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Sample records for late postpartum period

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

    PubMed Central

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

    2016-01-01

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

  2. Hemostatic profile during late pregnancy and early postpartum period in mares.

    PubMed

    Bazzano, M; Giannetto, C; Fazio, F; Marafioti, S; Giudice, E; Piccione, G

    2014-03-01

    Hemostasis is a physiological process that prevents excessive blood loss and represents a protective mechanism at the time of delivery. Peripartum hemorrhage is a recurring hazardous condition to mare's health; therefore, we aimed to study mares' hemostatic profile to investigate whether physiological adjustments occur during late pregnancy and early postpartum. Fifteen pregnant mares have been monitored from the 34th week of pregnancy until the third week after foaling. Fifteen nonpregnant mares were used as control group. Jugular blood samples were analyzed for platelet count (Plt), prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen (Fb). Platelet count showed significant changes at foaling (P < 0.05) and a negative correlation (r = -0.968; P = 0.032) with postpartum. Prothrombin time changed (P < 0.05) showing a significant correlation (r = 0.675; P = 0.016) with late pregnancy. Fibrinogen concentrations changed throughout the experimental period (P < 0.0001). The linear regression model revealed a positive correlation (r = 0.9210; P < 0.0001) between Fb and late pregnancy and a negative correlation (r = -0.9583; P = 0.042) between Fb and early postpartum. The shortening in PT recorded in the imminence of parturition along with the increase in Plt and Fb at foaling might reflect a physiological hypercoagulable state that constrains excessive bleeding, enhancing mares' odds of surviving. Our research improves the knowledge about blood coagulation in periparturient mares providing specific information on routine coagulation tests that may support in monitoring mare's hemostatic profile during late pregnancy and early postpartum.

  3. 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

  4. Inflammatory cytokine and acute phase protein concentrations in the peripheral blood and uterine washings of cows with subclinical endometritis in the late postpartum period.

    PubMed

    Brodzki, Piotr; Kostro, Krzysztof; Krakowski, Leszek; Marczuk, Jan

    2015-06-01

    The aim of the study was to evaluate the concentrations of proinflammatory cytokines: tumor necrosis factor (TNF-α) and interleukin-6 (IL-6), anti-inflammatory cytokine interleukin-10 (IL-10), and acute phase proteins (APPs)--haptoglobin (Hp) and serum amyloid A (SAA) in serum and uterine washings of cows with subclinical endometritis, and compare them to healthy animals. The study was performed on 24 cows on day 60 after delivery. The cows were divided into two groups based on the results of cytological tests: 12 cows with subclinical endometritis and 12 healthy cows. Experimental material consisted of blood serum and uterine washings. The levels of the following cytokines in the study material were determined with ELISA: TNF-α, IL-6, IL-10 and APPs - Hp and SAA. The results show that the levels of TNF-α (p < 0.01), IL-6, IL-10 as well as SAA and Hp were significantly higher in the serum of cows with subclinical endometritis compared to the controls (p < 0.001). Uterine washings had significantly higher levels of IL-6, IL-10, and Hp in the experimental cows compared to the controls (p < 0.001). The demonstrated differences in the concentration of cytokines and APP between cows with subclinical endometritis and healthy cows, in both the serum and uterine washings, may suggest the usefulness of these parameters in the diagnosis of subclinical endometritis in cows in the late postpartum period. PMID:25846950

  5. Changes in Maternal Plasma Adiponectin from Late Pregnancy to the Postpartum Period According to the Mode of Delivery: Results from a Prospective Cohort in Rio de Janeiro, Brazil

    PubMed Central

    Rebelo, Fernanda; Franco-Sena, Ana Beatriz; Struchiner, Claudio Jose; Kac, Gilberto

    2016-01-01

    Introduction Maternal plasma adiponectin is inversely related to insulin resistance, atherosclerosis and child health. However, little is known about its concentrations in the perinatal period, especially according to mode of delivery. Our aim is to evaluate the association between mode of delivery and changes in maternal plasma adiponectin from 3rd trimester of pregnancy to 30–45 days postpartum. Methods A cohort was recruited in Rio de Janeiro, Brazil, with four waves of follow-up: 5-13th, 22-26th, 30-36th gestational weeks and 30–45 days postpartum. Eligible subjects should be between 20–40 years of age, be free of chronic and infectious diseases and presenting with a singleton pregnancy. The mode of delivery was classified as vaginal (VD) or cesarean (CS). Plasma adiponectin concentration (μg/mL) was measured using commercial ELISA kits. Statistical analyses included the Wilcoxon rank-sum test and the multiple linear mixed effects model. Results A total of 159 participated in the study. Median adiponectin concentrations were higher for the VD group (n = 99; 8.25, IQR: 5.85–11.90) than for the CS group (n = 60; 7.34, IQR: 4.36–9.76; p = 0.040) in the postpartum samples but were not different between the two groups in the 3rd trimester. Women who underwent CS had a lower rate of increase in adiponectin concentration from the 3rd trimester to 30–45 days postpartum compared to those who underwent VD (β = -.15, 95% CI: -.28-.02, p = 0.030). Conclusion The CS procedure was associated with lower maternal circulating concentrations of adiponectin at 30–45 days postpartum, compared to the VD. PMID:27391647

  6. 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

  7. Hypertensive crisis during pregnancy and postpartum period.

    PubMed

    Too, Gloria T; Hill, James B

    2013-08-01

    Hypertension affects 10% of pregnancies, many with underlying chronic hypertension, and approximately 1-2% will undergo a hypertensive crisis at some point during their lives. Hypertensive crisis includes hypertensive urgency and emergency; the American College of Obstetricians and Gynecologists describes a hypertensive emergency in pregnancy as persistent (lasting 15 min or more), acute-onset, severe hypertension, defined as systolic BP greater than 160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia. Pregnancy may be complicated by hypertensive crisis, with lower blood pressure threshold for end-organ damage than non-pregnant patients. Maternal assessment should include a thorough history. Fetal assessment should include heart rate tracing, ultrasound for growth and amniotic assessment, and Doppler evaluation if growth restriction is suspected. Initial management of hypertensive emergency (systolic BP >160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia) generally includes the rapid reduction of blood pressure through the use of intravenous antihypertensive medications, with goal systolic blood pressure between 140 mmHg and 150 mmHg and diastolic pressure between 90 mmHg and 100 mmHg. First-line intravenous drugs include labetalol and hydralazine, but other agents may be used, including esmolol, nicardipine, nifedipine, and, as a last resort, sodium nitroprusside. Among patients with hypertensive urgency, slower blood pressure reduction can be provided with oral agents. The objective of this article is to review the current understanding, diagnosis, and management of hypertensive crisis during pregnancy and the postpartum period.

