnant women who are immune-suppressed and have chronic medical conditions or obstetric risk factors and close and sustained contact with a patient with infectious TB. Treatment during pregnancy is the same as for the general adult population. Infants born to mothers with active TB at delivery should undergo a complete diagnostic evaluation. Primary Isoniazid prophylaxis for at least twelve weeks is recommended for those with negative diagnostic tests and no evidence of disease. Repeated negative diagnostic tests are mandatory before interrupting prophylaxis. Separation of mother and infant is only necessary when the mother has received treatment for less than 2 weeks, is sputum smear-positive, or has drug-resistant TB. This case highlights important aspects for management of TB during the postpartum period which has a higher morbidity. We present a case of a young mother migrating from a developing nation to the USA, who was found to have a positive quantiFERON test associated with multiple cavitary lung lesions and gave birth to a healthy baby. PMID:27610260

  3. Postpartum Tuberculosis: A Diagnostic and Therapeutic Challenge.

    PubMed

    Kodadhala, Vijay; Gudeta, Alemeshet; Zerihun, Aklilu; Lewis, Odene; Ahmed, Sohail; Gajjala, Jhansi; Thomas, Alicia

    2016-01-01

    Tuberculosis (TB) infection in pregnant women and newborn babies is always challenging. Appropriate treatment is pivotal to curtail morbidity and mortality. TB diagnosis or exposure to active TB can be emotionally distressing to the mother. Circumstances can become more challenging for the physician if the mother's TB status is unclear. Effective management of TB during pregnancy and the postpartum period requires a multidisciplinary approach including pulmonologist, obstetrician, neonatologist, infectious disease specialist, and TB public health department. Current guidelines recommend primary Isoniazid prophylaxis in TB exposed pregnant women who are immune-suppressed and have chronic medical conditions or obstetric risk factors and close and sustained contact with a patient with infectious TB. Treatment during pregnancy is the same as for the general adult population. Infants born to mothers with active TB at delivery should undergo a complete diagnostic evaluation. Primary Isoniazid prophylaxis for at least twelve weeks is recommended for those with negative diagnostic tests and no evidence of disease. Repeated negative diagnostic tests are mandatory before interrupting prophylaxis. Separation of mother and infant is only necessary when the mother has received treatment for less than 2 weeks, is sputum smear-positive, or has drug-resistant TB. This case highlights important aspects for management of TB during the postpartum period which has a higher morbidity. We present a case of a young mother migrating from a developing nation to the USA, who was found to have a positive quantiFERON test associated with multiple cavitary lung lesions and gave birth to a healthy baby. PMID:27610260

  4. Postpartum Tuberculosis: A Diagnostic and Therapeutic Challenge

    PubMed Central

    Gudeta, Alemeshet; Zerihun, Aklilu; Lewis, Odene; Ahmed, Sohail; Gajjala, Jhansi; Thomas, Alicia

    2016-01-01

    Tuberculosis (TB) infection in pregnant women and newborn babies is always challenging. Appropriate treatment is pivotal to curtail morbidity and mortality. TB diagnosis or exposure to active TB can be emotionally distressing to the mother. Circumstances can become more challenging for the physician if the mother's TB status is unclear. Effective management of TB during pregnancy and the postpartum period requires a multidisciplinary approach including pulmonologist, obstetrician, neonatologist, infectious disease specialist, and TB public health department. Current guidelines recommend primary Isoniazid prophylaxis in TB exposed pregnant women who are immune-suppressed and have chronic medical conditions or obstetric risk factors and close and sustained contact with a patient with infectious TB. Treatment during pregnancy is the same as for the general adult population. Infants born to mothers with active TB at delivery should undergo a complete diagnostic evaluation. Primary Isoniazid prophylaxis for at least twelve weeks is recommended for those with negative diagnostic tests and no evidence of disease. Repeated negative diagnostic tests are mandatory before interrupting prophylaxis. Separation of mother and infant is only necessary when the mother has received treatment for less than 2 weeks, is sputum smear-positive, or has drug-resistant TB. This case highlights important aspects for management of TB during the postpartum period which has a higher morbidity. We present a case of a young mother migrating from a developing nation to the USA, who was found to have a positive quantiFERON test associated with multiple cavitary lung lesions and gave birth to a healthy baby.

  5. Associations of prepartum body condition score with occurrence of clinical endometritis and resumption of postpartum ovarian activity in dairy cattle.

    PubMed

    Kadivar, Ali; Ahmadi, Mohammad Rahim; Vatankhah, Mahmood

    2014-01-01

    This study was performed to investigate the effect of periparturient body condition score on the occurrence of clinical endometritis and postpartum resumption of ovarian activity in dairy cows. Eighty-seven lactating Holstein cows, fed with a total mixed ration diet, were included into the study. Body condition scoring (using a 5-point scale with quarter-point divisions) was performed by the same investigator using the visual technique every 2 weeks, from 2 weeks before until 6 weeks after calving. Palpation of the reproductive tract and ultrasonographic assessment of ovaries for detection of corpus luteum using a rectal linear probe was also performed at 2, 4, and 6 weeks after calving. Cows with clinical endometritis had significantly lower body condition score (BCS) than normal cows at all weeks pre- and postcalving, and cows that did not ovulate until 45 days after calving had a significantly lower BCS pre- and postpartum. Cows that did not ovulate until 45 days after calving also lost more BCS from 2 weeks before to 4 weeks after calving. Besides, first ovulation after calving take occurred later in cows with clinical endometritis compared to normal cows (P < 0.05). In conclusion, low BCS is a risk factor for postpartum endometritis and delayed cyclicity in dairy cows. BCS loss from dry-off to early lactation and occurrence of clinical endometritis can significantly affect postpartum ovarian activity.

  6. Determinants of changes in vitamin D status postpartum in Swedish women.

    PubMed

    Brembeck, Petra; Winkvist, Anna; Bååth, Mari; Bärebring, Linnea; Augustin, Hanna

    2016-02-14

    Low vitamin D status has been associated with unfavourable health outcomes. Postpartum, it is speculated that maternal vitamin D status decreases due to transfer of vitamin D from mother to child through breast milk. A few studies have investigated changes in maternal vitamin D postpartum and possible determinants. Thus, the aims of the present study were to determine changes in serum concentrations of 25-hydroxyvitamin D (25(OH)D) between 2 weeks and 12 months postpartum in Swedish women and to evaluate lactation and other determinants for changes in 25(OH)D concentration postpartum. In total, seventy-eight women were studied at 2 weeks, 4 months and 12 months postpartum. Data collection included measurements of weight and height as well as information about lactation, sun exposure, use of oestrogen contraceptives and physical activity level. Blood samples were collected and serum 25(OH)D levels were analysed using liquid chromatography-tandem MS. Dietary intake of vitamin D was recorded using 4-d food diaries. For all the women studied, mean serum 25(OH)D did not change between 2 weeks and 12 months postpartum (67 (SD 23) v. 67 (SD 19) nmol/l). No association was found between lactation and changes in serum 25(OH)D concentration postpartum. Significant determinants for postpartum changes in 25(OH)D concentration were use of vitamin D supplements (P=0·003), use of oestrogen contraceptives (P=0·013) and season (P=0·005). In conclusion, no changes were observed in 25(OH)D concentrations during the 1st year postpartum in these women and no association was found between lactation and changes in 25(OH)D concentration postpartum. The main determinants for the variation in changes in 25(OH)D concentrations postpartum were use of vitamin D supplements, use of oestrogen contraceptives and season. PMID:26586446

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

    PubMed

    Posillico, Caitlin K; Schwarz, Jaclyn M

    2016-02-01

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

  8. Postpartum contraception.

    PubMed

    Sober, Stephanie; Schreiber, Courtney A

    2014-12-01

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

  9. Plants used during pregnancy, childbirth and postpartum healthcare in Lao PDR: A comparative study of the Brou, Saek and Kry ethnic groups

    PubMed Central

    de Boer, Hugo; Lamxay, Vichith

    2009-01-01

    Background In many Southeast Asian cultures the activities and diet during the postpartum period are culturally dictated and a period of confinement is observed. Plants play an important role in recovery during the postpartum period in diet, traditional medicine, steam bath and mother roasting (where mother and child placed on a bed above a brazier with charcoal embers on which aromatic plants are laid). This research focuses on the use of plants during pregnancy, parturition, postpartum recovery and infant healthcare among three ethnic groups, the Brou, Saek and Kry. It aims to identify culturally important traditions that may facilitate implementation of culturally appropriate healthcare. Methods Data were collected in 10 different villages in Khammouane province, Lao PDR, through group and individual interviews with women by female interviewers. Results A total of 55 different plant species are used in women's healthcare, of which over 90% are used in postpartum recovery. Consensus Analysis rejects the hypothesis that the three ethnic groups belong to a single culture for postpartum plant use, and multidimensional scaling reveals non-overlapping clusters per ethnic group. Conclusion Medicinal plant use is common among the Brou, Saek and Kry to facilitate childbirth, alleviate menstruation problems, assist recovery after miscarriage, mitigate postpartum haemorrhage, aid postpartum recovery, and for use in infant care. The wealth of novel insights into plant use and preparation will help to understand culturally important practices such as confinement, dietary restrictions, mother roasting and herbal steam baths and their incorporation into modern healthcare. PMID:19737413

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

    PubMed Central

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

    2009-01-01

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

  11. Maternal Stress Predicts Postpartum Weight Retention

    PubMed Central

    Whitaker, Kara; Vernon, Marlo; Wilcox, Sara

    2014-01-01

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

  12. Postpartum blues: relationship between not-protein bound steroid hormones in plasma and postpartum mood changes.

    PubMed

    Heidrich, A; Schleyer, M; Spingler, H; Albert, P; Knoche, M; Fritze, J; Lanczik, M

    1994-02-01

    The relationship between non-bound steroid hormone levels in plasma and the occurrence of postpartum mood changes was investigated in 26 newly delivered mothers throughout the first 5 days postpartum. Studies with saliva samples had reported higher concentrations of 17 beta-estradiol and progesterone on the days of symptoms in women experiencing postpartum blues. As there had been a controversy as to how far saliva concentrations reflect free hormone levels in plasma, free hormone levels of 17 beta-estradiol and progesterone were determined in plasma using ultrafiltration. No significant difference concerning free hormone levels could be found between women with and without postpartum blues. PMID:8201129

  13. Ovarian activity and estrus behavior in early postpartum cows grazing Leucaena leucocephala in the tropics.

    PubMed

    Bottini-Luzardo, Maria; Aguilar-Perez, Carlos; Centurion-Castro, Fernando; Solorio-Sanchez, Francisco; Ayala-Burgos, Armin; Montes-Perez, Ruben; Muñoz-Rodriguez, David; Ku-Vera, Juan

    2015-12-01

    The legume Leucaena leucocephala (Leucaena) is widely used to supplement forage in silvopastoral livestock systems in Latin America. Little is known about its possible effects on the cow reproductive dynamic. The aim was to evaluate the effect of Leucaena foliage intake on re-establishment of ovarian activity and estrus behavior in early postpartum (7-90 days) cows. Twenty-four multiparous Bos taurus × Bos indicus cows were divided into two homogenous groups and assigned to one of two treatments: a silvopastoral system (SS, n = 12), consisting of an association of Cynodon nlemfuensis grass and L. leucocephala; and a control system (CS, n = 12), consisting of C. nlemfuensis alone. Intake of Leucaena in the SS ranged from 3.80 to 6.43 kg DM/cow/day. Plasma mimosine concentrations ranged from 1270 to 1530 μg/mL, and those for 2,3-dihydroxypyridine (DHP) from 147 to 729 μg/mL. No 3,4-DHP was detected in plasma. No difference (P > 0.05) between treatments was observed for the number of cows exhibiting small, medium, or dominant follicles, or estrus behavior. The number of cows which re-established ovarian cyclicity (n = 6) was lower (P < 0.05) in the SS than in the CS (n = 9). Corpus luteum lifespan was longer (P < 0.05) in the SS than in the CS. Intake of Leucaena affected the number of cows exhibiting ovarian cyclicity and extended corpus luteum life, but did not affect follicular development and estrus behavior. PMID:26210396

  14. Ovarian activity and estrus behavior in early postpartum cows grazing Leucaena leucocephala in the tropics.

    PubMed

    Bottini-Luzardo, Maria; Aguilar-Perez, Carlos; Centurion-Castro, Fernando; Solorio-Sanchez, Francisco; Ayala-Burgos, Armin; Montes-Perez, Ruben; Muñoz-Rodriguez, David; Ku-Vera, Juan

    2015-12-01

    The legume Leucaena leucocephala (Leucaena) is widely used to supplement forage in silvopastoral livestock systems in Latin America. Little is known about its possible effects on the cow reproductive dynamic. The aim was to evaluate the effect of Leucaena foliage intake on re-establishment of ovarian activity and estrus behavior in early postpartum (7-90 days) cows. Twenty-four multiparous Bos taurus × Bos indicus cows were divided into two homogenous groups and assigned to one of two treatments: a silvopastoral system (SS, n = 12), consisting of an association of Cynodon nlemfuensis grass and L. leucocephala; and a control system (CS, n = 12), consisting of C. nlemfuensis alone. Intake of Leucaena in the SS ranged from 3.80 to 6.43 kg DM/cow/day. Plasma mimosine concentrations ranged from 1270 to 1530 μg/mL, and those for 2,3-dihydroxypyridine (DHP) from 147 to 729 μg/mL. No 3,4-DHP was detected in plasma. No difference (P > 0.05) between treatments was observed for the number of cows exhibiting small, medium, or dominant follicles, or estrus behavior. The number of cows which re-established ovarian cyclicity (n = 6) was lower (P < 0.05) in the SS than in the CS (n = 9). Corpus luteum lifespan was longer (P < 0.05) in the SS than in the CS. Intake of Leucaena affected the number of cows exhibiting ovarian cyclicity and extended corpus luteum life, but did not affect follicular development and estrus behavior.

  15. Relationships between insulin-like growth factor-I, milk yield, body condition score, and postpartum luteal activity in high-producing dairy cows.

    PubMed

    Tamadon, Amin; Kafi, Mojtaba; Saeb, Mehdi; Mirzaei, Abdolah; Saeb, Saedeh

    2011-01-01

    The relations between body condition score (BCS), milk yield, serum insulin-like growth factor-I (IGF-I) profile, and luteal activity were investigated in postpartum dairy cows. Seventy-one healthy high-producing multiparous Holstein cows were subjected to transrectal ultrasound scanning twice weekly from the first to the eighth week postpartum. Blood samples were collected twice weekly to measure serum progesterone (P4) and every 2 weeks to detect serum IGF-I concentrations. BCS was monitored weekly after calving. Cows with serum P4 concentrations ≥1 ng/ml on at least two consecutive samplings were considered to have commenced luteal activity. Commencement of luteal activity (C-LA) was observed earlier than 45 days postpartum in 71.8% of cows while 28.2% showed C-LA later than 45 days. Prolonged luteal phase was the most common abnormal pattern of luteal activity observed. Cows with a C-LA earlier than 45 days postpartum had higher (P ≤ 0.05) mean serum concentrations of IGF-I than those with later C-LA. In addition, cows which showed C-LA earlier than 45 days postpartum had more optimal productive indices including shorter calving to conception interval and calving to first service interval (P ≤ 0.05), and fewer services per conception (P = 0.07). C-LA was significantly later in cows that lost more than 0.5 BCS units within 3 weeks postpartum than in those that lost less than 0.5 units BCS during the same interval (P = 0.02). We conclude that high-producing dairy cows with higher postpartum serum IGF-I concentrations have earlier commencement and normal luteal activity, and better reproductive performance. Severity and duration of BCS loss adversely affect commencement of luteal activity.

  16. A natural model of behavioral depression in postpartum adult female cynomolgus monkeys (Macaca fascicularis)

    PubMed Central

    CHU, Xun-Xun; Rizak, Joshua Dominic; YANG, Shang-Chuan; WANG, Jian-Hong; MA, Yuan-Ye; HU, Xin-Tian

    2014-01-01

    Postpartum depression (PPD) is a modified form of major depressive disorders (MDD) that can exert profound negative effects on both mothers and infants than MDD. Within the postpartum period, both mothers and infants are susceptible; but because PPD typically occurs for short durations and has moderate symptoms, there exists challenges in exploring and addressing the underlying cause of the depression. This fact highlights the need for relevant animal models. In the present study, postpartum adult female cynomolgus monkeys (Macaca fascicularis) living in breeding groups were observed for typical depressive behavior. The huddle posture behavior was utilized as an indicator of behavioral depression postpartum (BDP) as it has been established as the core depressive-like behavior in primates. Monkeys were divided into two groups: A BDP group (n=6), which were found to spend more time huddling over the first two weeks postpartum than other individuals that formed a non-depression control group (n=4). The two groups were then further analyzed for locomotive activity, stressful events, hair cortisol levels and for maternal interactive behaviors. No differences were found between the BDP and control groups in locomotive activity, in the frequencies of stressful events experienced and in hair cortisol levels. These findings suggested that the postpartum depression witnessed in the monkeys was not related to external factors other than puerperium period. Interestingly, the BDP monkeys displayed an abnormal maternal relationship consisting of increased infant grooming. Taken together, these findings suggest that the adult female cynomolgus monkeys provide a natural model of behavioral postpartum depression that holds a number of advantages over commonly used rodent systems in PPD modeling. The cynomolgus monkeys have a highly-organized social hierarchy and reproductive characteristics without seasonal restriction—similar to humans—as well as much greater homology to

  17. A natural model of behavioral depression in postpartum adult female cynomolgus monkeys (Macaca fascicularis).

    PubMed

    Chu, Xun-Xun; Dominic Rizak, Joshua; Yang, Shang-Chuan; Wang, Jian-Hong; Ma, Yuan-Ye; Hu, Xin-Tian

    2014-05-01

    Postpartum depression (PPD) is a modified form of major depressive disorders (MDD) that can exert profound negative effects on both mothers and infants than MDD. Within the postpartum period, both mothers and infants are susceptible; but because PPD typically occurs for short durations and has moderate symptoms, there exists challenges in exploring and addressing the underlying cause of the depression. This fact highlights the need for relevant animal models. In the present study, postpartum adult female cynomolgus monkeys (Macaca fascicularis) living in breeding groups were observed for typical depressive behavior. The huddle posture behavior was utilized as an indicator of behavioral depression postpartum (BDP) as it has been established as the core depressive-like behavior in primates. Monkeys were divided into two groups: A BDP group (n=6), which were found to spend more time huddling over the first two weeks postpartum than other individuals that formed a non-depression control group (n=4). The two groups were then further analyzed for locomotive activity, stressful events, hair cortisol levels and for maternal interactive behaviors. No differences were found between the BDP and control groups in locomotive activity, in the frequencies of stressful events experienced and in hair cortisol levels. These findings suggested that the postpartum depression witnessed in the monkeys was not related to external factors other than puerperium period. Interestingly, the BDP monkeys displayed an abnormal maternal relationship consisting of increased infant grooming. Taken together, these findings suggest that the adult female cynomolgus monkeys provide a natural model of behavioral postpartum depression that holds a number of advantages over commonly used rodent systems in PPD modeling. The cynomolgus monkeys have a highly-organized social hierarchy and reproductive characteristics without seasonal restriction-similar to humans-as well as much greater homology to humans

  18. Do Mothers' Opinions Matter in Teens' Sexual Activity?

    ERIC Educational Resources Information Center

    Fingerson, Laura

    2005-01-01

    Using the Add Health data (N = 9,530 dyads), this study explores sexual socialization in the family using the theory of reasoned action by assessing how mothers' opinions are associated with their childrens' sexual behavior. Findings suggest that the more sexually liberal teens think their mothers are, the more likely the teens are to have higher…

  19. 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…

  20. Postpartum Rh immunoprophylaxis.

    PubMed

    Sandler, S Gerald; Gottschall, Jerome L

    2012-12-01

    The postpartum dose of Rh immune globulin varies according to an individual laboratory estimation of fetal red blood cells in each mother's peripheral blood. In the United States, a four-step procedure determines the postpartum dose (number of vials of 300 micrograms; 1,500 international units) of Rh immune globulin (anti-D) for each RhD-negative mother who has delivered an RhD-positive newborn and has not already formed anti-D. The first step is a rosette fetal red blood cell screen to determine whether an excessive (greater than 30 mL fetal whole blood) fetomaternal hemorrhage occurred. If the rosette screen is negative, the mother receives one vial of Rh immune globulin for Rh immunoprophylaxis. If the rosette screen is positive, the blood sample is retested by a quantitative method, typically an acid-elution (Kleihauer-Betke) assay. The result of the acid-elution assay is converted to an estimation of the volume of the fetomaternal hemorrhage, which is the basis for calculating the dose of Rh immune globulin. The acid-elution assay is subjective, imprecise, and poorly reproducible. As a result, the formula for calculating the dose includes a precautionary adjustment, adding an extra vial in borderline situations to prevent underdosing. Flow cytometry is a more precise method for quantifying a fetomaternal hemorrhage. However, few hospitals use flow cytometry, because it is not cost-effective to maintain an expensive, high-technology laboratory service for the relatively few occasions when a precise quantitative determination of fetomaternal hemorrhage is required.

  1. 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

  2. Mothers in community health care activities: the Suita Mothers' Club. Part 2.

    PubMed

    Nishiuchi, M

    1985-01-01

    Trachoma was widespread in Japan in the early 1950s. In February of 1952 the Suita Mothers' Club started its checkup campaign for the prevention of trachoma. When the club was formed there were many flies and mosquitos throughout the city. Both flies and mosquitos carry or spread dangerous diseases. The Club began thinking seriously about the extermination of these insects. Additionally, one of the dampest areas in the city was selected as a model area for pest eradication. A 5-year plan was designed. The plan included cleaning up of family homes and vacant lots. The Suita Mothers' Club was also responsible for a program to strike out tuberculosis, as well as a program to prevent cerebral apoplexy. The Club has lasted about 35 years. It publishes a newsletter every month. Club members believe it is important to think as a group and act as a group.

  3. Exploring the use of Storybooks to Reach Mothers of Preschoolers with Nutrition and Physical Activity Messages

    PubMed Central

    Bellows, Laura; Spaeth, Amanda; Lee, Victoria; Anderson, Jennifer

    2013-01-01

    Objectives To assess perceptions stay-at-home mothers have about their preschoolers’ eating and physical activity behaviors and to explore the feasibility of utilizing storybooks in home-based nutrition and activity programming. Methods Focus groups were conducted with 24 mothers; intercept interviews with 30 parents; and a storybook prototype was developed and pretested in 8 preschool classrooms. Results Mothers acknowledged picky eating as an issue and were less likely to identify issues with physical activity but were interested in information on gross motor development. Mothers strongly supported storybooks as a modality to convey and reinforce health messages at home. The storybook prototype was well liked by parents, teachers and preschoolers. Conclusions and Implications Storybooks are a practical method to reach mothers and preschoolers and have the potential to elicit changes in eating and activity behaviors. Understanding mothers’ perceptions of healthy eating and physical activity is essential to ensure that storybook messages resonate with this audience. PMID:23415760

  4. 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…

  5. A Review of Postpartum Depression

    PubMed Central

    Andrews-Fike, Christa

    1999-01-01

    Postpartum depression (PPD) is an irritable, severely depressed mood that occurs within 4 weeks of giving birth and possibly as late as 30 weeks postpartum. Manifestations include crying spells, insomnia, depressed mood, fatigue, anxiety, and poor concentration. Patients may experience mild, moderate, or severe symptoms. Many psychosocial stressors may have an impact on the development of PPD. Recent studies conclude that the majority of factors are largely social in nature. The greatest risk is in women with a history of depression or other affective illness and in those who have experienced depression during past pregnancies. Women with significant risk factors should be followed closely in the postpartum period. The severity of symptoms and degree of impairment guide the approach to treatment. Treatment should begin with psychotherapy and advance to pharmacotherapy if needed; however, many patients benefit from concomitant treatment with both psychotherapy and medication. Common forms of psychotherapy include interpersonal therapy and short-term cognitive-behavioral therapy. Postpartum depression demands the same pharmacologic treatment as major depression does, with similar doses as those given to patients with nonpuerperal depression. It is essential to use an adequate dose of antidepressants in a duration sufficient to ensure complete recovery. Mothers should continue medication for 6 to 12 months postpartum to ensure a complete recovery. Inadequate treatment of depression puts women at risk for the sequelae of untreated affective illness, and the depression may become chronic, recurrent, and/or refractory. Family physicians are key players in the detection and treatment of PPD owing to the nature of the disease and the tendency for new mothers to negate their feelings as something other than a treatable psychiatric illness. PMID:15014700

  6. Relationships between thyroid hormones and serum energy metabolites with different patterns of postpartum luteal activity in high-producing dairy cows.

    PubMed

    Kafi, M; Tamadon, A; Saeb, M; Mirzaei, A; Ansari-Lari, M

    2012-08-01

    This study investigated the relationships of thyroid hormones, serum energy metabolites, reproductive parameters, milk yield and body condition score with the different patterns of postpartum luteal activity in the postpartum period. A total of 75 multiparous healthy (free of detectable reproductive disorders) Holstein dairy cows (mean peak milk yield = 56.5 ± 7.0 kg/day) were used in this study. Transrectal ultrasound scanning and blood sample collection were performed twice weekly. Serum concentrations of progesterone (P4) were measured twice weekly and beta-hydroxybutyrate (BHBA), non-esterified fatty acids, thyroxine (T4), 3,30,5-tri-iodothyronine (T3), free thyroxine (fT4) and free 3,30,5-tri-iodothyronine (fT3) were measured every 2 weeks from the 1st to the 8th week postpartum. On the basis of the serum P4 profile of the cows, 25 (33.4%) had normal luteal activity (NLA), whereas 30 (40%), 10 (13.3%), 6 (8%) and 4 (5.3%) had prolonged luteal phase (PLP), delayed first ovulation (DOV), anovulation (AOV) and short luteal phase, respectively. Serum T4 concentrations in PLP cows were higher than that in NLA cows at the 3rd week postpartum and did not change during the period of study, whereas in the NLA cows the concentrations increased (P < 0.05). Further, the least square (LS) mean of serum fT4 concentrations in the DOV and AOV cows were significantly lower than in the NLA cows during the study period (P < 0.05). In addition, the AOV cows had higher LS mean serum BHBA and T4 concentrations than the NLA cows in early weeks postpartum (P < 0.05). In conclusion, the serum thyroid hormones' profile differs in high-producing dairy cows showing PLP, AOV and DOV in comparison with the postpartum NLA cows.

  7. 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. PMID:25431167

  8. Postpartum thyroiditis.

    PubMed

    Argatska, Antoaneta B; Nonchev, Boyan I

    2014-01-01

    Postpartum thyroiditis (PPT) is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery or abortion. It is the most common thyroid disease in the postpartum period with incidence between 5 and 9%. In essence, it is an autoimmune inflammation of the thyroid, caused by changes in humoral and cell-mediated immune response. It has a characteristic biphasic course with an episode of transient thyrotoxicosis followed by transient or permanent hypothyroidism. Of all predisposing factors positive titers of thyroid peroxidase antibodies have the greatest importance. In some of the affected patients the disease course is marked by expressed hormonal disorders causing significant subjective symptoms. This underlines the need for early identification of risk groups aimed at prophylaxis and adequate treatment of thyroid dysfunction in the postpartum period. The frequency of PPT varies between analyses and studies on risk factors do not establish reliable predictive models for progression of the disease. This is due to the different methodology of research and the involvement of a number of genetic and non-genetic factors in different geographic regions. That is why implementation of mass screening programs is now controversial. The discrepancy in the opinions of researchers makes it necessary to have studies of the problem in performed in every clinical center in which the possible risk specific to the region and the population covered might be defined prognostically. The results of these studies can be used to introduce targeted and cost-effective screening for early detection of risk patients and prevention of morbidity and complications of PPT. PMID:25434070

  9. Postpartum thyroiditis.

    PubMed

    Argatska, Antoaneta B; Nonchev, Boyan I

    2014-01-01

    Postpartum thyroiditis (PPT) is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery or abortion. It is the most common thyroid disease in the postpartum period with incidence between 5 and 9%. In essence, it is an autoimmune inflammation of the thyroid, caused by changes in humoral and cell-mediated immune response. It has a characteristic biphasic course with an episode of transient thyrotoxicosis followed by transient or permanent hypothyroidism. Of all predisposing factors positive titers of thyroid peroxidase antibodies have the greatest importance. In some of the affected patients the disease course is marked by expressed hormonal disorders causing significant subjective symptoms. This underlines the need for early identification of risk groups aimed at prophylaxis and adequate treatment of thyroid dysfunction in the postpartum period. The frequency of PPT varies between analyses and studies on risk factors do not establish reliable predictive models for progression of the disease. This is due to the different methodology of research and the involvement of a number of genetic and non-genetic factors in different geographic regions. That is why implementation of mass screening programs is now controversial. The discrepancy in the opinions of researchers makes it necessary to have studies of the problem in performed in every clinical center in which the possible risk specific to the region and the population covered might be defined prognostically. The results of these studies can be used to introduce targeted and cost-effective screening for early detection of risk patients and prevention of morbidity and complications of PPT. PMID:25507668

  10. 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

  11. Reduction of liver function delays resumption of postpartum ovarian activity and alters the synthesis of acute phase proteins in dairy cows.

    PubMed

    Montagner, Paula; Krause, Ana Rita Tavares; Schwegler, Elizabeth; Weschenfelder, Marina Menoncin; Rabassa, Viviane Rohrig; Schneider, Augusto; Pereira, Rubens Alves; Brauner, Cássio Cassal; Del Pino, Francisco Augusto Burkert; Gonçalves, Fernanda Medeiros; Corrêa, Marcio Nunes

    2016-06-01

    The aim of this study was to evaluate the concentration of acute phase proteins, milk production, and resumption of postpartum ovarian activity of clinically healthy dairy cows in a semi-extensive system with different Liver Functionality Index (LFI) values. The animals were divided into two groups: Low LFI (LLFI: -7 to -12; n: 10) and High LFI (HLFI: -7 to -4; n: 10). Animals with LLFI had lower paraoxonase activity and lower albumin concentration in the pre- and postpartum periods (P<0.05), higher non-esterified fatty acids prepartum (P<0.005), and higher haptoglobin concentration postpartum (P<0.01). The LLFI group showed lower resumption of ovarian activity until 44days postpartum (29%; P<0.05) than HLFI (86%). Milk production did not differ between groups. Therefore, this study suggests that the LFI is an important biomarker of synthesis of acute phase proteins and the first ovulation interval, and it can be used to improve the production and reproductive performance. PMID:27234541

  12. Disrupted posterior cingulate-amygdala connectivity in postpartum depressed women as measured with resting BOLD fMRI.

    PubMed

    Chase, Henry W; Moses-Kolko, Eydie L; Zevallos, Carlos; Wisner, Katherine L; Phillips, Mary L

    2014-08-01

    Disengagement of emotion regulation circuits was previously shown in depressed mothers and was hypothesized to underlie the impaired maternal-infant sensitivity described in postpartum depression (PPD). We hypothesized similarly reduced resting-state functional connectivity in default mode network (DMN) regions involved in social cognition in PPD. Resting-state functional MRI, clinical and mother-infant attachment data were obtained from 14 unmedicated postpartum women with major depression and 23 healthy postpartum women. Posterior cingulate cortex (PCC) time series were extracted, filtered between 0.007 and 0.08 Hz and used as regressors in a whole brain general linear model analysis. PCC-right amygdala connectivity was significantly disrupted in depressed compared to healthy mothers for low-frequency neural activity, showing a negative (inverse) coupling in the depressed group but not in the controls. PCC-right amygdala connectivity was positively correlated with PCC-parahippocampus connectivity. Resting connectivity patterns of positive co-activations in postpartum women mirrored the canonical DMN. These findings of reduced PCC-amygdala coupling raise the possibility that PPD might involve the disruption of outward, preventative aspects of self-relevant thought and theory of mind/empathy processes. Further integrated studies of neural connectivity and these cognitive/behavioral dimensions are warranted.

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

    ERIC Educational Resources Information Center

    Rahayuningsih, Faizah Betty

    2015-01-01

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

  14. POSTPARTUM DOULAS: MOTIVATIONS AND PERCEPTIONS OF PRACTICE

    PubMed Central

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

    2010-01-01

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

  15. Physical Activity and Quality of Life of Mothers of Preschool Children.

    PubMed

    Babić, Ana; Humer, Jasmina Tomašić; Sincek, Daniela

    2015-06-01

    The main aim of this study was to explore physical activity regarding mothers of preschool children and connections concerning different aspects of their physical activity (at work, during transport, in free time, while doing housework) with subjective quality of life. Another aim was to investigate factors that are obstacles of living a physically active life in this population. The participants of the study were 252 Croatian women, who have at least one preschool child older than three years. The World Health Organization Quality Of Life - BREF questionnaire and International Physical Activity Questionnaire were used. Participants also gave some personal demographic data, and answered to questions about obstacles for participation in organized physical activity. Results of this research showed that mothers of preschool children were more physically active than the population of adults in general, but their physical activity was mostly housework activity. Physical activity in their free time was the only aspect of physical activity that was significantly correlated with different aspects of mother's subjective quality of life. Employed mothers and those who live in the towns had more physical activities in their free time. Organizational factors and feeling that family suffers for their absence were the most frequently perceived barriers for organized physical activity participation. Results revealed that only the physical activity in their free time contributes to mother's quality of life. Mothers of preschool children mostly do housework physical activity, so support of the social community for physical activity in their free time in this population is recommended. Such activities should be especially directed to unemployed mothers and those who live in the villages. PMID:26753459

  16. Mother and Child Health Pmp Report: 2011-2012 Activities

    NASA Astrophysics Data System (ADS)

    Charpak, Nathalie; Ruiz-Pelaez, Juan G.; de Leon-Mendoza, Socorro

    2014-07-01

    The following sections are included: * REMINDER: THE MOTHER AND CHILD PMP MANIFESTO (ERICE 2002) * SUMMARY OF THE WORK OF THE KANGAROO FOUNDATION FOR THE PAST 20 YEARS * WHAT ARE WE EXPECTING FROM 2014? * SOME NEWS FROM THE PHILIPPINES AND ASIA KMC NETWORK. * CONCLUSION

  17. Sciencing with Mother Goose: Activities for Integrating Science and Literature.

    ERIC Educational Resources Information Center

    Angus, Carolyn; Bell, Ann

    The pairing of Mother Goose rhymes and nursery tales with the scientific thinking process is an effective instructional strategy linking reading and science learning at the primary level. This paper presents several such pairings which stress the basic science processes in grades K-3 of observing, communicating, comparing, ordering, and…

  18. Infants of Depressed and Nondepressed Mothers Exhibit Differences in Frontal Brain Electrical Activity during the Expression of Negative Emotions.

    ERIC Educational Resources Information Center

    Dawson, Geraldine; And Others

    1997-01-01

    Examined electrical brain activity during negative and positive emotion expression in infants of depressed and nondepressed mothers. Found that, compared with infants of nondepressed mothers, infants of depressed mothers exhibited increased EEG activation in the frontal but not parietal region when expressing negative emotions. There were no…

  19. 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

  20. 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. PMID:27320943

  1. A Review of Postpartum Psychosis

    PubMed Central

    SIT, DOROTHY; ROTHSCHILD, ANTHONY J.; WISNER, KATHERINE L.

    2011-01-01

    Objective The objective is to provide an overview of the clinical features, prognosis, differential diagnosis, evaluation, and treatment of postpartum psychosis. Methods The authors searched Medline (1966–2005), PsycInfo (1974–2005), Toxnet, and PubMed databases using the key words postpartum psychosis, depression, bipolar disorder, schizophrenia, organic psychosis, pharmacotherapy, psychotherapy, and electroconvulsive therapy. A clinical case is used to facilitate the discussion. Results The onset of puerperal psychosis occurs in the first 1–4 weeks after childbirth. The data suggest that postpartum psychosis is an overt presentation of bipolar disorder that is timed to coincide with tremendous hormonal shifts after delivery. The patient develops frank psychosis, cognitive impairment, and grossly disorganized behavior that represent a complete change from previous functioning. These perturbations, in combination with lapsed insight into her illness and symptoms, can lead to devastating consequences in which the safety and well-being of the affected mother and her offspring are jeopardized. Therefore, careful and repeated assessment of the mothers’ symptoms, safety, and functional capacity is imperative. Treatment is dictated by the underlying diagnosis, bipolar disorder, and guided by the symptom acuity, patient’s response to past treatments, drug tolerability, and breastfeeding preference. The somatic therapies include antimanic agents, atypical antipsychotic medications, and ECT. Estrogen prophylaxis remains purely investigational. Conclusions The rapid and accurate diagnosis of postpartum psychosis is essential to expedite appropriate treatment and to allow for quick, full recovery, prevention of future episodes, and reduction of risk to the mother and her children and family. PMID:16724884

  2. Foster Mother-Infant Bonding: Associations between Foster Mothers' Oxytocin Production, Electrophysiological Brain Activity, Feelings of Commitment, and Caregiving Quality

    ERIC Educational Resources Information Center

    Bick, Johanna; Dozier, Mary; Bernard, Kristin; Grasso, Damion; Simons, Robert

    2013-01-01

    This study examined the biological processes associated with foster mother-infant bonding. In an examination of foster mother-infant dyads ("N" = 41, mean infant age = 8.5 months), foster mothers' oxytocin production was associated with their expressions of behavioral delight toward their foster infant and their average P3 response to images of…

  3. Mothers' efforts to promote healthy nutrition and physical activity for their preschool children.

    PubMed

    Bevan, Ann L; Reilly, Sandra M

    2011-10-01

    Children's lifestyles profoundly impact their health. This action research study explores how mothers manage to provide good nutrition and physical activity opportunities for their preschool children despite the challenges of daily living. Aware of these daily challenges, mothers are the best source of information about the usefulness of different strategies in providing healthy lifestyles for their children. In so doing, they display an ecological viewpoint that recognizes health as an individual and collective responsibility. PMID:21930026

  4. [Infanticide as a consequence of postpartum bonding disorder].

    PubMed

    Hornstein, C; Trautmann-Villalba, P

    2007-05-01

    Parental killing of their own children in the 1st year constitutes a rare phenomenon. Studies on infanticide show that mothers who kill their children are frequently psychiatrically disturbed. Depression is the most common postpartum disorder and may represent a vital danger for both mother and child. The association between depression and infanticide can usually be explained by maternal psychopathologic symptoms. The importance of a mother's bonding to her infant has not often been examined in respect to infanticide. The present case report underlines the importance of postpartum bonding disorder and its relation to a higher risk of infanticide.

  5. Postpartum Depression Action Plan

    MedlinePlus

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

  6. 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…

  7. What do mothers want to know about teens' activities? Levels, trajectories, and correlates.

    PubMed

    Smetana, Judith G; Rote, Wendy M

    2015-01-01

    Middle class mothers (n = 169) of middle adolescents (M = 15.69 years old) in the U.S. rated how much they want to know and responded qualitatively about what they "always" and "never" want to know about adolescents' risky prudential (e.g., drinking alcohol, using illegal drugs), personal (e.g., teens' private conversations), and multifaceted (involving overlapping prudential and personal concerns) activities. Latent growth curve modeling over one year showed that mothers wanted to know most about prudential, less about multifaceted, and least about personal activities; wanting to know declined over time for each type of activity, but less for prudential than for other activities. With teen problem behavior controlled, psychologically controlling parenting, supportive and negative interactions with teens, knowledge of adolescents' activities, and teens' age were associated with individual differences in mothers' initial ratings and trajectories of wanting to know, although results varied by domain and were moderated by teen gender.

  8. Effect of prepartum diet on postpartum ovarian activity in Holstein cows in a pasture-based dairy system.

    PubMed

    Cavestany, D; Viñoles, C; Crowe, M A; La Manna, A; Mendoza, A

    2009-08-01

    The hypothesis was that supplementation during the late prepartum period will differentially affect reproductive and productive variables according to parity. Primiparous (n=22) and multiparous (n=22) pregnant autumn calving Holstein cows were stratified in two groups according to parity (primiparous or multiparous) and within each group were randomly assigned to two treatments: (a) low supplemented (LS) or (b) high supplemented (HS) prepartum diet. The LS group was offered 5.2 kg/cow/day (DM basis) of wheat silage, and the HS group 4.7 kg cow/day (DM basis)/of corn silage and 3.6 kg (DM basis) of wheat bran+12 g of urea. Both groups grazed on natural pastures. After calving, all cows received the same diet. The experimental period was from 3 weeks before calving to 7 weeks postpartum (PP); body condition score (BCS) and blood samples for hormonal analyses were obtained weekly and ovarian ultrasonography was conducted three times per week. The loss in BCS around calving was less pronounced in HS cows, but only multiparous supplemented cows maintained BCS throughout the study. Non-esterified fatty acids (NEFA) increased during the prepartum period in the LS but not in the HS cows, with peak values occurring on day 14 PP in all groups. During the remainder of the experiment NEFA was greater in LS than in HS cows. Prepartum treatment did not affect the proportion of cows that had ovulations from the first dominant follicle postpartum, but decreased the interval to first ovulation in multiparous cows (22.9 compared with 38.2 days; P<0.05). This was associated with greater plasma IGF-I concentrations at the time the dominant follicle of the first follicular wave reached its maximum diameter (8.0 compared with 3.6 nmol/L; P<0.05). However, prepartum treatment had no effect on onset of ovarian activity in primiparous cows. Supplementation had no effect on milk production or milk protein percentage but increased milk fat percentage. We conclude that feeding a high

  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. Management of postpartum depression.