  8. 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

  9. 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.

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

    PubMed Central

    Barnett, Josephine; Bonuck, Karen

    2014-01-01

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

  11. [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

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

    PubMed Central

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

    2016-01-01

    concentration decreased up to 14th day post-partum and then started increasing from 21st day onward. Conclusion: Hematobiochemical parameters are indicative of health status of animals. Significantly low values of Hb, PCV, and TLC during first 2 weeks post-partum are indicative of stress. Catabolism of protein occurred during 2 weeks post-partum, as observed from increase in urea concentration. Decrease TGs and high level of NEFA during the transition period are suggestive of utilization of lipids for the supply of energy. High glucose level on 0 day indicates that the animals were in positive energy status. PMID:27051179

  13. Sleep and Mood During Pregnancy and the Postpartum Period.

    PubMed

    Bei, Bei; Coo, Soledad; Trinder, John

    2015-03-01

    During the perinatal period, compromises in sleep duration and quality are commonly reported by women and confirmed by objective measurements of sleep. Self-reported poor sleep has been associated with concurrent mood disturbance and with increased risk for future mood problems during pregnancy and the postpartum period. Findings on the relationship between objectively measured sleep and mood in perinatal women have been mixed. This article reviews the literature on the nature of and contributing factors to perinatal sleep disturbance, the relationship between sleep and mood, and intervention studies that aim to improve maternal sleep. PMID:26055670

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

    PubMed

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

    2015-12-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  17. 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

  18. [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

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

    ERIC Educational Resources Information Center

    Elliott, Timothy R.; And Others

    1996-01-01

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

  20. 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

  1. The Prevalence and Risk Factors of Paternal Depression from the Antenatal to the Postpartum Period and the Relationships between Antenatal and Postpartum Depression among Fathers in Hong Kong

    PubMed Central

    Koh, Y. W.; Chui, C. Y.; Tang, C. S. K.; Lee, A. M.

    2014-01-01

    Introduction. Despite the fact that maternal perinatal mental health problems have been extensively studied and addressed to be a significant health problem, the literature on paternal perinatal mental health problems is relatively scarce. The present study aims at determining the prevalence of paternal perinatal depression and identifying the risk factors and the relationship between antenatal and postpartum depression. Methodology. 622 expectant fathers were recruited from regional maternal clinics. The expectant fathers were assessed using standardized and validated psychological instruments on 3 time points including early pregnancy, late pregnancy, and six weeks postpartum. Results. Results showed that a significant proportion of expectant fathers manifested depressive symptoms during the perinatal period. Paternal antenatal depression could significantly predict higher level of paternal postpartum depression. Psychosocial risk factors were consistently associated with paternal depression in different time points. Conclusions. The present study points to the need for greater research and clinical attention to paternal depression given that it is a highly prevalent problem and could be detrimental to their spouse and children development. The present findings contribute to theoretical basis of the prevalence and risk factors of paternal perinatal depression and have implications of the design of effective identification, prevention, and interventions of these clinical problems. PMID:24600517

  2. 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.

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

    SciTech Connect

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

    2008-01-15

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

  4. Bipolar disorder in the postpartum period: management strategies and future directions.

    PubMed

    Pope, Carley J; Sharma, Verinder; Mazmanian, Dwight

    2014-07-01

    Bipolar I and II disorder are chronic and severe psychiatric illnesses that affect many women. Furthermore, women are at increased risk for mood episodes during the postpartum period compared with non-postpartum periods. Unfortunately, identification of clinically significant depressive or (hypo)manic episodes can be challenging. Delays in detection, as well as misdiagnosis, put women at risk of many negative consequences, such as symptom exacerbation and treatment refractoriness. Early and accurate detection of bipolar I or II disorder in the postpartum period is critical to improve prognosis. At this time, limited recommendations can be made due to a paucity of research. Further research on postpartum bipolar I or II disorder focusing on its identification, consequences and treatment is urgently needed to allow for empirically informed clinical decision-making. PMID:25259898

  5. Reversible posterior encephalopathy syndrome associated with late onset postpartum eclampsia: A case report

    PubMed Central

    Bo, Qi-Yu; Zhao, Xiu-He; Yang, Xue; Wang, Sheng-Jun

    2016-01-01

    Late onset postpartum eclampsia (LPE) is defined by its onset at >48 h after delivery. Reversible posterior encephalopathy syndrome (RPES) associated with LPE is uncommon, with the majority of RPES cases having a late postpartum onset within 4 weeks after childbirth. The present study reported the case of a 15-year old female presenting with convulsions that began 5 weeks after delivery. A magnetic resonance imaging scan of the brain revealed multiple lesions in the cortex, subcortical region and deep white matter of the bilateral cerebellum, and occipital, frontal and parietal lobes. The clinical manifestations and radiological abnormalities were readily resolved subsequent to antihypertension and anticonvulsion treatment. In conclusion, the present rare case indicates that LPE should be considered as a potential diagnosis even at 4 weeks after delivery. Furthermore, clinicians should familiarize with the reversible radioimaging features of RPES, since early recognition and adequate treatment are important to the outcome of patients. PMID:27602098

  6. Reversible posterior encephalopathy syndrome associated with late onset postpartum eclampsia: A case report

    PubMed Central

    Bo, Qi-Yu; Zhao, Xiu-He; Yang, Xue; Wang, Sheng-Jun

    2016-01-01

    Late onset postpartum eclampsia (LPE) is defined by its onset at >48 h after delivery. Reversible posterior encephalopathy syndrome (RPES) associated with LPE is uncommon, with the majority of RPES cases having a late postpartum onset within 4 weeks after childbirth. The present study reported the case of a 15-year old female presenting with convulsions that began 5 weeks after delivery. A magnetic resonance imaging scan of the brain revealed multiple lesions in the cortex, subcortical region and deep white matter of the bilateral cerebellum, and occipital, frontal and parietal lobes. The clinical manifestations and radiological abnormalities were readily resolved subsequent to antihypertension and anticonvulsion treatment. In conclusion, the present rare case indicates that LPE should be considered as a potential diagnosis even at 4 weeks after delivery. Furthermore, clinicians should familiarize with the reversible radioimaging features of RPES, since early recognition and adequate treatment are important to the outcome of patients.