    PubMed

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

    2013-01-01

    The mainstays of treatment for peripartum depression are psychotherapy and antidepressant medications. More research is needed to understand which treatments are safe, preferable, and effective. Postpartum depression, now termed peripartum depression by the DSM-V, is one of the most common complications in the postpartum period and has potentially significant negative consequences for mothers and their families. This article highlights common clinical challenges in the treatment of peripartum depression and reviews the evidence for currently available treatment options. Psychotherapy is the first-line treatment option for women with mild to moderate peripartum depression. Antidepressant medication in combination with therapy is recommended for women with moderate to severe depression. Although pooled case reports and small controlled studies have demonstrated undetectable infant serum levels and no short-term adverse events in infants of mothers breastfeeding while taking sertraline (Zoloft) and paroxetine (Paxil), further research is needed including larger samples and long-term follow-up of infants exposed to antidepressants via breastfeeding controlling for maternal depression. Pharmacologic treatment recommendations for women who are lactating must include discussion with the patient regarding the benefits of breastfeeding, risks of antidepressant use during lactation, and risks of untreated illness. There is a growing evidence base for nonpharmacologic interventions including repetitive transcranial magnetic stimulation, which may offer an attractive option for women who wish to continue to breastfeed and are concerned about their infants being exposed to medication. Among severe cases of peripartum depression with psychosis, referral to a psychiatrist or psychiatric advanced practice registered nurse is warranted. Suicidal or homicidal ideation with a desire, intent, or plan to harm oneself or anyone else, including the infant, is a psychiatric emergency, and

  11. Postpartum depression in rats: differences in swim test immobility, sucrose preference and nurturing behaviors.

    PubMed

    Fernandez, Jamie Winderbaum; Grizzell, J Alex; Philpot, Rex M; Wecker, Lynn

    2014-10-01

    Postpartum depression (PPD) is a common disorder affecting both mothers and their offspring. Studies of PPD in laboratory animals have typically assessed either immobility on forced swim testing or sucrose preference in ovariectomized rats following hormone supplementation and withdrawal or in stress models. To date, few studies have related these measures to maternal behaviors, a potential indicator of depressive-like activity postpartum. Because a single measure may be insufficient to characterize depression, the present study determined the distribution of depressive-like behaviors in Sprague-Dawley rats postpartum. Nurturing and non-nurturing behaviors exhibited by undisturbed dams were recorded during the first 12 days postpartum, and immobility in the forced swim test and sucrose preference were determined thereafter. A median-split analysis indicated that 19% of dams exhibited high sucrose preference and low immobility, 30% exhibited either only high immobility or only low sucrose preference, and 21% exhibited both high immobility and low preference. Dams exhibiting depressive-like activity on either or both tests displayed increased self-directed behaviors and decreased active nurturing during the dark phase of the diurnal cycle. This is the first study to characterize undisturbed nurturing and non-nurturing behaviors, and use both sucrose preference and immobility in the forced swim test, to classify PPD endophenotypes exhibited by rat dams following parturition. The present study underscores the idea that multiple tests should be used to characterize depressive-like behavior, which is highly heterogeneous in both the human and laboratory animal populations.

  12. Postpartum thyroid dysfunction.

    PubMed

    Browne-Martin, K; Emerson, C H

    1997-03-01

    Four disorders of the postpartum period are associated with thyroid dysfunction. The most common is PPT. Although recovery from thyroid dysfunction often occurs in PPT, many patients eventually develop permanent hypothyroidism. Postpartum Graves' Disease is less common than PPT, but it is not unusual. Whereas antithyroid drugs are indicated for postpartum Graves' Disease, they are not useful in PPT. Although they are rare, lymphocytic hypophysitis and postpartum pituitary infarction are important entities because they cause deficiencies of many critical hormones. The autoimmune nature of PPT, postpartum Graves' disease, and lymphocytic hypophysitis highlights the unique effects of pregnancy on the immune system.

  13. Latino Mothers in Farmworker Families’ Beliefs about Preschool Children’s Physical Activity and Play

    PubMed Central

    Grzywacz, Joseph G.; Arcury, Thomas A.; Trejo, Grisel; Quandt, Sara A.

    2014-01-01

    Objective Document beliefs about the contribution of physical activity to preschool-aged children’s health held by Latino mothers in farmworker families, and delineate their perceived barriers or constraints that impose limits on preschool-aged children’s physical activity. Method Qualitative data obtained through semi-structured in-depth interviews (N=33) with mothers of preschool-aged children living in Latino farmworker families in North Carolina. Results Mothers universally agree that regular vigorous physical activity is good for preschool-aged children’s health, including obesity prevention. However, excessive physical activity can produce illnesses, as well as other physical and emotional problems, and should be limited. Mothers wanted their children to engage in more sedentary forms of activity because they believed it would benefit learning. Physical and chemical hazards in rural environments, distance to parks and play spaces, and lack of familiarity and concerns about neighbors constrained children’s physical activity. Conclusions Although physical activity is believed to be beneficial, strong cultural beliefs and real contextual barriers undermine preschool-aged Latino farmworker children’s level of physical activity. PMID:24522435

  14. Physical Activity Experiences and Beliefs among Single Mothers: A Qualitative Study

    ERIC Educational Resources Information Center

    Dlugonski, Deirdre; Motl, Robert W.

    2016-01-01

    Purpose: Single motherhood has been associated with negative health consequences such as depression and cardiovascular disease. Physical activity might reduce these consequences, but little is known about physical activity experiences and beliefs that might inform interventions and programs for single mothers. The present study used…

  15. 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

  16. Effect of pre-partum feed supplementation on post-partum ovarian activity, milk production and calf growth of small holder dairy Cattle in Cameroon.

    PubMed

    Bayemi, Pougue Henri; Nsongka, Munji Victorine; Leinyuy, Isabelle; Webb, Edward Cottington; Nchadji, Justin Mbanya; Cavestany, Daniel; Bryant, Mike

    2015-01-01

    Seventy-two cows were selected for an on-farm study on the effect of feed supplementation before calving on milk production, ovarian activity and calf growth of Holstein, indigenous Red Fulani cows and their crosses. Pre-partum feed supplementation was done using cotton seed cake (80%), maize (18%), bone meal (1%) and kitchen salt (1% NaCl). Supplementation levels consisted of a low supplementation fed at 1 kg per animal per day and high supplementation fed at 2 kg per animal per day. In addition, Red Fulani cows received the supplements in two different ways namely a pre-partum supplementation consisting of 1 kg per cow per day and pre- and post-partum supplementation consisting of 1 kg per cow per day before calving and 1 kg per cow per day post-partum up to 30 days after calving. Blood samples were analysed using ELISA Progesterone kits to determine the length of post-partum anoestrus. Results show that pre-partum levels of feeding did not have any effect (P > 0.05) on body condition score (BCS) at 12 weeks after calving, calf birth weight, average daily weight gain of calves, milk production and post-partum anoestrus. High BCS at calving was shown to influence BCS at 12 weeks of lactation. Holstein cows had bigger calves (P < 0.01) at birth (45 kg) compared to traditional cows (36 kg) and crosses (34 kg). There was little benefit of pre-partum supplementation on the parameters investigated in this study. Consequently, low income farmers are advised to concentrate their efforts of supplementation early in lactation.

  17. [Postpartum depression: we know the risks, can it be prevented?].

    PubMed

    Zinga, Dawn; Phillips, Shauna Dae; Born, Leslie

    2005-10-01

    In the past 20 years, there has been increasing recognition that for some women, pregnancy may be burdened with mood problems, in particular depression, that may impact both mother and child. With identification of risk factors for postpartum depression and a growing knowledge about a biologic vulnerability for mood change following delivery, research has accumulated on attempts to prevent postpartum depression using various psychosocial, psychopharmacologic, and hormonal strategies. The majority of psychosocial and hormonal strategies have shown little effect on postpartum depression. Notwithstanding, results from preliminary trials of interpersonal therapy, cognitive-behavioural therapy, and antidepressants indicate that these strategies may be of benefit. Information on prevention of postpartum depression using dietary supplements is sparse and the available evidence is inconclusive. Although a few studies show promising results, more rigorous trials are required. The abounding negative evidence in the literature indicates that postpartum depression cannot be easily prevented, yet.

  18. Postpartum Depression and Social Support in China: A Cultural Perspective.

    PubMed

    Tang, Lu; Zhu, Ruijuan; Zhang, Xueying

    2016-09-01

    This study explored how Chinese culture affects the relationship between social support and postpartum depression. In-depth interviews with 38 mothers in mainland China showed that discrepancies between expected and perceived available social support and conflicts among social support providers are two major contributors to the stress associated with postpartum depression. These dynamics are deeply rooted in the context of Chinese culture with its distinctive gender roles and family dynamics. These cultural norms further prevent women from seeking social support. PMID:27491938

  19. Protease and protease inhibitory activity in pregnant and postpartum involuting uterus

    SciTech Connect

    Milwidsky, A.; Beller, U.; Palti, Z.; Mayer, M.

    1982-08-15

    The presence of two distinct proteolytic activities in the rat uterus was confirmed with /sup 14/C-labeled globin used as a sensitive protein substrate and following release of label into the trichloroacetic acid-soluble supernatant fraction. Protease I is a cytoplasmic acid protease while protease II is associated with the pellet fraction, can be extracted by 0.6 M sodium chloride, and is active at pH 7.0. Protease I activity is low during pregnancy and markedly increases at term achieving maximal activity at day 3 post partum with a subsequent decline to preterm activity values. Lactation did not affect the uterine protease I activity. Protease II activity is not significantly different during pregnancy, at term, and post partum. The presence of an inhibitor of protease I was suggested by a decrease in enzyme activity with an increased cytosolic protein concentration. The inhibitor also lessened bovine trypsin activity but had no effect on protease II. Although its inhibitory potency on trypsin fluctuated during the various uterine physiologic stages, these changes appeared to be statistically insignificant. Human uterine samples were also found to contain the two protease activities with similar changes in protease I post partum. It is suggested that, both in the rat and in man, uterine involution post partum is associated with a marked increase in activity of acid cytosolic protease, while a particulate neutral protease and a soluble inhibitor of trypsin, which are also present in uterine cells, do not appear to play a significant role in the dissolution of uterine tissues after parturition.

  20. Sciencing with Mother Goose: Observation Activities with Chicken Little.

    ERIC Educational Resources Information Center

    Angus, Carolyn

    1996-01-01

    Provides sample observation activities to accompany the nursery tale of Chicken Little. Includes five activities that involve the skills of observing, communicating, comparing, ordering, and categorizing to engage students in hands-on science. (DDR)

  1. ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period.

    PubMed

    2015-12-01

    Physical activity in all stages of life maintains and improves cardiorespiratory fitness, reduces the risk of obesity and associated comorbidities, and results in greater longevity. Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements. Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy. Obstetrician-gynecologists and other obstetric care providers should carefully evaluate women with medical or obstetric complications before making recommendations on physical activity participation during pregnancy. Although frequently prescribed, bed rest is only rarely indicated and, in most cases, allowing ambulation should be considered. Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychologic well-being. An exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20-30 minutes per day on most or all days of the week should be developed with the patient and adjusted as medically indicated. Additional research is needed to study the effects of exercise on pregnancy-specific outcomes and to clarify the most effective behavioral counseling methods, and the optimal intensity and frequency of exercise. Similar work is needed to create an improved evidence base concerning the effects of occupational physical activity on maternal-fetal health.

  2. Committee Opinion No. 650 Summary: Physical Activity and Exercise During Pregnancy and the Postpartum Period.

    PubMed

    2015-12-01

    Physical activity in all stages of life maintains and improves cardiorespiratory fitness, reduces the risk of obesity and associated comorbidities, and results in greater longevity. Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements. Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy. Obstetrician-gynecologists and other obstetric care providers should carefully evaluate women with medical or obstetric complications before making recommendations on physical activity participation during pregnancy. Although frequently prescribed, bed rest is only rarely indicated and, in most cases, allowing ambulation should be considered. Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychologic well-being. An exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20-30 minutes per day on most or all days of the week should be developed with the patient and adjusted as medically indicated. Additional research is needed to study the effects of exercise on pregnancy-specific outcomes and to clarify the most effective behavioral counseling methods, and the optimal intensity and frequency of exercise. Similar work is needed to create an improved evidence base concerning the effects of occupational physical activity on maternal-fetal health.

  3. Mother-Child Interactions during Shared Literacy Activities: Education in a Fractured Bilingual Environment

    ERIC Educational Resources Information Center

    Quiroz, Blanca; Dixon, L. Quentin

    2012-01-01

    Research indicates that mothers scaffold the literacy skills of their children when jointly engaged in literacy-related activities in monolingual families (Tamis-LeMonda et al., 2001). Yet little is known about the linguistic environment of English language learners in the USA, a group at high risk for reading difficulties if they are only taught…

  4. An Examination of Language Practices during Mother-Child Play Activities among Mexican Immigrant Families

    ERIC Educational Resources Information Center

    Palacios, Natalia; Kibler, Amanda K.; Baird, Ashley Simpson; Parr, Alyssa; Bergey, Rebecca

    2015-01-01

    We examined the language practices of five mother-child dyads during a structured play activity, particularly in relation to maternal question use. The study includes second-generation, 4-year-old children of Mexican immigrants who demonstrate either high vocabulary levels in English and Spanish or low levels of vocabulary in both languages.…

  5. Mothers' Knowledge of Early Adolescents' Activities following the Middle School Transition and Pubertal Maturation

    ERIC Educational Resources Information Center

    Laird, Robert D.; Marrero, Matthew D.

    2011-01-01

    This study tested a sequential mediation model to determine whether experiences, social cognitions, or parent-adolescent interactional processes account for lower levels of mothers' knowledge of adolescents' whereabouts and activities following early adolescents' transition into middle school (MS) and pubertal development. Cross-sectional data…

  6. 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.

  7. Nutrition and postpartum rebreeding in cattle.

    PubMed

    Randel, R D

    1990-03-01

    Body weight and condition score, although perhaps imprecise or subjective, are functional indicators of energy status and rebreeding performance after calving. Inadequate precalving and(or) postcalving energy or protein nutrition lowers pregnancy rates as well as first-service conception rates and extends postpartum intervals in suckled postpartum beef females. Normal nutritional regimens for dairy cows that are fed for maximal lactation do not exhibit long postpartum intervals or reduced fertility. Yet excessive protein intake may depress postpartum rebreeding performance, especially in older dairy cows. Feeding of ionophores, with increased ruminal propionate levels in the rumen, results in an earlier return to estrus postpartum. Underfeeding of the postpartum cow extends the period of ovarian inactivity. The underfed postpartum cow's lack of ovarian activity appears to be due to a suppression of the pulsatile release of LH from the anterior pituitary gland, which in turn is controlled by release of GnRH from the hypothalamus. Some metabolic compound(s) presumably act on the hypothalamic-pituitary-ovarian axis as the nutritional state of the animal is altered.

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

    PubMed

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

    2013-11-01

    Women with gestational diabetes mellitus (GDM) have a substantial risk of subsequently developing type 2 diabetes. This risk may be mitigated by engaging in healthy eating, physical activity, and weight loss when indicated. Since postpartum depressive symptoms may impair a woman's ability to engage in lifestyle changes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent GDM. The participants are part of the baseline cohort of the TEAM GDM (Taking Early Action for Mothers with Gestational Diabetes Mellitus) study, a one-year randomized trial of a lifestyle intervention program for women with a recent history of GDM, conducted in Boston, Massachusetts between June 2010 and September 2012. We administered the Edinburgh Postnatal Depression Scale (EPDS) at 4-15 weeks postpartum to women whose most recent pregnancy was complicated by GDM (confirmed by laboratory data or medical record review). An EPDS score ≥9 indicated depressive symptoms. We measured height and thyroid stimulating hormone, and administered a questionnaire to collect demographic data and information about breastfeeding and sleep. We calculated body mass index (BMI) using self-reported pre-pregnancy weight and measured height. We reviewed medical records to obtain data about medical history, including history of depression, mode of delivery, and insulin use during pregnancy. We conducted bivariable analyses to identify correlates of postpartum depressive symptoms, and then modeled the odds of postpartum depressive symptoms using multivariable logistic regression. Our study included 71 women (mean age 33 years ± 5; 59 % White, 28 % African-American, 13 % Asian, with 21 % identifying as Hispanic; mean pre-pregnancy BMI 30 kg/m(2) ± 6). Thirty-four percent of the women scored ≥9 on the EPDS at the postpartum visit. In the best fit model, factors associated with depressive symptoms at 6 weeks postpartum included cesarean

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

    PubMed Central

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

    2012-01-01

    Objectives Women with gestational diabetes mellitus (GDM) have a substantial risk of subsequently developing type 2 diabetes. This risk may be mitigated by engaging in healthy eating, physical activity, and weight loss when indicated. Since postpartum depressive symptoms may impair a woman's ability to engage in lifestyle changes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent GDM. Methods The participants are part of the baseline cohort of the TEAM GDM (Taking Early Action for Mothers with Gestational Diabetes Mellitus) study, a one-year randomized trial of a lifestyle intervention program for women with a recent history of GDM, conducted in Boston, Massachusetts between June 2010 and September 2012. We administered the Edinburgh Postnatal Depression Scale (EPDS) at 4-15 weeks postpartum to women whose most recent pregnancy was complicated by GDM (confirmed by laboratory data or medical record review). An EPDS score ≥9 indicated depressive symptoms. We measured height and thyroid stimulating hormone, and administered a questionnaire to collect demographic data and information about breastfeeding and sleep. We calculated body mass index (BMI) using self-reported pre-pregnancy weight and measured height. We reviewed medical records to obtain data about medical history, including history of depression, mode of delivery, and insulin use during pregnancy. We conducted bivariable analyses to identify correlates of postpartum depressive symptoms, and then modeled the odds of postpartum depressive symptoms using multivariable logistic regression. Results Our study included 71 women (mean age 33 years ±5; 59% White, 28% African-American, 13% Asian, with 21% identifying as Hispanic; mean pre-pregnancy BMI 30 kg/m2±6). Thirty-four percent of the women scored ≥9 on the EPDS at the postpartum visit. In the best fit model, factors associated with depressive symptoms at 6 weeks postpartum included

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

    PubMed

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

    2013-11-01

    Women with gestational diabetes mellitus (GDM) have a substantial risk of subsequently developing type 2 diabetes. This risk may be mitigated by engaging in healthy eating, physical activity, and weight loss when indicated. Since postpartum depressive symptoms may impair a woman's ability to engage in lifestyle changes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent GDM. The participants are part of the baseline cohort of the TEAM GDM (Taking Early Action for Mothers with Gestational Diabetes Mellitus) study, a one-year randomized trial of a lifestyle intervention program for women with a recent history of GDM, conducted in Boston, Massachusetts between June 2010 and September 2012. We administered the Edinburgh Postnatal Depression Scale (EPDS) at 4-15 weeks postpartum to women whose most recent pregnancy was complicated by GDM (confirmed by laboratory data or medical record review). An EPDS score ≥9 indicated depressive symptoms. We measured height and thyroid stimulating hormone, and administered a questionnaire to collect demographic data and information about breastfeeding and sleep. We calculated body mass index (BMI) using self-reported pre-pregnancy weight and measured height. We reviewed medical records to obtain data about medical history, including history of depression, mode of delivery, and insulin use during pregnancy. We conducted bivariable analyses to identify correlates of postpartum depressive symptoms, and then modeled the odds of postpartum depressive symptoms using multivariable logistic regression. Our study included 71 women (mean age 33 years ± 5; 59 % White, 28 % African-American, 13 % Asian, with 21 % identifying as Hispanic; mean pre-pregnancy BMI 30 kg/m(2) ± 6). Thirty-four percent of the women scored ≥9 on the EPDS at the postpartum visit. In the best fit model, factors associated with depressive symptoms at 6 weeks postpartum included cesarean

  11. Oxytocin and postpartum depression: Delivering on what's known and what's not

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The role of oxytocin in the treatment of postpartum depression has been a topic of growing interest. This subject carries important implications, given that postpartum depression can have detrimental effects on both the mother and her infant, with life long consequences for infant socioemotional and...

  12. Macrophage activation syndrome in a newborn infant born to a mother with autoimmune disease.

    PubMed

    Park, J H; Kim, S H; Kim, H J; Lee, S J; Jeong, D C; Kim, S Y

    2015-02-01

    Macrophage activation syndrome (MAS) is a complication of rheumatic disorders characterized by cytopenia, multiple organ dysfunction and coagulopathy associated with an inappropriate activation of macrophage. In neonatal lupus erythematosus, MAS is rare but fatal, requiring early diagnosis and treatment for optimal outcome. We report a case of MAS in a neonate born to a mother with autoimmune disease, improved by treatment with steroid, intravenous immunoglobulin and cyclosporine.

  13. Changes in Depressive Symptoms over 0–9 Months Postpartum

    PubMed Central

    Crow, Scott; McGovern, Patricia; Miner, Michael; Center, Bruce

    2011-01-01

    Abstract Objective To investigate mothers' changes in prevalence of postpartum depression (PPD) symptoms over 0–9 months postpartum and determine which symptoms best distinguish depressed from nondepressed women. Methods This was a prospective study of English-literate mothers of newborns, recruited from four family medicine clinics and three pediatric clinics. Mothers completed surveys at 0–1, 2, 4, 6, and 9 months postpartum, and surveys included demographic characteristics, a two-question depression screen, the 9-Item Patient Health Questionnaire (PHQ-9), and other health and work characteristics. Results There were 506 participants (33% response rate), and 112 (22.1%) had a positive PHQ-9 (score ≥10) at some time within the first 9 months after delivery. The proportion of women with a positive PHQ-9 was greatest at 0–1 month (12.5%), then fell to between 5.0% and 7.1% at 2–6 months, and rose again to 10.2% at 9 months postpartum. Most of the PHQ-9 symptoms differentiated well between depressed and nondepressed women; items that were less discriminating were abnormal sleep, abnormal appetite/eating, and fatigue. Assessment of possible predictors of a change from negative to positive PHQ-9 between 6 and 9 months postpartum revealed only one significant predictor: prior history of depression. Conclusions Depressive symptoms in this sample were most frequent at 0–1 month and 9 months postpartum. Most PHQ-9 items differentiated well between depressed and nondepressed mothers; these findings support the use of the PHQ-9 for PPD screening. Future research is needed to confirm our observed secondary peak in depressive symptoms at 9 months postpartum and to investigate possible causes. PMID:21351876

  14. Promoting active lifestyles in young children: investigating mothers' decisions about their child's physical activity and screen time behaviours.

    PubMed

    Hamilton, Kyra; Thomson, Courtney E; White, Katherine M

    2013-07-01

    Given increasing trends of obesity being noted from early in life and that active lifestyles track across time, it is important that children at a very young age be active to combat a foundation of unhealthy behaviours forming. This study investigated, within a theory of planned behaviour (TPB) framework, factors which influence mothers' decisions about their child's (1) adequate physical activity (PA) and (2) limited screen time behaviours. Mothers (N = 162) completed a main questionnaire, via on-line or paper-based administration, which comprised standard TPB items in addition to measures of planning and background demographic variables. One week later, consenting mothers completed a follow-up telephone questionnaire which assessed the decisions they had made regarding their child's PA and screen time behaviours during the previous week. Hierarchical multiple regression analyses revealed support for the predictive model, explaining an overall 73 and 78 % of the variance in mothers' intention and 38 and 53 % of the variance in mothers' decisions to ensure their child engages in adequate PA and limited screen time, respectively. Attitude and subjective norms predicted intention in both target behaviours, as did intentions with behaviour. Contrary to predictions, perceived behavioural control (PBC) in PA behaviour and planning in screen time behaviour were not significant predictors of intention, neither was PBC a predictor of either behaviour. The findings illustrate the various roles that psycho-social factors play in mothers' decisions to ensure their child engages in active lifestyle behaviours which can help to inform future intervention programs aimed at combating very young children's inactivity. PMID:22833334

  15. Effects of antenatal, postpartum and post-weaning melatonin supplementation on blood pressure and renal antioxidant enzyme activities in spontaneously hypertensive rats.

    PubMed

    Lee, S K; Sirajudeen, K N S; Sundaram, Arunkumar; Zakaria, Rahimah; Singh, H J

    2011-06-01

    Although melatonin lowers blood pressure in spontaneously hypertensive rats (SHR), its effect following antenatal and postpartum supplementation on the subsequent development of hypertension in SHR pups remains unknown. To investigate this, SHR dams were given melatonin in drinking water (10 mg/kg body weight/day) from day 1 of pregnancy until day 21 postpartum. After weaning, a group of male pups continued to receive melatonin till the age of 16 weeks (Mel-SHR), while no further melatonin was given to another group of male pups (Maternal-Mel-SHR). Controls received plain drinking water. Systolic blood pressure (SBP) was measured at 4, 6, 8, 12 and 16 weeks of age, after which the kidneys were collected for analysis of antioxidant enzyme profiles. SBP was significantly lower till the age of 8 weeks in Maternal-Mel-SHR and Mel-SHR than that in the controls, after which no significant difference was evident in SBP between the controls and Maternal-Mel-SHR. SBP in Mel-SHR was lower than that in controls and Maternal-Mel-SHR at 12 and 16 weeks of age. Renal glutathione peroxidase (GPx) and glutathione s-transferase (GST) activities, levels of total glutathione and relative GPx-1 protein were significantly higher in Mel-SHR. GPx protein was however significantly higher in Mel-SHR. No significant differences were evident between the three groups in the activities of superoxide dismutase, catalase and glutathione reductase. In conclusion, it appears that while antenatal and postpartum melatonin supplementation decreases the rate of rise in blood pressure in SHR offspring, it however does not alter the tendency of offspring of SHR to develop hypertension.

  16. Influence of crop residue ration supplementation on the attainment of puberty and postpartum reproductive activities of Red Sokoto goats.

    PubMed

    Malau-Aduli, B S; Eduvie, L O; Lakpini, C A M; Malau-Aduli, A E O

    2005-02-01

    The general objective of this study was to come up with an appropriate, affordable and locally available crop residue supplementation package that would enhance reproductive performance in small ruminants. Specifically, 28 Red Sokoto weaner does between 3 and 4 months of age weighing between 2 and 3 kg were used in the first experiment to determine the influence of crop residue supplementation on age and weight at puberty as determined by blood progesterone levels. In the second experiment, another 28 adult does (> or = 2 years old) of the same breed in the same flock with lactation numbers between 1 and 3 were used to determine the length of postpartum acyclic period. In both experiments, a 3 x 2 factorial experimental design comprising three dietary supplements (A, B, C) at two feeding levels (1% and 2% of body weight) fed in addition to a basal diet of Digitaria smutsii hay and natural pasture ad libitum with an unsupplemented negative control group (D) and four goats per treatment was utilized. In ration A, a conventional concentrate supplement consisting of maize, wheat offal, cottonseed cake and bonemeal was utilized; in rations B and C, the supplement consisted of guinea-corn bran, cowpea husk and groundnut haulms; and maize offal, groundnut shells and groundnut haulms respectively. Unsupplemented (ration D) weaner does reached puberty at a later age and had lighter body weights than all the others. Weaner does on ration 2A (concentrate fed at 2% of body weight) attained puberty at the earliest age and heaviest body weight, although the age at puberty was not significantly different from those on rations 1A (concentrate fed at 1% body weight), 1C and 2C. Blood progesterone profiles before and after puberty ranged from 0.05 to 9.0 ng/ml, respectively, and was highest in does fed rations A and C and least in the unsupplemented does. The mean interval between kidding and initiation of ovarian activity was 54.28 +/- 17.61 days and the mean interval between

  17. How Mothers Perceive Their Own Sexuality

    ERIC Educational Resources Information Center

    Trice-Black, Shannon

    2009-01-01

    For women, the transition to motherhood is often a time period filled with excitement, changes, and challenges. Mothers often face changes in their own sexuality in their adjustment to motherhood. The majority of research on the sexual changes during motherhood has focused on the first year postpartum of mothers and has emphasized biological,…

  18. Low Income, Mexican Mothers' Perception of Their Infants' Weight Status and Beliefs about Their Foods and Physical Activity

    ERIC Educational Resources Information Center

    Jimenez-Cruz, Arturo; Bacardi-Gascon, Montserrat; Castillo-Ruiz, Octelina; Mandujano-Trujillo, Zally; Pichardo-Osuna, Alexandra

    2010-01-01

    Childhood obesity is being considered a global health epidemic, and one of the countries mostly affected by it is Mexico. The aim of this study was to assess the perceptions of low-income mothers with regard to their child's weight status and physical activity and their beliefs about healthy and high-density foods. A total of 813 mothers attending…

  19. 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.

  20. 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.

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

    PubMed Central

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

    1996-01-01

    OBJECTIVE: To determine the strength of the association between antenatal psychosocial risk factors and adverse postpartum outcomes in the family, such as assault of women by their partner, child abuse, postpartum depression, marital dysfunction and physical illness. DATA SOURCES: MEDLINE, Cinahl, Famli, Psych Abstracts and the Oxford Database of Perinatal Trials were searched from relevant articles published from Jan. 1, 1980, to Dec. 31, 1993, with the use of MeSH terms "depression, involutional," "child abuse," "child neglect," "domestic violence," "family," "marital adjustment," "family health," "newborn health," "child health," "physical illness," "social support," "psychosocial risk," "prediction," "risk factors," "obstetrics" and "prenatal care." Further articles were identified from bibliographies. STUDY SELECTION: Of the 370 articles identified through the search, 118 were included for review. Studies were included if they examined the association between psychosocial risk factors and the outcomes of interest. Articles were excluded if they were reviews of poor quality or they had one or more of the following features: insufficient description of the sample, a high attrition rate, a lack of standardized outcome measures, outcomes other than the ones of interest or results that had already been reported in a previous study. DATA EXTRACTION: The strength of evidence of each study was evaluated. On the basis of the evidence, each risk factor was assigned a rating of the strength of its association with each of the postpartum outcomes. The ratings were class A (good evidence of association), class B (fair evidence) and class C (no clear evidence). Of the 129 antenatal psychosocial risk factors studied, 15 were found to have a class A association with at least one of the postpartum outcomes. DATA SYNTHESIS: Child abuse and abuse of the mother by her partner were most strongly correlated (class A evidence) with a history of lack of social support, recent life

  2. Racial and Ethnic Differences in Factors Associated With Early Postpartum Depressive Symptoms

    PubMed Central

    Howell, Elizabeth A.; Mora, Pablo A.; Horowitz, Carol R.; Leventhal, Howard

    2015-01-01

    OBJECTIVE To explore racial differences in reporting of early postpartum depressive symptoms. To explore whether racial differences in early postpartum experience (such as mother’s health status and social context) might account for racial differences in reported postpartum depressive symptoms. METHODS This was a telephone survey of 655 white, African-American, and Hispanic mothers between 2 and 6 weeks postpartum. Mothers reported on demographic factors, physical symptoms, daily function, infant behaviors, social support, skills in managing infant and household, access, and trust in the medical system. We explored racial differences in report of early postpartum depressive symptoms using bivariate and multivariate statistics. RESULTS African-American and Hispanic women more commonly reported postpartum depressive symptoms (43.9% and 46.8%, respectively) than white women (31.3%, P < .001). Similar factors (physical symptom burden, lack of social support, and lack of self-efficacy) were associated with early postpartum depressive symptoms in white, African-American, and Hispanic mothers. In a comprehensive model including other demographic factors, history of depression, physical symptoms, daily function, infant behavior, social support, skills in managing infant and household, access, and trust, the adjusted odds ratio for reported postpartum depressive symptoms remained elevated for African-American women at 2.16 (95% confidence interval 1.26–3.70) and Hispanic women at 1.89 (95% confidence interval 1.19–3.01) as compared with white women. CONCLUSION African-American and Hispanic mothers are at higher risk for reporting early postpartum depressive symptoms as compared with white mothers. Factors associated with these symptoms are similar among African-American, Hispanic, and white mothers. PMID:15932842

  3. Anhedonia in postpartum rats.

    PubMed

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

    2010-01-12

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

  4. Eating disorder symptoms pre- and postpartum.

    PubMed

    Pettersson, Cecilia Brundin; Zandian, Modjtaba; Clinton, David

    2016-08-01

    The study aimed to investigate symptoms of disordered eating pre- and postpartum using a standardised and widely used measure of eating disorder (ED) psychopathology. A consecutive series of women attending either prenatal (N = 426) or postnatal (N = 345) clinics in metropolitan Stockholm were assessed using the Eating Disorder Examination Questionnaire (EDE-Q). Assessments were conducted at either the first visit to prenatal clinics (10-12 weeks of pregnancy) or 6 to 8 months postpartum. An optimised shortened version of the EDE-Q was best suited for studying eating disorders pre- and postpartum. Using the optimised version of the instrument with 14 items and a cut-off score of ≥2.8, it was estimated that 5.3 % of prepartum and 12.8 % of postpartum mothers were suffering from clinical eating disorders. Seriously disordered eating behaviour during, and especially after, pregnancy may be more common than previously thought. It is imperative that health services focus increased attention on these problems by raising awareness, developing and extending specialist services, as well as through implementing educational programmes and training directed toward frontline healthcare services.

  5. Eating disorder symptoms pre- and postpartum.

    PubMed

    Pettersson, Cecilia Brundin; Zandian, Modjtaba; Clinton, David

    2016-08-01

    The study aimed to investigate symptoms of disordered eating pre- and postpartum using a standardised and widely used measure of eating disorder (ED) psychopathology. A consecutive series of women attending either prenatal (N = 426) or postnatal (N = 345) clinics in metropolitan Stockholm were assessed using the Eating Disorder Examination Questionnaire (EDE-Q). Assessments were conducted at either the first visit to prenatal clinics (10-12 weeks of pregnancy) or 6 to 8 months postpartum. An optimised shortened version of the EDE-Q was best suited for studying eating disorders pre- and postpartum. Using the optimised version of the instrument with 14 items and a cut-off score of ≥2.8, it was estimated that 5.3 % of prepartum and 12.8 % of postpartum mothers were suffering from clinical eating disorders. Seriously disordered eating behaviour during, and especially after, pregnancy may be more common than previously thought. It is imperative that health services focus increased attention on these problems by raising awareness, developing and extending specialist services, as well as through implementing educational programmes and training directed toward frontline healthcare services. PMID:26961005

  6. [Management of major postpartum hemorrhage].

    PubMed

    Nebout, Sophie; Merbai, Nadia; Faitot, Valentina; Keita, Hawa

    2014-02-01

    Postpartum hemorrhage (PPH) is defined by loss of greater than 500 mL of blood following vaginal delivery or 1,000 mL of blood following cesarean section, in the first 24 hours postpartum. Its incidence is up to 5% and the severe forms represent 1% of births. PPH is the first cause of obstetrical maternal mortality in France and 90% of these deaths are considered as preventable. Its management is multidisciplinary (obstetricians, anesthetists, midwives, biologists and interventional radiologists), based on treatment protocols where time is a major prognosis factor. In case of failure of the initial measures (oxytocin, manual placenta removal, uterus and birth canal examination), the management of severe forms includes active resuscitation (intravenous fluids, blood transfusion, vasoactive drugs), haemostatic interventions (sulprostone, tamponnade and haemostatic suture, surgical procedures and arterial embolization) and the correction of any potential coagulopathy (administration of blood products and haemostatic agents). PMID:24373716

  7. Postpartum renal vein thrombosis.

    PubMed

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  8. Annual Research Review: All Mothers Are Not Created Equal--Neural and Psychobiological Perspectives on Mothering and the Importance of Individual Differences

    ERIC Educational Resources Information Center

    Barrett, Jennifer; Fleming, Alison S.

    2011-01-01

    Quality of mothering relies on the integrity of multiple physiological and behavioral systems and on two maternal factors, one proximal and one distal, that have a great impact on how a mother mothers: postpartum depression and early experiences. To mother appropriately requires the action of systems that regulate sensation, perception, affect,…

  9. Maternal depressive symptoms and parenting practices 3-months postpartum.

    PubMed

    Balbierz, Amy; Bodnar-Deren, Susan; Wang, Jason J; Howell, Elizabeth A

    2015-06-01

    Using data from two postpartum depression randomized trials, we examined the association between postpartum depressive symptoms and parenting practices among a diverse group of mothers. We examined the association between safety practices (back sleep position, car seat use, smoke alarm), feeding practices (breastfeeding, infant intake of cereal, juice, water), and health care practices (routine well child and Emergency Room (ER) visits) with 3-month postpartum depressive symptoms assessed using the Edinburgh Depression Scale (EPDS ≥10). Fifty-one percent of mothers were black or Latina, 33 % had Medicaid, and 30 % were foreign born. Depressed mothers were less likely to have their infant use back sleep position (60 vs. 79 %, p < .001), always use a car seat (67 vs. 84 %, p < .001), more likely to feed their infants water, juice, or cereal (36 vs. 25 %, p = .04 respectively), and to bring their babies for ER visits (26 vs. 16 %, p = .03) as compared with non-depressed mothers. In multivariable model, depressed mothers remained less likely to have their infant use the back sleep position, to use a car seat, and to have a working smoke alarm in the home. Findings suggest the need to intervene early among mothers with depressive symptoms and reinforce positive parenting practices. PMID:25374288

  10. Self-Reported Depressive Symptoms in Lesbian Birth Mothers and Comothers

    ERIC Educational Resources Information Center

    Maccio, Elaine M.; Pangburn, Jaimee A.

    2012-01-01

    Despite the frequency of postpartum depression, little is known about the experiences of lesbian birth mothers and their female partners, or comothers. In this modest yet important exploratory investigation, 20 lesbian mothers completed a survey of self-reported postpartum depressive symptoms (PDS) and related risk factors. Results indicate that…

  11. Mothers Who Formula Feed: Their Practices, Support Needs and Factors Influencing Their Infant Feeding Decision

    ERIC Educational Resources Information Center

    Tarrant, Roslyn C.; Sheridan-Pereira, Margaret; McCarthy, Roberta A.; Younger, Katherine M.; Kearney, John M.

    2013-01-01

    The majority of mothers in Ireland provide formula milk to their infants during the initial weeks postpartum; however, data are lacking on their formula feeding practices and support needs. This prospective Dublin-based observational study, which included 450 eligible mother-term infant pairs recruited and followed up to six months postpartum,…

  12. Cognitive Behavioral Development in Children Following Maternal Postpartum Depression: A Review Article

    PubMed Central

    Mirhosseini, Hamid; Moosavipoor, Seyed Ahmad; Nazari, Mohammad Ali; Dehghan, Ahmad; Mirhosseini, Sara; Bidaki, Reza; Yazdian-anari, Pouria

    2015-01-01

    Mothers’ constitute is a very important part of infants’ social environment and mediate their experience with the surrounding world. Postpartum depression, which is considered one of the most common and important psychiatric disorders, affects 10–15% of mothers, its causes are different. By investigating various sources, some effects of this disorder have been observed on the cognitive development of children, particularly among boys, such as language, intelligence quotient (IQ), and behavioral problems. Thus, it is imperative to study the effects of postpartum depression on children’s growth and development and to identify methods of reducing these effects. This review indicates that postpartum depression in mothers reduces children’s cognitive performance. The adverse effects of postpartum depression on children’s development seem to be mediated by the mother’s interpersonal behavior and the infant gender. The review of previous studies shows that postpartum depression reduces children’s cognitive performance by impairing maternal mental and behavioral care. PMID:26816593

  13. 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…

  14. 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.…

  15. 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.…

  16. Postpartum Support International

    MedlinePlus

    ... 4773 1.800.944.4773 You are not alone Learn More Essential info about perinatal mood & anxiety ... women suffer from postpartum depression You are not alone You are not to blame With help, you ...

  17. Activation of inflammation/NF-kappaB signaling in infants born to arsenic-exposed mothers.

    PubMed

    Fry, Rebecca C; Navasumrit, Panida; Valiathan, Chandni; Svensson, J Peter; Hogan, Bradley J; Luo, Manlin; Bhattacharya, Sanchita; Kandjanapa, Krittinee; Soontararuks, Sumitra; Nookabkaew, Sumontha; Mahidol, Chulabhorn; Ruchirawat, Mathuros; Samson, Leona D

    2007-11-01

    The long-term health outcome of prenatal exposure to arsenic has been associated with increased mortality in human populations. In this study, the extent to which maternal arsenic exposure impacts gene expression in the newborn was addressed. We monitored gene expression profiles in a population of newborns whose mothers experienced varying levels of arsenic exposure during pregnancy. Through the application of machine learning-based two-class prediction algorithms, we identified expression signatures from babies born to arsenic-unexposed and -exposed mothers that were highly predictive of prenatal arsenic exposure in a subsequent test population. Furthermore, 11 transcripts were identified that captured the maximal predictive capacity to classify prenatal arsenic exposure. Network analysis of the arsenic-modulated transcripts identified the activation of extensive molecular networks that are indicative of stress, inflammation, metal exposure, and apoptosis in the newborn. Exposure to arsenic is an important health hazard both in the United States and around the world, and is associated with increased risk for several types of cancer and other chronic diseases. These studies clearly demonstrate the robust impact of a mother's arsenic consumption on fetal gene expression as evidenced by transcript levels in newborn cord blood.

  18. Effectiveness of a combined prenatal and postpartum smoking cessation program.

    PubMed

    Gadomski, Anne; Adams, Laurie; Tallman, Nancy; Krupa, Nicole; Jenkins, Paul

    2011-02-01

    Women frequently quit smoking during pregnancy but then relapse postpartum. The BABY & ME-Tobacco Free program combines prenatal and postpartum smoking cessation counseling and biomarker feedback with monthly postpartum incentives. The settings included 22 sites (WIC offices and prenatal clinics) in upstate New York. A quasi-experimental design was used to evaluate this intervention, that included four face-to-face prenatal sessions with a counselor who did smoking cessation counseling, carbon monoxide testing and random saliva cotinine testing. For 1 year postpartum, mothers were biochemically tested every 3-4 weeks and, if negative, were issued a voucher for diapers. Three implementation models were studied: multi-tasking counselors at fixed sites (Models 1 and 2) versus itinerant smoking cessation specialists (Model 3). Outcomes included biochemically validated abstinence rates during pregnancy and postpartum. Logistic regression was used to identify predictors of postpartum abstinence and program dropout. Proportional hazards regression was used to compare implementation models. Of the 777 pregnant women who enrolled in the program, 588 were eligible for the postpartum program. The intention to treat pregnancy quit rate was 60%. Postpartum, Model 3 showed consistently better quit outcomes than the other models. Predictors of abstinence at 6 months postpartum are: older age (OR = 1.07, 95% C.I. 1.02-1.12), lower baseline carbon monoxide level (OR = 0.69, 95% C.I. 0.49-0.97), Model 3 (OR = 4.60, 95% C.I. 2.80-7.57) and attending more prenatal sessions (OR = 3.52; 95% C.I. 2.19-5.65). The BABY & ME-Tobacco Free program is an effective smoking cessation program for pregnant and parenting women.