  7. Dry period management and optimization of post-partum reproductive management in dairy cattle.

    PubMed

    Gumen, A; Keskin, A; Yilmazbas-Mecitoglu, G; Karakaya, E; Wiltbank, Mc

    2011-09-01

    Dry period and early post-partum management are decisive factors for fertility in lactating dairy cows. Previous studies have shown that decreased dry matter intake (DMI) and increased non-esterified fatty acids (NEFA) negatively affect fertility and subsequent milk production. The traditional dry period decreases DMI prior to parturition, resulting in a decrease in energy intake. A negative energy balance increases NEFA concentration, and increased NEFA may impair the immune system, especially by decreasing neutrophil function prior to parturition. Earlier studies have shown that post-partum health disorders, including retained placenta and metritis, were correlated with periparturient neutrophil function. In addition, decreased DMI is also linked to a reduced body condition score (BCS) in dairy cows. These events in the periparturient period negatively affect fertility. Some manipulation, such as shortening the dry period, may be a solution to increased DMI in the periparturient period, preventing post-partum disorders and subsequent fertility issues. This article aims to explain the effects of shortening the dry period on reproduction and early post-partum treatments to improve fertility. In addition, timed artificial insemination protocols will be discussed for use during the post-partum period to improve fertility in dairy cows. PMID:21854457

  8. Late onset postpartum eclampsia without pre-eclamptic prodromi: clinical and neuroradiological presentation in two patients

    PubMed Central

    Veltkamp, R; Kupsch, A; Polasek, J; Yousry, T; Pfister, H

    2000-01-01

    In two patients eclampsia started 9 days postpartum. Headache and visual disturbances preceded seizures but none of the classic pre-eclamptic signs oedema, proteinuria, and hypertension were present until shortly before seizure onset. Brain herniation (patient 1) and status epilepticus (patient 2) necessitated neurointensive care management. Brain MRI initially showed only frontal sulcal effacement in one patient but later showed white matter hyperintensities on T2 weighted images and a previously undescribed pattern of cortical-subcortical postgadolinium enhancement on T1 weighted images in both. Neurological deficits and MRI findings were reversed with therapy in both patients. It is concluded that late postpartum eclampsia can manifest without classic prodromi and that characteristic MRI findings may lag behind clinical manifestation.

 PMID:11080241

  9. Human sexuality during pregnancy and the postpartum period.

    PubMed

    Brtnicka, H; Weiss, P; Zverina, J

    2009-01-01

    Sexual problems and dysfunctions during pregnancy are often led by the anxiety of hurting the fetus. Males are also afraid of hurting a female and females are afraid of insufficient satisfaction of a male partner. Just 12-14% of couples deny sexual problems after the childbirth. The main postpartum risk factor for dyspareunia is the extent of a birth injury. Breastfeeding is linked to a low coital activity, low sexual desires and low sexual satisfaction of females and their partners. Breastfeeding females start with a sexual life later; more often suffer from dyspareunia and indicate a lower satisfaction with the sexual intercourse. Further, episiotomy is associated with a higher prevalence of a postpartum dyspareunia. Low interest of antenatal and postnatal care providers in the issues of sexuality is documented. Lack of relevant information is the common reason for avoiding this topic. 76% of pregnant females would recommend a discussion on sexuality during pregnancy as a topic in an antenatal clinic and almost a half of pregnant women evaluate the information received from health care providers as insufficient (Ref. 48). Full Text (Free, PDF) www.bmj.sk. PMID:19711831

  10. 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

  11. 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…

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

    PubMed

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

    2015-10-01

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

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

    PubMed

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

    2015-10-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Zarghouni, Mehrzad; Cannon, Walter

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  17. 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

  18. [Clinical implications of occurrence of antithyroid antibodies in pregnant women and in the postpartum period].

    PubMed

    Jurczyńska, Jolanta; Zieleniewski, Wojciech

    2004-01-01

    Antithyroid antibodies are classified to immunoglobulin G. It is a varied group of antibodies as there are antibodies against TSH-receptor, against thyroid peroxidase and also against thyroglobulin. Pregnancy is a period in which the titres of antibodies decrease to protect fetus from abortion; but just after delivery they increase again. The clinical implications of this fact are varied and concern not only the thyroid gland but also other organs. Postpartum thyroid dysfunction (PPD) is one,possible disturbance due to presence of antithyroid antibodies. It can be divided into two various types: a) postpartum thyroiditis, b) Graves'-Basedow disease after delivery. Postpartum thyroiditis (PPT) is an example of autoimmune disease connected with many different factors such as genetic or environmental, but the most important factor is the presence of antibodies against thyroid peroxidase. PPT occurs in 50% of women with high titre of these antibodies. Higher risk of PPT also occurs within women with type I diabetes mellitus in comparison with the population, as well as within women-smokers. It is also proved that women with high titres of antibodies against TSH-receptor are more likely to suffer from Graves'-Basedow disease after delivery. The pathogenesis of postpartum depression is multifactorial. The occurrence of stressful life events (marital disharmony, housing and socioeconomic problems) and some biological factors (e.g. previous psychiatric illnesses) are strongly associated with postpartum depression. Some authors also said that postpartum depression depends on the presence of antithyroid antibodies during pregnancy. It is believed that cytokines which are released during the autoimmune process can affect the central nervous system and can determine changes in behavior. Some authors suggest that changes in concentration of thyroid hormones during the natural history of PPT can be connected with depression after delivery. It is also reported that high titres of

  19. 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.

  20. Effect of seasonal conditions on oestrus occurrence and postpartum period in Anatolian water buffaloes.

    PubMed

    Aksoy, M; Kaya, A; Uçar, M; Lehimcioglu, N; Tekeli, T

    2002-09-01

    Oestrus and calving records of Anatolian buffaloes were analyzed to investigate influence of climatic conditions on oestrus occurrence and postpartum period. Oestrus records showed a seasonal pattern concentrated between July and September which is the warmest period of the year. Likewise, more than half (52.7%) of the total calvings occurred between May and August. Month of calving significantly influenced the length of calving to first oestrus interval and open period (P < 0.01). The average length of open period was significantly shorter in autumn and summer calvers compared to those calved in spring and winter (P < 0.05) during long days. The humidity rate was negatively correlated with both calving to first oestrus interval and open period (P < 0.05). In conclusion, exposure to high environmental temperatures around 20 degrees C exerted no suppressive influence on ovarian activity in Anatolian buffaloes. Although humidity rate (P < 0.05) and ambient temperature (P < 0.01) was found to be correlated with the duration of postpartum period, day length might be the main factor regulating reproductive biorhythm and postpartum events in Anatolian buffalo cows.

  1. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period.