  19. The reproductive stage and experience of sexually receptive mothers alter their preference for pups or males.

    PubMed

    Agrati, Daniella; Fernández-Guasti, Alonso; Ferreira, Annabel

    2008-10-01

    Female rats show postpartum estrus, a unique stage in their reproductive cycle in which they are able to display maternal and sexual responses at the same time. To assess the relative value of pups or males for sexually receptive mothers with different hormonal profiles and reproductive experiences, we employed a 3-point star maze with 3 choice compartments containing: pups, a sexually active male, or no stimulus (neutral). Cycling maternal and nonmaternal females in late proestrus, independently of their previous reproductive experience, strongly preferred the male to the pups, although most postpartum estrous dams did not exhibit preference for the male. The majority of the postpartum primiparous females did not prefer the litter's chamber either, but a previous reproductive experience strongly determined their preference for the pups. These results suggest that the hormonal changes of the proestrus, in contrast to those of the postpartum estrus, promote a strong preference for the male that is not diminished by the maternal condition. Conversely, the endocrine changes of the postpartum facilitate the effect of previous reproductive experience in strengthening the incentive value of the pups.

  20. Maternal identity negotiations among low-income women with symptoms of postpartum depression.

    PubMed

    Abrams, Laura S; Curran, Laura

    2011-03-01

    In this study, we used a constructivist grounded theory approach to explore maternal identity negotiations among low-income ethnic minority mothers with postpartum depression (PPD) symptoms. Nineteen mothers were recruited from Women, Infant, and Children clinics located in two coastal cities in the United States to participate in in-depth interviews. Constant comparative analysis revealed that mothers experienced their PPD symptoms and poverty as evidence of maternal failure, but also drew on discourses of maternal self-sacrifice, engagement with their children, and pleasure in mothering to construct a positive sense of self. To negotiate these conflicting versions of self, mothers positively appraised their own mothering in relation to stigmatized "others" and framed their depression as a foreign entity, one that stood outside of a core, authentic sense of self. Through our consideration of the intersecting contexts of poverty and postpartum depressive symptoms, this article adds to the literature on PPD and mothering.

  1. Ovarian activity in beef and dairy cows with prolonged postpartum period and heifers that fail to conceive.

    PubMed

    Yimer, N; Rosnina, Y; Wahid, H; Saharee, A A; Yap, K C; Ganesamurthi, P

    2010-04-01

    The primary objectives of this study were to investigate incidence of abnormal ovarian cyclicity (AOC) and its type in dairy and beef cows with prolonged postpartum period (>90 days) and in heifers that fail to conceive. A total of 53 animals were included in the study: 17 Friesian crosses, 16 Braford crosses, eight Brangus crosses, and 12 local Kedah-Kelantan (KKX) crosses. These animals were initially checked for absence of pregnancy via palpation per rectum. Blood samples for progesterone analysis were obtained twice a week for 2 to 3 months following their spontaneous oestrous cycle, and all animals were rechecked for pregnancy at the end of the study. Progesterone analysis indicated that 33.9% of the total animals were having AOC: 18.9% with cessation of ovarian cyclicity, 9.4% with prolonged luteal phases (PLP), and 5.7% short luteal phases. The highest incidence was observed in Brangus crosses (62.5%), followed by Braford crosses (43.8%), and Friesian crosses (35.3%). In contrast, no AOC was observed in the local KKX breeds, and all of them were found to be pregnant at the end of the study. A significant difference (p < 0.05) in the incidence of AOC and its type was observed between Kedah-Kelantan crosses and the other breeds. Although not significant (p > 0.05), Friesian crosses showed a higher percentage incidence of AOC than beef cows (40% vs 36.4%), with major types being PLP (26.7%) in dairy and cessation of ovarian cycle (27.3%) in beef cows. Compared with beef heifers, beef cows showed a higher percentage of AOC (36.4% vs 28.6%) where again, cessation of cyclicity was the predominant abnormality. In conclusion, AOC reflected by abnormal endocrine pattern is a possible cause of reduction in fertility for dairy and beef cows beyond 90 days postpartum and heifers that fail to conceive. PMID:19809886

  2. Postpartum affective disorders: incidence and treatment.

    PubMed

    Ugarriza, D N

    1992-05-01

    1. Postpartum depression is a culture-bound syndrome found in Western societies. The lack of supportive rites and rituals for postpartum women shape depressive symptoms. 2. Postpartum depression is a term used for three distinct syndromes: postpartum "blues," postpartum psychosis, and postpartum depression. 3. Treatment issues surrounding each postpartum affective disorder are different and require education and support of family members as well as postpartum women.

  3. Not Just a Middle-Class Affliction: Crafting a Social Work Research Agenda on Postpartum Depression

    ERIC Educational Resources Information Center

    Abrams, Laura S.; Curran, Laura

    2007-01-01

    Postpartum depression (PPD) is a major mental health disorder that affects at least 13 percent of new mothers and has detrimental consequences for populations that are of concern to social workers, such as low-income women, women of color, young women, and single mothers. Despite the relevance of PPD to multiple social work problems and…

  4. Neonatal vaccine-strain varicella-zoster virus infection 22 days after maternal postpartum vaccination.

    PubMed

    Kluthe, Margaret; Herrera, Angel; Blanca, Haydee; Leung, Jessica; Bialek, Stephanie R; Schmid, D Scott

    2012-09-01

    A 25-day-old infant developed varicella 22 days after her mother received varicella vaccine postpartum. Infection with vaccine-strain varicella-zoster virus was confirmed by genetic analysis. The mother had no postvaccination rash nor did other contacts have rash or recent vaccination. The potential means of transmission to the infant are explored.

  5. 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).…

  6. Patterns of Brain Activation when Mothers View Their Own Child and Dog: An fMRI Study

    PubMed Central

    Gollub, Randy L.; Niemi, Steven M.; Evins, Anne Eden

    2014-01-01

    Neural substrates underlying the human-pet relationship are largely unknown. We examined fMRI brain activation patterns as mothers viewed images of their own child and dog and an unfamiliar child and dog. There was a common network of brain regions involved in emotion, reward, affiliation, visual processing and social cognition when mothers viewed images of both their child and dog. Viewing images of their child resulted in brain activity in the midbrain (ventral tegmental area/substantia nigra involved in reward/affiliation), while a more posterior cortical brain activation pattern involving fusiform gyrus (visual processing of faces and social cognition) characterized a mother's response to her dog. Mothers also rated images of their child and dog as eliciting similar levels of excitement (arousal) and pleasantness (valence), although the difference in the own vs. unfamiliar child comparison was larger than the own vs. unfamiliar dog comparison for arousal. Valence ratings of their dog were also positively correlated with ratings of the attachment to their dog. Although there are similarities in the perceived emotional experience and brain function associated with the mother-child and mother-dog bond, there are also key differences that may reflect variance in the evolutionary course and function of these relationships. PMID:25279788

  7. Postpartum Mood Disorders Screening in the NICU.

    PubMed

    Scheans, Patricia; Mischel, Rebecca; Munson, Margi; Bulaevskaya, Katya

    2016-01-01

    Maternal depression is increasingly recognized as the leading complication of childbearing. A mother's mental health impacts the well-being and long-term outcomes of her children. This column will discuss a systematic approach to screening for maternal postpartum mood disorders (PPMDs) and referring women to resources according to an established algorithm. This work was undertaken in a tertiary referral NICU and performed by dedicated NICU personnel with the goals of optimizing NICU infants' outcomes and supporting maternal and family health and well-being. PMID:27461203

  8. Listen Up: What We Can Learn From Women’s Birth and Postpartum Experiences

    PubMed Central

    Lothian, Judith A.

    2014-01-01

    In 2013, Childbirth Connection published findings from a U.S. study of women’s pregnancy, childbirth, and postpartum experiences, Listening to Mothers III. In this issue of The Journal of Perinatal Education, we publish the major survey findings of both the pregnancy and birth survey and the postpartum survey. This editorial discusses some of the major findings of the childbirth survey. Listening to what mothers have to say about their experiences suggests a mandate to “listen up” to what mothers are telling us and continue to advocate for evidence-based maternity care. Articles in this issue of the journal are presented.

  9. [Postpartum psychiatric disorders].

    PubMed

    Mazaira, Silvina

    2014-01-01

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

  10. Association of postpartum maternal tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine administration and timeliness of infant immunization.

    PubMed

    Kaur, Ishminder; George, Krissa J; Pena-Ricardo, Carolina; Kelly, Barbara A; Watson, Barbara

    2013-11-01

    A retrospective cohort study was conducted on infants of mothers delivering at an inner-city hospital in October 2009 where postpartum maternal tetanus toxoid, reduced diptheria toxoid and acellular pertussis (Tdap) vaccination had been initiated in May 2008. We compared mothers and infants in a Tdap intervention group discharged July 2008 (n=250) with a pre-Tdap control group discharged July 2007 (n=238). Postpartum maternal Tdap impacted positively timeliness of early infant immunization.

  11. Monoamine activity in anterior hypothalamus of guinea pig pups separated from their mothers.

    PubMed

    Harvey, A T; Moore, H; Lucot, J B; Hennessy, M B

    1994-02-01

    Brief isolation in a novel environment increased the ratios of 3-methoxy-4-hydroxyphenylethylene glycol to norepinephrine (MHPG:NE) and dihydroxyphenylacetic acid to dopamine (DOPAC:DA) in the anterior hypothalamus of guinea pig pups. Ratios were significantly elevated after 90 min of isolation and for MHPG:NE, after 30 min of isolation; changes were due to increases in MHPG and DOPAC. Home cage isolation produced no change in any measure of catecholamine activity. No changes in levels of serotonin or its metabolite were observed. In 1 experiment, resting levels of NE and DOPAC:DA were predictive of the rate of separation-induced vocalization. Maternal separation in the context of novelty increases hypothalamic NE and DA activity; however, both isolation and novelty are required because neither maternal separation in the home cage nor exposure to a novel cage together with the mother had any discernible effect. PMID:7514878

  12. Longitudinal changes in PON1 enzymatic activities in Mexican-American mothers and children with different genotypes and haplotypes

    SciTech Connect

    Huen, Karen; Harley, Kim; Bradman, Asa; Eskenazi, Brenda; Holland, Nina

    2010-04-15

    The paraoxonase 1 (PON1) enzyme prevents low-density lipoprotein oxidation and also detoxifies the oxon derivatives of certain neurotoxic organophosphate (OP) pesticides. PON1 activity in infants is low compared to adults, rendering them with lower metabolic and antioxidant capacities. We made a longitudinal comparison of the role of genetic variability on control of PON1 phenotypes in Mexican-American mothers and their children at the time of delivery (n = 388 and 338, respectively) and again 7 years later (n = 280 and 281, respectively) using generalized estimating equations models. At age 7, children's mean PON1 activities were still lower than those of mothers. This difference was larger in children with genotypes associated with low PON1 activities (PON1{sub -108TT}, PON1{sub 192QQ}, and PON1{sub -909CC}). In mothers, PON1 activities were elevated at delivery and during pregnancy compared to 7 years later when they were not pregnant (p < 0.001). In non-pregnant mothers, PON1 polymorphisms and haplotypes accounted for almost 2-fold more variation of arylesterase (AREase) and chlorpyrifos-oxonase (CPOase) activity than in mothers at delivery. In both mothers and children, the five PON1 polymorphisms (192, 55, -108, -909, -162) explained a noticeably larger proportion of variance of paraoxonase activity (62-78%) than AREase activity (12.3-26.6%). Genetic control of PON1 enzymatic activity varies in children compared to adults and is also affected by pregnancy status. In addition to known PON1 polymorphisms, unidentified environmental, genetic, or epigenetic factors may also influence variability of PON1 expression and therefore susceptibility to OPs and oxidative stress.

  13. 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

  14. Noradrenergic alpha-2 receptor modulators in the ventral bed nucleus of the stria terminalis – effects on anxiety behavior in postpartum and virgin female rats

    PubMed Central

    Smith, Carl D.; Piasecki, Christopher C.; Weera, Marcus; Olszewicz, Joshua; Lonstein, Joseph S.

    2014-01-01

    Emotional hyper-reactivity can inhibit maternal responsiveness in female rats and other animals. Maternal behavior in postpartum rats is disrupted by increasing norepinephrine release in the ventral bed nucleus of the stria terminalis (BSTv) with the α2-autoreceptor antagonist, yohimbine, or the more selective α2-autoreceptor antagonist, idazoxan (Smith et al., 2012). Because high noradrenergic activity in the BSTv can also increase anxiety-related behaviors, increased anxiety may underlie the disrupted mothering of dams given yohimbine or idazoxan. To assess this possibility, anxiety-related behaviors in an elevated plus maze were assessed in postpartum rats after administration of yohimbine or idazoxan. It was further assessed if the α2-autoreceptor agonist clonidine (which decreases norepinephrine release) would, conversely, reduce dams’ anxiety. Groups of diestrous virgins were also examined. It was found that peripheral or intra-BSTv yohimbine did increase anxiety-related behavior in postpartum females. However, BSTv infusion of idazoxan did not reproduce yohimbine’s anxiogenic effects and anxiety was not reduced by peripheral or intra-BSTv clonidine. Because yohimbine is a weak 5HT1A receptor agonist, other groups of females received BSTv infusion of the 5HT1A receptor agonist 8OH-DPAT, but it did not alter their anxiety-related behavior. Lastly, levels of norepinephrine and serotonin in tissue punches from the BSTv did not differ between postpartum and diestrous rats, but serotonin turnover was lower in mothers. These results suggest that the impaired maternal behavior after BSTv infusion of yohimbine or idazoxan cannot both be readily explained by an increase in dams’ anxiety, and that BSTv α2-autoreceptor modulation alone has little influence anxiety-related behaviors in postpartum or diestrous rats. PMID:23796237

  15. Lavender Fragrance Essential Oil and the Quality of Sleep in Postpartum Women

    PubMed Central

    Keshavarz Afshar, Mahnaz; Behboodi Moghadam, Zahra; Taghizadeh, Ziba; Bekhradi, Reza; Montazeri, Ali; Mokhtari, Pouran

    2015-01-01

    Background: Labor and delivery is a stressful stage for mothers. During these periods, sleep-related disorders have been reported. The problems of inadequate sleep include decrease in concentration, judgment, difficulty in performing daily activities, and an increase in irritability. Even the effects of moderate sleep loss on life and health quality can be similar to sleep deprivation. some research aggravated by aromatherapy on sleep quality in different periods of life so might be useful for the improve of sleep quality in postpartum women. Objectives: This study aimed to determine the effect of aromatherapy on the quality of sleep in postpartum women. The sample was recruited from medical health centers of Zanjan University of Medical Sciences. Patients and Methods: This study was a randomized clinical trial with the control group. A total of 158 mothers in postpartum period (with certain inclusion criteria) were enrolled in the study and assigned randomly to two groups of control and intervention. Lavender fragrance (made by Barij Essence Pharmaceutical Co.) was used by participants in the intervention group nightly before sleeping. The fragrance was dropped on cotton balls, which were placed on a cylindrical container at mothers’ disposal. Keeping the container at a projected distance of 20 cm, the participants inhaled 10 deep breaths and then the container was placed beside their pillow until morning. This procedure was done 4 times a week for 8 weeks. For the control group, the same intervention was done with the placebo. The instrument for collecting data was Pittsburgh sleep quality index, which was completed at the baseline, fourth, and eighth weeks after the intervention. Data were analyzed using independent t test and repeated measures analysis of variance calculated by SPSS16. Results: Before the intervention, there were no significant differences between mothers in two groups (P > 0.05). After 8 weeks follow up, a significant improvement appeared in

  16. Psychological distress and milk volume in lactating mothers.

    PubMed

    Hill, Pamela D; Aldag, Jean C; Chatterton, Robert T; Zinaman, Michael

    2005-10-01

    The purpose of this article is twofold: (a) to compare psychological distress as measured via self-reported perceived stress, sleep, and fatigue levels in lactating mothers of a term infant and mothers of a preterm infant and(b) to determine whether the addition of psychological distress to a previous model predicts milk volume at Postpartum Week 6 by gestation group. The convenience sample of 95 mothers of a preterm infant (31 weeks) and 98 mothers of a term infant completed the Perceived Stress Visual Analogue Scale, Richards-Campbell Sleep Questionnaire, and the Fatigue Visual Analog Scale. Stress, sleep difficulty, and fatigue levels decreased during the 6-week study period for mothers of a term but not for mothers of a preterm infant. Perceived stress, sleep difficulty, and fatigue during the first 6 weeks postpartum were not related to milk volume; thus, the mother's perceived psychological distress had no apparent effect on lactation. PMID:16157942

  17. Oxytocin and Postpartum Depression: Delivering on What’s Known and What’s Not

    PubMed Central

    Kim, Sohye; Soeken, Timothy A.; Cromer, Sara J.; Martinez, Sheila R.; Hardy, Leah R.; Strathearn, Lane

    2013-01-01

    The role of oxytocin in the treatment of postpartum depression has been a topic of growing interest. This subject carries important implications, given that postpartum depression can have detrimental effects on both the mother and her infant, with lifelong consequences for infant socioemotional and cognitive development. In recent years, oxytocin has received attention for its potential role in many neuropsychiatric conditions beyond its well-described functions in childbirth and lactation. In the present review, we present available data on the clinical characteristics and neuroendocrine foundations of postpartum depression. We outline current treatment modalities and their limitations, and proceed to evaluate the potential role of oxytocin in the treatment of postpartum depression. The aim of the present review is twofold: a) to bring together evidence from animal and human research concerning the role of oxytocin in postpartum depression, and b) to highlight areas that deserve further research in order to bring a fuller understanding of oxytocin’s therapeutic potential. PMID:24239932

  18. Reduced mitochondria cytochrome oxidase activity in adult children of mothers with Alzheimer's disease.

    PubMed

    Mosconi, Lisa; de Leon, Mony; Murray, John; E, Lezi; Lu, Jianghua; Javier, Elizabeth; McHugh, Pauline; Swerdlow, Russell H

    2011-01-01

    Biomarker studies demonstrate inheritance of glucose hypometabolism and increased amyloid-β deposition in adult offspring of mothers, but not fathers, affected by late-onset Alzheimer's disease (LOAD). The underlying genetic mechanisms are unknown. We investigated whether cognitively normal (NL) individuals with a maternal history of LOAD (MH) have reduced platelet mitochondrial cytochrome oxidase activity (COX, electron transport chain complex IV) compared to those with paternal (PH) or negative family history (NH). Thirty-six consecutive NL individuals (age 55 ± 15 y, range 27-71 y, 56% female, CDR = 0, MMSE ≥28, 28% APOE-4 carriers), including 12 NH, 12 PH, and 12 MH, received a blood draw to measure platelet mitochondrial COX activity. Citrate synthase activity (CS) was measured as a reference. Groups were comparable for clinical and neuropsychological measures. We found that after correcting for CS, COX activity was reduced by 29% in MH compared to NH, and by 30% in MH compared to PH (p ≤ 0.006). Results remained significant controlling for age, gender, education, and APOE. No differences were found between PH and NH. COX measures discriminated MH from the other groups with accuracy ≥75%, and relative risk ≥3 (p ≤ 0.005). Among NL with LOAD-parents, only those with MH showed reduced COX activity in platelet mitochondria compared to PH and NH. The association between maternal history of LOAD and systemic COX reductions suggests transmission via mitochondrial DNA, which is exclusively maternally inherited in humans.

  19. Perinatal Dyadic Psychotherapy for postpartum depression: a randomized controlled pilot trial.

    PubMed

    Goodman, Janice H; Prager, Joanna; Goldstein, Richard; Freeman, Marlene

    2015-06-01

    An integrated approach addressing maternal depression and associated mother-infant relationship dysfunction may improve outcomes. This study tested Perinatal Dyadic Psychotherapy (PDP), a dual-focused mother-infant intervention to prevent/decrease maternal postpartum depression and improve aspects of the mother-infant relationship related to child development. Women recruited from hospital postpartum units were screened using a three-stage process. Forty-two depressed first-time mothers and their 6-week-old infants were enrolled and randomized to receive the PDP intervention or usual care plus depression monitoring by phone. The intervention consisted of eight home-based, nurse-delivered mother-infant sessions consisting of (a) supportive, relationship-based, mother-infant psychotherapy, and (b) a developmentally based infant-oriented component focused on promoting positive mother-infant interactions. Data collected at baseline, post-intervention, and three-month follow-up included measures of maternal depression, anxiety, maternal self-esteem, parenting stress, and mother-infant interaction. Depression and anxiety symptoms and diagnoses decreased significantly, and maternal self-esteem increased significantly across the study time frame with no between-group differences. There were no significant differences between groups on parenting stress or mother-infant interaction at post-intervention and follow-up. No participants developed onset of postpartum depression during the course of the study. PDP holds potential for treating depression in the context of the mother-infant relationship; however, usual care plus depression monitoring showed equal benefit. Further research is needed to explore using low-intensity interventions as a first step in a stepped care approach and to determine what subset of at-risk or depressed postpartum mothers might benefit most from the PDP intervention. PMID:25522664

  20. Group therapy and its barriers for women suffering from postpartum depression.

    PubMed

    Ugarriza, Doris Noel

    2004-04-01

    Data were collected to pilot-test the feasibility and the effects of the "Gruen" Postpartum Depression Group Therapy as an intervention for depression for a small treatment and control group of postpartum depressed mothers. Treatment was a ten-week group therapy consisting of four interacting aspects: (1) education and information, (2) stress reduction techniques,(3) development of support systems, and (4) cognitive restructuring. Beck Depression Inventory II scores were significantly lower post treatment in the treatment group. Women stated psychoeducation was the greatest help to them. One of the problems associated with treating postpartum women was their inability to get to therapy because of childcare responsibilities.

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

    PubMed Central

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

    2014-01-01

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

  2. Maternal recasts and activity variations: a comparison of mother-child dyads involving children with and without SLI.

    PubMed

    Rezzonico, Stefano; de Weck, Geneviève; Salazar Orvig, Anne; da Silva Genest, Christine; Rahmati, Somayeh

    2014-04-01

    This study investigated maternal recast and the children's responses comparing dyads made up of a mother and a child with typical language development (TD) or a child with specific language impairment (SLI). More specifically, this article deals with the influence of the type of activity being carried out on the number and types of maternal recasts. A sample of 17 French-speaking children with SLI (age 5 to 7 years) matched with 17 TD same-age peers was observed in interaction with their mother during four different activities (joint reading, symbolic play, question guessing game and clue guessing game). The results showed that group and activity had an impact on the number and type of recasts. Mothers of children with SLI offered more recasts than mothers of TD children. The former preferred phonological recasts whereas the latter preferred lexical ones. Moreover, recasts were more frequently used in joint reading than in other activities. Regarding the children's responses, no significant difference was observed between the two groups. Children with SLI took up the maternal proposition more frequently after a lexical recast than after a recast of another type. The findings provide evidence for considering the features of the activities in clinical settings.

  3. Infant car seat usage. Effectiveness of a postpartum educational program.

    PubMed

    Goebel, J B; Copps, T J; Sulayman, R F

    1984-01-01

    A study, based on the social learning theory model and designed to assess the effect of a postpartum educational program on mothers' use of infant car seats at the time of discharge was conducted. The control group consisted of data for 92 mothers obtained by recording their behavior at the time of discharge regarding their use of infant car seats and eight other related measures. The postpartum study group (90) was shown an educational slide/audio tape presentation followed by a question-and-answer period and demonstration of car seats. They were also given a shoppers' guide and a pamphlet of facts and pictures of car seats. Statistical significance was obtained on several measures.

  4. Infant car seat usage. Effectiveness of a postpartum educational program.

    PubMed

    Goebel, J B; Copps, T J; Sulayman, R F

    1984-01-01

    A study, based on the social learning theory model and designed to assess the effect of a postpartum educational program on mothers' use of infant car seats at the time of discharge was conducted. The control group consisted of data for 92 mothers obtained by recording their behavior at the time of discharge regarding their use of infant car seats and eight other related measures. The postpartum study group (90) was shown an educational slide/audio tape presentation followed by a question-and-answer period and demonstration of car seats. They were also given a shoppers' guide and a pamphlet of facts and pictures of car seats. Statistical significance was obtained on several measures. PMID:6560047

  5. Mothers impose physical activity restrictions on their asthmatic children and adolescents: an analytical cross-sectional study

    PubMed Central

    2014-01-01

    Background Physical activities are important for children and adolescents, especially asthmatics. A significant proportion is considered less active than their non-asthmatic peers and mother’s beliefs about asthma are thought to be a determinant factor. The research objectives were to investigate whether mothers try to impose limitations on the physical activity (PA) of their asthmatic children/adolescents; identify associated factors; and explore if this attitude has any impact on children’s PA levels. Methods In this cross sectional investigation, we studied 115 asthmatics aged between 9 and 19 years and their mothers. Asthma severity, PA level and exercise induced bronchospasm (EIB) were evaluated. Mothers were questioned on their beliefs about physical activity in non-asthmatic and asthmatic children, if they imposed restrictions on their children’s physical activity, on EIB perception and personal levels of anxiety and depression. Results Ninety six percent of the mothers answered that PA are important for children and adolescents. Despite this, 37% of them admitted imposing restrictions to their children’s PA. This attitude was associated with mother’s negative opinions about asthmatics doing PA, perception of children’s dyspnea after running on a treadmill, mother’s anxiety level and children’s asthma severity. The mother’s restrictive attitudes were not associated with children’s lower PA levels. Conclusion A high proportion of the mothers said that they restrained their asthmatic children from engaging in physical activity. This fact should be recognized by health professionals and discussed with parents and caregivers as these negative beliefs may lead to conflicts and prejudiced attitudes that could discourage children’s involvement in physical activities and sports. PMID:24673939

  6. The Economic Resource Receipt of New Mothers

    ERIC Educational Resources Information Center

    Nichols, Laura; Elman, Cheryl; Feltey, Kathryn M.

    2006-01-01

    U.S. federal policies do not provide a universal social safety net of economic support for women during pregnancy or the immediate postpartum period but assume that employment and/or marriage will protect families from poverty. Yet even mothers with considerable human and marital capital may experience disruptions in employment, earnings, and…

  7. 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

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

    PubMed

    Li, Ming; Chou, Shinn-Yi

    2016-07-18

    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

  9. Breast Milk of HIV-Positive Mothers Has Potent and Species-Specific In Vivo HIV-Inhibitory Activity

    PubMed Central

    Wahl, Angela; Baker, Caroline; Spagnuolo, Rae Ann; Stamper, Lisa W.; Fouda, Genevieve G.; Permar, Sallie R.; Hinde, Katie; Kuhn, Louise; Bode, Lars; Aldrovandi, Grace M.

    2015-01-01

    ABSTRACT Despite the nutritional and health benefits of breast milk, breast milk can serve as a vector for mother-to-child HIV transmission. Most HIV-infected infants acquire HIV through breastfeeding. Paradoxically, most infants breastfed by HIV-positive women do not become infected. This is potentially attributed to anti-HIV factors in breast milk. Breast milk of HIV-negative women can inhibit HIV infection. However, the HIV-inhibitory activity of breast milk from HIV-positive mothers has not been evaluated. In addition, while significant differences in breast milk composition between transmitting and nontransmitting HIV-positive mothers have been correlated with transmission risk, the HIV-inhibitory activity of their breast milk has not been compared. This knowledge may significantly impact the design of prevention approaches in resource-limited settings that do not deny infants of HIV-positive women the health benefits of breast milk. Here, we utilized bone marrow/liver/thymus humanized mice to evaluate the in vivo HIV-inhibitory activity of breast milk obtained from HIV-positive transmitting and nontransmitting mothers. We also assessed the species specificity and biochemical characteristics of milk's in vivo HIV-inhibitory activity and its ability to inhibit other modes of HIV infection. Our results demonstrate that breast milk of HIV-positive mothers has potent HIV-inhibitory activity and indicate that breast milk can prevent multiple routes of infection. Most importantly, this activity is unique to human milk. Our results also suggest multiple factors in breast milk may contribute to its HIV-inhibitory activity. Collectively, our results support current recommendations that HIV-positive mothers in resource-limited settings exclusively breastfeed in combination with antiretroviral therapy. IMPORTANCE Approximately 240,000 children become infected with HIV annually, the majority via breastfeeding. Despite daily exposure to virus in breast milk, most infants

  10. Attention Deficit Hyper Activity Disorder (ADHD) and Stress: A Mutual Relationship between Children and Mothers

    PubMed Central

    Samiei, Mercedeh; Daneshmand, Reza; Keramatfar, Rasul; Khooshabi, Katayoon; Amiri, Nasrin; Farhadi, Yadollah; Farzadfard, Seyedeh Zeinab; Kachooi, Hamid; Samadi, Roya

    2015-01-01

    Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by high levels of inattention, hyperactivity and impulsivity which may result in mothers' stress. The current study aims to compare stress among 45 mothers of ADHD children who had referred to “Rofeydeh psychiatric center” with 45 mothers of normal children. Methods: Brief demographic researcher-made questionnaire, Child Symptom Inventory-4 (CSI-4), the Child Behavior Checklist (CBCL), and Parental Stress Index-Short Form (PSI/SF) were completed for each mother and child. Results: The results showed that except the component of acceptance, ADHD children had more problems in the field of attention compared with normal children. Mothers of ADHD children had also more stress compared with mothers of normal children. Discussion: ADHD can impair mothers' mental health by inducing stress and this issue has important clinical and treatment implications. Specific treatment programs should be designed and implemented in Iran for the mothers of ADHD children to reduce stress among them and therefore, improve their mental health status. PMID:27307956

  11. Active Negotiation: Mothers with Intellectual Disabilities Creating Their Social Support Networks

    ERIC Educational Resources Information Center

    Mayes, Rachel; Llewellyn, Gwynnyth; McConnell, David

    2008-01-01

    Background: The support networks of mothers with intellectual disabilities play an important role in caring for children. Understanding the support provided by the network is therefore vital in understanding the capacity of a mother to care for her child. Nevertheless, how these important networks came into existence is yet to be explored.…

  12. Mothers' and Fathers' Involvement in Home Activities with Their Children: Psychosocial Factors and the Role of Parental Self-Efficacy

    ERIC Educational Resources Information Center

    Giallo, Rebecca; Treyvaud, Karli; Cooklin, Amanda; Wade, Catherine

    2013-01-01

    Parent involvement in play, learning, and everyday home activities is important for promoting children's cognitive and language development. The aims of the study were to (a) examine differences between mothers' and fathers' self-reported involvement with their children, (b) explore the relationship between child, parent and family factors, and…

  13. [Postpartum thyroiditis. A review].

    PubMed

    Hurtado-Hernández, Z; Segura-Domínguez, A

    2013-01-01

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

  14. Assessing postpartum family functioning.

    PubMed

    Midmer, D; Talbot, Y

    1988-09-01

    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.

  15. 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

  16. 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

  17. Management of postpartum haemorrhage.

    PubMed

    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

  18. 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

  19. Mothers' and fathers' involvement with school-age children's care and academic activities in Navajo Indian families.

    PubMed

    Hossain, Ziarat; Anziano, Michael C

    2008-04-01

    This exploratory study examined mothers' and fathers' reports of time involvement in their school-age children's care and academic activities. The study also explored the relationship between parents' socioeconomic status (SES) variables (age, education, income, work hours, and length of marriage) and their relative involvement with children. Mother and father dyads from 34 two-parent Navajo (Diné) Indian families with a second- or third-grade child participated in the study. Repeated measures analysis of variance showed that mothers invested significantly more time in children's care on demand and academic activities than fathers, but the differences in maternal and paternal perceptions of time involvement in routine care were not significant. The gender of the child did not influence the amount of time parents invested in children's care and academic activities. Mothers' involvement with children was not related to any of the SES variables. Fathers' involvement was significantly associated with work hours and length of marriage, and work hours produced significant interaction with fathers' involvement with children. Findings are discussed in light of gender role differences in parental involvement with children within Navajo families. PMID:18426283

  20. Postpartum depression on the neonatal intensive care unit: current perspectives

    PubMed Central

    Tahirkheli, Noor N; Cherry, Amanda S; Tackett, Alayna P; McCaffree, Mary Anne; Gillaspy, Stephen R

    2014-01-01

    As the most common complication of childbirth affecting 10%–15% of women, postpartum depression (PPD) goes vastly undetected and untreated, inflicting long-term consequences on both mother and child. Studies consistently show that mothers of infants in the neonatal intensive care unit (NICU) experience PPD at higher rates with more elevated symptomatology than mothers of healthy infants. Although there has been increased awareness regarding the overall prevalence of PPD and recognition of the need for health care providers to address this health issue, there has not been adequate attention to PPD in the context of the NICU. This review will focus on an overview of PPD and psychological morbidities, the prevalence of PPD in mothers of infants admitted to NICU, associated risk factors, potential PPD screening measures, promising intervention programs, the role of NICU health care providers in addressing PPD in the NICU, and suggested future research directions. PMID:25473317

  1. Sleep and Sleepiness among First-Time Postpartum Parents: A Field- and Laboratory-Based Multimethod Assessment

    PubMed Central

    Insana, Salvatore P.; Montgomery-Downs, Hawley E.

    2012-01-01

    The study aim was to compare sleep, sleepiness, fatigue, and neurobehavioral performance among first-time mothers and fathers during their early postpartum period. Participants were 21 first-time postpartum mother-father dyads (N=42) and seven childless control dyads (N=14). Within their natural environment, participants completed one week of wrist actigraphy monitoring, along with multi-day self-administered sleepiness, fatigue, and neurobehavioral performance measures. The assessment week was followed by an objective laboratory based test of sleepiness. Mothers obtained more sleep compared to fathers, but mothers’ sleep was more disturbed by awakenings. Fathers had greater objectively measured sleepiness than mothers. Mothers and fathers did not differ on subjectively measured sleep quality, sleepiness, or fatigue; however, mothers had worse neurobehavioral performance than fathers. Compared to control dyads, postpartum parents experienced greater sleep disturbance, sleepiness, and sleepiness associated impairments. Study results inform social policy, postpartum sleep interventions, and research on postpartum family systems and mechanisms that propagate sleepiness. PMID:22553114

  2. A Problem-Solving Therapy Intervention for Low-Income, Pregnant Women at Risk for Postpartum Depression

    ERIC Educational Resources Information Center

    Sampson, McClain; Villarreal, Yolanda; Rubin, Allen

    2016-01-01

    Postpartum Depression (PPD) occurs at higher rates among impoverished mothers than the general population. Depression during pregnancy is one of the strongest predictors of developing PPD. Research indicates that non-pharmacological interventions are effective in reducing depressive symptoms but engaging and retaining low-income mothers remains a…

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

    PubMed

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

    2015-03-01

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

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

    PubMed

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

    2015-03-01

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

  5. Factors affecting breastfeeding cessation after discontinuation of antiretroviral therapy to prevent mother-to-child transmission of HIV.

    PubMed

    Morgan, Melissa C; Masaba, Rose O; Nyikuri, Mary; Thomas, Timothy K

    2010-07-01

    In the Kisumu Breastfeeding Study (KiBS), prevention of mother-to-child HIV transmission study, highly active antiretroviral therapy (HAART) is provided from 34 weeks gestation, through delivery to six months postpartum. The study recommends that women practice exclusive breastfeeding for six months, then wean abruptly. We sought to explore factors such as, education, family support, cultural norms, and sources of information about perinatal HIV transmission, which may influence a mother's decision to comply or not comply with the study's recommendation to stop breastfeeding when HAART is discontinued. We used semi-structured interviews of a purposive sample of 18 mothers participating in the KiBS. By interviewing 10 mothers who stopped breastfeeding and eight mothers who continued, it was possible to examine how different factors may have affected the groups of participants. All participants stated that it was not traditional to stop breastfeeding at six months. Participants who stopped breastfeeding reported more family support, were more educated, and were more likely to disclose their HIV status. Participants who continued breastfeeding more often expressed concern about stigma. Participants learned about mother-to-child transmission from clinics, churches, community groups, and other HIV-positive mothers. This substudy suggests that family support, education, and cultural norms are important factors that may influence a mother's decision regarding breastfeeding cessation. Thus, counseling and family support may play integral roles in the promotion of early breastfeeding cessation.

  6. The Effects of Gonadotrophin Releasing Hormone Administration in Early Postpartum Dairy Cows on Hormone Concentrations, Ovarian Activity and Reproductive Performance: A Review

    PubMed Central

    Leslie, K. E.

    1983-01-01

    Gonadotrophin releasing hormones have become widely used hormonal compounds in veterinary medicine, particularly with respect to bovine reproduction. The character and physiological actions of gonadotrophin releasing hormone are briefly reviewed and its clinical applications are summarized. The endocrinological research concerned with the use of gonadotrophin releasing hormone in the early postpartum period is discussed. Field trials which have been conducted to assess the effects of postpartum gonadotrophin releasing hormone administration on reproductive performance have varied widely in both design and interpretation of results. These experiments are reviewed, including the clinical trials using normal cows as well as those on cows with retained placenta. PMID:17422245

  7. [Maternal affect regulation of mothers with a history of abuse in mother-infant-interaction].

    PubMed

    Kress, Sandra; Cierpka, Manfred; Möhler, Eva; Resch, Franz

    2012-01-01

    Maternal intuitive skills can be threatened as a result of severe deprivation or unresolved trauma in the own childhood and can even be inaccessible to the mother. A mother's own childhood experience of abuse maybe a risk factor for repeated child abuse. As a follow-up study to assess the emotional availability of abused mothers it was investigated how a physical or sexual abuse appears in the mother-child interaction and communication in the context of "cycle of abuse" and whether it could give effect to it. Interactions of mothers with abuse experience were compared with those of mothers without an abuse experience and evaluated five months postpartum with the Munich clinical communication scale (MKK). The results suggest that maltreatment experienced mothers show less emotion tuning to their child in a standardized interaction sequence.

  8. Individual, social and environmental factors influencing physical activity levels and behaviours of multiethnic socio-economically disadvantaged urban mothers in Canada: A mixed methods approach

    PubMed Central

    2012-01-01

    Background Existing data provide little insight into the physical activity context of multiethnic socio-economically disadvantaged mothers in Canada. Our primary objectives were: (1) to use focus group methodology to develop tools to identify the individual, social, and environmental factors influencing utilitarian and leisure time physical activities (LTPA) of multiethnic SED mothers; and (2) to use a women specific physical activity survey tool to assess psychosocial barriers and supports and to quantify individual physical activity (PA) levels of multi-ethnic SED mothers in Canada. Methods Qualitative focus group sessions were conducted in West, Central and Eastern Canada with multiethnic SED mothers (n = 6 focus groups; n = 42 SED mothers) and with health and recreation professionals (HRPs) (n = 5 focus groups; n = 25 HRPs) involved in community PA programming for multiethnic SED mothers. Administration of the women specific Kaiser Physical Activity Survey (KPAS) tool was completed by consenting SED mothers (n = 59). Results More than half of SED mothers were employed and had higher total PA scores with occupation included than unemployed mothers. However, nearly 60% of both groups were overweight or obese. Barriers to LTPA included the lack of available, affordable and accessible LTPA programs that responded to cultural and social needs. Concerns for safety, nonsupportive cultural and social norms and the winter climate were identified as key barriers to both utilitarian and LTPA. Conclusions Findings show that multiethnic SED mothers experience many barriers to utilitarian and LTPA opportunities within their communities. The varying LTPA levels among these multi-ethnic SED mothers and the occurrence of overweight and obesity suggests that current LTPA programs are likely insufficient to maintain healthy body weights. PMID:22500882

  9. 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. PMID:23707843

  10. Motivators and barriers to healthful eating and physical activity among low-income overweight and obese mothers.

    PubMed

    Chang, Mei-Wei; Nitzke, Susan; Guilford, Eileen; Adair, Constance H; Hazard, Diana L

    2008-06-01

    Low-income women who are overweight and obese are at high risk for long-term retention of weight gain during pregnancy, in part because they may have poor diets and inadequate physical activity, both of which may be exacerbated by stressful situations. This study identified motivators and barriers to healthful eating and physical activity among low-income overweight and obese non-Hispanic black and non-Hispanic white mothers. Qualitative data were collected via eight focus group interviews. Eighty low-income overweight and obese non-Hispanic black (n=41) and non-Hispanic white (n=39) mothers, age 18 to 35 years, were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children sites in six counties in Michigan. Personal appearance, fit in clothes, inability to play with their children, and social support were motivating factors for healthful eating and physical activity. Stressful experiences triggered emotional eating and reduced participants' ability to practice these behaviors. Other factors-for example, wanting quick weight-loss results-made it difficult for these mothers to follow recommended healthful lifestyle practices. Nutrition educators can address these concerns by including information about ways to deal with stress and emotional eating and emphasizing the benefits of healthful eating and physical activity in their program plans.

  11. Assessment of the nutrition and physical activity education needs of low-income, rural mothers: can technology play a role?