    PubMed

    Jones, Ian; Chandra, Prabha S; Dazzan, Paola; Howard, Louise M

    2014-11-15

    The perinatal period is associated with an increased risk of severe mental disorders. We summarise the evidence regarding the epidemiology, risk factors, and treatment of severe mental illness in relation to childbirth, focusing on bipolar disorder, affective psychosis, and schizophrenia. We discuss women with ongoing chronic conditions and those with the onset of new episodes of post-partum psychosis. Despite the importance of perinatal episodes, with suicide a leading cause of maternal death, few studies are available to guide the management of women with severe mental disorders in pregnancy and the post-partum period. However, general principles of management are discussed, including the need for an individual risk-benefit analysis for each woman. PMID:25455249

  2. Do Pregnancy, Postpartum Period and Lactation Predispose to Recurrent Toxoplasmic Retinochoroiditis?

    PubMed Central

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

    2015-01-01

    Backgrund The aim of the study was a statistical analysis of the possible effects of pregnancy, postpartum period, and lactation on increased risk for reactivation of toxoplasmic retinochoroiditis. Material/Methods A retrospective study was undertaken of the clinical records of 661 patients referred with the diagnosis of acute toxoplasmic retinochoroiditis to the Department of Zoonoses and Tropical Diseases, Medical University of Warsaw and to the Department of Ophthalmology, Medical University of Warsaw in the years 1994–2014. This group of inpatients consisted of 213 women of child-bearing age (18 to 40 years). Reactivation of toxoplasmic retinochoroiditis was observed in 24 women aged 15 to 39 years who were pregnant, in the postpartum period, or lactating. To compare the rate of the relapses in pregnant/lactating patients vs. non-pregnant/non-lactating patients, the Fisher exact test was used. Calculations were performed with WinPepi software (Abramson JH (2004) WINPEPI (PEPI-for-Windows) for epidemiologists. Epidemiologic Perspectives & Innovations, 2005, 1: 6). Results A total of 28 reactivations of toxoplasmic retinochoroiditis were observed (16 episodes in pregnancy, 4 in the postpartum period, and 8 during lactation) in 24 women aged 15 to 39 years. In 3 women, multiple episodes were reported (in early pregnancy and the postpartum period in 2 women, and during 2 pregnancies and lactation in 1 woman). Statistical analysis showed that the risk of an episode of toxoplasmic retinochoroiditis is 7.4-fold higher in pregnancy compared to the non-pregnant/non-lactating women (p<0.0001). Conclusions Women of childbearing age with toxoplasma ocular lesions should be informed by their doctors about possible active recurrences during pregnancy and should be followed carefully by an ophthalmologist when pregnant. PMID:25703198

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-06

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

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

    PubMed Central

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

    2016-01-01

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

  7. Ovarian and Renal Vein Thrombosis: A Rare Cause of Fever Outer the Postpartum Period.

    PubMed

    Togan, Turhan; Turan, Hale; Cifci, Egemen; Çiftci, Ceylan

    2015-01-01

    Although there is no other underlying disease, women can sometimes experience rare and serious diseases such as ovarian vein thrombosis (OVT) and renal vein thrombosis (RVT) after giving birth. The widespread development of thrombosis is treated for the first time in this study. Stasis, coagulation factor abnormalities, and intimal damage to the venous thrombosis risk can increase during pregnancy. It was mentioned that it diagnoses an abnormality in the hypercoagulability half of women with OVT. Despite the hypercoagulant abnormality observed in pregnant women, it was very unusual that the renal vein thrombosis led to this complication. It can lead to severe complication of OVT which can even cause death. It was the first time that the renal vein and ovarian vein thrombosis were observed in the postpartum period, and there was no coagulation abnormality. It is known that the thrombus in the postpartum period can be observed with the fever of unknown origin. The problematic, but rarely observed, postpartum disease such as ovarian venous thrombosis (OVT) is generally observed in the right ovarian vein. In this disease, avoiding the resulting laparotomy heparin and intravenous antibiotics is best solution for the patient. If it is to be noted a fever for unknown reasons, that it be thrombosis.

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

    PubMed

    Medan, M S; El-Daek, T

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed Central

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

    2015-01-01

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

  13. 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

  14. [The treatment of bipolar disorder during pregnancy and the postpartum period].

    PubMed

    Gülöksüz, Sinan; Akdeniz, Fisun; Ince, Bahri; Oral, Esat Timuçin

    2010-01-01

    The prevalence of bipolar disorder (BD) in males and females is almost equal. The onset of BD in females typically occurs during the reproductive years, complicating its treatment. Although it was once believed that pregnancy prevents recurrence, studies have shown that recurrence is common and severe during pregnancy. On the other hand, the effects of pharmacological treatment on obstetrical outcome are not well known and some of these agents are considered teratogenic. Thus, the decision to treat pregnant patients with psychotropic agents requires solving an ethical dilemma. Risk-benefit decisions should be made while considering both the risk of relapse of BD and its morbidity, and the risk of fetal exposure to psychotropic medications. Moreover, the risk of recurrence increases dramatically in the postpartum period. It is well known that all of the psychotropic medications studied enter the breast milk. Thus, their effects on infants should be considered while prescribing for a breastfeeding mother. The aim of this review was to discuss the safety profiles of the treatment options for pregnant and breastfeeding BD patients. Firstly, each medication's effects on organ dysgenesis, neonatal toxicity, and neurobehavioral development, and their associated adverse events during pregnancy and the postpartum period are discussed, with a focus on the emerging literature. Given this background, practical suggestions on tailoring treatment in BD patients, from preconception to breastfeeding are highlighted.

  15. Management of colorectal neoplasia during pregnancy and in the postpartum period

    PubMed Central

    Aytac, Erman; Ozuner, Gokhan; Isik, Ozgen; Gorgun, Emre; Stocchi, Luca

    2016-01-01

    AIM: To report our experience on management of colorectal neoplasia during pregnancy and in the postpartum period. METHODS: Patients who were diagnosed with colorectal cancer during pregnancy or in the postpartum period (< 6 mo), between 8/1997 and 4/2013, in our department were reviewed. Patient characteristics, operations, fetal health and follow-up during pregnancy, type of delivery and oncologic outcomes were analyzed. RESULTS: Eight patients met our study criteria. Median age at the time of diagnosis of colorectal cancer was 31 years. Median follow-up after surgery was 36 mo. Median duration of symptoms before diagnosis was 16 wk. Three patients were diagnosed with colorectal cancer during pregnancy and underwent surgery prior to delivery. None of the patients received adjuvant treatment during pregnancy. Five patients were diagnosed with colorectal cancer within a median of 2.1 mo after delivery and underwent surgery. No adverse neonatal outcomes were noted. All deliveries were at term (2 cesarean sections) except for one preterm delivery following low anterior resection on the 34th week of pregnancy. CONCLUSION: There has been a significant delay in the diagnosis of colorectal cancer which is probably due to overlap of symptoms and signs between these tumors and a normal pregnancy. Surgery for colorectal cancer during pregnancy can be performed safely without compromising maternal and fetal outcomes. PMID:27559434

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

    PubMed Central

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

    2016-01-01

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

  17. 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

  18. 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

  19. 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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Topatan, Serap; Demirci, Nurdan

    2015-10-01

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

  2. Blood lymphocyte subpopulations, neutrophil phagocytosis and proteinogram during late pregnancy and postpartum in mares.

    PubMed

    Agrícola, R; Carvalho, H; Barbosa, M; Pereira, M; Medeiros, J A S; Ferreira-Dias, G

    2008-04-01

    The aim of this study was to evaluate peripheral blood lymphocyte subpopulations, neutrophil phagocytic capacity and proteinogram characteristics in mares, during the last trimester of pregnancy and in postpartum. Measurement of phagocytosis and quantification of T-lymphocyte subsets were done by flow cytometry. Quantification of T-lymphocyte subsets was performed with monoclonal antibodies specific for CD2, CD3, CD4 and CD8 cell markers. Natural killer and B-cell counts were estimated mathematically. Serum proteinogram was obtained by electrophoresis. No significant differences were observed between gestation and postpartum on CD4(+), CD8(+) and NK(+) lymphocyte subsets, CD4 : CD8 ratio and phagocytosis. The percentage of cells expressing CD3 (64.2 +/- 1.8) and CD2 (68.4 +/- 1.7) (Mean +/- SEM) was reduced during gestation vs postpartum (69.7 +/- 1.5 and 73.8 +/- 1.4 respectively) (p < 0.05). During pregnancy, CD19(+) (31.6 +/- 1.7) was higher than in postpartum (26.2 +/- 1.4) (p < 0.05). Total T cells (2911 +/- 227 cells/mul), T helper cells (2144 +/- 169 cells/mul) and T-cytotoxic cells (767 +/- 68 cells/mul) were depressed in pregnancy, when compared with postpartum (4093 +/- 337 cells/mul; 3004 +/- 276 cells/mul; 1089 +/- 94 cells/mul respectively) (p < 0.01). Total white blood cell count was reduced during pregnancy (8815 +/- 427 cells/mul) with respect to postpartum (10742 +/- 446 cells/mul) (p < 0.01), while neutrophil count did not change. Total proteins, albumin, alpha(1),alpha(2),beta(1), beta(2), gamma globulins and albumin : globulin did not differ. Our results suggest that the physiological immune depression occurring in mares, during gestation might be due to T-helper and T-cytotoxic lymphocytes reduction.

  3. Determinants of bone and blood lead concentrations in the early postpartum period

    PubMed Central

    Brown, M. J.; Hu, H.; Gonzales-Cossio, T.; Peterson, K.; Sanin, L.; Kageyama, M. d.; Palazuelos, E.; Aro, A.; Schnaas, L.; Hernandez-Avila, M.

    2000-01-01

    OBJECTIVE—This study investigated determinants of bone and blood lead concentrations in 430 lactating Mexican women during the early postpartum period and the contribution of bone lead to blood lead.
METHODS—Maternal venous lead was measured at delivery and postpartum, and bone lead concentrations, measured with in vivo K-x ray fluorescence, were measured post partum. Data on environmental exposure, demographic characteristics, and maternal factors related to exposure to lead were collected by questionnaire. Linear regression was used to examine the relations between bone and blood lead, demographics, and environmental exposure variables.
RESULTS—Mean (SD) blood, tibial, and patellar lead concentrations were 9.5 (4.5) µg/dl, 10.2 (10.1) µg Pb/g bone mineral, and 15.2 (15.1) µg Pb/g bone mineral respectively. These values are considerably higher than values for women in the United States. Older age, the cumulative use of lead glazed pottery, and higher proportion of life spent in Mexico City were powerful predictors of higher bone lead concentrations. Use of lead glazed ceramics to cook food in the past week and increased patellar lead concentrations were significant predictors of increased blood lead. Patellar lead concentrations explained one third of the variance accounted for by the final blood lead model. Women in the 90th percentile for patella lead had an untransformed predicted mean blood lead concentration 3.6 µg/dl higher than those in the 10th percentile.
CONCLUSIONS—This study identified the use of lead glazed ceramics as a major source of cumulative exposure to lead, as reflected by bone lead concentrations, as well as current exposure, reflected by blood lead, in Mexico. A higher proportion of life spent in Mexico City, a proxy for exposure to leaded gasoline emissions, was identified as the other major source of cumulative lead exposure. The influence of bone lead on blood lead coupled with the long half life of lead in bone has

  4. Traditional beliefs and practices in the postpartum period in Fujian Province, China: a qualitative study

    PubMed Central

    Raven, Joanna H; Chen, Qiyan; Tolhurst, Rachel J; Garner, Paul

    2007-01-01

    Background Zuo yuezi is the month postpartum in China associated with a variety of traditional beliefs and practices. We explored the current status of zuo yuezi from social, cultural and western medical perspectives. Methods We interviewed family members (36) and health workers (8) in Fujian Province, selecting one rural and one rapidly developing urban county. We asked about their traditional beliefs and their behaviour postpartum. We used a framework approach to identify main themes. We categorised reported behaviour against their probable effects on health, drawing on Western standards. Results Respondents reported that zuo yuezi was commonly practiced in urban and rural families to help the mother regain her strength and protect her future health. Zuo yuezi included: dietary precautions, such as eating more food and avoiding cold food; behavioural precautions, such as staying inside the home, avoiding housework and limiting visitors; hygiene precautions, such as restricting bathing and dental hygiene; and practices associated with infant feeding, including supplementary feeding and giving honeysuckle herb to the infant. Respondents reported that the main reasons for adhering to these practices were respect for tradition, and following the advice of elders. Categorised against Western medical standards, several zuo yuezi practices are beneficial, including eating more, eating protein rich food, avoiding housework, and daily vulval and perineal hygiene. A few are potentially harmful, including giving honeysuckle herb, and avoiding dental hygiene. Some women reported giving infants supplementary feeds, although zuo yuezi emphasises breast feeding. Conclusion Zuo yuezi is an important ritual in Fujian. In medical terms, most practices are beneficial, and could be used by health staff to promote health in this period. Further research on reported potentially harmful practices, such as supplements to breast feeding, is needed. PMID:17584930