    PubMed

    Atkinson, Nancy L; Billing, Amy S; Desmond, Sharon M; Gold, Robert S; Tournas-Hardt, Amy

    2007-08-01

    The purpose of this study was to examine the perceptions of low-income, rural mothers regarding their need for nutrition and physical activity education and the role of technology in addressing those needs. Quantitative and qualitative research was combined to examine the nature and scope of the issues faced by this target population. Women who were currently receiving food stamps and had children in nursery school to eighth grade were recruited through a state database to participate in a telephone survey (N = 146) and focus groups (N = 56). Low-income, rural mothers were aware of and practiced many health behaviors related to nutrition and physical activity, but they faced additional barriers due to their income level, rural place of residence, and having children. They reported controlling the fat content in the food they cooked and integrating fruits and vegetables but showed less interest in increasing fiber consumption. They reported knowing little about physical activity recommendations, and their reported activity patterns were likely inflated because of seeing housework and child care as exercise. To stretch their food budget, the majority reported practicing typical shopping and budgeting skills, and many reported skills particularly useful in rural areas: hunting, fishing, and canning. Over two-thirds of the survey respondents reported computer access and previous Internet use, and most of those not yet online intended to use the Internet in the future. Those working in rural communities need to consider technology as a way to reach traditionally underserved populations like low-income mothers. PMID:17696049

  12. Assessment of the nutrition and physical activity education needs of low-income, rural mothers: can technology play a role?

    PubMed

    Atkinson, Nancy L; Billing, Amy S; Desmond, Sharon M; Gold, Robert S; Tournas-Hardt, Amy

    2007-08-01

    The purpose of this study was to examine the perceptions of low-income, rural mothers regarding their need for nutrition and physical activity education and the role of technology in addressing those needs. Quantitative and qualitative research was combined to examine the nature and scope of the issues faced by this target population. Women who were currently receiving food stamps and had children in nursery school to eighth grade were recruited through a state database to participate in a telephone survey (N = 146) and focus groups (N = 56). Low-income, rural mothers were aware of and practiced many health behaviors related to nutrition and physical activity, but they faced additional barriers due to their income level, rural place of residence, and having children. They reported controlling the fat content in the food they cooked and integrating fruits and vegetables but showed less interest in increasing fiber consumption. They reported knowing little about physical activity recommendations, and their reported activity patterns were likely inflated because of seeing housework and child care as exercise. To stretch their food budget, the majority reported practicing typical shopping and budgeting skills, and many reported skills particularly useful in rural areas: hunting, fishing, and canning. Over two-thirds of the survey respondents reported computer access and previous Internet use, and most of those not yet online intended to use the Internet in the future. Those working in rural communities need to consider technology as a way to reach traditionally underserved populations like low-income mothers.

  13. 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. PMID:25239433

  14. Cryptogenic postpartum stroke.

    PubMed

    Bereczki, Dániel; Szegedi, Norbert; Szakács, Zoltán; Gubucz, István; May, Zsolt

    2016-01-01

    An estimated 25-40% of ischemic strokes are classified as cryptogenic, which means the cause of the cerebral infarction remains unidentified. One of the potential pathomechanisms - especially among young patients with no cardiovascular risk factors - is paradoxical embolism through a patent foramen ovale. Pregnancy, cesarean delivery and the postpartum period are associated with an increased risk of cerebrovascular events. Factors that may contribute to ischemic strokes during gestation and puerperium include classic cardiovascular risk factors, changes in hemostaseology/hemodynamics, and pregnancy-specific disorders such as pre-eclampsia, eclampsia, postpartum cerebral angiopathy or peripartum cardiomyopathy. In this case report, we present a 36-year-old thrombolysis candidate undergoing mechanical thrombectomy 3 weeks after a cesarean section due to HELLP-syndrome. After evaluation of anamnestic and diagnostic parameters, closure of the patent foramen ovale has been performed. In the absence of specific guidelines, diagnostic work-up for cryptogenic stroke should be oriented after the suspected pathomechanism based on patient history and clinical picture. As long as definite evidences emerge, management of cryptogenic stroke patients with pathogenic right-to-left shunt remains individual based on the mutual decision of the patient and the multidisciplinary medical team. PMID:27591063

  15. 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.

  16. The Role of Childhood Trauma and Posttraumatic Stress Disorder in Postpartum Sleep Disturbance

    PubMed Central

    Swanson, Leslie M.; Hamilton, Lindsay; Muzik, Maria

    2015-01-01

    In the present study, we examined sleep complaints in postpartum women with a past history of childhood trauma relative to postpartum women who were not exposed to childhood trauma. We also assessed whether sleep was differentially affected by the type of childhood trauma experienced and the relative contribution of posttraumatic stress disorder. Participants completed questionnaires related to mental health over the phone at four months postpartum (n = 173). We found that after adjusting for covariates, participants who reported childhood neglect or physical abuse (regardless of sexual abuse) were significantly more likely to endorse difficulty falling asleep and staying asleep relative to participants who were not exposed to childhood trauma. Furthermore, PTSD was associated with sleep problems, such that mothers with childhood trauma who had recovered from a past history of PTSD were more likely to have difficulty falling and staying asleep than mothers who were exposed to childhood trauma but never developed PTSD, while mothers with persistent PTSD were at the highest risk for reporting sleep problems. Our findings affirm the contribution of childhood trauma and PTSD to postpartum sleep problems, and suggest that sleep may be disturbed in the postpartum even in women who have recovered from PTSD. PMID:25403425

  17. Perceived parenting stress in the course of postpartum depression: the buffering effect of maternal bonding.

    PubMed

    Reck, C; Zietlow, A-L; Müller, M; Dubber, S

    2016-06-01

    Research investigating maternal bonding and parenting stress in the course of postpartum depression is lacking. Aim of the study was to investigate the development and potential mediation of both constructs in the course of postpartum depression. n = 31 mothers with postpartum depression according to DSM-IV and n = 32 healthy controls completed the German version of the Postpartum Bonding Questionnaire and the Parenting Stress Index at two measuring times: acute depression (T1) and remission (T2). At T1, the clinical group reported lower bonding and higher parenting stress. Bonding was found to partially mediate the link between maternal diagnosis and parenting stress. Furthermore, the clinical group reported lower bonding and higher parenting stress averaged over both measurement times. However, at T2, the clinical group still differed from the controls even though they improved in bonding and reported less parenting stress. A significant increase of bonding was also observed in the control group. Maternal bonding seems to buffer the negative impact of postpartum depression on parenting stress. The results emphasize the need for interventions focusing on maternal bonding and mother-infant interaction in order to prevent impairment of the mother-child relationship. PMID:26592705

  18. 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.

  19. Impact of inherited bleeding disorders on pregnancy and postpartum hemorrhage.

    PubMed

    Shahbazi, Shirin; Moghaddam-Banaem, Lida; Ekhtesari, Fatemeh; Ala, Fereydoun A

    2012-10-01

    Inherited bleeding disorders are caused by various genetic defects in the proteins involved in haemostasis. Female patients or carriers are faced with the risk of haemorrhage throughout life. During pregnancy and postpartum, this complication affects the health of either the mother or the baby, or both. This retrospective cohort study was designed to assess the occurrence of obstetric bleeding in the three trimesters of pregnancy, along with primary and secondary postpartum haemorrhage among 100 women with inherited bleeding disorders. A questionnaire was designed in order to collect historical data. The patients were evaluated in three groups: haemophilia carriers, von Willebrand disease (VWD) and rare bleeding disorders. In comparison with normal women, significantly severe bleeding was observed among patients in all of the five stages. VWD patients showed a higher frequency of bleeding in first trimester but the rate of miscarriage was lower. Haemophilia carriers were threatened with bleeding complications during the prenatal period, but they also had the highest frequency of postpartum haemorrhage. Based on our results, vaginal bleeding is a serious threat in all three patient groups, especially during the first trimester of pregnancy and in the postpartum period.

  20. 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

  1. Impact of inherited bleeding disorders on pregnancy and postpartum hemorrhage.

    PubMed

    Shahbazi, Shirin; Moghaddam-Banaem, Lida; Ekhtesari, Fatemeh; Ala, Fereydoun A

    2012-10-01

    Inherited bleeding disorders are caused by various genetic defects in the proteins involved in haemostasis. Female patients or carriers are faced with the risk of haemorrhage throughout life. During pregnancy and postpartum, this complication affects the health of either the mother or the baby, or both. This retrospective cohort study was designed to assess the occurrence of obstetric bleeding in the three trimesters of pregnancy, along with primary and secondary postpartum haemorrhage among 100 women with inherited bleeding disorders. A questionnaire was designed in order to collect historical data. The patients were evaluated in three groups: haemophilia carriers, von Willebrand disease (VWD) and rare bleeding disorders. In comparison with normal women, significantly severe bleeding was observed among patients in all of the five stages. VWD patients showed a higher frequency of bleeding in first trimester but the rate of miscarriage was lower. Haemophilia carriers were threatened with bleeding complications during the prenatal period, but they also had the highest frequency of postpartum haemorrhage. Based on our results, vaginal bleeding is a serious threat in all three patient groups, especially during the first trimester of pregnancy and in the postpartum period. PMID:22821002

  2. Economic stress and cortisol among postpartum low-income Mexican American women: buffering influence of family support

    PubMed Central

    Jewell, Shannon L.; Luecken, Linda J.; Gress-Smith, Jenna; Crnic, Keith A.; Gonzales, Nancy A.

    2016-01-01

    Low-income Mexican American women experience significant health disparities during the postpartum period. Contextual stressors, such as economic stress, are theorized to affect health via dysregulated cortisol output. However, cultural protective factors including strong family support may buffer the impact of stress. In a sample of 322 low-income Mexican American women (mother age 18–42; 84% Spanish-speaking; modal family income $10,000–$15,000), we examined the interactive influence of economic stress and family support at 6 weeks postpartum on maternal cortisol output (AUCg) during a mildly challenging mother-infant interaction task at 12 weeks postpartum, controlling for 6 week maternal cortisol and depressive symptoms. The interaction significantly predicted cortisol output such that higher economic stress predicted higher cortisol only among women reporting low family support. These results suggest that family support is an important protective resource for postpartum Mexican American women experiencing elevated economic stress. PMID:26332931

  3. 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

  4. Biological and psychosocial predictors of postpartum depression: systematic review and call for integration.

    PubMed

    Yim, Ilona S; Tanner Stapleton, Lynlee R; Guardino, Christine M; Hahn-Holbrook, Jennifer; Dunkel Schetter, Christine

    2015-01-01

    Postpartum depression (PPD) adversely affects the health and well being of many new mothers, their infants, and their families. A comprehensive understanding of biopsychosocial precursors to PPD is needed to solidify the current evidence base for best practices in translation. We conducted a systematic review of research published from 2000 through 2013 on biological and psychosocial factors associated with PPD and postpartum depressive symptoms. Two hundred fourteen publications based on 199 investigations of 151,651 women in the first postpartum year met inclusion criteria. The biological and psychosocial literatures are largely distinct, and few studies provide integrative analyses. The strongest PPD risk predictors among biological processes are hypothalamic-pituitary-adrenal dysregulation, inflammatory processes, and genetic vulnerabilities. Among psychosocial factors, the strongest predictors are severe life events, some forms of chronic strain, relationship quality, and support from partner and mother. Fully integrated biopsychosocial investigations with large samples are needed to advance our knowledge of PPD etiology. PMID:25822344

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

    PubMed Central

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

    2016-01-01

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

  6. Self-Capacitating Activities of Mothers' Clubs of Primarily Indigenous Membership in Bolivia.

    ERIC Educational Resources Information Center

    Felty, Amelia Smith

    A case study was conducted of the organized, cooperative efforts of women in six communities in Bolivia. From December 1978 through January 1988, visits were made to women's organizations called "mothers' clubs." Effects of club membership on members, their families, and their communities were examined. A research review showed that: (1) women can…

  7. Parental Protectiveness and Unprotected Sexual Activity among Latino Adolescent Mothers and Fathers

    ERIC Educational Resources Information Center

    Lesser, Janna; Koniak-Griffin, Deborah; Huang, Rong; Takayanagi, Sumiko; Cumberland, William G.

    2009-01-01

    Latino pregnant and parenting adolescents living in inner cities are one of the populations at risk for acquiring HIV. Although teen parenthood has been predominantly looked at with a focus on potential adverse physical, emotional, and socioeconomic outcomes for the mother and child; a growing body of literature has documented the strengths and…

  8. Postpartum Depression among Rural Women from Developed and Developing Countries: A Systematic Review

    ERIC Educational Resources Information Center

    Villegas, Laura; McKay, Katherine; Dennis, Cindy-Lee; Ross, Lori E.

    2011-01-01

    Purpose: Postpartum depression (PPD) is a significant public health problem, with significant consequences for the mother, infant, and family. Available research has not adequately examined the potential impact of sociodemographic characteristics, such as place of residence, on risk for PPD. Therefore, this systematic review and meta-analysis…

  9. Relationship between Postpartum Depression and Maternal Perceptions about Ethnotheories and Childrearing Practices

    ERIC Educational Resources Information Center

    Defelipe, Renata P.; Bussab, Vera S. R.; Vieira, Mauro L.

    2016-01-01

    Postpartum depression (PPD) is a mood disorder which can adaptively alter maternal socialisation strategies. Our objective was to investigate differences in ethnotheories and childrearing practices of mothers with low (N = 46) and high (N = 45) intensity of PPD. The Brazilian version of Edinburgh Postnatal Depression Scale was applied at 3, 8 and…

  10. Social Support, Infant Temperament, and Parenting Self-Efficacy: A Mediational Model of Postpartum Depression

    ERIC Educational Resources Information Center

    Cutrona, Carolyn E.; Troutman, Beth R.

    1986-01-01

    Infant temperamental difficulty was strongly related to mothers' level of postpartum depression, both directly and through the mediation of parenting self-efficacy. Social support appeared to function protectively against depression, primarily through self-efficacy. Practical and theoretical implications are discussed. (Author/RH)

  11. Antepartum and Postpartum Exposure to Maternal Depression: Different Effects on Different Adolescent Outcomes

    ERIC Educational Resources Information Center

    Hay, Dale F.; Pawlby, Susan; Waters, Cerith S.; Sharp, Deborah

    2008-01-01

    Background: Postpartum depression (PPD) is considered a major public health problem that conveys risk to mothers and offspring. Yet PPD typically occurs in the context of a lifelong episodic illness, and its putative effects might derive from the child's exposure to other episodes, in pregnancy or later childhood. The aim of the study is to test…

  12. Postabortal and postpartum contraception.

    PubMed

    Cameron, Sharon

    2014-08-01

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

  13. Limbic brain activation for maternal acoustic perception and responding is different in mothers and virgin female mice.

    PubMed

    Geissler, Diana B; Sabine Schmidt, H; Ehret, Günter

    2013-01-01

    Mothers are primed to become maternal through hormonal changes during pregnancy and delivery of young, virgin females need experience with young for performing maternally. The activation of brain areas controlling maternal behavior can be studied by stimulus-induced expression of the immediate-early gene Fos and immunocytochemical labeling of the FOS protein in activated cells. With this technique we identified areas of the mouse limbic system stimulated by acoustically adequate or inadequate models of pup ultrasounds that, if perceived as adequate, direct the search for lost pups (phonotaxis). Behavioral observations and neural activation data suggest that adequate (50 kHz long tones) and inadequate ultrasound models (50 kHz short or 20 kHz long tones) are differently processed in limbic areas of mothers and virgin females with 1 or 5 days of pup-caring experience depending on the news value and the recognition of the stimuli: High numbers of FOS-positive cells in the medial preoptic area, lateral septum, and bed nucleus of the stria terminalis (mothers and virgins) relate to the salience (news value) of the perceived sounds; contextual stress may be reflected by high activation in parts of the amygdala and the ventromedial hypothalamus (virgins); high activation in the piriform cortex suggests associative learning of adequate sounds and in the entorhinal cortex remembering associations of adequate sounds with pups (virgins). Thus brain areas were differently activated in animals with maternal emotions, however different responses to pup cues depending on how they got primed to behave maternally and on how they evaluated the stimulation context.

  14. Psychobiology of postpartum mood disorders.

    PubMed

    Wisner, K L; Stowe, Z N

    1997-02-01

    Postpartum mood disorders are common. The clustering of mood-disorder episodes after birth compels a search for factors particularly potent during childbearing. In this article, the complex relationships between the dynamic postbirth physiological environment and mood disorder are discussed. Available studies show a lack of evidence that serum levels of gonadal hormones account for mood disturbance in women. However, substantial amounts of data demonstrate their ability to modulate other neuroendocrine systems. Alterations in hypothalamic-pituitary-adrenal (HPA) axis function attributable to childbearing show remarkable similarity to those observed in depressed women. Postpartum women are also at increased risk for hypothalamic-pituitary-thyroidal (HPT) axis dysfunction that may increase affective-disorder vulnerability. A decreased rate of postpartum recovery of HPA- and HPT-axis function may play a more central role than cross-sectional measures. Understanding the etiology of postpartum mood disorders will require integration of multiple psychosocial and biological risk factors. Further research is critically needed.

  15. Postpartum management of diabetes pregnancy.

    PubMed

    Hossain, Nazli

    2016-09-01

    Diabetes mellitus has assumed the role of an epidemic. Previously considered a disease of affluent developed countries, it has become more common in developing countries. Pakistan is included among the countries with a high prevalence of diabetes. In this scenario, postpartum management of a woman with diabetes mellitus becomes more important as in this period counseling and educating a woman is essential. Counselling includes life style modifications to prevent future risks involving all the systems of the body. This review article discusses management of diabetes mellitus in postpartum period, guidelines for postpartum screening of women with gestational diabetes mellitus, risks involved in future life and stresses upon the need of local population based studies. Primary care providers and gynaecologists must realize the importance of postpartum screening for diabetes mellitus and provide relevant information to women as well. PMID:27582163

  16. Postpartum Depression: An Interactional View.

    ERIC Educational Resources Information Center

    Kraus, Mary Ann; Redman, E. Scott

    1986-01-01

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

  17. Bipolar Disorder in Pregnancy and Postpartum: Principles of Management.

    PubMed

    Khan, Sabrina J; Fersh, Madeleine E; Ernst, Carrie; Klipstein, Kim; Albertini, Elizabeth Streicker; Lusskin, Shari I

    2016-02-01

    Pregnancy and postpartum represent times of increased vulnerability for women with bipolar disorder, yet this condition remains under-diagnosed and under-treated. As 50 % of pregnancies are unplanned, the risks associated with the illness and the potential risks associated with treatment should be considered when a woman of reproductive age first presents for evaluation. This article reviews the epidemiology of perinatal bipolar disorder, screening recommendations, and treatment with pharmacotherapy and electroconvulsive therapy (ECT). An overview of the data in pregnancy and lactation is presented for lithium, lamotrigine, valproic acid, newer antipsychotics, and ECT. General principles of management include close monitoring in pregnancy and postpartum, careful adjustment of the treatment regimen to attenuate the risk of relapse, and avoidance of valproic acid when possible. Thoughtful consideration of these issues will minimize the risks to the mother and baby.

  18. Mothers and Fathers at Play with their Children with Down Syndrome: Influence on Child Exploratory and Symbolic Activity

    PubMed Central

    de Falco, Simona; Esposito, Gianluca; Venuti, Paola; Bornstein, Marc H.

    2012-01-01

    Background Through play children exercise their emerging mental abilities, and for their part, when in collaborative play, caregivers often adjust their behaviours to assist their children’s progress. In this study, we focused on comparisons between play of Down Syndrome (DS) children with their two parents as well as on comparisons between the two parents’ play behaviours. Method Altogether 40 parent–child dyads participated: 20 children with DS (M age = 36.14 months) with their mothers and separately with their fathers. We coded participants’ play behaviours during child solitary and mother–child and father–child collaborative sessions. Results Although children increased exploratory play from solitary to collaborative sessions with both parents, symbolic play increased only during joint play with fathers. Fathers displayed less symbolic and more exploratory activity compared to mothers. Mothers and fathers alike were attuned to their children, although fathers showed a higher degree of attunement. Conclusions This study shows that maternal and paternal contributions to DS child play skills are positive but different. During collaborative play children received specific and nonoverlapping scaffolding from their two parents, and fathers’ contributions were unique. PMID:23275758

  19. Measuring the risk factors for postpartum depression: development of the Japanese version of the Postpartum Depression Predictors Inventory-Revised (PDPI-R-J)

    PubMed Central

    2013-01-01

    Background Postpartum depression (PPD) is a global phenomenon. Depression in the first month following delivery is experienced by 20% of mothers in Japan. Therefore, a screening instrument that identifies the risk for depression during pregnancy and in the early postpartum period is required for primary prevention. The aims of this study were to develop the Japanese version of the Postpartum Depression Predictors Inventory-Revised (PDPI-R-J) and determine its predictive validity during pregnancy and one month after delivery. Methods In order to develop the inventory, two bilingual translators translated the PDPI-R into Japanese. Then, back translation was done and a thorough discussion with the original developer was conducted in order to establish semantic equivalence. After the PDPI-R-J was developed, the study used a prospective cohort design. A total of 84 women in their eighth month of pregnancy participated in the study. Seventy-six mothers completed the PDPI-R-J at the first month after childbirth. Women were diagnosed using Mini-International Neuropsychiatric Interview (M.I.N.I.) to determine the presence of minor or major depression at the first month after childbirth and the receiver operating characteristic curve was plotted to evaluate the predictive capacity of PDPI-R-J. Results Of the 76 mothers who completed the PDPI-R-J during the first-month assessment, 16 mothers (21%) met the PPD criteria. The prenatal version of the PDPI-R-J administered during pregnancy accurately predicted 62.8% of PPD (95% CI 0.48–0.77) and the postpartum version administered at the first month after delivery predicted 82.0% of PPD (95% CI 0.71–0.93). The cutoffs identified were 5.5 for the prenatal version and 7.5 for the postpartum version. The PDPI-R-J postpartum version, which includes items relating to the infant, increased the predictive validity of PPD (0.67 to 0.82). Comments from the participants included that the use of the PDPI-R-J enhanced the chance to openly

  20. Can postpartum maternal urinary iodine be used to estimate iodine nutrition status of newborns?

    PubMed

    Nazeri, Pantea; Mirmiran, Parvin; Hedayati, Mehdi; Mehrabi, Yadollah; Delshad, Hossein; Azizi, Fereidoun

    2016-04-14

    I deficiency can lead to detrimental effects, particularly in neonates and young infants. The aim of this study was to explore whether postpartum maternal urinary I can be used to estimate the I status of newborns. In this cross-sectional study conducted in Tehran, lactating mothers and newborns, within 3-5 d postpartum, were randomly selected. Urine samples were collected from each mother and newborn, and a heel-prick blood sample was obtained from all newborns as part of the routine national newborn screening programme. According to the WHO criteria, median urinary I concentration (UIC) 5 mIU/l was considered as I insufficiency. A total of 147 postpartum women and neonates, aged 27·8 (SD 5·3) years and 4·2 (SD 0·6) d, respectively, completed this study. The median UIC was 68·0 (interquartile range (IQR) 39·4-133·5) and 212·5 (IQR 92·3-307·3) µg/l in postpartum mothers and newborns, respectively. The median neonatal TSH was 1·00 (IQR 0·50-1·70) mIU/l. There was no significant difference in the neonatal UIC and TSH of infants whose mothers had deficient and sufficient urinary I. In the multiple linear regression, neonatal UIC value was associated with maternal urinary I (P=0·048) and parity (P=0·039); a significant association was observed between neonatal TSH and infant sex (P=0·038) and birth weight (P=0·049). The findings of our study demonstrate that, despite postpartum mothers being mildly I deficient, I status of their infants was adequate as assessed by UIC and TSH values. It seems factors other than maternal urinary I may influence the I status in newborns. PMID:26857284

  1. Can postpartum maternal urinary iodine be used to estimate iodine nutrition status of newborns?

    PubMed

    Nazeri, Pantea; Mirmiran, Parvin; Hedayati, Mehdi; Mehrabi, Yadollah; Delshad, Hossein; Azizi, Fereidoun

    2016-04-14

    I deficiency can lead to detrimental effects, particularly in neonates and young infants. The aim of this study was to explore whether postpartum maternal urinary I can be used to estimate the I status of newborns. In this cross-sectional study conducted in Tehran, lactating mothers and newborns, within 3-5 d postpartum, were randomly selected. Urine samples were collected from each mother and newborn, and a heel-prick blood sample was obtained from all newborns as part of the routine national newborn screening programme. According to the WHO criteria, median urinary I concentration (UIC) 5 mIU/l was considered as I insufficiency. A total of 147 postpartum women and neonates, aged 27·8 (SD 5·3) years and 4·2 (SD 0·6) d, respectively, completed this study. The median UIC was 68·0 (interquartile range (IQR) 39·4-133·5) and 212·5 (IQR 92·3-307·3) µg/l in postpartum mothers and newborns, respectively. The median neonatal TSH was 1·00 (IQR 0·50-1·70) mIU/l. There was no significant difference in the neonatal UIC and TSH of infants whose mothers had deficient and sufficient urinary I. In the multiple linear regression, neonatal UIC value was associated with maternal urinary I (P=0·048) and parity (P=0·039); a significant association was observed between neonatal TSH and infant sex (P=0·038) and birth weight (P=0·049). The findings of our study demonstrate that, despite postpartum mothers being mildly I deficient, I status of their infants was adequate as assessed by UIC and TSH values. It seems factors other than maternal urinary I may influence the I status in newborns.

  2. The impact of postpartum depression and anxiety disorders on children's processing of facial emotional expressions at pre-school age.

    PubMed

    Meiser, Susanne; Zietlow, Anna-Lena; Reck, Corinna; Träuble, Birgit

    2015-10-01

    To enhance understanding of impaired socio-emotional development in children of postpartum depressed or anxious mothers, this longitudinal study addressed the question of whether maternal postpartum depression and anxiety disorders result in deficits in children's processing of facial emotional expressions (FEEs) at pre-school age. Thirty-two mothers who had fulfilled Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria for postpartum depression and/or anxiety disorder and their pre-school aged children were tested for FEE processing abilities and compared to a healthy control group (n = 29). Child assessments included separate tasks for emotion recognition and emotion labelling. Mothers completed an emotion recognition test as well as the Structured Clinical Interview for DSM-IV Axis I Disorders I (SCID-I). Children of postpartum depressed and/or anxious mothers performed significantly worse than control children at labelling, but not at recognizing facial expressions of basic emotions. Emotion labelling at pre-school age was predicted by child age and maternal postpartum mental health, but neither current maternal mental health nor current maternal emotion recognition was associated with child FEE processing. Results point to a specific importance of early social experiences for the development of FEE labelling skills. However, further studies involving sensitive measures of emotion recognition are needed to determine if there might also exist subtle effects on FEE recognition.

  3. Teen Mothers' Experience of Intimate Partner Violence: A Metasynthesis.

    PubMed

    Bekaert, Sarah; SmithBattle, Lee

    2016-01-01

    Pregnant and parenting teens suffer higher rates of intimate partner violence (IPV) than older mothers. This qualitative metasynthesis explores teen mothers' experience with IPV during pregnancy and postpartum. Organized by the metaphor of a web, findings highlight how pervasive violence during childhood contributes to teen pregnancy and the risk of IPV as violence is normalized. The web constricts through the partner's control as violence emerges or worsens with pregnancy. Young mothers become increasingly isolated, and live with the physical and psychological consequences of IPV. Trauma-informed nursing practice is needed to support teen mothers in violent intimate relationships to spin a new web. PMID:27490882

  4. Repeated long separations from pups produce depression-like behavior in rat mothers.

    PubMed

    Boccia, Maria L; Razzoli, Maria; Vadlamudi, Sivaram Prasad; Trumbull, Whit; Caleffie, Christopher; Pedersen, Cort A

    2007-01-01

    Long maternal (LMS) versus brief maternal (BMS) daily separations of rat pups from their mothers have contrasting effects on their adult stress responses and maternal behavior by, respectively, decreasing and increasing licking received from their mothers. We hypothesized that LMS decreases pup-licking in mothers by inducing learned helplessness, creating a depression-like state. We subjected postpartum rats to LMS (3 h), BMS (15 min) or no separation (NMS) on postpartum days 2-14. After weaning, mothers were given a forced swim test (FST). LMS mothers exhibited more immobility and fewer escape attempts than BMS or NMS mothers. These results suggest that LMS induces a depression-like state, which may account for the reductions in maternal behavior seen in LMS mothers. Immobility in the FST is recognized as an animal model of depression. Therefore, LMS may be a model of maternal depression. PMID:17118566

  5. 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

  6. Bright light therapy to promote sleep in mothers of low-birth-weight infants: a pilot study.

    PubMed

    Lee, Shih-Yu; Aycock, Dawn M; Moloney, Margaret F

    2013-10-01

    Having a low-birth-weight (LBW) infant in a neonatal intensive care unit (NICU) can intensify a mother's sleep disturbances due to both stress and the dim lighting in the ICU setting, which desynchronizes circadian rhythms. The purpose of this pilot study was to examine the effectiveness of a 3-week bright light therapy intervention on sleep and health outcomes of mothers with LBW infants in the NICU. Controlled stratified randomization was used to assign 30 mothers to a treatment or control group. Data were collected at pretreatment (second week postpartum) and after the 3-week intervention. Sleep data were assessed by wrist actigraph (total sleep time [TST], circadian activity rhythms [CARs]) and the General Sleep Disturbance scale. Other outcome variables were measured by the Lee's Fatigue scale, Edinburgh Postpartum Depression scale, and the Medical Outcomes Short Form 36, version 2. Mothers averaged 26.6 (SD = 6.3) years of age, and the majority were Black (73%). The mean gestational age for the infants was 27.7 (SD = 2.0) weeks. Small to large effect sizes were found when comparing the pre- to posttreatment differences between groups. Although none of the differences were statistically significant in this small sample, for mothers in the treatment group nocturnal TST (d = .33), CAR (d = 1.06), morning fatigue (d = .22), depressive symptoms (d = .40), physical health-related quality of life (d = .33), and mental health-related quality of life (d = .60) all improved compared to the control group. Bright light therapy is feasible for mothers with infants in an NICU. Clinically significant improvements have been evidenced; a larger-scale trial of effectiveness is needed. PMID:22593231

  7. Bright light therapy to promote sleep in mothers of low-birth-weight infants: a pilot study.

    PubMed

    Lee, Shih-Yu; Aycock, Dawn M; Moloney, Margaret F

    2013-10-01

    Having a low-birth-weight (LBW) infant in a neonatal intensive care unit (NICU) can intensify a mother's sleep disturbances due to both stress and the dim lighting in the ICU setting, which desynchronizes circadian rhythms. The purpose of this pilot study was to examine the effectiveness of a 3-week bright light therapy intervention on sleep and health outcomes of mothers with LBW infants in the NICU. Controlled stratified randomization was used to assign 30 mothers to a treatment or control group. Data were collected at pretreatment (second week postpartum) and after the 3-week intervention. Sleep data were assessed by wrist actigraph (total sleep time [TST], circadian activity rhythms [CARs]) and the General Sleep Disturbance scale. Other outcome variables were measured by the Lee's Fatigue scale, Edinburgh Postpartum Depression scale, and the Medical Outcomes Short Form 36, version 2. Mothers averaged 26.6 (SD = 6.3) years of age, and the majority were Black (73%). The mean gestational age for the infants was 27.7 (SD = 2.0) weeks. Small to large effect sizes were found when comparing the pre- to posttreatment differences between groups. Although none of the differences were statistically significant in this small sample, for mothers in the treatment group nocturnal TST (d = .33), CAR (d = 1.06), morning fatigue (d = .22), depressive symptoms (d = .40), physical health-related quality of life (d = .33), and mental health-related quality of life (d = .60) all improved compared to the control group. Bright light therapy is feasible for mothers with infants in an NICU. Clinically significant improvements have been evidenced; a larger-scale trial of effectiveness is needed.

  8. Commentary: postpartum psychosis, infanticide, and insanity--implications for forensic psychiatry.

    PubMed

    Hatters Friedman, Susan; Sorrentino, Renée

    2012-01-01

    Two dozen nations have infanticide laws that decrease the penalty for mothers who kill their children of up to one year of age. The United States does not have such a law, but mentally ill mothers may plead not guilty by reason of insanity. As in other crimes, in addition to the diagnosis of a mental disorder, other factors, such as knowledge of wrongfulness and motive, are critical to the assessment. Postpartum psychosis has been described for 2,000 years and modern science supports a genetic component to the risk. Yet, the Diagnostic and Statistical Manual of Mental Disorders does not include it as a diagnosis, leading to difficulty in testimony. In this article, we discuss postpartum psychosis, infanticide law, and research regarding mothers who kill, and we make recommendations to forensic psychiatrists.

  9. The Role of Co-Infections in Mother-to-Child Transmission of HIV§

    PubMed Central

    King, Caroline C.; Ellington, Sascha R.; Kourtis, Athena P.

    2015-01-01

    In HIV-infected women, co-infections that target the placenta, fetal membranes, genital tract, and breast tissue, as well as systemic maternal and infant infections, have been shown to increase the risk for mother-to-child transmission of HIV (MTCT). Active co-infection stimulates the release of cytokines and inflammatory agents that enhance HIV replication locally or systemically and increase tissue permeability, which weakens natural defenses to MTCT. Many maternal or infant co-infections can affect MTCT of HIV, and particular ones, such as genital tract infection with herpes simplex virus, or systemic infections such as hepatitis B, can have substantial epidemiologic impact on MTCT. Screening and treatment for co-infections that can make infants susceptible to MTCT in utero, peripartum, or postpartum can help reduce the incidence of HIV infection among infants and improve the health of mothers and infants worldwide. PMID:23305198

  10. Maternal-Infant Behavior at 2-Days and at 28-Days Post-Partum Following Maternal-Infant Contact in the Recovery Room.

    ERIC Educational Resources Information Center

    Gewirtz, Jacob L.; And Others

    Behavioral outcomes in mother-infant interaction in the first month of life after contact in the recovery room are described. In the first postpartum hour, personnel presented 62 infants to their mothers. Personnel crossed two modes (skin-to-skin versus cradling) and two durations (15 versus 60 minutes) of contact. Instances of maternal and infant…

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

    PubMed Central

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

    2015-01-01

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

  12. Diagnosis and management of post-partum disorders: a review

    PubMed Central

    Brockington, Ian

    2004-01-01

    This paper reviews the psychiatry of the puerperium, in the light of work published during the last eight years. Many distinct disorders are seen. In addition to various psychoses and a heterogeneous group of depressions, there are specific anxiety, obsessional and stress-related disorders. It is important to identify severe disorders of the mother-infant relationship, which usually respond to treatment, but have pernicious effects if untreated. The complexity of post-partum psychiatry requires the deployment of multidisciplinary specialist teams, which can handle the challenges of therapy, prevention, training, research and service development. PMID:16633463

  13. Paraganglioma Presenting as Postpartum Fever of Unknown Origin

    PubMed Central

    Narechania, Shraddha; Bath, Amrita; Ghassemi, Laleh; Lokhande, Chetan; Haddad, Abdo; Yousuf, Ali Mir; Marquard, Jessica; Gopalakrishna, K. V.

    2015-01-01

    A young healthy postpartum mother presented with intermittent high fevers and tachycardia. Appropriate testing was done to rule out infectious causes including pan cultures but no identifiable infectious source was found. A CT of the abdomen showed a retroperitoneal mass with two small pulmonary nodules and a bony metastatic lesion. She was found to have stage 4 extra-adrenal paraganglioma with metastases to the lungs and spine. She underwent resection of the mass and is currently undergoing palliative radiation to the spine for pain control. Subsequent genetic testing identified a likely pathogenic variant in SDHB, confirming a diagnosis of Hereditary Paraganglioma-Pheochromocytoma syndrome. PMID:26236513

  14. Improving Quality and Efficiency of Postpartum Hospital Education

    PubMed Central

    Buchko, Barbara L.; Gutshall, Connie H.; Jordan, Elizabeth T.

    2012-01-01

    The purpose of this study was to investigate the implementation of an evidence-based, streamlined, education process (comprehensive education booklet, individualized education plan, and integration of education into the clinical pathway) and nurse education to improve the quality and efficiency of postpartum education during hospitalization. A one-group pretest–posttest design was used to measure the quality of discharge teaching for new mothers and efficiency of the education process for registered nurses before and after implementation of an intervention. Results indicated that a comprehensive educational booklet and enhanced documentation can improve efficiency in the patient education process for nurses. PMID:23997552

  15. The Roles of Resilience and Childhood Trauma History: Main and Moderating Effects on Postpartum Maternal Mental Health and Functioning

    PubMed Central

    Sexton, Minden B.; Hamilton, Lindsay; McGinnis, Ellen W.; Rosenblum, Katherine L.; Muzik, Maria

    2015-01-01

    Objective Recently postpartum women participated to investigate main and moderating influences of resilience and childhood history of maltreatment on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), parental sense of mastery, and family functioning. Method At 4-months postpartum, 214 mothers (145 with a history of childhood abuse or neglect) completed interviews assessing mental health symptoms, positive functioning, resilience and trauma history. Multiple and moderated linear regression with the Connor- Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaires (CTQ) were conducted to assess for main and moderating effects. Results Resilience, childhood trauma severity, and their interaction predicted postpartum PTSD and MDD. In mothers without childhood maltreatment, PTSD was absent irrespective of CD-RISC scores. However, for those with the highest quartile of CTQ severity, 8% of those with highest resilience in contrast with 58% of those with lowest CD-RISC scores met PTSD diagnostic criteria. Similar, in those with highest resilience, no mothers met criteria for postpartum MDD, irrespective of childhood trauma, while for those with lowest quartile of resilience, 25% with lowest CTQ severity and 68% of those with highest CTQ severity were depressed. The CD-RISC, but not the CTQ, was predictive of postpartum sense of competence. The CD-RISC and the CTQ were predictive of postpartum family functioning, though no moderating influence of resilience on childhood trauma was found. Conclusions Resilience is associated with reduced psychopathology and improved wellbeing in all mothers. It further serves as a buffer against psychiatric symptoms following childhood trauma. Such findings may assist in identification of those at greatest risk of adverse functioning postpartum, utilization of resilience-enhancing intervention may benefit perinatal wellness, and reduce intergenerational transmission of risk. PMID:25560192

  16. The Heritability of Postpartum Depression

    PubMed Central

    Corwin, Elizabeth J.; Kohen, Ruth; Jarrett, Monica; Stafford, Brian

    2012-01-01

    Postpartum depression (PPD) is a serious mood disorder that may carry life-long consequences for a woman and her family. Multiple risk factors for PPD have been identified, including psychosocial, situational, and biological stimuli, several of which are experienced by most, if not all, postpartum women. Given the commonality of these risk factors, it is unclear why fewer than 20% of postpartum women actually develop PPD. In this review, we suggest that different susceptibility to PPD among postpartum women may be explained by the presence or absence of genetic variants that confer increased risk. We review three categories of genes known to code for proteins associated with depression in the general population or proteins known to be affected by childbirth for their possible association with PPD, including genes related to central nervous system monoamine availability, proinflammatory cytokines, and brain neuropeptides. Only two studies are available in the literature to date specifically looking at polymorphisms in postpartum women as related to PPD; both are concerned with monoamine availability. These are discussed in further depth. Conclusions regarding the contribution of genetic polymorphisms to the development of PPD are mixed. Ultimately, the complexity of the disorder and the interrelationships among different genes thought to contribute to depression suggest that much more research is required to understand the heritability of PPD. The complexity of the disorder also suggests that epigenetic influences must be considered as well when discussing susceptibility. PMID:20453020

  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. Changes in the lipids of human milk from 2 to 16 weeks postpartum.

    PubMed

    Clark, R M; Ferris, A M; Fey, M; Brown, P B; Hundrieser, K E; Jensen, R G

    1982-01-01

    Changes in total lipid, fatty acids, total cholesterol, free cholesterol, and lipid phosphorus in mature milk with time were investigated. Milk samples were collected from 10 mothers at 2, 6, 12, and 16 weeks postpartum. During 1 day, each mother donated two complete breast expressions. Expressions were taken using an electric breast pump 1 h after the previous a.m. and p.m. nursing. For each mother, the a.m. and p.m. samples were pooled for analysis. It was observed that the amount of total lipid increased significantly (p less than 0.05) from 3.9 g/100 ml at 2 weeks to 5.2 g/100 at 16 weeks postpartum. The total fatty acid composition remained uniform during the investigation. Average total cholesterol and free cholesterol in the milk were 10.3 mg/100 ml and 8.3 mg/100 ml, respectively. These concentrations did not change significantly with time postpartum. Average lipid phosphorus was 3.9 mg/100 ml and also remained constant throughout. We conclude that the fatty acid pattern, lipid phosphorus, total cholesterol, and free cholesterol of mature milk to 16 weeks postpartum remains relatively constant while total lipid concentration increases.