  5. Comparison of population structure in Ohio's late archaic and late prehistoric periods.

    PubMed

    Tatarek, N E; Sciulli, P W

    2000-07-01

    Previous studies of population structure among prehistoric groups in the Ohio valley region have shown that hunting-gathering populations exhibited a different structure than horticultural populations. Among both Late Archaic hunter-gatherers and Late Prehistoric horticulturists, covariance structures for cranial metrics were found to be homogenous within the populations, but the Late Archaic subpopulations showed little differentiation while the Late Prehistoric subpopulations exhibited a marked differentiation. Biodistance based on cranial discrete trait frequency showed similar patterns, but in the Late Archaic discrete trait distance was associated significantly with the geographical distance separating populations. The present investigation is an extension of the previous studies increasing the Late Prehistoric sample (n = 8 samples and n = 341 individuals) and using the Harpending-Ward model, modified for use with multivariate quantitative data, to estimate the effects of differential gene flow and the amount of differentiation within populations. Results of the present analyses indicate that differentiation among subpopulations, measured by minimum F(ST), was greater in the Late Prehistoric compared to the Late Archaic period. However, for both periods the minimum F(ST) is comparable to values found for historic native populations of the northeast woodlands. Analysis of differential gene flow in the Late Archaic period indicates that geographically peripheral populations were affected more by external gene flow than more central populations. Late Prehistoric populations exhibit a very complex pattern of differential gene flow. We discuss the latter pattern in terms of proposed culture change in the Late Prehistoric period of Ohio. PMID:10861353

  6. 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

  7. The relationships between physical violence, verbal abuse and women’s psychological distress during the postpartum period

    PubMed Central

    ROMITO, PATRIZIA; POMICINO, LAURA; LUCCHETTA, CHIARA; SCRIMIN, FEDERICA; TURAN, JANET MOLZAN

    2009-01-01

    Objective To analyse the relationship between violence in the post-partum period and mothers’ psychological distress. Method Three hundred and fifty two women responded to a questionnaire after the birth, at the Trieste Hospital (Italy), and 292 of them responded to a telephone interview 8 months later. Psychological distress was evaluated with the General Health Questionnaire (GHQ); partner and family violence were evaluated with a 28-item scale. Results Eight months post-partum, 10% of women were experiencing violence either from the partner or from another family member; 5% showed high psychological distress. Multivariate analyses show that, after adjustment for covariates, the OR for depressive symptoms was 19.17 for women experiencing partner or family violence. Being dissatisfied with their working situation, hospitalisation of the baby and pre-pregnancy mental health were also significantly associated with high GHQ scores Conclusion These results stress the relationship between violence in post-partum and maternal psychological distress. Measures aimed to identify and end violence against women around pregnancy could contribute to the improvement of women’s mental health post-partum. PMID:19533491

  8. 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

  9. 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

  10. 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.

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

    PubMed Central

    2012-01-01

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

  13. Characteristics and Outcomes of AKI Treated with Dialysis during Pregnancy and the Postpartum Period.

    PubMed

    Hildebrand, Ainslie M; Liu, Kuan; Shariff, Salimah Z; Ray, Joel G; Sontrop, Jessica M; Clark, William F; Hladunewich, Michelle A; Garg, Amit X

    2015-12-01

    Acute kidney injury (AKI) is a rare complication of pregnancy, but may be associated with significant morbidity and mortality in young and often otherwise healthy women. We conducted a retrospective population-based cohort study of all consecutive pregnancies over a 15-year period (1997-2011) in Ontario, Canada, and describe the incidence and outcomes of AKI treated with dialysis during pregnancy or within 12 weeks of delivery. Of 1,918,789 pregnancies, 188 were complicated by AKI treated with dialysis (incidence: 1 per 10,000 [95% confidence interval, 0.8 to 1.1]). Only 21 of 188 (11.2%) women had record of a preexisting medical condition; however, 130 (69.2%) women experienced a major pregnancy-related complication, including preeclampsia, thrombotic microangiopathy, heart failure, sepsis, or postpartum hemorrhage. Eight women died (4.3% versus 0.01% in the general population), and seven (3.9%) women remained dialysis dependent 4 months after delivery. Low birth weight (<2500 g), small for gestational age, or preterm birth (<37 weeks' gestation) were more common in pregnancies in which dialysis was initiated (35.6% versus 14.0%; relative risk, 3.40; 95% confidence interval, 2.52 to 4.58). There were no stillbirths and fewer than five neonatal deaths (<2.7%) in affected pregnancies compared with 0.1% and 0.8%, respectively, in the general population. In conclusion, AKI treated with dialysis during pregnancy is rare and typically occurs in healthy women who acquire a major pregnancy-related medical condition such as preeclampsia. Many affected women and their babies have good short-term outcomes.

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

    PubMed

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

    2015-10-01

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

  15. [The impact of thyroid function in women of reproductive age: infertility, pregnancy and the postpartum period].

    PubMed

    Speer, Gábor

    2013-12-22

    This article reviews the management and diagnosis of thyroid dysfunction during pregnancy and postpartum, which was published by any of the endocrine societies in 2012. The author presents human data based on these clinical practice guidelines, however, there are also many unresolved questions. Especially, there are inconsistencies about screening using plasma TSH measurement. In pregnancy the main causes of hyperthyroidism are Graves's disease and gestational transient thyrotoxicosis. Generally, gestational transient thyrotoxicosis does not require medication, whereas Graves's disease needs antithyroid drug therapy. Postpartum thyroiditis occurs more frequently in antithyroid peroxidase-positive women, who should be screened using serum thyrotropin measurements at 6 to 12 gestation weeks and at 3 and 6 months postpartum. Because overt maternal hypothyroidism, due to autoimmune pathophysioloical mechanisms, negatively affects the fetus, timely recognition and treatment are important. The subclinical form of maternal hypothyroidism should also be treated. A link between thyroid dysfunction and infertility has been warranted. PMID:24334133

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

    PubMed Central

    2013-01-01

    Background HPV persistence is a key determinant of cervical carcinogenesis. The influence of postpartum on HPV clearance has been debated. This study aimed to assess HPV clearance in later pregnancy and postpartum among HIV-positive and negative women. Methods We conducted a follow-up study with 151 HPV-positive women coinfected with HIV, in 2007–2010. After baseline assessment, all women were retested for HPV infection using PCR in later pregnancy and after delivery. Multivariable logistic regressions assessed the putative association of covariates with HPV status in between each one of the successive visits. Results Seventy-one women (47%) have eliminated HPV between the baseline visit and their second or third visits. HIV-positive women took a significantly longer time (7.0 ± 3.8 months) to clear HPV, compared to those not infected by HIV (5.9 ± 3.0 months). HPV clearance was significantly more likely to take place after delivery than during pregnancy (84.5% x 15.5%). Conclusions Both HIV-positive and negative women presented a significant reduction in HPV infection during the postpartum period. HIV-positive status was found to be associated with a longer period of time to clear HPV infection in pregnant women. PMID:24289532