  20. 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. PMID:26266033

  1. An Intervention To Reduce Postpartum Depressive Symptoms: A Randomized Controlled Trial

    PubMed Central

    Howell, Elizabeth A; Bodnar-Deren, Susan; Balbierz, Amy; Loudon, Holly; Mora, Pablo A.; Zlotnick, Caron; Wang, Jason; Leventhal, Howard

    2013-01-01

    Depressive symptoms and depression are a common complication of childbirth and a growing body of literature suggests that there are modifiable factors associated with their occurrence. We developed a behavioral educational intervention targeting these factors and successfully reduced postpartum depressive symptoms in a randomized trial among low-income black and Latina women. We now report results of 540 predominantly white, high income mothers in a second randomized trial. Mothers in the intervention arm received a 2-step intervention that prepared and educated mothers about modifiable factors associated with postpartum depressive symptoms (e.g., physical symptoms, low self-efficacy), bolstered social support, and enhanced management skills. The control arm received enhanced usual care. Participants were surveyed prior to randomization, 3-weeks, 3-months, and 6-months postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS of 10 or greater). Prevalence of depressive symptoms postpartum were unexpectedly low precluding detection of difference in rates of depressive symptoms among intervention vs. enhanced usual care post hospitalization: 3-weeks (6.0 % vs. 5.6%, p=.83), 3-months (5.1% vs. 6.5%, p=.53) and 6-months (3.6% vs. 4.6%, p=.53). PMID:24019052

  2. The Depressed Mother as a Source of Stimulation for Her Infant.

    ERIC Educational Resources Information Center

    Livingood, Amy Bookman; And Others

    1983-01-01

    Compared 25 postpartum depressed mothers and controls with respect to the stimulation they provided for their infants during feeding. Results indicated no differences in levels of stimulation. However, depressed mothers provided significantly lower levels of unconditional positive regard. No relationship was demonstrated between marital adjustment…

  3. Doulas' Perceptions on Single Mothers' Risk and Protective Factors, and Aspirations Relative to Child-Birth

    ERIC Educational Resources Information Center

    Arat, Gizem

    2013-01-01

    This study the author aims to explore the perceptions of doulas on single mothers' risk and protective factors, and aspirations relative to child-birth in the postpartum care. The current study was conducted by semi-structured questions, case file reviews, field notes, and twelve home visits via utilizing Grounded Theory. These mothers receive…

  4. The Relation of Family and Partner Support to the Adjustment of Adolescent Mothers.

    ERIC Educational Resources Information Center

    Unger, Donald G.; Wandersman, Lois Pall

    1988-01-01

    Examines the influence of teenage mothers' perceptions of family and partner social support on the mothers' postpartum adjustment. Both partner and family support are related to satisfaction with life, but each type of support is associated in a different way with parenting and concerns about daily living. (RJC)

  5. Sleep disturbances and depressive symptoms in healthy postpartum women: a pilot study.

    PubMed

    Tsai, Shao-Yu; Thomas, Karen A

    2012-06-01

    In this pilot study we examined the relationship between objective and subjective sleep disturbances and depressive symptoms in 22 healthy primiparous postpartum women within 3 months after delivery. We found that none of the women in our study had clinically significant depression scores on the Edinburgh Postnatal Depression Scale; nonetheless, a variable duration of night-time sleep from night to night during the 7-day monitoring period and reported awakening too early were significantly correlated with increased depressive symptoms. Results suggest that first-time mothers who complain of irregular night-time sleep duration and waking up too early should be screened and evaluated for potential postpartum depressive symptoms. PMID:22431157

  6. ANXIETY AND ATTACHMENT TO THE MOTHER IN PRESCHOOLERS RECEIVING PSYCHIATRIC CARE: THE FATHER-CHILD ACTIVATION RELATIONSHIP AS A PROTECTIVE FACTOR.

    PubMed

    Gaumon, Sébastien; Paquette, Daniel; Cyr, Chantal; Émond-Nakamura, Mutsuko; St-André, Martin

    2016-07-01

    This 49-family study is the first to explore the father-child relationship in a clinical population of preschoolers (at a tertiary care child psychiatry clinic) and to examine its relation to child anxiety and attachment to the mother. A moderation model of the father-child activation relationship on the relation between attachment to the mother and child anxiety was tested and discussed. Analyses confirmed the expected independence between mother-child attachment and father-child activation as well as the association between mother-child attachment and anxiety. The highest levels of anxiety were found in insecure children, and more specifically, in insecure-ambivalent children and insecure disorganized-controlling children of the caregiving subtype. Hypotheses regarding the relation between anxiety and activation were only partially confirmed. Finally, the activation relationship with the father was shown to have a moderating effect on the relation between attachment to the mother and child anxiety; activation by the father may be considered either a protective or a risk factor. Results for this clinical population of young children are discussed in the light of attachment theory and activation relationship theory. The study's findings have the potential to contribute to the development of preventative, diagnostic, and intervention programs that take both parental figures into account. PMID:27333431

  7. ANXIETY AND ATTACHMENT TO THE MOTHER IN PRESCHOOLERS RECEIVING PSYCHIATRIC CARE: THE FATHER-CHILD ACTIVATION RELATIONSHIP AS A PROTECTIVE FACTOR.

    PubMed

    Gaumon, Sébastien; Paquette, Daniel; Cyr, Chantal; Émond-Nakamura, Mutsuko; St-André, Martin

    2016-07-01

    This 49-family study is the first to explore the father-child relationship in a clinical population of preschoolers (at a tertiary care child psychiatry clinic) and to examine its relation to child anxiety and attachment to the mother. A moderation model of the father-child activation relationship on the relation between attachment to the mother and child anxiety was tested and discussed. Analyses confirmed the expected independence between mother-child attachment and father-child activation as well as the association between mother-child attachment and anxiety. The highest levels of anxiety were found in insecure children, and more specifically, in insecure-ambivalent children and insecure disorganized-controlling children of the caregiving subtype. Hypotheses regarding the relation between anxiety and activation were only partially confirmed. Finally, the activation relationship with the father was shown to have a moderating effect on the relation between attachment to the mother and child anxiety; activation by the father may be considered either a protective or a risk factor. Results for this clinical population of young children are discussed in the light of attachment theory and activation relationship theory. The study's findings have the potential to contribute to the development of preventative, diagnostic, and intervention programs that take both parental figures into account.

  8. Postpartum Post-Traumatic Stress Disorder

    MedlinePlus

    ... 944.4773 Learn More Pregnancy & Postpartum Mental Health Social Support Online Training Depression During Pregnancy & Postpartum Anxiety During ... this illness is caused by a real or perceived trauma during delivery or postpartum. ... and/or lack of support and reassurance during the delivery Women who have ...

  9. Postpartum Coronary Vasospasm with Literature Review

    PubMed Central

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

    2014-01-01

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

  10. The Identification of Postpartum Depression

    PubMed Central

    Sit, Dorothy K.; Wisner, Katherine L.

    2009-01-01

    Postpartum depression (PPD) is the most common medical complication of childbearing. Universal screening maximizes the likelihood of prompt identification of PPD. Obstetrician-gynecologists routinely evaluate postpartum women for a general health examination and review of family planning options at approximately 6 weeks after birth; therefore, they are well-positioned to identify PPD. In this paper, we review the diagnostic criteria for postpartum depressive disorders and clinical risk factors predictive of PPD. We examine depression screening tools, appropriate cut-points associated with positive screens, the optimal timing for screening and the acceptability of depression screening in obstetrical settings. Lastly, we explore how to manage patients who screen positive for depression and treatment options for women with PPD. PMID:19661761

  11. Mother and Toddler Activity in the Zone of Proximal Development for Pretend Play as a Predictor of Higher Child IQ

    ERIC Educational Resources Information Center

    Morrissey, Anne-Marie; Brown, P. Margaret

    2009-01-01

    This study investigated the pretend play of mother-toddler dyads in relation to later child IQ. Twenty-one toddlers were videotaped in monthly play sessions with their mothers, from age 8 to 17 months, and later assessed at 5 years of age on the Stanford-Binet IV. Children's and mothers' pretend play levels and frequencies were measured using…

  12. Origins of Mothers' and Fathers' Beliefs about Infant Crying

    ERIC Educational Resources Information Center

    Leerkes, Esther M.; Parade, Stephanie H.; Burney, Regan V.

    2010-01-01

    Origins of mothers' and fathers' beliefs about infant crying were examined in 87 couples. Parents completed measures of emotion minimization in the family of origin, depressive symptoms, empathy, trait anger, and coping styles prenatally. At 6 months postpartum, parents completed a self-report measure of their beliefs about infant crying. Mothers…

  13. 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

  14. 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

  15. Association of serum prolactin and oxytocin with milk production in mothers of preterm and term infants.

    PubMed

    Hill, Pamela D; Aldag, Jean C; Demirtas, Hakan; Naeem, Villian; Parker, Noah P; Zinaman, Michael J; Chatterton, Robert T

    2009-04-01

    The present study was designed to compare milk production and hormone responses (prolactin [PRL], oxytocin [OT]) and to determine associations of hormone levels with milk production in mothers of preterm (PT) and term (TM) infants during the first 6 weeks postpartum. Mothers of PT infants (n = 95) were all pump dependent; mothers of TM infants (n = 98) were all feeding their infant at breast. Mothers of nonnursing PT infants produced less milk over time compared to mothers of TM infants. A higher proportion of PT mothers had lower basal PRL levels compared with TM mothers. PRL and frequency of breast stimulation combined positively influenced milk production in PT mothers. OT levels were higher in PT versus TM mothers, but OT was not related to milk production. Further study is warranted regarding interventions to enhance milk production, particularly in pump-dependent mothers of PT infants.

  16. Dietary Behaviour Pattern and Physical Activity in Overweight and Obese Egyptian Mothers: Relationships with Their Children’s Body Mass Index

    PubMed Central

    Hassan, Nayera E.; Wahba, Saneya; El-Alameey, Inas R.; El-Masry, Sahar A.; AbuShady, Mones M.; Hameed, Enas R. Abdel; Ibrahim, Tarek S.; Boseila, Samia

    2016-01-01

    BACKGROUND: Obesity and related morbidity increase in Egyptian women and their children. A better understanding of dietary and activity patterns is needed to reduce obesity prevalence. AIM: The present study aimed to assess dietary patterns and physical activity in Egyptian overweight and obese mothers and to explore its relationships with their children’s body mass index (BMI). SUBJECTS AND METHODS: This descriptive case-control study was conducted at the National Research Center. The study included a sample of 64 overweight and obese mothers and 75 children, compared with apparently healthy non-obese mothers and their children of matched age and social class. Tested questionnaires were used to collect information of the studied subjects. RESULTS: A statistically significantly higher incidence of unemployment, large family size was observed in overweight & obese women compared to controls (P < 0.05). Those women who consumed vegetables more than 3 times a week were less likely to be overweight or obese (P < 0.05). No significant association were detected between mothers’ physical activity, dietary behaviour variables and children’s BMI except for consuming beverages with added sugar (95%CI = 0.074-0.985, P<0.05). CONCLUSION: Improper dietary patterns, nonworking mothers and big family size are associated with obesity among Egyptian women. Emphasis should be given to increasing physical activity and encourage healthier diets among Egyptian mothers and their children. PMID:27703555

  17. The effect of preterm birth on infant negative affect and maternal postpartum depressive symptoms: A preliminary examination in an underrepresented minority sample

    PubMed Central

    Barroso, Nicole; Hartley, Chelsey M.; Bagner, Daniel M.; Pettit, Jeremy W.

    2015-01-01

    Objective To examine the effect of preterm birth on maternal postpartum depressive symptoms and infant negative affect in an underrepresented minority sample. Method Participants were 102 mothers and their 3- to 10-month-old infants. Mothers completed the Edinburgh Postnatal Depression Scale and the Infant Behavior Questionnaire-Revised. Results Relative to normative samples, the current underrepresented minority sample of mostly Hispanics and Blacks displayed high rates of preterm birth (30%) and maternal postpartum depressive symptoms (17%). Preterm birth had a significant direct effect on postpartum depressive symptoms and infant negative affect. Additionally, there was an indirect effect of postpartum depressive symptoms on the relation between preterm birth and infant negative affect. Specifically, lower birth weight and gestational age predicted higher levels of depressive symptoms in the mother, and higher levels of depressive symptoms in the mother, in turn, predicted higher levels of infant negative affect. Conclusion Findings emphasize the importance of screening for postpartum depressive symptoms and infant negative affect among mothers and their preterm infants, especially among families from underrepresented minority backgrounds. PMID:25879520

  18. Transfer of polychlorinated biphenyls to infants from their mothers

    SciTech Connect

    Kodama, H.; Ota, H.

    1980-03-01

    Transfer of polychlorinated biphenyls (PCBs) which are environmental pollutants, to infants from their mothers was investigated from 1974 to 1977. The following samples were collected and analyzed for PCBs using a gas chromatographic determination: (a) maternal blood at 8 and 4 months prepartum, delivery, and 1, 3, 5, and 7 months postpartum; (b) cord blood at delivery; (c) human milk at 1, 3, 5, and 7 months postpartum; and (d) newborn infant blood at 3 months, 1, 2, and 3 yr after birth. The PCB levels in maternal blood gradually elevated with the progress of gestation and then decreased, reaching a general population level at 5 months postpartum. The PCB level in maternal blood at delivery was significantly higher than that in the cord blood. The mean values of PCB levels in human milk at 3 months postpartum-both the whole and fat basis-showed some differences in each sampling time period, however, those values were generally obtained within the normal range of ordinary Japanese lactating women. When the cord blood at delivery was considered as newborn infant blood at birth, the PCB levels in the blood of breast-fed infants rose markedly with ingestion of human milk, exceeding the level in the blood of their mothers at 3 months postpartum, and tended to increase until 1 yr of age, and then gradually decreased at 2 and 3 yr of age. However, the PCB levels in the blood of bottle-fed infants remained at a low concentration level during the same period. In this survey, the concentration of PCBs in the blood of two newborn infants who received their mothers' milk for a longer period of time than the other infants, continued to increase exponentially, finally reaching about a four-fold value of their mothers. These results suggest that the quantity of PCBs transferred to infants from their mothers via lactation was much greater than that transferred placentally.

  19. Suicidal Ideation in Depressed Postpartum Women: Associations with Childhood Trauma, Sleep Disturbance and Anxiety

    PubMed Central

    Sit, Dorothy; Luther, James; Buysse, Daniel; Dills, John L.; Eng, Heather; Okun, Michele; Wisniewski, Stephen; Wisner, Katherine L

    2015-01-01

    Background Suicide is one of the leading causes of death in postpartum women. Identifying modifiable factors related to suicide risk in mothers after delivery is a public health priority. Our study aim was to examine associations between suicidal ideation (SI) and plausible risk factors (experience of abuse in childhood or as an adult, sleep disturbance, and anxiety symptoms) in depressed postpartum women. Methods This secondary analysis included 628 depressed mothers at 4–6 weeks postpartum. Diagnosis was confirmed with the Structured Clinical Interview for DSM-IV. We examined SI from responses to the Edinburgh Postnatal Depression Scale-EPDS item 10; depression levels on the Structured Interview Guide for the Hamilton Depression Rating Scale, Atypical Depression Symptoms (SIGH-ADS); plus sleep disturbance and anxiety levels with subscales from the EPDS and SIGH-ADS items on sleep and anxiety symptoms.. Results Of the depressed mothers, 496 (79%) ‘never’ had thoughts of self-harm; 98 (15.6%) ‘hardly ever’; and 34 (5.4%) ‘sometimes’ or ‘quite often’. Logistic regression models indicated that having frequent thoughts of self-harm was related to childhood physical abuse (odds ratio-OR=1.68, 95% CI=1.00, 2.81); in mothers without childhood physical abuse, having frequent self-harm thoughts was related to sleep disturbance (OR=1.15, 95%CI=1.02, 1.29) and anxiety symptoms (OR=1.11, 95%CI=1.01, 1.23). Discussion Because women with postpartum depression can present with frequent thoughts of self-harm and a high level of clinical complexity, conducting a detailed safety assessment, that includes evaluation of childhood abuse history and current symptoms of sleep disturbance and anxiety, is a key component in the management of depressed mothers. PMID:26001587

  20. 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…

  1. Parental Protectiveness and Unprotected Sexual Activity Among Latino Adolescent Mothers and Fathers

    PubMed Central

    Lesser, Janna; Koniak-Griffin, Deborah; Huang, Rong; Takayanagi, Sumiko; Cumberland, William G.

    2012-01-01

    Latino pregnant and parenting adolescents living in inner cities are one of the populations at risk for acquiring HIV. Although teen parenthood has been predominantly looked at with a focus on potential adverse physical, emotional, and socioeconomic outcomes for the mother and child; a growing body of literature has documented the strengths and resiliency of young parents. Respeto/Proteger: Respecting and Protecting Our Relationships is a culturally rooted couple-focused and asset-based HIV prevention program developed for young Latino parents. In this program, parental protectiveness (defined as the parent-child emotional attachment that positively influences parental behavior) is viewed as an intrinsic and developing critical factor that supports resiliency and motivates behavioral change. The primary purpose of this article is to describe the longitudinal randomized study evaluating the effect of this intervention on unprotected vaginal sex 6 months post intervention and to determine whether parental protectiveness had a moderating effect on the intervention. The unique features of our database allow for examination of both individual and couple outcomes. PMID:19824837

  2. Efficacy of rectal misoprostol for prevention of postpartum hemorrhage.

    PubMed

    Mirteimouri, Masoumeh; Tara, Fatemeh; Teimouri, Batool; Sakhavar, Nahid; Vaezi, Afsaneh

    2013-01-01

    Postpartum hemorrhage is an important cause of maternal morbidity and mortality after delivery. Active management of postpartum hemorrhage by an uterotonic drug decreases the rate of postpartum hemorrhage. The aim of this study is to evaluate the efficacy of rectal misoprostol for prevention of postpartum hemorrhage. This double blind randomized clinical trial was performed on full term pregnant women candidate for vaginal delivery, referred to Zahedan Imam Ali Hospital during 2008-2009. They were randomly divided into two groups of rectal misoprostol and oxytocin. The women in misoprostol group received 400 μg rectal misoprostol after delivery and the women in oxytocin group received 3 IU oxytocin in 1 L ringer serum, intravenously. Rate of bleeding, need to any surgery interventions, rate of transfusion and changes in hemoglobin and hematocrite were compared between two groups. A total of 400 patients (200 cases in misoprostol group and 200 in oxytocin group) entered to the study. Rate of bleeding > 500 cc was significantly higher in oxytocin group than misoprostol group (33% vs. 19%) (p = 0.005). Also, need to excessive oxytocin for management of postpartum hemorrhage was significantly lower in misoprostol group than oxytocin group (18% vs. 30%) (p = 0.003). Decrease in hematocrite was significantly more observed in oxytocin group than misoprostol group (mean decrease of hematocrite was 1.3 ± 1.6 in misoprostol group and 1.6 ± 2.2 in oxytocin group). Two groups were similar in terms of side-effects. Rectal misoprostol as an uterotonic drug can decrease postpartum hemorrhage and also can prevent from decrease of hemoglobin as compared to oxytocin. PMID:24250623

  3. Brain dynamics in young infants' recognition of faces: EEG oscillatory activity in response to mother and stranger.

    PubMed

    Mash, Clay; Bornstein, Marc H; Arterberry, Martha E

    2013-05-01

    The brain electrical responses of 3-month-old infants were compared between images of familiar and unfamiliar faces. Infants were shown images of their mothers and of appearance-matched female strangers for 500 ms per trial while their electroencephalography was recorded. Electroencephalographic signals were segmented from stimulus onset through 1200 ms, and segments were analyzed in the time-frequency domain with a continuous wavelet transform. Differentiated responses were apparent in three time windows: 370-480, 610-690, and 830-960 ms. Across response windows, event-related synchronization or desynchronization was observed in beta or gamma frequency bands at the left frontal, midline central, bilateral temporal, and right parietal sites. In conclusion, these findings provide the first evidence of organized brain activity underlying familiar face recognition in very young infants and are discussed in relation to comparable patterns that have been observed in adults.

  4. Bio-psycho-socio-demographic and Obstetric Predictors of Postpartum Depression in Pregnancy: A prospective Cohort Study

    PubMed Central

    Abdollahi, Fatemeh; Rohani, Samad; Sazlina, Ghazali Shariff; Zarghami, Mehran; Azhar, Md Zain; Lye, Munn Sann; Rezaiee Abhari, Farideh; Majidi, Zohreh; Mozafari, Soghra

    2014-01-01

    Objective: There are various attempts to confirm variables that could predict postpartum depression in advance. This study determined antenatal risk factors for postpartum depression in women at risk of developing this disorder. Methods: A prospective cohort study was conducted with 2279 eligible women who attended at Mazandaran province’ primary health centers from 32-42 weeks of pregnancy to eighth postpartum weeks. The women were screened for symptoms of depression using the Iranian version of Edinburgh Postnatal Depression Scale. An Edinburgh Postnatal Depression Scale score of > 12 indicated possible postpartum depression. Univariate and multiple logistic regression models were used for data analysis. Results: A total of 2083women during 32-42 weeks of gestation participated in this study and were followed up to 8-week postpartum. Four hundred and three (19.4%) mothers yielded scores above the threshold of 12. Depression and general health state in pregnancy based on Edinburgh Postnatal Depression Scale (OR = 1.35, CI = 1.3-1.4) and General Health Questionnaire-28 (OR = 1.03, CI = 1.01-1.04), respectively were significant independent antenatal risk factors of depression symptoms at 8-week postpartum. Mothers who lived in nuclear families (OR = 1.38, CI = 1.04-1.84), whose husbands had lower educational status (OR = 0.95, CI = 0.91-0.99), and with delayed prenatal care (OR = 1.01, CI = 1.001-1.03) were more susceptible to postpartum depression. Conclusion: A comprehensive antenatal assessment focused on psychiatric problems, environmental and obstetric factors would benefit pregnant women in the prevention of postpartum depression. PMID:25053953

  5. The Effect of Slow-Stroke Back Massage on the Anxiety Levels of Iranian Women on the First Postpartum Day

    PubMed Central

    Jahdi, Fereshteh; Mehrabadi, Maryam; Mortazavi, Forough; Haghani, Hamid

    2016-01-01

    Background Anxiety disorder is common during the postpartum period. Back massage relaxation techniques are one of the most important nonpharmacological interventions to prevent and control postpartum-related anxiety. Objectives To determine the effectiveness of slow-stroke back massage on the anxiety levels of primiparous mothers in the first days after delivery. Materials and Methods This single-blind controlled clinical trial consisted of 100 primiparous mothers with normal deliveries. The mothers were randomly allocated to interventional (n = 50) or control (n = 50) groups using binary blocks. Both groups were followed up just before, immediately after, and the morning after the intervention. Data were collected using a demographic questionnaire and Spielberger’s state anxiety inventory (STAI) questionnaire. Results The mean age of the mothers was 22 years. There were no significant between-group differences in age (P = 0.333), education (P = 0.427), and medication during labor and the postpartum period (P = 0.412). There was no statistically significant difference between the mean anxiety scores of the experimental (6.66 ± 35.48) and control groups (9.05 ± 37.42) before the intervention (P = 0.268). Immediately after the massage and the next morning, there was a significant between-group difference in the anxiety scores (P < 0.001). Conclusions The findings demonstrate that slow-stroke back massage is a simple, inexpensive, noninvasive, and effective method to reduce the anxiety levels of primiparous women during the first postpartum day. PMID:27781122

  6. The relationship between breastfeeding and postpartum weight change--a systematic review and critical evaluation.

    PubMed

    Neville, C E; McKinley, M C; Holmes, V A; Spence, D; Woodside, J V

    2014-04-01

    Pregnancy and the postpartum period is a time of increased vulnerability for retention of excess body fat in women. Breastfeeding (BF) has been shown to have many health benefits for both mother and baby; however, its role in postpartum weight management is unclear. Our aim was to systematically review and critically appraise the literature published to date in relation to the impact of BF on postpartum weight change, weight retention and maternal body composition. Electronic literature searches were carried out using MEDLINE, EMBASE, PubMed, Web of Science, BIOSIS, CINAHL and British Nursing Index. The search covered publications up to 12 June 2012 and included observational studies (prospective and retrospective) carried out in BF mothers (either exclusively or as a subgroup), who were ≤ 2 years postpartum and with a body mass index (BMI) >18.5 kg m(-2), with an outcome measure of change in weight (including weight retention) and/or body composition. Thirty-seven prospective studies and eight retrospective studies were identified that met the selection criteria; studies were stratified according to study design and outcome measure. Overall, studies were heterogeneous, particularly in relation to sample size, measurement time points and in the classification of BF and postpartum weight change. The majority of studies reported little or no association between BF and weight change (n=27, 63%) or change in body composition (n=16, 89%), although this seemed to depend on the measurement time points and BF intensity. However, of the five studies that were considered to be of high methodological quality, four studies demonstrated a positive association between BF and weight change. This systematic review highlights the difficulties of examining the association between BF and weight management in observational research. Although the available evidence challenges the widely held belief that BF promotes weight loss, more robust studies are needed to reliably assess the

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

    PubMed

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

    2015-01-01

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

  8. Does spontaneous genital tract trauma impact postpartum sexual function?

    PubMed Central

    Rogers, Rebecca G.; Borders, Noelle; Leeman, Lawrence M.; Albers, Leah L.

    2009-01-01

    Changes in sexual function are common in postpartum women. In this comparative, descriptive study, a prospective cohort of midwifery patients consented to documentation of genital trauma at birth and assessment of sexual function three months postpartum. The impact of spontaneous genital trauma on postpartum sexual function was the focus of the study. Trauma was categorized into minor trauma (no trauma or 1st degree perineal or other trauma that was not sutured) or major trauma (2nd, 3rd, or 4th degree lacerations or any trauma that required suturing). Women who underwent episiotomy or operative delivery were excluded. Fifty eight percent (326/565) of enrolled women gave sexual function data; of those, 276 (85%) reported sexual activity since delivery. Seventy percent (193) of women sustained minor trauma and 30% (83) sustained major trauma. Sexually active women completed the Intimate Relationship Scale (IRS), a 12 item questionnaire validated as a measure of postpartum sexual function. Both trauma groups were equally likely to be sexually active. Total IRS scores did not differ between trauma groups nor did complaints of dyspareunia. However, for two items, significant differences were demonstrated: women with major trauma reported less desire to be held, touched, and stroked by their partner than women with minor trauma, and women who required perineal suturing reported lower IRS scores than women who did not require suturing. PMID:19249654

  9. Electrolyte profile of Malaysian mothers' milk.

    PubMed

    Shaikh Alaudeen; Nor Muslim; Kamarul Faridah; Ali Azman; Hamid Arshat

    1988-12-01

    The influence of socioeconomic status (ethnicity, income, and parity) on electrolyte composition (sodium and potassium) in human milk is little known. The authors have thus quantitatively analyzed approximately 700 samples of milk (1-90 days postpartum) obtained from healthy Malaysian mothers (Malay, Chinese, and Indians) of full-term infants. Results show that the mean concentration (mmol/1) of sodium is highest 48.2 +/- 1.7; mean +/- SEM) in the Malaysian mothers' colostrum and this value decreased by 30% in their transitional milk and remained constant throughout subsequent days of lactation. Ethnically, it is found that the level of sodium in colostrum of Malay and Chinese mothers was similar but the Indian mothers' colostrum showed apparently higher value (52.7 +/- 3.4 mmpl/1) that is statistically insignificant. The transitional milk of all 3 ethnic groups studied exhibited similar levels of sodium. On subsequent days of lactation (mature milk) the Malay mothers exhibited the lowest concentration (25.9 +/- 2.6 mmol/1) of sodium that is significantly (p .05) different from that of Chinese and Indian mothers. Income and parity do not significantly affect the sodium level in Malaysian mothers' milk during all stages of lactation studied. The level of potassium, however, did not change significantly with days of lactation. Like sodium, potassium too was not influenced by income and parity. PMID:12342168

  10. Electrolyte profile of Malaysian mothers' milk.

    PubMed

    Alaudeen, S; Muslim, N; Faridah, K; Azman, A; Arshat, H

    1988-12-01

    The influence of socioeconomic status (ethnicity, income and parity) on electrolyte composition (sodium and potassium) in human milk is little known. We have thus quantitatively analyzed approximately 700 samples of milk (1-90 days postpartum) obtained from healthy Malaysian mothers' (Malay, Chinese and Indians) of full term infants. Results show that the mean concentration (mmol/l) of sodium is highest (48.2+or-1.7, Mean+or-SEM) in the Malaysian mothers' colostrum and this value decreased by 30% in their transitional milk and remained constant throughout subsequent days of lactation (mature milk). Ethnically, it is found that the level of sodium in colostrum of Malay and Chinese mothers were similar while the Indian mothers' colostrum showed apparently higher value (52.7+or-3.4 mmol/l) that is statistically insignificant. The transitional milk of all 3 ethnic groups studied exhibited similar levels of sodium. On subsequent days of lactation (mature milk) the Malay mothers exhibited lowest concentration (25.9+or-2.6 mmol/l) of sodium that is significantly (P0.05) different from that of Chinese and Indian mothers. Income and parity do not significantly affect the sodium level in Malaysian mothers' milk during all stages of lactation studied. The level of potassium, however did not change significantly with days of lactation. Like sodium, potassium too was not influenced by income and parity. (Author's). PMID:12342169

  11. Electrolyte profile of Malaysian mothers' milk.

    PubMed

    Alaudeen, S; Muslim, N; Faridah, K; Azman, A; Arshat, H

    1988-12-01

    The influence of socioeconomic status (ethnicity, income and parity) on electrolyte composition (sodium and potassium) in human milk is little known. We have thus quantitatively analyzed approximately 700 samples of milk (1-90 days postpartum) obtained from healthy Malaysian mothers' (Malay, Chinese and Indians) of full term infants. Results show that the mean concentration (mmol/l) of sodium is highest (48.2+or-1.7, Mean+or-SEM) in the Malaysian mothers' colostrum and this value decreased by 30% in their transitional milk and remained constant throughout subsequent days of lactation (mature milk). Ethnically, it is found that the level of sodium in colostrum of Malay and Chinese mothers were similar while the Indian mothers' colostrum showed apparently higher value (52.7+or-3.4 mmol/l) that is statistically insignificant. The transitional milk of all 3 ethnic groups studied exhibited similar levels of sodium. On subsequent days of lactation (mature milk) the Malay mothers exhibited lowest concentration (25.9+or-2.6 mmol/l) of sodium that is significantly (P0.05) different from that of Chinese and Indian mothers. Income and parity do not significantly affect the sodium level in Malaysian mothers' milk during all stages of lactation studied. The level of potassium, however did not change significantly with days of lactation. Like sodium, potassium too was not influenced by income and parity. (Author's).

  12. Education for adolescent mothers in a hospital setting.

    PubMed Central

    Badger, E; Burns, D; Rhoads, B

    1976-01-01

    This paper describes an innovative service program designed to help adolescent mothers become more effective parents. Mother-infant pairs are recruited in the postpartum unit of Cincinnati (Ohio) General Hospital, and weekly classes are held in a pediatric clinic waiting room until infants are approximately six months of age. Medical consultation and/or treatment and education for parenthood in the areas of health, nutrition, and infant stimulation are the foci of the program. The interest and participation of the mothers, the opinion of professionals, tests of maternal knowledge, and measurements of maternal-infant interaction attest to the value and success of this program. PMID:1275122

  13. Polar bear mother-offspring interactions in maternity dens in captivity.

    PubMed

    van Gessel, Chad

    2015-01-01

    Two female polar bears at Dierenrijk Zoo in the Netherlands were monitored at their maternity den one day before the birth of their cubs and three days postpartum. Each bear was monitored for 96 hr to document behaviour and vocalisations. The goal was to obtain insight into the differences between the mother that lost her litter and the other that successfully reared her cubs. Six groups of cub vocalisations were identified: Comfort, Discomfort, Distress, Nursing Attempts, Nursing, and No Vocalisation. Maternal vocalisations were split into three groups: Calm, Grooming, and Stress. Maternal behaviours were also split into three groups: Active, Rest, and Stress. The unsuccessful mother produced more stress vocalisations before and during the birth of her cub, whereas the successful mother appeared less stressed. Vocalisations indicate that the cub that died tried to nurse but was unsuccessful. The unsuccessful mother showed less stress as her cub got weaker and vocalised less. From this I suggest that maternal stress was a factor in cub mortality. PMID:26252623

  14. Polar bear mother-offspring interactions in maternity dens in captivity.

    PubMed

    van Gessel, Chad

    2015-01-01

    Two female polar bears at Dierenrijk Zoo in the Netherlands were monitored at their maternity den one day before the birth of their cubs and three days postpartum. Each bear was monitored for 96 hr to document behaviour and vocalisations. The goal was to obtain insight into the differences between the mother that lost her litter and the other that successfully reared her cubs. Six groups of cub vocalisations were identified: Comfort, Discomfort, Distress, Nursing Attempts, Nursing, and No Vocalisation. Maternal vocalisations were split into three groups: Calm, Grooming, and Stress. Maternal behaviours were also split into three groups: Active, Rest, and Stress. The unsuccessful mother produced more stress vocalisations before and during the birth of her cub, whereas the successful mother appeared less stressed. Vocalisations indicate that the cub that died tried to nurse but was unsuccessful. The unsuccessful mother showed less stress as her cub got weaker and vocalised less. From this I suggest that maternal stress was a factor in cub mortality.

  15. Recognition of Mother's voice evokes metabolic activation in the medial prefrontal cortex and lateral thalamus of Octodon degus pups.

    PubMed

    Braun, K; Poeggel, G

    2001-01-01

    In a variety of animal species, including primates, vocal communication is an essential part to establish and maintain social interactions, including the emotional bond between the newborn, its parents and siblings. The aim of this study in pups of the trumpet-tailed rat, Octodon degus, was to identify cortical and subcortical brain regions, which are involved in the perception of vocalizations uttered by the mother. In this species, which is characterized by an elaborated vocal repertoire, the (14C)-2-fluoro-deoxyglucose autoradiography was applied to measure region-specific metabolic activation in response to the presentation of a learned emotionally relevant acoustic stimulus, the maternal calls. Already at the age of eight days the precentral medial cortex, anterior cingulate cortex and the lateral thalamus could be identified by their enhanced metabolic activation in response to the presentation of the emotionally relevant maternal nursing calls, whereas other brain areas, such as the hippocampus and amygdala did not show stimulus-induced activation. Since in humans changes of activity patterns in relation to the emotional content of spoken language have been observed in similar brain regions, e.g. in the anterior cingulate cortex, Octodon degus may provide a suitable animal model to study the cellular and synaptic mechanisms underlying perception, production and processing of conspecific vocalizations.

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

    PubMed

    Agrati, Daniella; Lonstein, Joseph S

    2016-01-01

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

  17. The Mother-Infant Relationship and Infant Attachment in a South African Peri-Urban Settlement

    ERIC Educational Resources Information Center

    Tomlinson, Mark; Cooper, Peter; Murray, Lynne

    2005-01-01

    A sample of 147 mother-infant dyads was recruited from a peri-urban settlement outside Cape Town and seen at 2- and 18-months postpartum. At 18 months, 61.9% of the infants were rated as securely attached (B); 4.1% as avoidant (A); 8.2% as resistant (C); and 25.8% disorganized (D). Postpartum depression at 2 months, and indices of poor parenting…

  18. Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum.

    PubMed

    Brand, Elizabeth; Kothari, Catherine; Stark, Mary Ann

    2011-01-01

    Although breastfeeding is known to be beneficial to both mother and infant, many women encounter barriers to breastfeeding, even after successful breastfeeding initiation, which may put them at greater risk for early cessation of breastfeeding. The objectives of this study were to conduct a secondary analysis of data from a longitudinal study of postpartum depression to (a) examine factors related to very early discontinuation of breastfeeding (at 2 weeks postpartum) following hospital discharge and (b) identify women's reasons for very early cessation of breastfeeding. The results of this study support findings from previous research. Having a perceived support system, whether it is personal or professional, may have an effect on both the initiation and duration of breastfeeding. Educating expectant and new mothers, especially women who encounter multiple barriers and are at risk for very early cessation of breastfeeding, of the benefits of breastfeeding and supporting them in developing efficient techniques and problem-solving skills can help increase the duration of breastfeeding.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    Zhao, Changjiu; Gammie, Stephen C.

    2014-01-01

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

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

    PubMed

    Zhao, Changjiu; Gammie, Stephen C

    2014-12-01

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

  2. Exposure to female pheromones during pregnancy causes postpartum anxiety in mice.

    PubMed

    Larsen, Caroline M; Grattan, David R

    2010-01-01

    The postpartum period is associated with an increased incidence of pathological anxiety, exerting a substantial burden on both the mother and the baby. We have shown that pharmacological suppression of prolactin in early pregnancy decreases maternal neurogenesis to cause postpartum anxiety. The present data demonstrate that physiological suppression of prolactin secretion through exposure to unfamiliar female pheromones throughout pregnancy prevented the normal postpartum attenuation of anxiety in mice, resulting in high anxiety relative to postpartum controls. Female pheromone-exposed mice also showed severely impaired maternal behavior in an anxiogenic situation. Mice exposed to female pheromones had decreased serum prolactin levels in early pregnancy, resulting in an ablation of the normal increase of neurogenesis on day 7 of pregnancy. These data demonstrate that low serum prolactin levels in early pregnancy, whether induced pharmacologically or as a physiological consequence of exposure to unfamiliar female pheromones, result in failure to show the normal adaptive decrease in anxiety after birth. This provides new insight into possible mechanisms that might underlie postpartum anxiety in women.

  3. The Postpartum Telogen Effluvium Fallacy

    PubMed Central

    Mirallas, Oriol; Grimalt, Ramon

    2016-01-01

    Introduction Postpartum telogen effluvium (PPTE) is a commonly described entity, but few studies deal with the real incidence and pathogenesis of this claimed common disease. Objective To analyze the objective data published and to define the real incidence of the so-called PPTE. Method A retrospective review of the published data was conducted. Results No statistically significant data were found in any of the papers reviewed, which could support the conclusion that the amount of hair shedding between pregnant and postpartum women is different. Conclusion PPTE is not a well-defined entity, and the exact incidence is unknown. From our literature review, we could state that the frequency of PPTE is so low and undefined that we dare say that PPTE does not exist. PMID:27386466

  4. Adolescent satisfaction with postpartum contraception and body weight concerns.

    PubMed

    Hellerstedt, W L; Story, M

    1998-06-01

    Factors having a potential effect on adolescents' use of and satisfaction with postpartum contraceptive methods were assessed in three focus groups involving 22 adolescent mothers of an infant under 12 months of age recruited from a Minnesota (US) clinic specializing in the prenatal and postpartum care of adolescent women. The average age of study participants was 17 years (range, 13-19 years). All adolescents chose to use contraception after delivery. 16 (73%) were using Depo-Provera, 3 were using oral contraceptives, and 3 were using condoms/foam. Most Depo-Provera users made their decision to accept this method with their prenatal care provider during pregnancy. Many had taken the pill at some point, but reported it was hard for them to take it every day. Despite concerns about side effects (especially increased hunger/weight gain and irregular menstrual bleeding), adolescent Depo-Provera acceptors preferred this method because it did not require daily compliance. 16 women (73%) considered themselves overweight, and they attributed this to both their pregnancy weight gain and their contraceptive method. Skepticism regarding their ability to lose weight through healthy eating and exercise was widespread. However, the desire to prevent another pregnancy through use of an effective method such as Depo-Provera was stronger than the desire to return to one's pre-pregnancy body weight. Overall, these adolescent mothers seemed resigned about their inability as a result of the demands of motherhood to resolve their malaise, fatigue, and sense of not being physically fit. These findings suggest a need for effective weight management and health-promoting programs for adolescent mothers that take into account their multiple role demands and generally limited financial resources.

  5. "I Wanna Have a Good Future": Teen Mothers' Rise in Educational Aspirations, Competing Demands, and Limited School Support

    ERIC Educational Resources Information Center

    SmithBattle, Lee

    2007-01-01

    This longitudinal study examined teen mothers' descriptions of being students before and after giving birth and the impact of mothering on their educational goals and school progress. Nineteen teens and at least one of their parents were interviewed six times from the third trimester of pregnancy to 10 months postpartum. Regardless of their school…

  6. Postpartum IUDS: keys for success.

    PubMed

    O'Hanley, K; Huber, D H

    1992-04-01

    Intrauterine device (IUD) insertion is convenient and efficient in the postplacental and immediate postpartum periods. Insertion at these times is demonstrably safe, having a low incidence of infection, few bleeding problems, and low perforation rates. IUD expulsion rates can vary widely, and are a function of timing of insertion, type of IUD, and insertion technique. When a copper T device is inserted postplacentally or immediately postpartum by an experienced and trained clinician, expulsion rates of about 7-15 per 100 users at six months can be expected. Women must be told how to detect expulsions and instructed to return for reinsertion or for another method. Most investigators emphasize that high fundal IUD placement will reduce the expulsion rate. Unplanned pregnancy rates for postplacental IUD insertion range from 2.0-2.8 per 100 users at 24 months when using modern copper IUDs, correct insertion technique, careful postinsertion instructions and good follow-up. Postplacental insertions are performed manually or with a ring forceps. Immediate postpartum insertions (10 minutes to 48 hours after delivery) are performed with the ring forceps.

  7. Mother Goose Is Alive and Culturally Relevant.

    ERIC Educational Resources Information Center

    Crawley, Sharon

    1992-01-01

    Asserts that Mother Goose rhymes are culturally relevant. Offers ways in which Mother Goose can be used in the classroom. Discusses activities for language arts, movement, art, music, science, and mathematics instruction. (PRA)

  8. Mothering Curricula

    ERIC Educational Resources Information Center

    Hoeptner Poling, Linda; Suominen Guyas, Anniina; Keys, Kathleen

    2012-01-01

    This article attends to revealing complicated, intersecting, and symbiotic relationships of mothering, academia, and art education practice. The authors seek to articulate rhizomatic interconnections through their narratives and art, attempting to make sense of what it means to educate, nurture, and care within a location of power, in the…

  9. Seasonal Effects on Depression Risk and Suicidal Symptoms in Postpartum Women

    PubMed Central

    Sit, Dorothy; Seltman, Howard; Wisner, Katherine L.

    2011-01-01

    Background Postpartum depression (PPD) is the most common complication of childbirth. Suicide is a leading cause of maternal death in the first postpartum year. Depressed mothers often have suicidal ideation (SI). Depression and suicidality may vary across the seasons. Previous studies of seasonality and PPD were relatively small or encumbered by study design constraints. We examined the possible relationship between seasonality, depression, and SI in 9,339 new mothers. Methods From 2006 to 2010, the investigators screened women within 4–6 weeks postpartum with the Edinburgh Postnatal Depression Scale (EPDS). We used spectral analysis to explore seasonal variation in risk for depression and suicidality. Results The study team screened 9,339 new mothers, of whom 1,316 (14%) women had positive depression scores (EPDS ≥ 10) which suggest PPD risk; 294 (3%) women had SI (item 10 ≥ 1). A positive EPDS was associated significantly with SI. PPD risk varied significantly across 12-months—risk was highest in December. We detected no seasonal variation in SI. Conclusions Effects of seasonal light variation may contribute to increased risk for depressive symptoms. Suicidality could be related to maternal depression but not seasonal variation. PMID:21381158

  10. "Doing the month": Postpartum practices in Chinese women.