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

    PubMed Central

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

    2015-01-01

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

  18. Intrathoracic gastric perforation: a late complication of an unknown postpartum recurrent hiatal hernia.

    PubMed

    Lococo, Filippo; Cesario, Alfredo; Meacci, Elisa; Granone, Pierluigi

    2012-08-01

    Diaphragmatic hernias occurring during pregnancy are an uncommon event. In very rare occasions, the clinical situation can suddenly worsen due to obstruction, torsion or infarction of the herniated viscera. Here, we describe a challenging case of a post-partum diaphragmatic hiatus hernia complicated by intrathoracic gastric perforation. A 23-year old woman was admitted at our hospital with a syndrome characterized by epigastralgy, dyspnoea and fever. She had previously undergone a laparoscopic antireflux surgery for hiatus hernia (6 years before) and a recent (4 months) unremarkable vaginal delivery. Due to the persistence of a pelvic pain after the delivery, she had been taking pain-killers as a self-administered medication. A CT scan showed a massive left pleural effusion and a complete herniation of the stomach into the left hemithorax. After placing a chest drainage and removing up to 3000 ml of brownish purulent fluid, a repeat CT scan (with water soluble contrast swallow) showed a leak at the level of the stomach. At surgery, we observed a complete intrathoracic herniation through a large diaphragmatic hiatal defect and a small well-defined gastric ulcer. A primary repair of both the stomach and the diaphragm was performed. We take the opportunity presented by this report to briefly discuss the patho-physiological mechanisms underlying this unusual complication.

  19. Influence of hormonal and nonhormonal estrus synchronization methods on follicular and oocyte quality in primiparous lactating does at early postpartum period.

    PubMed

    Arias-Alvarez, M; García-García, R M; Torres-Rovira, L; González-Bulnes, A; Rebollar, P G; Lorenzo, P L

    2010-01-01

    High-yield lactating does need effective estrus synchronization methods to improve their reproductive outcome by enhancing ovarian function. The aim of the current work was to analyze ovarian follicular and oocyte characteristics of hormonal and nonhormonal estrus synchronization regimes in primiparous lactating rabbit does (Oryctolagus cuniculus) in the early postpartum period (Day 11). Females were randomly treated with either (1) a hormonal standard treatment with 25 IU equine chorionic gonadotropin (eCG) 48h before artificial insemination (eCG group) or (2) an alternative nonhormonal treatment consisting of doe-litter separation 24h before artificial insemination (Bio group). No significant differences were found in serum estradiol and progesterone concentrations between experimental groups. During the histologic study, the Bio group presented a higher number of primordial (P<0.05) and primary follicles (P=0.07) compared with that of the eCG group, whereas secondary and antral follicular populations were similar. Rates of late atretic follicles assessed by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling technique were not different between treatments, but the eCG group showed a significantly higher number of mid-atretic follicles compared with that of the Bio group. Nuclear in vitro oocyte maturation (IVM), measured as metaphase II rate, and in vitro steroidogenic response of cumulus-oocyte complexes, measured by ELISA, did not show significant differences between treatments. However, confocal study showed that cytoplasmic maturation of oocytes, in terms of cortical granule migration rate, was significantly higher in the Bio group compared with that after the eCG treatment. In conclusion, transient doe-litter separation seems to improve ovarian response in terms of follicular health and oocyte competence compared with that after the eCG treatment. Therefore, a 24-h-long transient weaning could be an alternative nonhormonal method for

  20. 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.

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

    PubMed Central

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

    2013-01-01

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

  2. A complete insect from the Late Devonian period.

    PubMed

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

    2012-08-01

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

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

    PubMed

    Tesařová, Drahomíra

    2015-01-01

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

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

    PubMed

    Tesařová, Drahomíra

    2015-01-01

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

  5. 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 ...

  6. 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.

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

    PubMed

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

    2013-12-01

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

  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. 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

  10. 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

  11. Iatromathematica (medical astrology) in late antiquity and the Byzantine period.

    PubMed

    Papathanassiou, M

    1999-01-01

    Byzantium inherited the rich astrological tradition of Late Antiquity, especially that of Alexandria, where even in the 6th century A.D., astrology was taught in philosophical schools. The great number of Byzantine astrological MSS, which preserve works of famous authors and many anonymous treatises, shows the survival and continuity of astrology in Byzantium. Through medical astrology physicians can better understand the temperament of an individual man and find out about his bodily constitution and psychic faculties, his inclination to chronic and acute diseases, the possibilities of curable or incurable cases, and finally the periods of major danger for his health. They can conjecture about the evolution of a disease, choose a favorable time for an operation, or initiate a cure.

  12. Antibody responses to Plasmodium falciparum and Plasmodium vivax blood-stage and sporozoite antigens in the postpartum period

    PubMed Central

    McLean, Alistair R. D.; Boel, Machteld E.; McGready, Rose; Ataide, Ricardo; Drew, Damien; Tsuboi, Takafumi; Beeson, James G.; Nosten, François; Simpson, Julie A.; Fowkes, Freya J. I.

    2016-01-01

    During pregnancy a variety of immunological changes occur to accommodate the fetus. It is unknown whether these changes continue to affect humoral immunity postpartum or how quickly they resolve. IgG levels were measured to P. falciparum and P. vivax antigens in 201 postpartum and 201 controls over 12 weeks. Linear mixed-effects models assessed antibody maintenance over time and the effect of microscopically confirmed Plasmodium spp. infection on antibody levels, and whether this was different in postpartum women compared with control women. Postpartum women had reduced Plasmodium spp. antibody levels compared to controls at baseline. Over 12 weeks, mean antibody levels in postpartum women increased to levels observed in control women. Microscopically confirmed P. falciparum and P. vivax infections during follow-up were associated with an increase in species-specific antibodies with similar magnitudes of boosting observed in postpartum and control women. Antibodies specific for pregnancy-associated, VAR2CSA-expressing parasites did not rapidly decline postpartum and did not boost in response to infection in either postpartum or control women. After pregnancy, levels of malaria-specific antibodies were reduced, but recovered to levels seen in control women. There was no evidence of an impaired ability to mount a boosting response in postpartum women. PMID:27558000

  13. Antibody responses to Plasmodium falciparum and Plasmodium vivax blood-stage and sporozoite antigens in the postpartum period.