    PubMed

    Liu, Yan Qun; Petrini, Marcia; Maloni, Judith A

    2014-05-01

    This review describes the traditional ancient Chinese postpartum practice of "doing the month" or "zuoyuezi", the evidence for specific practices, maternal adherence to practices, and their effect upon the maternal postpartum physical and psychological health. A comprehensive search yielded 38 English or Chinese publications about common practices, adherence to practices, and their effects upon Chinese women's physical and psychological health. Doing the month involves a series of practices related to the maternal role, physical activity, maintenance of body warmth, and food consumption that are believed to restore maternal postpartum health and prevent future disease. Strengths of these practices include acknowledgment of the woman's societal and familial contribution to childbearing and the provision of consistent family support. There is concern for the effect of some practices upon both maternal physical and psychological health, particularly for postpartum depression. Current evidence about the effects of doing-the-month practices upon maternal health needs to be integrated into the traditional practices of doing the month to improve maternal health. PMID:24798890

  11. Mother-child bonding assessment tools☆

    PubMed Central

    Perrelli, Jaqueline Galdino Albuquerque; Zambaldi, Carla Fonseca; Cantilino, Amaury; Sougey, Everton Botelho

    2014-01-01

    Objective: To identify and describe research tools used to evaluate bonding between mother and child up to one year of age, as well as to provide information on reliability and validity measures related to these tools. Data source: Research studies available on PUBMED, LILACS, ScienceDirect, PsycINFO and CINAHL databases with the following descriptors: mother-child relations and mother infant relationship, as well as the expressions validity, reliability and scale. Data synthesis: 23 research studies were selected and fully analyzed. Thirteen evaluation research tools were identified concerning mother and child attachment: seven scales, three questionnaires, two inventories and one observation method. From all tools analyzed, the Prenatal Attachment Inventory presented the higher validity and reliability measures to assess mother and fetus relation during pregnancy. Concerning the puerperal period, better consistency coefficients were found for Maternal Attachment Inventory and Postpartum Bonding Questionnaire. Besides, the last one revealed a higher sensibility to identify amenable and severe disorders in the affective relations between mother and child. Conclusions: The majority of research tools are reliable to study the phenomenon presented, although there are some limitations regarding the construct and criterion related to validity. In addition to this, only two of them are translated into Portuguese and adapted to women and children populations in Brazil, being a decisive gap to scientific production in this area. PMID:25479859

  12. Blocking the postpartum mouse dam's CB1 receptors impairs maternal behavior as well as offspring development and their adult social-emotional behavior.

    PubMed

    Schechter, Michal; Pinhasov, Albert; Weller, Aron; Fride, Ester

    2012-01-15

    Maternal care is the newborns' first experience of social interaction, which affects their development and social competence throughout life. For the first time, we investigated the involvement of the endocannabinoid system (ECS) in mother-infant interaction in mice. We found that blocking the dam's CB1 receptors (CB1R) by the antagonist/inverse agonist rimonabant (SR141716) during postpartum days 1-8 affected maternal behavior as well as the social and emotional characteristics of the offspring as adults. Pups of rimonabant treated dams (RTD) had lower body weight during the first week of life and emitted fewer ultrasonic vocalizations (USVs) than vehicle treated dams (VTD). RTD crouched less over their pups and exhibited delayed pup retrieval. In Y-maze preference tests conducted at weaning age, females and males of both groups preferred their dam over milk. Males and females of RTD preferred dam over pup and pup over milk as opposed to the control group. At the age of 2.5 months, males of RTD displayed less motor activity. In the social behavior test, RTD male and female offspring were both more active, showing higher levels of active social interaction and rearing. These results indicate that the ECS is crucial for establishment of maternal behavior during the first postpartum week, with a long-term impact on the offspring's socio-emotional development. PMID:22020200

  13. [Mothers' knowledge about exclusive breastfeeding].

    PubMed

    da Silva, Nichelle Monique; Waterkemper, Roberta; da Silva, Eveline Franco; Cordova, Fernanda Peixoto; Bonilha, Ana Lucia de Lourenzi

    2014-01-01

    This is a descriptive study, with a qualitative approach, aimed to identify the knowledge of puerperal women on exclusive breastfeeding. Data were collected between September-October 2011, through semi-structured interview. Thirteen puerperal women, interned in a rooming unit of a public institution in the city of Caxias do Sul-RS, participated in the study. Data analysis was performed using thematic analysis. From the interpretation of information three categories emerged: the knowledge about exclusive breastfeeding, the breastfeeding process and the influences of received information. Even getting information from health professionals in the prenatal period, it is possible to understand that there is a need to improve communication and monitoring of mothers, as a continuity of professional care in the postpartum period, and also later, in the remote.

  14. Extra early physical contact and aspects of the early mother-infant relationship.

    PubMed

    Taylor, P M; Taylor, F H; Campbell, S B; Maloni, J A; Cannon, M

    1985-01-01

    We tested the hypothesis that extra early physical contact between mother and infant enhances aspects of their early relationship. Healthy, middle-class mothers and their healthy, firstborn, singleton infants delivered vaginally at full-term were randomly assigned to receive either regular contact (RC; N = 39) or extra early physical contact (EC; N = 39) following delivery. RC infants remained in cribs beside their mothers' beds, while EC infants and mothers had a mean of 46 min of physical contact in the recovery room. There was no difference between EC and RC subjects for the following outcome measures: amount of time mothers chose to have infants with them during the postpartum hospital stay; quality of mother-infant interaction at two days and one month; concern mothers expressed for the infant at one month; mothers' perception of their postpartum adjustment; mothers' perception of the infant at two days and one month, and of the infant's temperament at eight months; and extent of mothers' assisting with and soothing the child during a physical examination at 13 months. EC children cried significantly less during the examination at 13 months. These findings do not support the hypothesis that extra early physical contact between mother and infant enhances their relationship.

  15. Mother and baby yoga is good for you.

    PubMed

    MacDonald, Cheryl

    2013-05-01

    Mother and baby yoga is becoming more and more popular in the western world, as postpartum mothers discover the benefits of being able to 'work out', bond with their baby and relax, all in one session. Postnatal yoga can offer calm and a sense of wellbeing, helping mothers to improve and stabilise their emotional health and to bond. Additionally the mother is able to focus on her relationship with her baby, rebuild the weakened pelvic floor, strengthen the abdominal muscles and even alleviate back and neck pain. For babies, yoga can aid digestion and alleviate colic; help to strengthen tiny limbs; improve sleep patterns; and enhance their ability to interact with their mother and other people. PMID:23789249

  16. Facilitators, barriers, and components of a culturally-tailored afterschool physical activity program in preadolescent African-American girls and their mothers

    PubMed Central

    Alhassan, Sofiya; Greever, Cory; Nwaokelemeh, Ogechi; Mendoza, Albert; Barr-Anderson, Daheia J.

    2013-01-01

    Objectives Traditional physical activity (PA) programs have not been effective in increasing PA in African-American girls. Currently, there is limited information regarding the components of PA programs that drive participation in African-American girls. The purpose of this investigation was to describe the facilitators, barriers, and components of a culturally-tailored afterschool PA program that will potentially inspire the participation of African-American mother-daughter dyads. Methods Six focus groups (n=12 mother-daughter dyads; daughters, 7–10 yrs in age) were conducted between March and May 2012. Focus group semi-structured interviews were transcribed, coded, and systematically analyzed using NVivo. Results Mothers reported a preference for non-traditional (dancing, household chores) types of PA. While daughters preferred to participate in both dance-based and traditional types (walking, riding bikes) of PA. Participants felt that the use of a culturally-tailored dance program would be appealing because it highlights the cultural and historical legacy of the African-American culture. Mothers wanted programs that would allow them time to spend with their daughters. Top three dance styles that mothers wanted to participate in were African, Hip-hop, and Salsa/samba. While, daughters reported that they would enjoy participating in Hip-hop, African, and Jazz. The most common responses given for resources needed for participating in a culturally-tailored afterschool dance program were the location of the program, transportation, and childcare for siblings. Conclusions The present investigation highlights some cultural factors related to facilitators and barriers of PA that should be addressed in designing PA studies for African-American girls and their mothers. PMID:24620442

  17. Child murder committed by severely mentally III mothers: an examination of mothers found not guilty by reason of insanity. 2005 Honorable Mention/Richard Rosner Award for the best paper by a fellow in forensic psychiatry or forensic psychology.

    PubMed

    Friedman, Susan Hatters; Hrouda, Debra R; Holden, Carol E; Noffsinger, Stephen G; Resnick, Phillip J

    2005-11-01

    Forensic hospital records of 39 severely mentally ill mothers adjudicated Not Guilty by Reason of Insanity for filicide (child murder by parents) were analyzed to describe characteristics preceding this tragedy and to suggest prevention strategies. Almost three-quarters of the mothers (72%) had previous mental health treatment. Over two thirds (69%) of the mothers were experiencing auditory hallucinations, most frequently command hallucinations, and half (49%) were depressed at the time of the offense. Over one third (38%) of the filicides occurred during pregnancy or the postpartum period, and many had a history of postpartum psychosis. Almost three-quarters (72%) of the mothers had experienced considerable developmental stressors, such as death of their own mother or incest. Maternal motives for filicide were predominantly "altruistic" (meaning murder out of love) or "acutely psychotic" (occurring in the throes of psychosis, without rational motive). Psychiatrists should perform careful risk assessments for filicide in mothers with mental illnesses.

  18. Child murder committed by severely mentally III mothers: an examination of mothers found not guilty by reason of insanity. 2005 Honorable Mention/Richard Rosner Award for the best paper by a fellow in forensic psychiatry or forensic psychology.

    PubMed

    Friedman, Susan Hatters; Hrouda, Debra R; Holden, Carol E; Noffsinger, Stephen G; Resnick, Phillip J

    2005-11-01

    Forensic hospital records of 39 severely mentally ill mothers adjudicated Not Guilty by Reason of Insanity for filicide (child murder by parents) were analyzed to describe characteristics preceding this tragedy and to suggest prevention strategies. Almost three-quarters of the mothers (72%) had previous mental health treatment. Over two thirds (69%) of the mothers were experiencing auditory hallucinations, most frequently command hallucinations, and half (49%) were depressed at the time of the offense. Over one third (38%) of the filicides occurred during pregnancy or the postpartum period, and many had a history of postpartum psychosis. Almost three-quarters (72%) of the mothers had experienced considerable developmental stressors, such as death of their own mother or incest. Maternal motives for filicide were predominantly "altruistic" (meaning murder out of love) or "acutely psychotic" (occurring in the throes of psychosis, without rational motive). Psychiatrists should perform careful risk assessments for filicide in mothers with mental illnesses. PMID:16382847

  19. 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.

  20. Postpartal anxiety and depression in mothers of term and preterm infants.

    PubMed

    Gennaro, S

    1988-01-01

    This study examined differences in anxiety and depression in mothers of term and preterm infants in the first week postpartum and over the next 6 weeks. Mothers of 41 preterm infants were matched with 41 mothers of term infants on parity, type of delivery, age, and race. Sixteen mothers of preterm infants and 10 mothers of term infants completed all 7 weeks of data collection. Mothers of preterm infants were significantly more anxious and depressed than mothers of term infants in the first postpartal week but this difference did not persist over time. Maternal affect was unrelated to parity or type of delivery in the first postpartal week and over time. There were no differences among mothers of premature infants in initial anxiety or depression, based on the level of illness of the infant.

  1. Mothering and anxiety: Social support and competence as mitigating factors for first-time mothers.

    PubMed

    Chavis, Llena

    2016-07-01

    This study investigated anxiety as a phenomenon distinct from depression and evaluated several variables that influence anxiety in first-time mothers. This explored the relationship between maternal sense of competence (both of mothering and efficacy) and perceived social support (from family, friends, and significant others) and first-time mothers' postpartum anxiety, when depression, socioeconomic status (SES), and marital status were controlled for. The population studied were 86 first-time mothers made up of women with children 24 months or younger in two populations of Kentucky and Michigan. The constructs of maternal sense of competence and perceived social support were found to be significant in explaining first-time mothers' anxiety. The study concluded that a combined association of perceived social support and maternal sense of competence were associated with a 34% (change in R-squared = .339) decrease of a first-time mothers' anxiety. However, not all types of social support, or maternal competence appeared to be equally important with regards to maternal anxiety: social support from friends and family and maternal sense of competence in regard to productivity appeared to be most significant. Lastly, some recommendations for health practitioners who work with mothers are provided. PMID:27266719

  2. Differences in sedentary time and physical activity among mothers and children using a movement-to-music video program in the home environment: a pilot study.

    PubMed

    Tuominen, Pipsa P A; Husu, Pauliina; Raitanen, Jani; Luoto, Riitta M

    2016-01-01

    Measured objectively, less than a quarter of adults and under half of preschool children in Finland meet the physical activity recommendations. Moreover, higher sedentary time among parents (such as watching television) is associated with higher sedentary time of their children. The study introduces an intervention based on reducing sedentary behavior among mothers and their children. It utilizes a combination of music and exercise via a motivation-targeting movement-to-music video program in the home environment. Data were collected in summer 2014 from Finland's Pirkanmaa region. Each mother-child pair (n = 24, child age: 4-7 years) was assigned to the intervention and control group. Both groups used an accelerometer and completed physical activity diaries for two consecutive weeks (14 days) during waking hours. In addition, the intervention group was instructed to use the movement-to-music video program during the second week. Differences between groups were expected in analysis of sedentary time and physical activity between weeks 1 and 2. The parameters assessed were sedentary time (i.e., lying down or sitting), standing still, and time spent in physical activity. Less sedentary time was revealed in week 2 than in week 1 among both intervention group mothers (56.6 vs. 53.3 %) and for intervention group children (49.5 vs. 46.0 %). The opposite was true of control group mothers (52.1 vs. 52.4 %) and children (46.7 vs. 49.8 %). Within-group differences in mothers' sedentary time correlated moderately with the children's sedentary time (Spearman's r = 0.56). All groups exhibited slightly more standing in the second week than in week 1. Both sets of intervention participants also engaged in more light physical activity in week 2, with the opposite evident for the two control sets. In all groups, except the control children, the proportion of moderate to vigorous physical activity was higher in the second week than the first. The use of music and video

  3. Influence of hepatic load from far-off dry period to early postpartum period on the first postpartum ovulation and accompanying subsequent fertility in dairy cows

    PubMed Central

    KAWASHIMA, Chiho; ITO, Nozomi; NAGASHIMA, Shuntarou; MATSUI, Motozumi; SAWADA, Kumiko; SCHWEIGERT, Florian J.; MIYAMOTO, Akio; KIDA, Katsuya

    2016-01-01

    The aim of the present study was to investigate nutritional and metabolic parameters during the dry and early postpartum periods of ovulatory and anovulatory cows, as well as their postpartum reproductive performance. Blood samples from 20 multiparous Holstein cows were collected once a week from the far-off dry period to 3 weeks postpartum. Early postpartum (0–3 weeks) ovulation was confirmed using plasma progesterone concentration profiles, and cows were considered ovulatory if they had resumed luteal activity by this point (n = 9), whereas cows that had not were considered anovulatory (n = 11). Data from the ovulatory and anovulatory cows were analyzed separately for the far-off dry period (7–4 weeks prepartum), the close-up dry period (3–1 weeks prepartum), and the early postpartum period (0–3 weeks). Serum gamma-glutamyl transpeptidase activity (far-off, P = 0.065; close-up, P = 0.051; and early postpartum, P = 0.030) and aspartate aminotransferase (close-up, P = 0.050 and early postpartum, P = 0.087) activities were higher in anovulatory than in ovulatory cows. The days open period was longer (P = 0.019) in anovulatory than in ovulatory cows, and the number of artificial inseminations per conception (P = 0.025) was greater. In conclusion, we found that continuously high gamma-glutamyl transpeptidase activities in serum, which may be induced by liver disorders, prevent subsequent ovulation and affect subsequent fertility, even if cows obtain sufficient ovulation-related energy and β-carotene. PMID:26935323

  4. In Search of Neural Endophenotypes of Postpartum Psychopathology and Disrupted Maternal Caregiving

    PubMed Central

    Moses-Kolko, E. L.; Horner, M. S.; Phillips, M. L.; Hipwell, A. E.; Swain, J. E.

    2015-01-01

    This is a selective review that provides the context for the study of perinatal affective disorder mechanisms and outlines directions for future research. We integrate existing literature along neural networks of interest for affective disorders and maternal caregiving: (i) the salience/fear network; (ii) the executive network; (iii) the reward/social attachment network; and (iv) the default mode network. Extant salience/fear network research reveals disparate responses and corticolimbic coupling to various stimuli based upon a predominantly depressive versus anxious (post-traumatic stress disorder) clinical phenotype. Executive network and default mode connectivity abnormalities have been described in postpartum depression (PPD), although studies are very limited in these domains. Reward/social attachment studies confirm a robust ventral striatal response to infant stimuli, including cry and happy infant faces, which is diminished in depressed, insecurely attached and substance-using mothers. The adverse parenting experiences received and the attachment insecurity of current mothers are factors that are associated with a diminution in infant stimulus-related neural activity similar to that in PPD, and raise the need for additional studies that integrate mood and attachment concepts in larger study samples. Several studies examining functional connectivity in resting state and emotional activation functional magnetic resonance imaging paradigms have revealed attenuated corticolimbic connectivity, which remains an important outcome that requires dissection with increasing precision to better define neural treatment targets. Methodological progress is expected in the coming years in terms of refining clinical phenotypes of interest and experimental paradigms, as well as enlarging samples to facilitate the examination of multiple constructs. Functional imaging promises to determine neural mechanisms underlying maternal psychopathology and impaired caregiving, such

  5. Depression in Pregnancy and Postpartum Period

    PubMed Central

    Sood, Mamta; Sood, A.K.

    2003-01-01

    This prospective study was carried out in a service hospital, with the aim to study the prevalence and incidence of depression in pregnancy and postpartum period. Eighty Four consecutive patients attending the antenatal outpatient in the Obstetrics & Gynaecology department in their last trimester of pregnancy were recruited for the study. They were assessed on Beck Depression Inventory thrice viz. during third trimester of pregnancy, within 3 days of delivery (early postpartum period) & within 4-8 weeks of delivery (late postpartum period).The prevalence of depression was 8.3%, 20% and 12.8% respectively at three ratings. The incidence was 16% and 10% in the early & late postpartum period respectively. Further analysis revealed that depression in pregnancy correlated significantly with depression in early postpartum period, but not with late postpartum period. Depression in early postpartum period correlated with depression in late postpartum period.These findings have implications for early detection and care of women at risk for developing depression. PMID:21206814

  6. Postpartum hemorrhage: use of hemostatic combat gauze.

    PubMed

    Schmid, Bernd C; Rezniczek, Günther A; Rolf, Norbert; Maul, Holger

    2012-01-01

    Cheap and simple interventions that are intended to minimize postpartum hemorrhage are of major public health concern. We report a case of postpartum hemorrhage in which conservative interventions had failed. The use of a chitosan-covered gauze that originally was developed for combat trauma allowed us to achieve hemostasis, and a seemingly inevitable hysterectomy was avoided. PMID:22011588

  7. Use of postpartum care: predictors and barriers.

    PubMed

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

    2014-01-01

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

  8. Thai nurses' beliefs about breastfeeding and postpartum practices.

    PubMed

    Kaewsarn, Pattaya; Moyle, Wendy; Creedy, Debra

    2003-07-01

    Cultural beliefs are important determinants of health care behaviours. Nurses have an important influence on infant feeding decisions and maternal postpartum care, but little is known about the extent to which their practice is influenced by traditional beliefs and/or recent innovations driven by evidence-based research. The aim of this study was to investigate Thai nurses' traditional beliefs about breastfeeding and related postpartum care, and their impact on nursing practice. A survey of 372 nurses working in hospitals and health services in Ubon Ratchathani, Thailand was undertaken. Questionnaire items were developed from a review of the literature and exploratory interviews with Thai women. Descriptive statistics were used to represent the incidence of particular beliefs and behaviours. Chi-square analyses were conducted to determine relationships between demographic characteristics and traditional beliefs and practices. There were discrepancies between nurses' beliefs and contemporary evidence-based practices. Many nurses supported traditional Thai postpartum practices such as food restrictions and encouraging hot baths. Some traditional beliefs supported by nurses may be detrimental to women and babies such as "lying by fire", discarding of colostrum, and giving boiled water to neonates. Only half the nurses reported that they encouraged mothers to breastfeed immediately following birth. The study was undertaken in the North-East of Thailand, where the population is known to have strong belief systems. Reliability and content validity of the tool would be enhanced through replication studies and qualitative investigations of other breastfeeding issues. There is a need for professional development strategies such as peer review and mentoring to address inadequate knowledge and outdated practices of some health professionals, as well as continuity of care models to assess quality care outcomes that are culturally appropriate.

  9. Schizophrenia: Do Sense Perceptions Correlate with Episodic Activity, as Indians Know Kokopelli/Pele Matches with Mother Earth's Electromagnetic Field Activity, EMF?

    NASA Astrophysics Data System (ADS)

    McCulley, Aspen; Pawa Matagamon, Sagamo; McLeod, David Matthew

    2007-10-01

    Certain Indian cognomens seem to indicate an environmental awareness of an electromagnetic wrath some traditional cultures are careful to acknowledge and accommodate. These include Pele/Kokopelli, Keitan, and Hobomock, that have carried explicit information our cultures have been cognizant of Mother Earth's not-always-benign influences. Let's consider schizophrenia, with or without a viral cofactor, and Kokopelli/Pele. She/he may be explicitly referenced as a hunch-backed, flute-playing individual, dancing-around in correlation with Earth's electromagnetic activities. Depending on the specific version and its details, individuals, particularly children, are admonished to avoid certain areas. Of especial importance and relevance may be cultural awareness that individuals, whom another type of culture has discriminated against, despite no a priori guilt, are explicitly absolved of culpability by the blanket statement that The Great Spirit is implicated in their behavior. Of course, this provides information of a religious sort, possibly corroborated by a currently prominent individual.

  10. [Trace and anxiety of nursing mothers with insufficient and normal breast feeding indicators].

    PubMed

    Aragaki, Ilva Marico Mizumoto; Silva, Isília Aparecida; dos Santos, Jair Lício Ferreira

    2006-09-01

    The objective of this study was to identify and compare the trace and the anxiety state on the 10th day postpartum and the anxiety state on the 30th day postpartum of primiparous and multiparous nursing mothers who present insufficient breast feeding indicators and nursing mothers with normal breast feeding, in order to verify the possible relationships between the anxiety state of the nursing mothers in those two moments with the insufficient breast feeding indicators presented. This is an exploratory and descriptive study, whose data has been gotten from 168 nursing mothers and their children by means of interviews in nursing consultations in the 10th and 30th day postpartum. The results obtained showed that primiparous and multiparous with insufficient breast feeding and primiparous with normal lactation presented higher anxiety state trace than the anxiety state on the 10th and 30th day postpartum. There was remission of the maternal signals of anxiety with the passing of time, which may be caused by the correction of the breast feeding technique and support to the nursing mothers.

  11. Condom Tamponade in the Management of Primary Postpartum Haemorrhage: A Report of three cases in Ghana.

    PubMed

    Maya, Ernest T; Buntugu, Kennedy A; Aki, Lovelace; Srofenyoh, Emmanuel K

    2015-09-01

    Postpartum haemorrhage is one of the major causes of maternal mortality worldwide. The leading cause of primary postpartum haemorrhage is uterine atony and active management of the third stage of labour with oxytocin is recommended for preventing primary postpartum haemorrhage. Parenteral oxytocin is also the drug of choice for medical management of postpartum haemorrhage secondary to uterine atony. Condom uterine balloon tamponade is .a low cost technique that can be used as a second-line option for treatment. We report retrospectively three cases of primary PPH secondary to uterine atony which were managed successfully with condom tamponade. Condom tamponade is effective in managing post partum haemorrhage secondary to uterine atony and we advocate for the training of all skilled attendants on how to insert the condom tamponade.

  12. Pertussis seroprevalence in adults, post-partum women and umbilical cord blood.

    PubMed

    Fallo, Aurelia; Manonelles, Gabriela; Hozbor, Daniela; Lara, Claudia; Huespe, Miguel; Mazzeo, Silvina; Canle, Oscar; Galas, Marcelo; López, Eduardo

    2014-08-01

    Pertussis is a vaccine-preventable disease that affects people of all ages. Young adults who have lost their immunity to pertussis are the major source of infection in infants. Given the steady increase of pertussis cases, new prevention strategies are required. Objective. To assess pertussis seroprevalence in adult blood donors, post-partum women, and umbilical cords. Metod. Measurement of total titers of anti-Bordetella spp. (Bordetella) antibodies using an enzyme-linked immunosorbent assay. Serum samples from 103 donors, 101 post-partum women and 100 umbilical cords were analyzed. Titers <80 were considered of low impact against the disease. The assessment included transplacental transfer of antibodies and the umbilical cord/maternal ratio of antibody titers. Results. Donors mean age was: 28 ± 6 years old. Mediananti-Bordetella titers: 320; interquartile range (IQR):160-320; 10% had titers <80. Post-partum women mean age was: 26 ± 6 years old. Median anti-Bordetella titers:160 (IQR:80-320), with titers significantly lower than in female donors (p= 0.00002). Titers <80 were found in 30% of post-partum women. Median anti-Bordetella titers in umbilical cords: 160 (IQR: 80-160). Titers <80 were more frequently found in umbilical cords than in mothers (44% versus 30%, p= 0.04). Transplacental transfer was 0.83. Umbilical cord titers were equal to maternal titers in 54% of cases, lower in 37%, and higher only in 8%. Conclusion. Titers of anti-Bordetella antibodies in post-partum women were significantly lower than in female blood donors. Titers <80 were found in 30% of post-partum women and 44% of umbilical cords. These data may account for the high rates of pertussis in young infants who have not yet completed their vaccination schedule.

  13. Intrauterine, postpartum and adult relationships between arachidonic acid (AA) and docosahexaenoic acid (DHA).

    PubMed

    Kuipers, Remko S; Luxwolda, Martine F; Janneke Dijck-Brouwer, D A; Muskiet, Frits A J

    2011-11-01

    Erythrocyte (RBC) fatty acid compositions from populations with stable dietary habits but large variations in RBC-arachidonic (AA) and RBC-docosahexaenoic acid (DHA) provided us with insight into relationships between DHA and AA. It also enabled us to estimate the maternal RBC-DHA (mRBC-DHA) status that corresponded with no decrease in mRBC-DHA during pregnancy, or in infant (i) RBC-DHA or mRBC-DHA during the first 3 months postpartum (DHA-equilibrium) while exclusively breastfeeding. At delivery, iRBC-AA is uniformly high and independent of mRBC-AA. Infants born to mothers with low RBC-DHA exhibit higher, but infants born to mothers with high RBC-DHA exhibit lower RBC-DHA than their mothers. This switch from 'biomagnification' into 'bioattenuation' occurs at 6g% mRBC-DHA. At 6g%, mRBC-DHA is stable throughout pregnancy, corresponds with postpartum infant DHA-equilibrium of 6 and 0.4g% DHA in mature milk, but results in postpartum depletion of mRBC-DHA to 5g%. Postpartum maternal DHA-equilibrium is reached at 8g% mRBC-DHA, corresponding with 1g% DHA in mature milk and 7g% iRBC-DHA at delivery that increases to 8g% during lactation. This 8g% RBC-DHA concurs with the lowest risks of cardiovascular and psychiatric diseases in adults. RBC-data from 1866 infants, males and (non-)pregnant females indicated AA vs. DHA synergism at low RBC-DHA, but antagonism at high RBC-DHA. These data, together with high intakes of AA and DHA from our Paleolithic diet, suggest that bioattenuation of DHA during pregnancy and postnatal antagonism between AA and DHA are the physiological standard for humans across the life cycle. PMID:21561751

  14. CLEFT PALATE IN HIV-EXPOSED NEWBORNS OF MOTHERS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY

    PubMed Central

    James, Ayotunde; Oluwatosin, Babatunde; Njideka, Georgina; Babafemi; Benjamin, Onyekwere George; Olufemi, David; Leo, Robert; Folorunso, Isaac; Phylis; Olusina, Olusegun

    2014-01-01

    Aims Cleft lip/palate, though rare, is the commonest head and neck congenital malformation. Both genetic and environmental factors have been implicated in the aetiopathogenesis but the role of in-utero exposure to human immunodeficiency virus (HIV) and highly active antiretroviral therapy (HAART) is still being investigated. This short communication reports the occurrence of cleft palate in three newborns exposed in-utero to HIV and HAART. Material and methods This is a case series of HIV-exposed newborns observed to have cleft palate among a larger cohort of HIV-exposed and unexposed newborns in a study evaluating the effect of HIV infection and HAART on newborn hearing. The Risk Ratio (RR) was calculated to detect a potential association between in-utero exposure to Efavirenz containing ART and cleft palate. Results Three HIV-exposed newborns with cleft palate were identified during hearing screening performed on 126 HIV-exposed and 121 HIV unexposed newborns. Two had exposure to tenofovir+lamivudine+efavirenz (TDF+3TC+EFV) while the third had exposure to zidovudine+lamivudine+nevirapine (ZDV+3TC+NVP) during the first trimester. There was no statistically significant association between presence of cleft palate and exposure to an EFV containing HAART regimen (p=0.07, RR=10.95 [0.94-126.84]). Conclusions This communication highlights the possible aetiologic role of HAART in cleft palate, the need for further prospective follow-up studies and establishment of antiretroviral pregnancy, birth and neonatal registries. PMID:25653715

  15. New evidence on breastfeeding and postpartum depression: the importance of understanding women's intentions.

    PubMed

    Borra, Cristina; Iacovou, Maria; Sevilla, Almudena

    2015-04-01

    This study aimed to identify the causal effect of breastfeeding on postpartum depression (PPD), using data on mothers from a British survey, the Avon Longitudinal Study of Parents and Children. Multivariate linear and logistic regressions were performed to investigate the effects of breastfeeding on mothers' mental health measured at 8 weeks, 8, 21 and 32 months postpartum. The estimated effect of breastfeeding on PPD differed according to whether women had planned to breastfeed their babies, and by whether they had shown signs of depression during pregnancy. For mothers who were not depressed during pregnancy, the lowest risk of PPD was found among women who had planned to breastfeed, and who had actually breastfed their babies, while the highest risk was found among women who had planned to breastfeed and had not gone on to breastfeed. We conclude that the effect of breastfeeding on maternal depression is extremely heterogeneous, being mediated both by breastfeeding intentions during pregnancy and by mothers' mental health during pregnancy. Our results underline the importance of providing expert breastfeeding support to women who want to breastfeed; but also, of providing compassionate support for women who had intended to breastfeed, but who find themselves unable to.

  16. New evidence on breastfeeding and postpartum depression: the importance of understanding women's intentions.

    PubMed

    Borra, Cristina; Iacovou, Maria; Sevilla, Almudena

    2015-04-01

    This study aimed to identify the causal effect of breastfeeding on postpartum depression (PPD), using data on mothers from a British survey, the Avon Longitudinal Study of Parents and Children. Multivariate linear and logistic regressions were performed to investigate the effects of breastfeeding on mothers' mental health measured at 8 weeks, 8, 21 and 32 months postpartum. The estimated effect of breastfeeding on PPD differed according to whether women had planned to breastfeed their babies, and by whether they had shown signs of depression during pregnancy. For mothers who were not depressed during pregnancy, the lowest risk of PPD was found among women who had planned to breastfeed, and who had actually breastfed their babies, while the highest risk was found among women who had planned to breastfeed and had not gone on to breastfeed. We conclude that the effect of breastfeeding on maternal depression is extremely heterogeneous, being mediated both by breastfeeding intentions during pregnancy and by mothers' mental health during pregnancy. Our results underline the importance of providing expert breastfeeding support to women who want to breastfeed; but also, of providing compassionate support for women who had intended to breastfeed, but who find themselves unable to. PMID:25138629

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

    PubMed Central

    Hounton, Sennen; Winfrey, William; Barros, Aluisio J. D.; Askew, Ian

    2015-01-01

    Background The first 12 months following childbirth are a period when a subsequent pregnancy holds the greatest risk for mother and baby, but also when there are numerous contacts with the healthcare system for postnatal care for mother and baby (immunisation, nutrition, etc.). The benefits and importance of postpartum family planning are well documented. They include a reduction in risk of miscarriage, as well as mitigation of (or protection against) low birth weight, neonatal and maternal death, preterm birth, and anaemia. Objectives The objectives of this paper are to assess patterns and trends in the use of postpartum family planning at the country level, to determine whether postpartum family planning is associated with birth interval and parity, and to identify the health services most closely associated with postpartum family planning after adjusting for socio-economic characteristics. Design Data were used from Demographic and Health Surveys that contain a reproductive calendar, carried out within the last 10 years, from Ethiopia, Malawi, and Nigeria. All women for whom the calendar was completed and who gave birth between 57 and 60 months prior to data collection were included in the analysis. For each of the births, we merged the reproductive calendar with the birth record into a survey for each country reflecting the previous 60 months. The definition of the postpartum period in this paper is based on a period of 3 months postpartum. We used this definition to assess early adoption of postpartum family planning. We assessed variations in postpartum family planning according to demographic and socio-economic variables, as well as its association with various contact opportunities with the health system [antenatal care (ANC), childbirth in facilities, immunisation, etc.]. We did simple descriptive analysis with tabular, graphic, and ‘equiplot’ displays and a logistic regression controlling for important background characteristics. Results Overall

  18. New insights into perinatal depression: pathogenesis and treatment during pregnancy and postpartum

    PubMed Central

    Meltzer-Brody, Samantha

    2011-01-01

    Maternal perinatal mental health has enormous consequences for the well-being of the mother, her baby, and the family. Although it is well documented that perinatal depression is both common and morbid, with a prevalence of 10% to 15% in the general population, there remain many critically important unanswered questions about the pathogenesis of perinatal depression and most effective treatment regimens. Current lines of evidence from both human and animal models implicate hormonal dysregulation, abnormalities in hypothalamic-pituitary-adrenal axis activity, and the contributions of genetics and epigenetics as playing key roles in the development of perinatal reproductive mood disorders. Investigations into both human and animal models of perinatal depression offer much promise for the future identification of the underlying pathophysiology and subsequent early identification and/or prevention and appropriate treatment for women at risk for postpartum depression. Lastly, although it is generally accepted that pregnancy is not protective with regard to new onset or relapse of depression, the way to best treat maternal depression during pregnancy and lactation remains hotly debated. Future research in this area will more clearly elucidate the underlying pathogenesis, the potential long-term impact of perinatal depression on the developing fetus, and how best to counsel pregnant women about the risks of untreated major depressive disorder versus the risks of psychopharmacologic treatment during pregnancy and lactation. PMID:21485749

  19. Mothers' expectations and other factors affecting breastfeeding at six months in Greece.

    PubMed

    Bouras, Georgios; Mexi-Bourna, Panagioula; Bournas, Nicolaos; Christodoulou, Christos; Daskalaki, Anna; Tasiopoulou, Ioanna; Poulios, Antonios

    2013-12-01

    The objective of this study is to determine the factors influencing breastfeeding duration in Greece. A total of 145 women were interviewed, on the third day post-partum. Women were followed up by telephone interviews at three and six months post-partum. Chi-square test and binomial sequential logistic regression analysis were used for statistical analysis. Results from this study show that baby-friendly hospital, antenatal courses, mother's perception of her capability to successfully breastfeed her infant, mother's intention to breastfeed for a duration of six months or more, mother's and father's education level, introduction of complementary foods or fluids, caesarean delivery, smoking and ethnicity were significantly associated with the duration of breastfeeding. In conclusion, additional antenatal and postnatal framework is necessary. Mothers' prediction of the duration of breastfeeding is an additional tool for identification of women with a high probability for early weaning. PMID:23711488

  20. Longitudinal effects of contextual and proximal factors on mother-infant interactions among Brazilian adolescent mothers.

    PubMed

    Diniz, Eva; DeSousa, Diogo; Koller, Silvia H; Volling, Brenda L

    2016-05-01

    Adolescent mothers often come from vulnerable backgrounds which might impact the quality of both maternal and infant behavior. Despite the negative impact of adolescent motherhood for maternal and infant behavior, social support may decrease the risks and promote maternal behavior toward the infant. The aim of this study was to investigate longitudinally the effects of proximal (maternal behavior) and distal (mother's perceived social support) variables on infant development in a sample of Brazilian adolescent mothers and their infants. Thirty-nine adolescent mothers (Mage=17.26years; SD=1.71) were observed interacting with their infants at 3 and 6 months postpartum and reported on social support. Results revealed that maternal and infant behavior were associated within and across times. Mothers' perceived social support at 3 months had an indirect effect on infant behavior at 6 months, totally mediated by maternal behavior at 6 months. Our findings revealed the mutual influence between maternal and infant behavior, revealing a proximal process. The results also underscored the importance of the passage of time in the interplay between mother-infant interactions and their developmental context. PMID:27110652

  1. Neutrophil functions and cytokines expression profile in buffaloes with impending postpartum reproductive disorders.

    PubMed

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

    2013-10-01

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

  2. 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.

  3. Macronutrients in human milk at 2, 12, and 16 weeks postpartum.

    PubMed

    Ferris, A M; Dotts, M A; Clark, R M; Ezrin, M; Jensen, R G

    1988-06-01

    This study evaluated changes in human milk composition from 2 to 16 weeks postpartum. Milk from 12 mothers was analyzed for lipid (utilizing a modified Folch), lactose (enzymatic hydrolysis), and nitrogen (semi-micro Kjeldahl). Energy was calculated by fractional analysis and bomb calorimetry. All samples were from well-defined subjects, and uniform collection procedures were used. Milk lipid, total nitrogen, and energy content differed significantly from one woman to another. Lipid and energy content increased from 3.98 +/- 1.0 to 5.50 +/- 1.1 gm/100 ml and 68.5 +/- 9.8 to 83.0 +/- 11.1 kcal/100 ml, respectively, and nitrogen content decreased significantly from 0.24 +/- 0.05 to 0.16 +/- 0.02 gm/100 ml from 2 to 16 weeks postpartum. Lactose remained statistically stable, increasing from 6.3 +/- 0.7 to 7.0 +/- 0.7 gm/100 ml. Estimates of energy from fractional analysis of macronutrients produced lower caloric estimates, especially at 2 weeks postpartum. Statistical differences over time and between and among mothers were found at all periods studied; therefore, on the basis of these data, we caution against reliance on single sample values as representative of mature milk either for individuals or for groups.

  4. Postpartum depression: perceptions of a diverse sample of low-income women.

    PubMed

    Jarosinski, Judith M; Pollard, Deborah Lynn

    2014-03-01

    Postpartum depression (PPD) continues to significantly impact women and their families during the perinatal period. Consequences of untreated PPD in the mother may lead to impaired mother-infant bonding, recurring psychiatric illness, and fewer positive parenting behaviors. North Carolina participates in the Pregnancy Risk Assessment Monitoring System (PRAMS) survey and has the second highest self-reported rate of postpartum depressive symptoms at 19.0%. The full study used both quantitative and qualitative methods. The qualitative approach, an interpretive Heideggerian perspective, elicited the postpartum clients' perceptions of risk factors, how those perceptions affected the pregnancy experience, and how self-efficacy played a role in their perceived ability to make healthy choices. The sample was comprised of 60 pregnant women between the ages of 18 and 40. Four themes were found: (1) Feeling joy and apprehension at once, (2) Depression is something you think about (3) Rearranging your thinking, and (4) Garnering support. The women in this study believed that support was an indispensable tool in dealing with feelings of sadness and depression. Critical aspects of becoming involved in their pregnancy included changing their expectations and knowing how to detect and seek help when depressive symptoms occurred. PMID:24597584

  5. [Vestibular dysfunction in the postpartum period following gestosis].

    PubMed

    Likhachev, S A; Astapenko, A V; Osos, E L; Tarasevich, N M

    2010-01-01

    The state of the vestibular system was evaluated in 30 postpartum women following gestosis and 25 controls after uncomplicated pregnancy. Examination using the electronystagmographic technique failed to reveal spontaneous nystagmus (Ny) in the latter group whereas 13.3% and 30% women of the former group had it with the eyes open and closed respectively. Provocative functional tests significantly improved detectability of Ny. Hyperventilation was associated with Ny in 80% and 12% of the women after complicated and uneventful pregnancy respectively while orthostatic test revealed Ny in 63% and 12% of them. Active head rotation with closed eyes produced well-apparent experimental Ny in women of both groups, but it was significantly more pronounced in the former one. Post-gestosis women displayed markedly impaired reaction in vestibular-ocular reflex suppression test. It is concluded that 80% of the women with complicated pregnancy exhibited vestibular dysfunction of central origin in the postpartum period. PMID:20517270

  6. Obtaining confirmation through social relationships: Norwegian first-time mothers' experiences while on maternity leave.

    PubMed

    Alstveit, Marit; Severinsson, Elisabeth; Karlsen, Bjørg

    2010-03-01

    The social relationships of employed women on maternity leave undergo significant changes. The aim of the study was to illuminate first-time mothers' experiences of social relationships while on maternity leave. Nine mothers were interviewed at both 3-5 months and 11-14 months post-partum and the data were analyzed by means of interpretative analysis. The main theme of obtaining confirmation through social relationships was based on two themes (being confirmed by other mothers and balancing between being a mother and an employee) and on four subthemes (seeking company, sharing experiences, feeling ineffective and in a state of stagnation, and trying to handle contact with the workplace). In order to strengthen the social relationships of mothers, the mother-child health service should offer all mothers the opportunity to join a peer support group, while employers could keep in regular contact with staff members on maternity leave.

  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. PMID:26694498

  8. 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

  9. Hantavirus pulmonary syndrome in a postpartum woman.

    PubMed

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

    2016-09-01

    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

  10. 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.

  11. Personal and professional support for mothers of NICU and healthy newborns.

    PubMed

    Coffman, S; Levitt, M J; Deets, C

    1991-01-01

    Personal support provided by close social network members and professional support provided by nurses were studied in 83 postpartum mothers and newborns in neonatal intensive care units and newborn nurseries. Mothers perceived each type of support differently in terms of outcomes. Only personal support was significantly related to emotional affect and life satisfaction outcomes. Both personal and professional support were related to relationship satisfaction outcomes. Findings suggest that personal support and professional support be treated as separate concepts.

  12. What Patterns of Postpartum Psychological Distress Are Associated with Maternal Concerns about Their Children's Emotional and Behavioural Problems at the Age of Three Years?

    ERIC Educational Resources Information Center

    Benzies, Karen; Mychasiuk, Richelle; Tough, Suzanne

    2015-01-01

    Mothers experiencing psychological distress in the postpartum period may have difficulties parenting their children. Inconsistent and unresponsive parenting may increase the risk of later emotional and behavioural problems in children. The purpose of this study was to identify how maternal psychological characteristics cluster at eight weeks…

  13. Influence of Social Context on Eating, Physical Activity, and Sedentary Behaviors of Latina Mothers and their Preschool-Age Children

    ERIC Educational Resources Information Center

    Lindsay, Ana C.; Sussner, Katarina M.; Greaney, Mary L.; Peterson, Karen E.

    2009-01-01

    As more U.S. children grow up in Latino families, understanding how social class, culture, and environment influence feeding practices is key to preventing obesity. The authors conducted six focus groups and 20 in-depth interviews among immigrant, low-income Latina mothers in the Northeast United States and classified 17 emergent themes from…

  14. Mother-Infant Dyadic State Behaviour: Dynamic Systems in the Context of Risk

    ERIC Educational Resources Information Center

    Coburn, Shayna S.; Crnic, Keith A.; Ross, Emily K.

    2015-01-01

    Dynamic systems methods offer invaluable insight into the nuances of the early parent-child relationship. This prospective study aimed to highlight the characteristics of mother-infant dyadic behavior at 12?weeks post-partum using state space grid analysis (total n?=?322). We also examined whether maternal prenatal depressive symptoms and…

  15. The Impact of Maternal Characteristics and Contextual Variables on Infant-Mother Attachment

    ERIC Educational Resources Information Center

    Huth-Bocks, Alissa C.; Levendosky, Alytia A.; Bogat, G. Anne; von Eye, Alexander

    2004-01-01

    This prospective study examined the effects of maternal characteristics, social support, and risk factors on infant-mother attachment in a heterogeneous sample. Two hundred and six women between the ages of 18 and 40 were interviewed during their last trimester of pregnancy and 1 year postpartum. Structural equation modeling revealed that maternal…

  16. Child Immunization Status among a Sample of Adolescent Mothers: Comparing the Validity of Measurement Strategies

    ERIC Educational Resources Information Center

    Phillips, Clarissa; Cota-Robles, Sonia; Knight, Margaret; Francis, Judith; Phillips, Elizabeth; Mazerbo, Laurie

    2011-01-01

    This study of adolescent mothers sought to identify whether a single general question asked by phone or a detailed, vaccine-specific question asked in a self-report questionnaire best captured infant immunization status at 6 months postpartum, by comparing them with immunization record books. Responses to a global question about whether infants…

  17. The Effect of Early and Extended Neonatal Contact on Mother-Infant Interaction.

    ERIC Educational Resources Information Center

    Hopkins, John B.

    In this study, 104 primarily indigent primiparous mothers from urban and rural areas and their healthy, full-term neonates were placed in one of four conditions during the normal postpartum lying-in period. Conditions were control, initial contact, rooming-in, and initial contact plus rooming-in. Dependent variables consisted of scores on the…

  18. Drug Dependence in Pregnancy: Clinical Management of Mother and Child. Services Research Reports and Monograph Series.

    ERIC Educational Resources Information Center

    Finnegan, Loretta P., Ed.

    This resouce manual compiles research findings concerning treatment of pregnant addicts. Major topics covered are: (1) prevalence and classification of psychotropic drug use; (2) pharmacologic effects on mother and infant; (3) clinical management during pregnancy; (4) management of labor, delivery, and the immediate post-partum period; (5)…

  19. Early Contact and Infant-Mother Attachment at One-Year.

    ERIC Educational Resources Information Center

    Ottaviano, Christine M.; And Others

    This paper reports the effects of one hour of extra post-partum contact between mother and infant on the quality of the attachment observed when the infant was one year old. It was hypothesized that infants in the extra contact condition would be classified as securely attached while regular contact infants would be less frequently classified as…

  20. The Impact of a Volunteer Postpartum Doula Program on Breastfeeding Success: A Case Study.

    PubMed

    Cattelona, Georg'ann; Friesen, Carol A; Hormuth, Laura J

    2015-11-01

    Bloomington Area Birth Services (BABS), centered in Bloomington, Indiana, is a community-based program that provides comprehensive education and support for new breastfeeding mothers, infants, family members, and the community by working together with local hospitals, midwives, obstetricians, pediatric offices, and social service agencies to create a seamless continuity of care for families. To help with continuity of care in the community, BABS established a volunteer doula program (birth and postpartum), allowing BABS to combine the services of a community lactation center with birth and postpartum doulas. This article describes the volunteer doula program and highlights one client's story in an effort to encourage and motivate other communities to focus their limited dollars on the development of a volunteer doula program.

  1. 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

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

    PubMed

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

    2016-09-12

    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.

  3. 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.

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

    PubMed

    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

  5. Experiential and hormonal correlates of maternal behavior in teen and adult mothers.

    PubMed

    Krpan, Katherine M; Coombs, Rosemarie; Zinga, Dawn; Steiner, Meir; Fleming, Alison S

    2005-01-01

    This study explores the role of cortisol and early life experiences in the regulation of maternal behavior and mood in teen and adult mothers. Primiparous mothers (n=119) (teen mothers < 19 years, n=42), young mothers (19-25 years, n= 4), and mature mothers, (>25 years, n=43) were assessed for their maternal behavior, mood, and hormonal profile at approximately 6 weeks postpartum. Outcome measures were analyzed as a function of age and early life experience. Results showed an interaction between age and type of maternal behavior, where teen mothers engaged in more instrumental (e.g. changing diapers, adjusting clothes) less affectionate (e.g., stroking, kissing, patting) behavior, and mature mothers engaged in more affectionate and less instrumental behavior. When groups were reassessed based on early life experience (consistency of care during the first 12 years of life: consistent care; having at least one consistent caregiver, inconsistent care; having multiple and changing caregivers), an interaction was also found between consistency of care and type of behavior shown, where mothers who received inconsistent care engaged in more instrumental and less affectionate behavior. Compared to mature mothers, teen mothers who were breast feeding also had higher salivary cortisol levels, and high cortisol in teen mothers related to decreased fatigue and increased energy. These results suggest that early life experiences are linked to mothering behavior and are consistent with the emerging human and animal literature on intergenerational effects of mothering style. PMID:15579272

  6. Perpetration and Victimization of Intimate Partner Aggression Among Rural Mothers

    PubMed Central

    Schwab Reese, Laura M.; Harland, Karisa; Smithart, Kelsey

    2015-01-01

    Abstract Intimate partner aggression is a leading cause of injury among women of child-bearing age. Research suggests that pregnancy and the postpartum period are times of increased vulnerability to aggression. Since rural women are at an increased risk of intimate partner aggression, research is needed to examine the role of pregnancy and the presence of children on intimate partner aggression among this vulnerable population. The purpose of this study is to examine the association between young children and intimate partner aggression victimization and perpetration among a rural sample. This analysis utilized data from biologic females of child-bearing age from the Keokuk County Rural Health Study, a cohort study of over 1,000 rural families conducted from 1994 to 2011. Crude and adjusted logistic regression was used to determine the relationship between having a young child and experiencing four forms of intimate partner aggression: verbal aggression perpetration, verbal aggression victimization, physical aggression perpetration, and physical aggression victimization. Having young children was significantly associated with increased odds of perpetrating verbal aggression but not victimization of verbal aggression or perpetration and victimization of physical aggression. This significant relationship persisted after adjustment for education, employment, or location of residence but not age or marital status. The increased odds of perpetrating verbal aggression among mothers in a rural area highlight the need for interventions designed for rural parents. One method of reducing intimate partner aggression may be to incorporate intimate partner aggression prevention activities into existing child abuse intervention activities.

  7. Postnatal foraging demands alter adrenocortical activity and psychosocial development.

    PubMed

    Lyons, D M; Kim, S; Schatzberg, A F; Levine, S

    1998-05-01

    Mother squirrel monkeys stop carrying infants at earlier ages in high-demand (HD) conditions where food is difficult to find relative to low-demand (LD) conditions. To characterize these transitions in psychosocial development, from 10- to 21-weeks postpartum we collected measures of behavior, adrenocortical activity, and social transactions coded for initiator (mother or infant), goal (make-contact or break-contact), and outcome (success or failure). Make-contact attempts were most often initiated by HD infants, but mothers often opposed these attempts and less than 50% were successful. Break-contact attempts were most often initiated by LD infants, but mothers often opposed these attempts and fewer LD than HD infant break-contact attempts were successful. Plasma levels of cortisol were significantly higher in HD than LD mothers, but differences in adrenocortical activity were less consistent in their infants. HD and LD infants also spent similar amounts of time nursing on their mothers and feeding on solid foods. By rescheduling some transitions in development (carry-->self-transport), and not others (nursing-->self-feeding), mothers may have partially protected infants from the immediate impact of an otherwise stressful foraging task. PMID:9589217

  8. 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

  9. "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. PMID:25595913

  10. Family Health Climate and Adolescents’ Physical Activity and Healthy Eating: A Cross-Sectional Study with Mother-Father-Adolescent Triads

    PubMed Central

    Niermann, Christina Y. N.; Kremers, Stef P. J.; Renner, Britta; Woll, Alexander

    2015-01-01

    Introduction The importance of the family environment for children’s and adolescents’ health behavior has been demonstrated, the underlying mechanisms of this influence remain unclear. Therefore, the aim of the study was to investigate the relationship between family environmental and individual determinants. It was hypothesized that the Family Health Climate (FHC) is associated with adolescents’ physical activity and dietary behavior and that intrinsic motivation mediates this association. Methods Cross-sectional data were collected from 198 families (mother, father, and child) using questionnaires. Perceptions of FHC of mothers, fathers, and their children were assessed using the FHC-scales for physical activity (FHC-PA) and nutrition (FHC-NU). The adolescents also rated their intrinsic motivation for exercise and healthy eating, their physical activity and consumption of healthful food. A structural equation model was analyzed and a bootstrapping procedure was used to test direct and indirect effects. Results The FHC-PA was related to the amount of weekly physical activity and the FHC-NU to the consumption of fruit, vegetables and salad. These effects were mediated by adolescents’ intrinsic motivation; the indirect effects were significant for both behaviors. Discussion These results emphasize the importance of the FHC in shaping adolescents’ physical activity and dietary behavior. Individual motivational factors are potential mediators of family and parental influences. Considering family-level variables and their interaction with individual factors contributes to the understanding of adolescents’ health behavior. PMID:26606157

  11. Adherence to extended postpartum antiretrovirals is associated with decreased breastmilk HIV-1 transmission: Results of the BAN study

    PubMed Central

    DAVIS, Nicole L.; MILLER, William C.; HUDGENS, Michael G.; CHASELA, Charles S.; SICHALI, Dorothy; KAYIRA, Dumbani; NELSON, Julie A. E.; STRINGER, Jeffrey S. A.; ELLINGTON, Sascha R.; KOURTIS, Athena P.; JAMIESON, Denise J; VAN DER HORST, Charles

    2015-01-01

    Objective Estimate association between postpartum antiretroviral adherence and breastmilk HIV-1 transmission Design Prospective cohort study Methods Mother-infant pairs were randomized after delivery to immediately begin receiving 28 weeks of either triple maternal antiretrovirals (zidovudine, lamivudine, and either nevirapine, nelfinavir, or lopinavir-ritonavir) or daily infant nevirapine as part of the Breastfeeding, Antiretrovirals, and Nutrition study. Associations between postpartum antiretroviral adherence and rate of breastmilk HIV-1 transmission were estimated using Cox models. We measured adherence over four postpartum time intervals using pill count, suspension bottle weight, and maternal self-report. Adherence was categorized and lagged by one interval. Missing adherence measures were multiply imputed. Infant HIV-1 infection was determined by DNA PCR every 2-6 weeks. The primary endpoint was infant HIV-1 infection by 38 weeks of age among infants alive and uninfected at 5 weeks. Results Analyses included 1479 mother-infant pairs and 45 transmission events. Using pill count and bottle weight information, 22-40% of mother-infant pairs at any given interval were <90% adherent. Having ≥90% adherence was associated with a 52% (95% CI 3-76%) relative reduction in the rate of breastmilk HIV-1 transmission, compared with having <90% adherence when controlling for study arm, breastfeeding status, and maternal characteristics. Complete case analysis rendered similar results (n=501; relative reduction 59%, 95% CI 6-82%). Conclusion Non-adherence to extended postpartum ART regimens in ‘real world’ settings is likely to be higher than that seen in BAN. Identifying mothers with difficulty adhering to antiretrovirals, and developing effective adherence interventions, will help maximize benefits of ARV provision throughout breastfeeding. PMID:25493600

  12. Web-Based Intervention for Postpartum Depression: Formative Research and Design of the MomMoodBooster Program

    PubMed Central

    Milgrom, Jeannette; Seeley, John R; Stuart, Scott; Schembri, Charlene; Tyler, Milagra S; Ericksen, Jennifer; Lester, Whitney; Gemmill, Alan W; Lewinsohn, Peter

    2012-01-01

    Background Postpartum depression is a significant public health problem affecting approximately 13% of women. There is strong evidence supporting Cognitive Behavioral Therapy (CBT) for successful psychosocial treatment. This treatment model combines cognitive and behavioral strategies to address pessimism, attributions for failure, low self-esteem, low engagement in pleasant activities, social withdrawal, anxiety, and low social support. Encouraging results have been reported for using Web-based CBT interventions for mental health domains, including the treatment of panic disorder, post-traumatic stress disorder, and complicated grief and depression. To date, however, Web-based interventions have not been used and evaluated specifically for the treatment of postpartum depression. Objective We describe the formative work that contributed to the development of our Web-based intervention for helping to ameliorate symptoms of postpartum depression, and the design and key components of the program. Methods A total of 17 focus group participants and 22 usability testers, who shared key characteristics with the participants of our planned feasibility study, took part. The proposed structure and ingredients of the program and mock-ups of selected webpages were presented to focus group participants. At various points, participants were asked a series of thought questions designed to elicit opinions and set the occasion for group discussion. At the end of the session, participants were asked to describe their overall reaction to the proposed features of the program emphasizing candid opinions about what they did not like and features they thought were missing and should be added. Usability testers were asked to interact with a series of seven different Web-based interactions planned for the program while receiving minimal direction. Each tester was asked to describe her thoughts using a think-aloud technique. They were then asked to consider all that they had learned about

  13. Gestational hormone profiles predict human maternal behavior at 1-year postpartum.

    PubMed

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

    2016-09-01

    In many non-human species, including primates, gestational reproductive hormones play an essential role in the onset of maternal motivation and behaviors. We investigated the associations between prepartum estradiol and progesterone and maternal behavior at 1-year postpartum in 177 women. Blood was obtained at five gestational time points and an index of quality of maternal care was determined using a well-validated mother-child interaction protocol. Women who exhibited higher quality maternal care at 1-year postpartum were characterized by unique gestational profiles of estradiol, progesterone and the estrogen to progesterone ratio; specifically by slower accelerations and levels of these hormone trajectories beginning in midgestation. Further, it appeared that both fetal sex and parity moderated these findings, with first time mothers and mothers of females showing stronger associations. In sum, these data document persisting associations between prepartum hormone profiles and human maternal behavior. More broadly, these findings add to the growing literature highlighting the perinatal period as one of critical neurodevelopment in the lifespan of the human female. PMID:27427279

  14. 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

  15. 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

  16. The intricacies of induced lactation for same-sex mothers of an adopted child.

    PubMed

    Wilson, Erica; Perrin, Maryanne Tigchelaar; Fogleman, April; Chetwynd, Ellen

    2015-02-01

    The definition of a modern family is changing. In this case study, we describe the breastfeeding experience of a child receiving human milk from all 3 of his mothers: his 2 adoptive mothers, who induced lactation to nurse him, and his birth mother, who shared in his early feeding during the open adoption process and continued to pump and send milk to him for several months. We review the lactation protocol used by his adoptive mothers and the unique difficulties inherent in this multi-mother family dynamic. Both adoptive mothers successfully induced moderate milk production using a combination of hormonal birth control, domperidone, herbal supplements, and a schedule of breast pumping. However, because of the increased complexity of the immediate postpartum period and concerns with defining parental roles in a same-sex marriage, maintenance of milk production was difficult. PMID:25311827

  17. Relationship Satisfaction Among Mothers of Children With Congenital Heart Defects: A Prospective Case-Cohort Study

    PubMed Central

    Solberg, Øivind; Holmstrøm, Henrik; Landolt, Markus A.; Eskedal, Leif T.; Vollrath, Margarete E.

    2013-01-01

    Objective To assess the level of partner relationship satisfaction among mothers of children with different severity of congenital heart defects (CHD) compared with mothers in the cohort. Methods Mothers of children with mild, moderate, or severe CHD (n = 182) and a cohort of mothers of children without CHD (n = 46,782) from the Norwegian Mother and Child Cohort Study were assessed at 5 time points from pregnancy to 36 months postpartum. A 5-item version of the Relationship Satisfaction scale was used, and relevant covariates were explored. Results The trajectories of relationship satisfaction among mothers of children with varying CHD severity did not differ from the trajectories in the cohort. All women in the cohort experienced decreasing relationship satisfaction from 18 months after delivery up to 36 months after delivery. Conclusions Having a child with CHD, regardless of severity, does not appear to exacerbate the decline in relationship satisfaction. PMID:23792348

  18. Anxiety levels of mothers with newborns in a Neonatal Intensive Care Unit in Turkey

    PubMed Central

    Mizrak, Berrak; Deniz, Ayse Ozge; Acikgoz, Ayfer

    2015-01-01

    Objective: To compare the anxiety levels of mothers with newborns in a Neonatal Intensive Care Unit (NICU) and mothers with healthy newborns in a postpartum care service (PCS). Methods: This descriptive study was conducted in state and medical school hospitals located in Eskisehir and Afyon, Turkey. The first 200 mothers, including mothers with newborns in a PCS (n=100) and mothers with newborns in a NICU (n=100); participants were followed starting March 1, 2014. Questionnaires to determine the characteristics of mothers and newborns were used as data collection tools, including the State-Trait Anxiety Inventory Scale (STAI TX-1 – STAI TX-2). Results: Trait anxiety levels were not significantly different between mothers with newborns in the NICU and mothers with newborns in PCS (t=0.588, p=0.557), whereas state anxiety levels were significantly different between the two groups (t=-5.109, p=<0.001). The state anxiety levels of mothers whose infants were in the NICU were determined to be higher compared to those of mothers whose infants were in PCS. Conclusion: Being a mother of a sick newborn can elevate anxiety and lead to in mothers. During this challenging time, the support of nurses can increase mothers’ abilities to cope with the stress of a sick newborn. PMID:26649009

  19. Small families mean better health for mothers and kids.

    PubMed

    Mugumya, E

    1994-01-01

    The practice of family planning (FP) has been used since time immemorial to solve community, individual, and familial problems. There are Biblical references to incest being used to ensure the conception of children and to coitus interruptus being used to prevent conception. Pastoralists used cessation of breastfeeding of male calves to promote the conception and birth of more desirable female calves. The condom has ancient precursors made of animal intestines, and the IUD has a prototype in the stone commonly inserted in the uterus of a camel during long journeys to prevent conception. The issues of effectiveness, safety, and convenience that led to these ancient activities also inform the development and use of modern contraception. FP incorporates fertility control, both treatment for infertility and contraception; abortion is regarded as an indicator of a need for FP, not as part of FP. FP is justified on the grounds of human rights, because it allows an individual to choose whether or not to have a child; on the grounds of health, because maternal age and parity affect the health of the mother and child; on socioeconomic grounds, because overpopulation creates drains on already decreasing resources and because birth to unwed mothers creates difficulties for the children and for society; and on the grounds of improving the status of women because unwanted pregnancy causes women to abandon educational and employment opportunities. The maternal and child health and FP services in Uganda provide immunization, nutrition, prenatal and postpartum care, young child clinic services, school health education, and FP services. PMID:12318959

  20. The child's active role in mother-child, father-child psychotherapy: a psychodynamic approach to the treatment of relational disturbances.

    PubMed

    Harel, Judith; Kaplan, Hayuta; Avimeir-Patt, Raya; Ben-Aaron, Miriam

    2006-03-01

    The short-term mother-child and father-child psychoanalytic psychotherapy assumes that children develop specific types of relationships with each parent, as well as with the parenting couple. The model integrates an intra-psychic, object-relational view with an interpersonal perspective to the treatment of relational disturbances in childhood. The same therapist meets with the mother-child, father-child dyads on a weekly basis, along with regular meetings with the parental dyad. The model focuses on the developmentally prelatency child's need for the active participation of both parents in the here-and-now shared experiences of the therapeutic process. The participants express, in interactions and in enactments, various contents and meanings of their specific patterns of relations. The therapist addresses the behaviours as well as the meanings of relations, thus promoting reflective understanding and experiential changes in self, other, and self-other relations. The child's active and different participation with each parent is the main change-promoting factor. The child uses mainly the medium of play to express his/her needs and to mobilize the therapist's help. The therapist's access to the different dyads is utilized to better understand the explicit and implicit relational themes. The therapist supports the co-construction of new and different behaviour patterns and the co-creation of additional meanings to representations. The setup fosters the child's active participation in each dyad's growth-promoting changes.

  1. Conceptualization and development of a theory-based healthful eating and physical activity intervention for postpartum women who are low income.

    PubMed

    Ebbeling, Cara B; Pearson, Meredith N; Sorensen, Glorian; Levine, Rachel A; Hebert, James R; Salkeld, Judith A; Peterson, Karen E

    2007-01-01

    Eating and physical activity behaviors that confer risk for chronic disease are prominent among women from varying ethnic and racial groups who are low income. Conceptualization and development of a theory-based behavioral intervention to address their unique needs during the first year following childbirth comprised four steps: (a) translating public health guidelines and emerging epidemiologic data into specific intervention messages; (b) developing practical strategies to operationalize theoretical constructs, in the context of a social ecological framework; (c) stating achievement-based objectives and writing scripts for five home visits; and (d) conducting formative research. Focus group participants expressed a desire for a "health mentor," not somebody who "nags" or "stresses you out." Paraprofessionals from the Expanded Food and Nutrition Education Program (EFNEP) were directly involved in pretesting the intervention and remain involved as health mentors. This intervention can serve as a basis for future organizational partnerships to benefit the health of populations who are low income.

  2. Postpartum haemorrhage in Zimbabwe: a risk factor analysis.

    PubMed

    Tsu, V D

    1993-04-01

    For both cases and controls, only singleton, vertex births with spontaneous onset of labor without oxytocic or instrumental intervention during delivery between May 1 and December 31, 1989, were included, and all eligible mothers were residents of Greater Harare. There were 2 case groups: women with postpartum hemorrhage after a normal vaginal delivery, and women with cephalopelvic disproportion (CPD) requiring surgical or instrumental delivery. Postpartum hemorrhage (PPH) was defined as excess bleeding with a minimum of 600 ml rather than 500 ml. Data were abstracted from the medical records. 2 control groups (PPH and CPD) were combined for a control group of 299 normal deliveries. Cases were much more likely than controls to have a traumatic delivery involving vaginal or cervical tears, which accounted for more than one-third of the hemorrhages. Uterine atony was the most common cause of PPH. There was one maternal death among the cases (case fatality rate of 6.6/1000). The perinatal mortality among the cases was 33.8/1000 live births (3 stillbirths, 2 neonatal deaths) and none among controls. Although cases and controls had similar mean gravidity (3.3) and parity (2.2), cases were more likely to have had either none or 1 previous delivery. Cases also had a higher proportion of grand multiparas (5 or more previous deliveries). More cases than controls reported outcomes such as PPH, miscarriage in the first or second trimester, or neonatal death. The results of the logistic regression analysis showed that women 35 years or more at delivery were at 2.5 times greater risk of PPH than were younger women. Women who were hospitalized antenatally for a pregnancy-related problem were at 3-4 times greater risk of PPH than were women without hospitalization. Occiput transverse or posterior fetal head position was associated with a nearly/10-fold greater relative risk for PPH.

  3. POSTPARTUM AND NEONATAL NURSING CARE DURING THE 2009 H1N1 INFLUENZA PANDEMIC

    PubMed Central

    Zapata, Lauren B.; Ruch-Ross, Holly S.; Williams, Jennifer L.; Ruhl, Catherine

    2016-01-01

    We describe select influenza infection control policies and practices related to postpartum and newborn care during the 2009 H1N1 pandemic. In an online survey of obstetric and neonatal nurses, significantly more nurses indicated a written hospital policy supporting each of the practices during versus before the pandemic. The two practices least oft en implemented were temporary separation of healthy newborns from ill mothers (37.7 percent) and testing newborns for influenza virus infection if signs of influenza were observed (31.4 percent). Presence of written hospital policies increased implementation of practices. Findings may be useful to guide planning for future pandemics or other public health emergencies. PMID:23957794

  4. The Neurobiological Impact of Postpartum Maternal Depression: Prevention and Intervention Approaches.

    PubMed

    Drury, Stacy S; Scaramella, Laura; Zeanah, Charles H

    2016-04-01

    The lasting negative impact of postpartum depression (PPD) on offspring is well established. PPD seems to have an impact on neurobiological pathways linked to socioemotional regulation, cognitive and executive function, and physiologic stress response systems. This review focus on examining the current state of research defining the effect of universal, selected, and indicated interventions for PPD on infant neurodevelopment. Given the established lasting, and potentially intergenerational, negative implications of maternal depression, enhanced efforts targeting increased identification and early intervention approaches for PPD that have an impact on health outcomes in both infants and mothers represent a critical public health concern. PMID:26980123

  5. Mentalization-based psychotherapy interventions with mothers-to-be.

    PubMed

    Markin, Rayna D

    2013-09-01

    In recent years, the theory of mentalization has been applied to a number of clinically relevant areas including psychotherapy for patients with borderline personality disorder, therapy with adolescents and children, treatment of self-harm in young people, parent-infant early interventions, and even community outreach (see Midgley & Vrouvam, 2012. Minding the child: Mentalizing interventions with children, young people, and their families. London and New York: Routledge). Extending on this body of work, the present article applies the theory of mentalization to psychotherapies that aim to help first time expecting mothers psychologically adjust to and prepare for motherhood. Theory and research suggest that pregnancy represents an intermediate space in which, under ideal circumstances, the woman comes to represent herself as a mother, her unborn child as a separate and intentional being, and her emotional bond or attachment to the fetus. However, the expecting mother's own conflictual experiences being mothered are likely to influence her ability to mentalize her pregnancy, setting the stage for problems in the mother-infant dyad postpartum. This article explores how mentalizing techniques may be used in psychotherapy to help mothers-to-be to mentalize their emerging identity as a mother, their unborn child, and their developing relationship to the fetus.

  6. Postpartum IUCD: Rediscovering a Languishing Innovation.

    PubMed

    Balsarkar, Geetha Dharmesh; Nayak, Arun

    2015-07-01

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

  7. Mothers in the NICU: outsider to partner.

    PubMed

    Heermann, Judith A; Wilson, Margaret E; Wilhelm, Patricia A

    2005-01-01

    The emerging care delivery model for Neonatal Intensive Care Units (NICU) is family-focused, developmentally supportive care. The purpose of this study was to explore and describe mothers' experience of becoming a mother while their infants were receiving care in the NICU. A qualitative research design was used. Interviews with 15 mothers whose infants were in a Level III NICU were analyzed using Spradley's domain analysis approach. Mothers developed from outsider to engaged parent along four continua: (1) focus: from NICU to baby; (2) ownership: from their baby to my baby; (3) caregiving: from passive to active; and (4) voice: from silence to advocacy. Mothers entered the continua at different points and moved at different rates toward "engaged parenting." The final stage, partnering, required active participation of nurses. Mothers' development evolved in predictable patterns. The results of this study can be considered in implementation and evaluation plans for NICUs moving to family-focused developmental care.

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

    PubMed Central

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

    2012-01-01

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

  9. Predictors of postpartum depression: prospective study of 264 women followed during pregnancy and postpartum.

    PubMed

    Gaillard, Adeline; Le Strat, Yann; Mandelbrot, Laurent; Keïta, Hawa; Dubertret, Caroline

    2014-02-28

    The prevalence of postpartum depression is approximately 13%. Postpartum depression is associated with a higher maternal morbidity and mortality, and also with pervasive effects on the emotional, cognitive and behavioral development of the child. The aim of our study was to identify socio-demographic, psychosocial and obstetrical risk factors of postpartum depression in a middle class community sample, using a prospective design. We enrolled consecutively 312 pregnant outpatients in a single maternity unit. The first assessment was conducted between 32 and 41 weeks gestation, and a second time between 6 and 8 weeks after delivery. Depressive symptoms were measured using the French version of the Edinburgh Postnatal Depression Scale (EPDS). A cut-off score of 12/30 or above was considered as indicative of Major Depression. Of the initial sample of 312 women, 264 (84.6%) were followed-up between 6 and 8 weeks after delivery and considered for analysis. Depression during pregnancy, migrant status, and physical abuse by the partner were independently associated with postpartum depression when considered together, whereas physical complications were significantly associated with postpartum depression only when adjusting for antenatal depression. Depression during pregnancy, history of physical abuse, migrant status and postpartum physical complications are four major risk factors for postpartum depression. PMID:24370337

  10. An exploratory factor analysis of the Parenting strategies for Eating and physical Activity Scale (PEAS) for use in Hispanic mothers of adolescent and preadolescent daughters with overweight.

    PubMed

    Matthews-Ewald, Molly R; Posada, Alexandria; Wiesner, Margit; Olvera, Norma

    2015-12-01

    Existing measures of feeding and physical activity parenting strategies have not been validated for use among Hispanic mothers of adolescent and preadolescent daughters with overweight. The purpose of this study was to investigate the factor structure of the Parenting strategies for Eating and Activity Scale (PEAS) among 134 Hispanic mothers (Mage=38.81, SD±6.34) of adolescent and preadolescent daughters with overweight. Results from this exploratory study revealed that a three-factor structure (Limit Setting, Monitoring, and Discipline) and a 13-item revised PEAS measure might be better suited for use with this population. The revised Limit Setting, Monitoring, Discipline, and total subscales had good reliability (α=0.89, α=0.88, α=0.90, and α=0.87, respectively) and the subscale inter-item correlations were strong. To assess the concurrent validity, the revised PEAS subscales were correlated with both subscales of the Behavioral Strategies to Reduce Fat and Increase Fiber (Parent Report) in a subset of the sample (n=78). The Monitoring and Discipline subscales were found to be correlated with the Behavioral Strategies to Reduce Fat (r=.36 and r=.27, p<.05, respectively) and Increase Fiber (r=.40 and r=.35, p<.01, respectively) subscales. However, the revised PEAS Limit Setting subscale was not correlated with either Reduce Fat or Increase Fiber strategy. Taken together, these results indicated some degree of concurrent validity. Results from this study should be cross-validated using confirmatory factor analysis approaches.

  11. Effects of postpartum exercise program on fatigue and depression during "doing-the-month" period.

    PubMed

    Ko, Yi-Li; Yang, Chi-Li; Chiang, Li-Chi

    2008-09-01

    This study explored the effectiveness of an exercise program on reducing levels of fatigue and depression among postpartum women who were "doing-the-month" in a maternity center in Taiwan. Previous studies related to postpartum have focused on depression rather than women's feelings of fatigue, and no study related to exercise has previously been conducted in a Taiwan maternity center. A low-intensity exercise program was specifically designed and administered to 31 subjects in the study's intervention group. Another 30 subjects (the control group) followed a traditional, non-physically active postpartum care regimen. Those in the intervention group were required to participate in at least 6 exercise program sessions during their one month postpartum stay. All subjects were asked to fill out a fatigue and depression questionnaire before and after the program. A Fatigue Symptom Checklist (FSC) was used to measure fatigue, and the Center for Epidemiological Studies Depression (CESD) was used to confirm the development of depression. Results showed statistically significant differences between the two groups in terms of fatigue levels, with statistical improvements (p < .05) registered by the intervention group in terms of levels of physical and psychological fatigue and fatigue symptoms. However, no significant changes in depression between the two groups were found. Study results demonstrate that a low-intensity exercise program can offer a good platform for clinicians and researchers to help reduce fatigue in postpartum women. PMID:18792887

  12. Kawasaki disease in a postpartum patient.

    PubMed Central

    Fason, Janet T.; Fry, Yvonne W.; Smith, Dominique

    2004-01-01

    Kawasaki disease, also known as mucocutaneous lymph node syndrome, is a multisystem disease. It usually affects children below the age of five, but it occasionally affects adults. There are less than 50 English-reported adult cases in the literature, and only five reported cases of Kawasaki disease and pregnancy, as of 2003. The cases associated with pregnancy involved patients who had a history of Kawasaki disease during childhood and addressed how the complications of the illness (i.e,. coronary artery aneurysms) were managed during pregnancy and delivery. There are no reported cases of Kawasaki disease in postpartum patients. This article presents a case of Kawasaki disease in a 21-year-old, four-week postpartum patient who initially responded to intravenous (IV) antibiotic therapy. This paper will review the diagnosis and treatment of Kawasaki disease as well as the multiple outside variables that impact the management of adult postpartum patients with Kawasaki disease. PMID:15586654

  13. Case Report: Postpartum Cough and Dyspnea.

    PubMed

    Czerwinski, Eileen M

    2016-01-01

    Peripartum/postpartum cardiomyopathy (PPCM) is a rare condition associated with pregnancy in which there is left ventricular (LV) dysfunction resulting in symptoms of heart failure (). This occurs in previously healthy women and is seen in the last month of pregnancy or during the first 5 months postpartum (). Incidence ranges from 1 in 1,300 to 1 in 15,000 pregnancies in the United States (). A case study is presented of a patient with severe impairment of LV function seen in the emergency department (ED). The ED is a common location for initial presentation; therefore, the ED provider should be cognizant of key features of PPCM. The differential diagnosis and medical management of PPCM are discussed. Emergency department management should focus on 3 key elements: an increase in inotropy and a reduction in preload and afterload. Differences between postpartum and peripartum states are outlined. PMID:27482991

  14. [Postpartum psychoses. A case report].

    PubMed

    Musella, V; Passannanti, G; Pellicano, M; Cirillo, D; Tanzillo, M; Busiello, G; Vitelli, R

    1996-09-01

    The puerperal period is a critical one in the life of a woman, due to the numerous changes which occur at biological and psychological levels and also at the level of relationships. Various disturbances of a psychiatric nature may emerge during this period which represents a "risky" phase from a psycho-pathological point of view. Among some of these disturbances, so-called "puerperal psychoses", there is an uncertain nosographic connection. According to some authors, these psychoses could be distinct nosographic events, while others prefer to include them in psychotic disturbances which have already been classified. From this point of view the puerperal period would be a stressful event. Risk factors would be a first birth, previous psychotic puerperal episodes, inherited serious psychiatric disturbances and caesarean section. The therapy used in the case of such disturbances must take into account many aspects and implications which don't exclusively concern the new mother but which also look significantly at the newborn baby, and the patient's family circumstances. All this implies the necessity for a close collaboration between specialists in different medical areas (psychiatry and obstetrics). Particular attention should be given to the type of disturbed relationship which can occur between the mother and the new born child. The analysis of our case has stimulated many reflections from a clinical, therapeutic and prognostic point of view, and as a result we tent to agree with published material on the subject. PMID:8999386

  15. Mother-daughter in vitro fertilization triplet surrogate pregnancy.

    PubMed

    Michelow, M C; Bernstein, J; Jacobson, M J; McLoughlin, J L; Rubenstein, D; Hacking, A I; Preddy, S; Van der Wat, I J

    1988-02-01

    A successful triplet pregnancy has been established in a surrogate gestational mother following the transfer of five embryos fertilized in vitro. The oocytes were donated by her biological daughter, and the sperm obtained from the daughter's husband. The daughter's infertility followed a total abdominal hysterectomy performed for a postpartum hemorrhage as a result of a placenta accreta. Synchronization of both their menstrual cycles was obtained using oral contraceptive suppression for 2 months, followed by stimulation of both the surrogate gestational mother and her daughter such that embryo transfer would occur at least 48 hr after the surrogate gestational mother's own ovulation. This case raises a number of medical, social, psychological, and ethical issues. PMID:3367072

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

    PubMed

    Pearlstein, Teri

    2013-11-01

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

  17. 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 one bearing the gravidic CL. A balance in the number of such follicles was reached toward the end of the first month. In conclusion, although some follicular activity was recorded in the ovaries of all buffaloes, true postpartum resumption of cyclicity in the months of increasing daylight hours was delayed in the majority of animals. PMID:15725449

  18. 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 one bearing the gravidic CL. A balance in the number of such follicles was reached toward the end of the first month. In conclusion, although some follicular activity was recorded in the ovaries of all buffaloes, true postpartum resumption of cyclicity in the months of increasing daylight hours was delayed in the majority of animals.

  19. The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort study*

    PubMed Central

    Wesnes, SL; Hunskaar, S; Bo, K; Rortveit, G

    2009-01-01

    Objective The objectives of this study were to investigate prevalence of urinary incontinence at 6 months postpartum and to study how continence status during pregnancy and mode of delivery influence urinary incontinence at 6 months postpartum in primiparous women. Design Cohort study. Setting Pregnant women attending routine ultrasound examination were recruited to the Norwegian Mother and Child Cohort Study (MoBa). Population A total of 12 679 primigravidas who were continent before pregnancy. Methods Data are from MoBa, conducted by the Norwegian Institute of Public Health. Data are based on questionnaires answered at week 15 and 30 of pregnancy and 6 months postpartum. Main outcome measures Urinary incontinence 6 months postpartum is presented as proportions, odds ratios and relative risks (RRs). Results Urinary incontinence was reported by 31% of the women 6 months after delivery. Compared with women who were continent during pregnancy, incontinence was more prevalent 6 months after delivery among women who experienced incontinence during pregnancy (adjusted RR 2.3, 95% CI 2.2–2.4). Adjusted RR for incontinence after spontaneous vaginal delivery compared with elective caesarean section was 3.2 (95% CI 2.2–4.7) among women who were continent and 2.9 (95% CI 2.3–3.4) among women who were incontinent in pregnancy. Conclusion Urinary incontinence was prevalent 6 months postpartum. The association between incontinence postpartum and mode of delivery was not substantially influenced by incontinence status in pregnancy. Prediction of a group with high risk of incontinence according to mode of delivery cannot be based on continence status in pregnancy. PMID:19220234

  20. Behavioral and Pharmacological Investigation of Anxiety and Maternal Responsiveness of Postpartum Female Rats in a Pup Elevated Plus Maze

    PubMed Central

    Yang, Yu; Qin, Jingxue; Chen, Weihai; Sui, Nan; Chen, Hong; Li, Ming

    2015-01-01

    The present study investigated the validity of a novel pup-based repeated elevated plus maze task to detect reduced anxiety and increased maternal responsiveness in postpartum female rats and explored the roles of dopamine D2, serotonin transporter and GABA/benzodiazepine receptors in the mediation of these processes. Sprague-Dawley postpartum or nulliparous female rats were tested 4 times every other day on postpartum days 4, 6 and 8 in an elevated plus maze with 4 pups or 4 pup-size erasers placed on each end of the two open arms. When tested with erasers, untreated postpartum mother rats entered the open arms proportionally more than nulliparous rats. They also tended to spend more time in the open arms, indicating reduced anxiety. When tested with pups, postpartum rats retrieved pups into the closed arms, entered the open arms and closed arms more and had a higher moving speed than nulliparous rats, indicating increased maternal responsiveness. Both haloperidol (0.1 or 0.2 mg/kg, sc) and fluoxetine (5 or 10 mg/kg, ip) dose- and time-dependently decreased the percentage of time spent in the open arms and speed, but did not affect the percentage of open arm entries. Diazepam (1.0 or 2.0 mg/kg, ip) did not affect pup retrieval, open arm time/entry in lactating rats. Thus, the percentage of open arm entries appears to be the most sensitive measure of anxiety in postpartum female rats, while speed could be used to index maternal responsiveness to pups, which are likely mediated by the dopamine D2 and serotonin transporter systems. PMID:26159828

  1. Postpartum haemorrhage: a cause of maternal morbidity.

    PubMed

    Shirazee, Hasibul Hasan; Saha, Sudip Kr; Das, Indrani; Mondal, Tanmoy; Samanta, Sandip; Sarkar, Moloy

    2010-10-01

    To identify and analyse the risk factors associated with postpartum haemorrhage (PPH) and assess their impact on the maternal morbidity, a prospective observational study was carried out over a period of one year in a tertiary level referral institute in Kolkata, West Bengal, India. All the cases of PPH were identified and studied. Data analyses were done using Chi-square test. Out of 210 cases of maternal morbidity, 79 (37.6%) were found to have PPH as the causative factor. Uterine atonicity was found to be the main cause leading to 45 cases (56.9%) of PPH. With respect to the mode of delivery severe PPH was found in 34.3% of vaginally and 60% of operatively delivered patients which had statistical significance. More number of severe PPH cases, 17/31 (54.8%), had delivered outside the medical college. Here comes the role of 24-hour quality emergency obstetric care (EMOC), active management of 3rd stage of labour and early referral to the higher centre. The case fatality rate of PPH during the study period was 7.5%. This finding is quite close to the observation made in a North Indian tertiary hospital based study. In order to reduce maternal morbidity and thereby indirectly maternal mortality and to improve the overall maternal health, prevention and control of PPH can play a significant role. An integrated approach at all levels of healthcare delivery system, active management of labour and efficient emergency obstetric care will help in controlling the PPH. PMID:21510550

  2. Can Early Postpartum Home Visits by Trained Community Health Workers Improve Breastfeeding of Newborns?

    PubMed Central

    Mannan, Ishtiaq; Rahman, Syed Moshfiqur; Sania, Ayesha; Seraji, Habibur R; Arifeen, Shams El; Winch, Peter; Darmstadt, Gary L; Baqui, Abdullah

    2010-01-01

    Objectives Whether postpartum visits by trained community health workers (CHW), reduce newborn breastfeeding problems. Methods CHWs made antenatal and postpartum home visits promoting newborn care practices including breastfeeding. CHWs assessed neonates for adequacy of breastfeeding and provided hands on support to mothers to establish breastfeeding. History and observation data of 3,495 neonates were analyzed to assess effects of CHW visitation on feeding problems. Results Inappropriate breastfeeding position and attachment were the predominant problems (12% –15%). 6% of newborns who received home visit by CHWs within 3 days had feeding difficulties, compared to 34% of those who did not (OR: 7.66, 95% CI: 6.03–9.71, p=0.00). Latter group was 11.4 times (95% CI: (6.7–19.3, p=0.00) more likely to have feeding problems as late as day 6–7, than the former. Conclusions Counselling and hands on support on breastfeeding techniques by trained workers within first 3 days of birth, should be part of community based postpartum interventions. PMID:18596714

  3. Psychiatric Morbidity and Correlates in Postpartum Women in a Tertiary Care Hospital

    PubMed Central

    Kumar, Narendra; Nagaraj, Anil Kumar Mysore; Koudike, Umashree; Majgi, Sumanth Mallikarjuna

    2016-01-01

    Background: A range of psychological disorders occur in women in the postpartum period apart from the traditional blues, postpartum depression and psychosis. These include obsession of infanticide, PTSD, morbid preoccupations regarding child birth and disorders of mother-infant relationships, though they are under emphasized. Methods: it is a cross-sectional study conducted in the tertiary maternity care hospital. A total of 152 study subjects were interviewed on MINI (Mini International Neuropsychiatric Inventory) and GAF (Global Assessment of Functioning) within 2 weeks after delivery. Results: The psychiatric morbidity was seen in 67 (44%) of the study subjects. About 26% of subjects had Depressive disorder NOS. Obsessive harm to the child, Panic disorder, Social phobia were the other disorders identified. There were no cases of Mania, Bipolar disorder, psychosis, post traumatic stress disorder or substance use disorder diagnosed across the sample. The Global Assessment of Functioning (GAF) score averaged 87.8. Statistically significant association was seen to be present between psychiatric illness and number of previous still births and dead children before this delivery (P = 0.045). Conclusions: The study reveals that psychiatric co-morbidity is very common in the postpartum period and can be detected as early as first week after delivery. Social phobia identified as a common association is a new finding and needs further replication. It needs a larger sample with a prospective assessment to generalize the findings of our study. PMID:27570341

  4. Retention to Care of HIV-Positive Postpartum Females in Kumasi, Ghana

    PubMed Central

    Reece, Rebecca; Norman, Betty; Kwara, Awewura; Flanigan, Timothy; Rana, Aadia

    2016-01-01

    Background Despite the success of prevention of mother-to-child transmission programs, transition to care in the postpartum period is vulnerable to being lost to care. Methods The authors performed a 2-year retrospective study of postpartum HIV-infected patients at Komfo Anokye Teaching Hospital in Kumasi, Ghana. The outcome was classified as optimal follow-up, suboptimal follow-up, and loss to follow-up (LTFU). Univariate and multivariate analyses were used to identify factors associated with optimal retention. Results Follow-up was optimal in 66%, suboptimal in 16%, and LTFU in 18% of patients. The rate of LTFU was 22% among women diagnosed at pregnancy and 13% among those with known HIV diagnosis (P = .078). Adherence counseling (odds ratio [OR] 5.0, confidence interval [CI] 1.6-15.7; P = .006) and family planning (FP; OR 2.3, CI 1.0-5.3; P = .041) were predictive of optimal follow-up. Conclusion At 1 year, only two-thirds of postpartum women remained in care. Investigating barriers to adherence counseling and FP may impact engagement in care among HIV-infected women. PMID:26319433

  5. Using clinical decision support as a means of implementing a universal postpartum depression screening program.

    PubMed

    Loudon, Holly; Nentin, Farida; Silverman, Michael E

    2016-06-01

    A major barrier to the diagnosis of postpartum depression (PPD) includes symptom detection. The lack of awareness and understanding of PPD among new mothers, the variability in clinical presentation, and the various diagnostic strategies can increase this further. The purpose of this study was to test the feasibility of adding clinical decision support (CDS) to the electronic health record (EHR) as a means of implementing a universal standardized PPD screening program within a large, at high risk, population. All women returning to the Mount Sinai Hospital OB/GYN Ambulatory Practice for postpartum care between 2010 and 2013 were presented with the Edinburgh Postnatal Depression Scale (EPDS) in response to a CDS "hard stop" built into the EHR. Of the 2102 women who presented for postpartum care, 2092 women (99.5 %) were screened for PPD in response to a CDS hard stop module. Screens were missing on ten records (0.5 %) secondary to refusal, language barrier, or lack of clarity in the EHR. Technology is becoming increasingly important in addressing the challenges faced by health care providers. While the identification of PPD has become the recent focus of public health concerns secondary to the significant social burden, numerous barriers to screening still exist within the clinical setting. The utility of adding CDS in the form of a hard stop, requiring clinicians to enter a standardized PPD mood assessment score to the patient EHR, offers a sufficient way to address a primary barrier to PPD symptom identification at the practitioner level.

  6. 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. PMID:24164818

  7. Mental health treatment need among pregnant and postpartum women/girls entering substance abuse treatment.

    PubMed

    Coleman-Cowger, Victoria H

    2012-06-01

    Substance use during pregnancy is widely acknowledged as a major public health concern with detrimental effects on both mother and unborn child. Mental health issues often co-occur with substance use and may trigger continued use during pregnancy or relapse to use postpartum, though little is known about the extent of these issues in pregnant and postpartum women entering substance abuse treatment. The purpose of this study is: (a) to examine self-reported mental health in a population of women and girls who were pregnant in the past year and are entering substance abuse treatment, and (b) to determine whether disparity exists in mental health treatment received across groups by race and age if a treatment need is present. Secondary data analysis was conducted with Global Appraisal of Individual Needs (GAIN) data from 502 female adolescents and adults who reported having been pregnant in the past year and who completed the GAIN upon entry into substance abuse treatment. Participants were compared on demographic, diagnostic, and problem severity variables by race and age. Results indicate that mental health treatment need is high among the whole pregnant and postpartum sample, but African American and Hispanic women and girls are receiving less mental health treatment than other groups despite having a need for it. No mental health treatment acquisition disparity was found by age.

  8. Associations Between Prenatal Coparenting Behavior and Observed Coparenting Behavior at 9 Months Postpartum

    PubMed Central

    Altenburger, Lauren E.; Schoppe-Sullivan, Sarah J.; Lang, Sarah N.; Bower, Daniel J.; Kamp Dush, Claire M.

    2015-01-01

    Coparenting, or the ways partners relate to each other in their roles as parents, is important to child and family functioning. However, it remains unclear whether coparenting begins at or prior to a child’s birth. This study tested whether expectant parents’ behavior in the Prenatal Lausanne Trilogue Play procedure (PLTP), an assessment designed in Switzerland for examining prebirth coparenting behavior, forecasted postnatal observations of coparenting behavior in a sample of first-time parents in the United States. 182 dual-earner couples expecting their first child participated in the PLTP during the third trimester of pregnancy, and at 9 months postpartum, observations of coparenting behavior were obtained from mother-father-infant play interactions. Structural equation modeling analyses indicated significant continuity between expectant parents’ prenatal coparenting behavior and their observed postpartum coparenting behavior one year later. In particular, couples who engaged in higher quality prenatal coparenting behavior demonstrated more supportive and less undermining coparenting behavior at 9 months postpartum, even after controlling for observed prenatal couple behavior and self-reported couple relationship functioning. Thus, this study demonstrated the validity and utility of the PLTP as a window into the development of coparenting, and supported the notion that the coparenting relationship develops prior to the child’s birth and is already distinct from the couple relationship. PMID:25000135

  9. [The Efficacy of Rooming-In in the Context the Physical and Mental Health of New Mothers].

    PubMed

    Tsai, Shuo-Shin; Yang, Mei-Sang; Wang, Hsiu-Hung

    2016-06-01

    The Breastfeeding-Friendly Policy promotes successful breastfeeding by encouraging postpartum rooming-in and other practices that have been shown to increase breastfeeding success. Puerperium is a key transition period in a woman's life during which she faces physical changes as well as changes in roles and tasks as she transitions into motherhood. During this transition period, postpartum women typically follow the rooming-in and breastfeeding practices that are recommended by the hospital. However, without suitable assistance, the physical and mental problems that often accompany childbirth may impact the postpartum health of the mother. This article reflects on the potential health problems that are encountered by postpartum women who adopt 24-hour rooming-in practices from the perspective of their health rights and proposes suggestions for improving these practices as a reference for related government and healthcare workers. PMID:27250966

  10. Obstetric, Sociodemographic, and Psychosocial Problems of Postpartum Adolescents of Huambo, Angola

    PubMed Central

    Tavares, Hamilton dos Prazeres; Tavares, Suelma Beatriz Marques Prata; Capingana, Daniel Pires; da Gama, Silvana Granado Nogueira; da Silva, Luiz Guilherme Pessoa

    2016-01-01

    This study aims to establish a profile of teenage pregnancy (<20 years) at a hospital in Huambo, Angola. Subjects were categorized into two age groups, 10–16 and 17–19 years. We interviewed 381 mothers in the postpartum maternity ward of the Central Hospital of Huambo. Statistical analysis then followed two stages, a descriptive analysis of the study population and analysis through a bivariate 2 × 2 table, using a chi-squared test to evaluate the hypothesis of homogeneity of proportions with a significance level of 5%. Comparing the two groups revealed a more frequent occurrence of problems among mothers under 17 years of age, including a higher frequency of involvement with unemployed parents, more often not living with parents, and fewer prenatal consultations. PMID:27226740

  11. Neonate-Mother Interaction during Breast-Feeding.

    ERIC Educational Resources Information Center

    Thoman, Evelyn B.; And Others

    Using a modified time-sampling procedure, 20 primiparous and 20 multiparous mothers were observed while breast-feeding their 48-hour old infants. In comparison with multiparous mothers, primiparous mothers (1) spend more time in non-feeding activities, (2) spend more time feeding male infants, (3) change activity more frequently, (4) provide more…

  12. The Impact of Postpartum Depression on Quality of Life in Women After Child's Birth

    PubMed Central

    Sadat, Zohreh; Abedzadeh-Kalahroudi, Masoumeh; Kafaei Atrian, Mahboobeh; Karimian, Zahra; Sooki, Zahra

    2014-01-01

    Background: Postpartum depression (PPD) is a common problem after child's birth and may influence the quality of life (QOL). Investigation of postpartum QOL and depression can be useful for better care for mothers and improvement of their well-being. Objectives: The objective of this study was to assess the life quality in mothers with and without PPD. Patients and Methods: In a prospective study, women who had experienced child's birth with and without PPD were recruited in Kashan-Iran. PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS) and QOL was measured by SF-36 questionnaire. Data collection was conducted at two assessment points: second month (n = 321) and fourth month (n = 300) postpartum. Based on EPDS, a score of 13 or more was defined as PPD. Mean scores of SF-36 questionnaire were compared between women with and without PPD at two assessment points and within each group from the first to the second assessments. Moreover, correlation between scores of EPDS and scores of life quality dimensions were evaluated. Data were analyzed by using the Student’s t-test, Mann–Whitney U-test, ANOVA, Kruskal-Wallis, Chi-square test, Pair t test, Wilcoxon, Pearson and Spearman Correlation Coefficient. Results: Differences in seven out of eight mean scores of QOL dimensions (except role-physical) between depressed and non-depressed women at the first and the second assessments were significant. Results of changes in mean scores of QOL dimensions from the first to the second assessments in each group showed that non-depressed women scored higher in all of eight dimensions with significant differences in two dimensions (bodily pain and role-emotional as well as mental health component). In depressed women, scores of life quality decreased in some of QOL dimensions but differences were not significant. There were significant negative correlations between EPDS scores and scores of seven out of eight SF-36 sub-scales (except role-physical) in addition

  13. Differences in parenting stress between married and single first time mothers at six to eight weeks after birth.

    PubMed

    Copeland, Debra; Harbaugh, Bonnie Lee

    2005-01-01

    Parenting stress has been shown to affect relationships between mothers and their infants. Single mothers may experience more parenting stress due to exposure to stressors that are unique to their environment. The purpose of this secondary analysis was to determine the differences between married and single first-time mothers on the Parenting Stress Index/Short Form (PSI/SF Abidin, 1995). A convenience sample of 22 single and 52 married first-time mothers were recruited from postpartum units in two large metropolitan hospitals in the southeastern United States. During hospitalization, participants completed a demographic sheet and at six weeks postpartum, were mailed the PSI/SF. T-tests were assessed for differences between mean scores. Study findings indicate significant differences between single and married first-time mothers on the Parental Distress subscale (t = -3.468, p = .001), the Difficult Child subscale (t = -2.032, p = .046), and Defensive Responding subscale (t = -3.720, p = .000), with single mothers consistently scoring higher than married mothers; however, there was not a significant statistical difference between mothers on the Parent-Child Dysfunctional Interaction subscale (t = -1.290, p = .201). Overall, single mothers scored higher on the Total Parenting Stress scores of the PSI/SF than married mothers (t = -2.858, p = .005), suggesting that single women experience more stress as a new mother than married new mothers. It is important to understand the specific stressors of new, single mothers and to develop nursing interventions that decrease parenting stress in single mothers.

  14. "It's Not All About My Baby's Sleep": A Qualitative Study of Factors Influencing Low-Income African American Mothers' Sleep Quality.

    PubMed

    Zambrano, Danielle N; Mindell, Jodi A; Reyes, Naomi R; Hart, Chantelle N; Herring, Sharon J

    2016-01-01

    Low-income African American mothers are at particular risk for poor postpartum sleep. This study sought to understand facilitators and barriers that exist to getting a good night's sleep among these high-risk mothers. Semistructured interviews with 18 low-income African Americans (3-6 months postpartum) were conducted. Most mothers described their own sleep quality to be poor, despite the fact that their babies' sleep improved substantially from the newborn period. Mothers kept themselves awake due to their own internal worry and anxiety, along with external factors that were largely independent of babies' sleep, including work and school commitments and the home environment. For the few mothers with good sleep quality, time management and family support were strong facilitators. Findings lay the groundwork for sleep improvement interventions.

  15. “I Was a Full Time Proper Smoker”: A Qualitative Exploration of Smoking in the Home after Childbirth among Women Who Relapse Postpartum

    PubMed Central

    Coleman, Tim; Lewis, Sarah; Cooper, Sue

    2016-01-01

    Background Many women stop smoking during pregnancy but relapse shortly afterwards, potentially putting their infants at risk of secondhand smoke (SHS) exposure. Women who were able to stop during pregnancy may be a motivated group, receptive to making behaviour changes postpartum to protect their infant from SHS exposure. Understanding more about their experiences of relapse, and if this influences home smoking behaviours and children’s exposure to SHS in the home may help to inform intervention development to prevent infant SHS exposure. Methods Guided by interpretative phenomenological methodology we conducted and analysed nine semi-structured interviews with women who quit smoking during pregnancy, but relapsed ≤3 months postpartum. Findings Central to mothers’ accounts of their smoking behaviours during pregnancy and postpartum was their desire to be a ‘responsible mother’. Mothers described using strategies to protect their infant from SHS exposure, and held strong negative attitudes towards other smoking parents. After relapsing, mothers appeared to reposition themselves as ‘social’ or ‘occasional’ smokers rather than ‘regular’ smokers. Conclusions Findings suggest that interventions to prevent/reduce infants' home SHS exposure should build on mothers' intentions to be responsible parents. As mothers who relapse principally view themselves as ‘social’ or ‘occasional’ smokers, interventions that are highlighted as relevant for women with these types of smoking patterns may be more likely to be responded to, and, ultimately, be effective. PMID:27308829

  16. Hispanic Mothers' Perceptions of Self-Determination

    ERIC Educational Resources Information Center

    Shogren, Karrie

    2012-01-01

    Limited research has explored the perceptions of self-determination held by diverse families. In this study, seven mothers of transition-age youth with severe disabilities who were Hispanic were interviewed. Each mother was actively engaged in advocacy related to diverse children with disabilities in their local schools and communities. Mothers…

  17. Uterine artery embolization for primary postpartum hemorrhage

    PubMed Central

    Kim, Tae-Hee; Lee, Hae-Hyeog; Kim, Jun-Mo; Ryu, Ae-Li; Chung, Soo-Ho; Seok Lee, Woo

    2013-01-01

    Background: Postpartum hemorrhage is the leading cause of severe maternal morbidity and death. A prompt management of uterine artery embolization (UAE) is important for a good outcome. UAE is generally accepted to be a safe and reliable procedure. Objective: To estimate critical patient characteristics influencing the success of UAE for the treatment of emergent primary postpartum hemorrhage. Materials and Methods: This was a cross sectional study that reviewed 121 patients who were diagnosed primary postpartum hemorrhage between February 2002 and December 2009 at a tertiary treatment center among 4,022 deliveries. We evaluated patient clinical characteristics associated with a successful surgical outcome of UAE. Results: The success rate for UAE was 96%. For two cases, UAE complication was associated with fever (>38.5oC). Five patients had problems that required admission to the intensive care unit (ICU). Conclusion: To increase the surgical success rate and lower the number of ICU admissions, the decision to treat primary postpartum hemorrhage using UAE should be based on individual patient clinical findings under the direction of obstetrics staff and an interventional radiologist. PMID:24639786

  18. 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

  19. Barriers to completion of desired postpartum sterilization.

    PubMed

    Boardman, Lori A; DeSimone, Michael; Allen, Rebecca H

    2013-02-01

    Tubal sterilization is a highly effective, permanent, and safe method of contraception. Many women who desire postpartum sterilization do not obtain the procedure due to barriers. We performed a retrospective cohort study examining patients from a single obstetrics practice who delivered between 1/1/07 and 6/30/07 at Women and Infants Hospital in Providence, RI. During the study period, 626 women in the practice delivered. Of these subjects, 87 (14%) desired postpartum sterilization. Of these 87, 45 (51.7%) underwent sterilization as planned. In multivariable analysis controlling for age, BMI, delivery mode and marital status, older age (OR 2.15, 95% CI 1.12, 4.12, p=0.02) and cesarean delivery (OR 19.65, 95% CI 3.75, 103.1, p < 0.001) were associated with completion of postpartum sterilization and being married (OR 0.10, 95% CI 0.02, 0.56, p=0.009) and having a higher BMI (OR 0.60, 95% CI 0.39, 0.91, p=0.02) were associated with incompletion. Only half of women who request postpartum sterilization antenatally end up obtaining the procedure.

  20. Mother-Child Bonding.

    ERIC Educational Resources Information Center

    Pearce, Joseph Chilton

    1994-01-01

    Examines the nature of mother-child bonding from the prenatal stage through early infancy, discussing how the mother's actions, even before birth, stimulate her child's senses. Explains the crucial role that physical contact, breastfeeding, and visual stimuli have on mother-child bonding in human and animal newborns. (MDM)

  1. Postpartum Teens’ Breakfast Consumption is Associated with Snack and Beverage Intake and Body Mass Index

    PubMed Central

    Schwarz, Cynthia; Budd, Elizabeth L; Yount, Byron W; Lapka, Christina

    2010-01-01

    Addressing high risk dietary patterns among postpartum teens may help reduce weight retention and prevent intergenerational obesity. The objective of this study was to describe the relationship between breakfast consumption and outcomes of snack and beverage intake and body mass index (BMI) among postpartum teens. During 2007–2009, 1,330 postpartum teens across 27 states participated in a cross-sectional, baseline assessment of a group-randomized, nested cohort study. Participants were enrolled in the Parents as Teachers Teen Program and completed a seven-day recall of breakfast, snack and beverage consumption. BMI was calculated from heights and weights obtained by on-site staff. Sample descriptives were compared across breakfast consumption frequency groupings by one-way analysis of variance tests or chi-square tests. General Linear Models assessed relationships between breakfast consumption and measures of snack and sweetened beverage intake, water consumption, and BMI-for-age percentile. Almost half (42%) of the sample consumed breakfast fewer than two days per week. Those who ate breakfast six to seven days per week consumed 1,197 fewer calories per week from sweet and salty snacks, 1,337 fewer calories per week from sweetened drinks, and had a lower BMI compared to those who ate breakfast fewer than two days per week (p<.05). Consumption of fruit, vegetables, milk, water and cereal as a snack were higher among regular breakfast consumers (p<.05). While breakfast consumption among postpartum teens is low, those who regularly consume breakfast had healthier snacking behaviors and weight. Interventions are needed to encourage breakfast consumption among teen mothers. PMID:21185974

  2. The Effect of Baby Books on Mothers' Reading Beliefs and Reading Practices.

    PubMed

    Auger, Anamarie; Reich, Stephanie M; Penner, Emily K

    2014-07-01

    The impact of a baby book intervention on promoting positive reading beliefs and increasing reading frequency for low-income, new mothers (n = 167) was examined. The Baby Books Project randomly assigned low-income, first-time mothers to one of three study conditions, receiving educational books, non-educational books, or no books, during pregnancy and over the first year of parenthood. Home-based data collection occurred through pregnancy until 18 months post-partum. Mothers who received free baby books had higher beliefs about the importance of reading, the value of having resources to support reading, and the importance of verbal participation during reading. The results showed that providing any type of baby books to mothers positively influenced maternal reading beliefs, but did not increase infant-mother reading practices. Maternal reading beliefs across all three groups were significantly associated with self-reported reading frequency when children were at least 12 months of age.

  3. Psychosocial aspects of Taiwanese postpartum depression phenomenological approach: a preliminary report.

    PubMed

    Chen, C H; Wu, H Y; Tseng, Y F; Chou, F H; Wang, S Y

    1999-01-01

    To understand how Taiwanese women experience postpartum depression, a phenomenological study was conducted. A purposive sample of six mothers participated in the present study. All the subjects' interviews were tape recorded and then transcribed. The transcription of each subject's oral description of postpartum depression experience was analyzed using Colaizzi's phenomenological methodology. Three categories, with ten themes, were derived from the analysis. The first category is unbalanced role-enacting. It includes these four themes: (1) the discrepancies in the husband-wife relationship; (2) the shadowy position of a daughter-in-law; (3) the incompetence as a mother; and (4) the dilemma of a woman's identity. The second category is fragmented time-space representation. The themes included are: (5) cultural bondage; (6) loss of ideals; and (7) reinterpretation of family history. The third category is the uneasy self. It contains the themes of: (8) psychological disability; (9) sense of self-dissatisfaction; and (10) the notion or behavior of destruction. PMID:10063795

  4. 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.

  5. 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. PMID:25704738

  6. [Practical implementation of an integrated care model in mother-child treatment].

    PubMed

    Kunze, J; Wagner, K; Fittig, E

    2016-09-01

    This article summarizes the specific treatment options in the combined mother-child treatment for women with postpartum psychiatric disorders. The incidence of postpartum mental illness is high, especially for postpartum depression that probably occurs in10-15 % of cases. Mental disorders not only have a negative impact on the mental health of the women affected, such as chronification and suicidal tendencies but can also adversely affect the mother-child relationship as well as the emotional and cognitive development of the child. For these reasons it is important, also under the aspects of a primary prevention with respect to the children of mentally ill mothers, to provide a needs-oriented, timely and disorder-specific interactional therapy, which also considers the long-term aspects of treatment. At the Celenus Klinik Carolabad in Chemnitz an integrated treatment model, the "Carola PLUS", could be established that caters for the particularly high demands of combined care and treatment for both mother and child. PMID:27531206

  7. Recognition of the efficacy of relaxation program on sleep quality of mothers with premature infants

    PubMed Central

    Karbandi, Soheila; Hosseini, Seyedeh Maryam; Masoudi, Reza; Hosseini, Seyedeh Asieh; Sadeghi, Farshad; Moghaddam, Maryam Hesari

    2015-01-01

    Background and Aim: The postpartum period is a critical then effects on the structure of the family. Most women in the postpartum period may place at risk of undesirable experiences such as changes in sleep patterns. Therefore, this study aimed to identify the efficacy of the relaxation program on sleep quality of mothers with premature infants. Materials and Methods: This study is a clinical trial that 60 mothers with premature infants. The mothers in the intervention group were trained for muscle progressive relaxation by Jacobson method within 24–72 h after delivery. Research tool was the Pittsburgh Sleep Quality Index, which was completed by the mother at the beginning of the study, end of the first and the second 4-week. Data were analyzed using parametric statistics tests by SPSS software version 16. Results: No significant difference was observed between two groups in terms of underlying characteristics (P < 0.05). The independent t-test at the beginning of the study showed that the comparison of the mean scores of mothers’ sleep quality has no significant difference between two groups (P = 0.43). But, 1-month after the intervention (P = 0.024) and 2 months after the intervention (P > 0.001), mean sleep quality score in the intervention group was significantly less than the control group. Conclusion: Relaxation training can improve mothers’ sleep quality at postpartum period. PMID:27462639

  8. 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

  9. The Importance of Religiosity/Spirituality in the Sexuality of Pregnant and Postpartum Women

    PubMed Central

    Pinto, José Manuel de Matos; Fabião, Joana Alice da Silva Amaro de Oliveira; García, Ana Maria Carrobles; Abellán, Minerva Velasco; Rodrigues, Manuel Alves

    2016-01-01

    In this article, we decided to study the representation of the Spanish pregnant and postpartum women and the importance of religiosity/spirituality and the social context for them. We analyzed the influence of religion on the woman within her social context. Objective: to understand how pregnant and postpartum women experience their sexuality according to their religious beliefs and the opinion of others from a socially learned perspective. Method: qualitative study using ethnography. This study aims at understanding reality from the women’s point of view, acknowledging that the points of view are constructed through interaction with others, through cultural and historical norms that influence the lives of individuals. Results: The findings indicate a difference in the religious beliefs and sexual behaviors of these women, which is more marked in urban than rural areas. Mothers have an influence on their daughters, conditioning their behavior. Conclusion We conclude that the process of change is underway. However, some paradoxes still persist concerning the sexual roles to be adopted, as well as some contradictions between sexual behaviors and the statements on religion. Within the scope of our study, we can confirm that pregnant and postpartum women are more or less pressured by the religious and social norms conveyed by their mothers, mainly in rural settings. From an external point of view, to be sexually free goes against the maternal and social expectations. However, the internal representation, marked by religion, that has been experienced over the years does not change the narratives of sexual experiences, assigning women to traditional role. This role brings conflict more or less assumed by women. PMID:27309528

  10. Women's perceptions of antenatal, delivery, and postpartum services in rural Tanzania

    PubMed Central

    Mahiti, Gladys Reuben; Mkoka, Dickson Ally; Kiwara, Angwara Dennis; Mbekenga, Columba Kokusiima; Hurtig, Anna-Karin; Goicolea, Isabel

    2015-01-01

    Background Maternal health care provision remains a major challenge in developing countries. There is agreement that the provision of quality clinical services is essential if high rates of maternal death are to be reduced. However, despite efforts to improve access to these services, a high number of women in Tanzania do not access them. The aim of this study is to explore women's views about the maternal health services (pregnancy, delivery, and postpartum period) that they received at health facilities in order to identify gaps in service provision that may lead to low-quality maternal care and increased risks associated with maternal morbidity and mortality in rural Tanzania. Design We gathered qualitative data from 15 focus group discussions with women attending a health facility after child birth and transcribed it verbatim. Qualitative content analysis was used for analysis. Results ‘Three categories emerged that reflected women's perceptions of maternal health care services: “mothers perceive that maternal health services are beneficial,” “barriers to accessing maternal health services” such as availability and use of traditional birth attendants (TBAs) and the long distances between some villages, and “ambivalence regarding the quality of maternal health services” reflecting that women had both positive and negative perceptions in relation to quality of health care services offered’. Conclusions Mothers perceived that maternal health care services are beneficial during pregnancy and delivery, but their awareness of postpartum complications and the role of medical services during that stage were poor. The study revealed an ambivalence regarding the perceived quality of health care services offered, partly due to shortages of material resources. Barriers to accessing maternal health care services, such as the cost of transport and the use of TBAs, were also shown. These findings call for improvement on the services provided. Improvements

  11. Don't worry, be (moderately) happy: Mothers' anxiety and positivity during pregnancy independently predict lower mother-infant synchrony.

    PubMed

    Moore, Ginger A; Quigley, Kelsey M; Voegtline, Kristin M; DiPietro, Janet A

    2016-02-01

    Maternal positivity and mother-infant synchrony have been linked, independently, to beneficial infant outcomes; however, research that has examined relations between the two has found that higher positivity is associated with lower synchrony. Methodological issues may inform this counter-intuitive association and clinical theory supports its validity. This study examined the theory that heightened positivity associated with anxiety is a way of avoiding negative emotion and contributes to lower synchrony because it interferes with appropriate responding to infant cues. We examined mothers' (N=75) self-reported anxiety and verbal expression of positivity during pregnancy in relation to mother-infant synchrony at 6 months post-partum. Verbal positivity was assessed using linguistic analysis of interviews about pregnancy experiences. Mother and infant affect and gaze were coded during interaction and synchrony was computed as the correlation between mother and infant behaviors. Higher verbal positivity and anxiety during pregnancy independently predicted lower mother-infant synchrony, suggesting distinct pathways to the same degree of synchrony with potentially different consequences for infant development.

  12. Don't worry, be (moderately) happy: Mothers' anxiety and positivity during pregnancy independently predict lower mother-infant synchrony.

    PubMed

    Moore, Ginger A; Quigley, Kelsey M; Voegtline, Kristin M; DiPietro, Janet A

    2016-02-01

    Maternal positivity and mother-infant synchrony have been linked, independently, to beneficial infant outcomes; however, research that has examined relations between the two has found that higher positivity is associated with lower synchrony. Methodological issues may inform this counter-intuitive association and clinical theory supports its validity. This study examined the theory that heightened positivity associated with anxiety is a way of avoiding negative emotion and contributes to lower synchrony because it interferes with appropriate responding to infant cues. We examined mothers' (N=75) self-reported anxiety and verbal expression of positivity during pregnancy in relation to mother-infant synchrony at 6 months post-partum. Verbal positivity was assessed using linguistic analysis of interviews about pregnancy experiences. Mother and infant affect and gaze were coded during interaction and synchrony was computed as the correlation between mother and infant behaviors. Higher verbal positivity and anxiety during pregnancy independently predicted lower mother-infant synchrony, suggesting distinct pathways to the same degree of synchrony with potentially different consequences for infant development. PMID:26705933

  13. Mother goats do not forget their kids' calls.

    PubMed

    Briefer, Elodie F; Padilla de la Torre, Monica; McElligott, Alan G

    2012-09-22

    Parent-offspring recognition is crucial for offspring survival. At long distances, this recognition is mainly based on vocalizations. Because of maturation-related changes to the structure of vocalizations, parents have to learn successive call versions produced by their offspring throughout ontogeny in order to maintain recognition. However, because of the difficulties involved in following the same individuals over years, it is not clear how long this vocal memory persists. Here, we investigated long-term vocal recognition in goats. We tested responses of mothers to their kids' calls 7-13 months after weaning. We then compared mothers' responses to calls of their previous kids with their responses to the same calls at five weeks postpartum. Subjects tended to respond more to their own kids at five weeks postpartum than 11-17 months later, but displayed stronger responses to their previous kids than to familiar kids from other females. Acoustic analyses showed that it is unlikely that mothers were responding to their previous kids simply because they confounded them with the new kids they were currently nursing. Therefore, our results provide evidence for strong, long-term vocal memory capacity in goats. The persistence of offspring vocal recognition beyond weaning could have important roles in kin social relationships and inbreeding avoidance.

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

    PubMed Central

    2011-01-01

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

  15. Wound healing-like immune program facilitates postpartum mammary gland involution and tumor progression

    PubMed Central

    Martinson, Holly A.; Jindal, Sonali; Durand-Rougely, Clarissa; Borges, Virginia F.; Schedin, Pepper

    2014-01-01

    Women diagnosed with breast cancer within 5 years postpartum have poor survival rates. The process of postpartum mammary gland involution, whereby the lactating gland remodels to its pre-pregnant state, promotes breast cancer progression in xenograft models. Macrophage influx occurs during mammary gland involution, implicating immune modulation in the promotion of postpartum breast cancer. Herein, we characterize the postpartum murine mammary gland and find an orchestrated influx of immune cells similar to that which occurs during wound healing. Further, the normal involuting gland may be in an immunosuppressed state as discerned by the transient presence of Foxp3+ regulatory T cells and IL-10+ macrophages with T cell suppressive function. To determine the influence of the postpartum immune microenvironment on mammary tumor promotion, we developed an immune-competent model. In this model, mammary tumors in the involution group are six-fold larger than nulliparous group tumors, have decreased CD4+ and CD8+ T cell infiltrates and contain a greater number of macrophages with the ability to inhibit T cell activation. Targeting involution with a neutralizing antibody against the immunosuppressive cytokine IL-10 reduces tumor growth in involution group mice but not in nulliparous mice, implicating the involution microenvironment as the primary target of αIL-10 treatment. Relevance to women is implicated, as we find post-lactational human breast tissue has transient high IL-10+ and Foxp3+ immune cell infiltrate. These data show an immune modulated microenvironment within the normal involuting mammary gland suggestive of immunosuppression, that when targeted reduces tumor promotion, revealing possible immune-based strategies for postpartum breast cancer. PMID:25187059

  16. Wound healing-like immune program facilitates postpartum mammary gland involution and tumor progression.

    PubMed

    Martinson, Holly A; Jindal, Sonali; Durand-Rougely, Clarissa; Borges, Virginia F; Schedin, Pepper

    2015-04-15

    Women diagnosed with breast cancer within 5 years postpartum have poor survival rates. The process of postpartum mammary gland involution, whereby the lactating gland remodels to its prepregnant state, promotes breast cancer progression in xenograft models. Macrophage influx occurs during mammary gland involution, implicating immune modulation in the promotion of postpartum breast cancer. Herein, we characterize the postpartum murine mammary gland and find an orchestrated influx of immune cells similar to that which occurs during wound healing. Further, the normal involuting gland may be in an immunosuppressed state as discerned by the transient presence of Foxp3(+) regulatory T cells and IL-10(+) macrophages with T cell suppressive function. To determine the influence of the postpartum immune microenvironment on mammary tumor promotion, we developed an immune-competent model. In this model, mammary tumors in the involution group are sixfold larger than nulliparous group tumors, have decreased CD4(+) and CD8(+) T cell infiltrates and contain a greater number of macrophages with the ability to inhibit T cell activation. Targeting involution with a neutralizing antibody against the immunosuppressive cytokine IL-10 reduces tumor growth in involution group mice but not in nulliparous mice, implicating the involution microenvironment as the primary target of αIL-10 treatment. Relevance to women is implicated, as we find postlactational human breast tissue has transient high IL-10(+) and Foxp3(+) immune cell infiltrate. These data show an immune modulated microenvironment within the normal involuting mammary gland suggestive of immunosuppression, that when targeted reduces tumor promotion, revealing possible immune-based strategies for postpartum breast cancer.

  17. Milk fat globule glycoproteins in human milk and in gastric aspirates of mother's milk-fed preterm infants.

    PubMed

    Peterson, J A; Hamosh, M; Scallan, C D; Ceriani, R L; Henderson, T R; Mehta, N R; Armand, M; Hamosh, P

    1998-10-01

    Human milk fat globule (HMFG) glycoproteins can prevent infections by microorganisms in breast-fed infants; the MUC-1 mucin inhibits binding of S-fimbriated Escherichia coli to buccal mucosa, and lactadherin may prevent symptomatic rotavirus infections. In this study, the survival of these HMFG glycoproteins in the stomach of human milk-fed preterm infants (gestational age = 27.5 +/- 0.4 wk) was assessed, and levels in their mothers' milk determined, using specific RIAs. Butyrophilin, a major component of HMFG membrane that has no demonstrated antimicrobial activity, was studied for comparison. The levels of mucin, lactadherin, and butyrophilin in 41 milk samples of 20 mothers were 729 +/- 75, 93 +/- 10, and 41 +/- 3 microg/mL, respectively. Mucin and lactadherin were significantly higher in early milk samples (<15 d postpartum) than in later milk samples (15-90 d postpartum), whereas butyrophilin showed no such difference. Significant amounts of mucin and lactadherin were found in almost all gastric aspirates of human milk-fed infants, even 4 h after feeding (mucin, 270 +/- 30 microg/mL; lactadherin, 23.2 +/- 4.4 microg/mL), whereas butyrophilin was rapidly degraded in the majority of aspirates. Western blot analysis demonstrated that the immunoreactive mucin, lactadherin, and butyrophilin in the milk-fed gastric aspirates had the expected native molecular weights. Mucin and lactadherin survived at all gastric pH values, whereas butyrophilin was found only at pH > 4. Neither lactadherin nor butyrophilin were detected in gastric aspirates of formula-fed infants (gestational age = 27.8 +/- 0.5 wk), whereas the very low level of mucin (9.1 +/- 1.1 microg/mL) in this group is presumably cross-reacting gastric mucin. These results demonstrate that two HMFG glycoproteins implicated in prevention of infection, MUC-1 mucin and lactadherin, survive and maintain their integrity in the stomachs of human milk-fed preterm infants.

  18. Emotional memory in pregnant women at risk for postpartum depression.

    PubMed

    Williams, Marissa E; Becker, Suzanna; McKinnon, Margaret C; Wong, Queenie; Cudney, Lauren E; Steiner, Meir; Frey, Benicio N

    2015-10-30

    Postpartum depression (PPD) is associated with debilitating effects on mothers and their infants. A previous history of depression is considered the strongest risk factor for PPD. Depressed individuals recall more negative than positive content and higher levels of stress hormones released during encoding are associated with enhanced recall of emotional stimuli. This study examined the impact of a previous history of major depressive disorder (MDD) and pregnancy on emotional memory. Seventy-seven participants completed the study [44 pregnant women in the second trimester of pregnancy with and without a lifetime history of MDD and 33 non-pregnant women with and without a lifetime history of MDD]. All completed an encoding task and provided salivary cortisol (sCORT) and alpha-amylase (sAA) samples. Participants returned one week later for a surprise incidental recognition memory task. Women with a history of MDD had worse recognition than women without a history of MDD for negative, but not positive images; this effect was independent of sCORT and sAA levels. Pregnancy did not affect emotional memory. Considering that several previous studies found enhanced memory bias for negative content during depressive states, our results suggest that clinical remission may be associated with an opposite cognitive processing of negative emotional content. PMID:26272023

  19. Evaluation of the clinical effect of an on-line course for community nurses on post-partum emotional distress: a community-based longitudinal time-series quasi-experiment.

    PubMed

    Thome, Marga; Orlygsdottir, Brynja; Elvarsson, Bjarki Thor

    2012-09-01

    About 14% of Icelandic women suffer post-partum from frequent depressive symptoms, and of those, 12% also report a high degree of parenting stress. Education of nurses and midwives on post-partum distress is crucial in reducing its degree. The purpose of the study is to evaluate the clinical effect of an on-line course for community nurses on post-partum emotional distress. A community-based, longitudinal, time-series quasi-experiment was conducted in four stages from 2001 to 2005. Mothers attending 16 health centres throughout Iceland and scoring ≥ 12 on the Edinburgh Postnatal Depression Scale (EPDS) at the 9th week post-partum were eligible to participate. Health centres were divided into experimental (EHC) and control centres (CHC), and control centres were crossed over to experimental centres the following year and new control centres recruited. Nurses at EHC attended an on-line course on post-partum emotional distress. Participating mothers answered the EPDS; the Parenting Stress Index/Short form and the Fatigue Scale. Nursing diagnoses and interventions were recorded at all study centres. Of the women who were eligible (n = 163), 57% (n = 93) participated. At baseline, 9 weeks post-partum, there were no significant differences between groups of women in the rate of depressive symptoms, fatigue or parenting stress. Women in all groups improved on all distress indicators over time; however, those from the EHC improved statistically and clinically significantly more on depressive symptoms than those from the CHC. Documentation of particular nursing diagnoses and interventions was significantly more frequent at the EHC, but referrals to specialists were significantly less frequent. On-line education for nurses on post-partum emotional distress is feasible and is related to improvement in post-partum depressive symptoms.

  20. Testing a model of physical activity among mothers and fathers of young children: integrating self-determined motivation, planning, and the theory of planned behavior.

    PubMed

    Hamilton, Kyra; Cox, Stephen; White, Katherine M

    2012-02-01

    Parents are at risk for inactivity; however, research into understanding parental physical activity (PA) is scarce. We integrated self-determined motivation, planning, and the theory of planned behavior (TPB) to better understand parental PA. Parents (252 mothers, 206 fathers) completed a main questionnaire assessing measures underpinning these constructs and a 1-week follow-up of PA behavior to examine whether self-determined motivation indirectly influenced intention via the TPB variables (i.e., attitude, subjective norm, and perceived behavioral control) and intention indirectly influenced behavior via planning. We found self-determined motivation on intention was fully mediated by the TPB variables and intention on behavior was partially mediated by the planning variables. In addition, slight differences in the model's paths between the sexes were revealed. The results illustrate the range of important determinants of parental PA and provide support for the integrated model in explaining PA decision making as well as the importance of examining sex differences.