    PubMed

    McLean, Alistair R D; Boel, Machteld E; McGready, Rose; Ataide, Ricardo; Drew, Damien; Tsuboi, Takafumi; Beeson, James G; Nosten, François; Simpson, Julie A; Fowkes, Freya J I

    2016-01-01

    During pregnancy a variety of immunological changes occur to accommodate the fetus. It is unknown whether these changes continue to affect humoral immunity postpartum or how quickly they resolve. IgG levels were measured to P. falciparum and P. vivax antigens in 201 postpartum and 201 controls over 12 weeks. Linear mixed-effects models assessed antibody maintenance over time and the effect of microscopically confirmed Plasmodium spp. infection on antibody levels, and whether this was different in postpartum women compared with control women. Postpartum women had reduced Plasmodium spp. antibody levels compared to controls at baseline. Over 12 weeks, mean antibody levels in postpartum women increased to levels observed in control women. Microscopically confirmed P. falciparum and P. vivax infections during follow-up were associated with an increase in species-specific antibodies with similar magnitudes of boosting observed in postpartum and control women. Antibodies specific for pregnancy-associated, VAR2CSA-expressing parasites did not rapidly decline postpartum and did not boost in response to infection in either postpartum or control women. After pregnancy, levels of malaria-specific antibodies were reduced, but recovered to levels seen in control women. There was no evidence of an impaired ability to mount a boosting response in postpartum women. PMID:27558000

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

    PubMed Central

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

    2016-01-01

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

  15. 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

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

    PubMed

    Pourrat, O

    2015-03-01

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

  17. Application of disease management principles to pregnancy and the postpartum period.

    PubMed

    Fetterolf, Donald E; Stanziano, Gary; Istwan, Niki

    2008-06-01

    Pregnancy and newborn care rank among the top health care expenditures for health plans and employers. Traditionally treated as episodic conditions, maternity and newborn clinical management is most often reactive in nature, event driven, and not perceived as a continuum. Existing models of pure disease management are not suited for addressing this continuum because the condition of pregnancy is not a disease, is not chronic, and is self-limited. Wellness approaches may be applicable for prenatal care, but they fail to fully engage the complexities and intervention needed for high-risk pregnancies. Case management alone is too comprehensive to focus on the high volume of pregnancies, which must be screened and accommodated at the health plan level. Alternatively, the management of a pregnant population through a continuum starting with early prenatal care and commencing with newborn and maternal postpartum care is optimal. We describe a total maternal-newborn solution (TMNS) that considers pregnancy as a unique, high-volume condition with infrequent, but costly, complications that can benefit from primary and secondary preventive efforts to avoid or reduce the impact of complications in a cost-effective manner. A TMNS helps to improve the quality of care delivered as participants and their health care providers are encouraged to follow standardized clinical guidelines and monitored for compliance. A TMNS is made possible with the use of an enterprise information technology platform that provides a common infrastructure to track participant encounters and interventions and measure and report on maternal and newborn care delivered. Preliminary outcomes for the TMNS program prove it to be a promising approach for addressing the clinical and cost management of the pregnancy continuum.

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

    PubMed Central

    Gingnell, Malin; Bannbers, Elin; Moes, Harmen; Engman, Jonas; Sylvén, Sara; Skalkidou, Alkistis; Kask, Kristiina; Wikström, Johan; Sundström-Poromaa, Inger

    2015-01-01

    Marked endocrine alterations occur after delivery. Most women cope well with these changes, but the postpartum period is associated with an increased risk of depressive episodes. Previous studies of emotion processing have focused on maternal–infant bonding or postpartum depression (PPD), and longitudinal studies of the neural correlates of emotion processing throughout the postpartum period in healthy women are lacking. In this study, 13 women, without signs of post partum depression, underwent fMRI with an emotional face matching task and completed the MADRS-S, STAI-S, and EPDS within 48 h (early postpartum) and 4–6 weeks after delivery (late postpartum). Also, data from a previous study including 15 naturally cycling controls assessed in the luteal and follicular phase of the menstrual cycle was used. Women had lower reactivity in insula, middle frontal gyrus (MFG), and inferior frontal gyrus (IFG) in the early as compared to the late postpartum assessment. Insular reactivity was positively correlated with anxiety in the early postpartum period and with depressive symptoms late postpartum. Reactivity in insula and IFG were greater in postpartum women than in non-pregnant control subjects. Brain reactivity was not correlated with serum estradiol or progesterone levels. Increased reactivity in the insula, IFG, and MFG may reflect normal postpartum adaptation, but correlation with self-rated symptoms of depression and anxiety in these otherwise healthy postpartum women, may also suggest that these changes place susceptible women at increased risk of PPD. These findings contribute to our understanding of the neurobiological aspects of the postpartum period, which might shed light on the mechanisms underlying affective puerperal disorders, such as PPD. PMID:26061879

  19. 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

  20. 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

  1. 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.

  2. 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

  3. 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

  4. Effect of supplementation with vitamins E, C and β-carotene on antioxidative/oxidative status parameters in sows during the postpartum period.

    PubMed

    Szczubiał, M

    2015-01-01

    The effect of vitamins E, C and β-carotene supplementation in sows on the parameters of antioxidative/oxidative status during the postpartum period was investigated. Twenty four primiparous sows, divided into two groups (experimental and control), were included in the study. After the half-way point of pregnancy until farrowing, each experimental sow received feed supplemented twice a week with 200 mg of vitamin E and 1000 mg of vitamin C, and additionally, 70 mg of β-carotene were administered via intramuscular injection, on day 14 and day 7 before farrowing. The control group was not supplemented. Blood samples were collected before supplementation (gestational day 57-58), 48 hours and 7 days after parturition. The following antioxidative and oxidative parameters were measured using spectrophotometric methods: glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), catalase (CAT), vitamin C, vitamin E, thiobarbituric acid reactive substances (TBARS), and sulfhydryl groups (SH groups). In supplemented sows the erythrocyte activity of GSH-Px and CAT was found to be significantly higher on day 7 after farrowing and the activity of SOD was significantly higher at 48 hours postpartum, compared to the control group. The concentration of vitamins C and E in plasma of the supplemented group was found to be significantly higher and the content of TBARS was found significantly lower at both postpartum measurement points, compared to the control group. The content of SH groups was significantly higher on day 7 postpartum, compared to the control group. The study findings indicate that supplementation of pregnant sows with vitamins E, C and β-carotene in the second half of pregnancy has beneficial effects on the antioxidative/oxidative balance in the postpartum period by increasing the antioxidative potential and reducing lipid and protein peroxidation. PMID:26172179

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

    PubMed Central

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

    2015-01-01

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

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. Slow recovery of blood glucose in the insulin tolerance test during the prepartum transition period negatively impacts the nutritional status and reproductive performance postpartum of dairy cows.

    PubMed

    Lee, Hsu-Hsun; Kida, Katsuya; Miura, Ryotaro; Inokuma, Hisashi; Miyamoto, Akio; Kawashima, Chiho; Haneda, Shingo; Miyake, Yoh-Ichi; Matsui, Motozumi

    2012-04-01

    In peripartum dairy cows, insulin resistance (IR) increases to adjust the direction of energy to lactation after calving. To investigate the effect of prepartum IR on postpartum reproductive performance, the insulin tolerance test (ITT) was applied to 15 cows at 3 weeks (Pre21) and 10 days (Pre10) before the predicted calving date. Blood glucose area under the curve (AUC(glu)) within 120 min after administration of 0.05 IU/kg-BW insulin was calculated. The occurrence of first ovulation, days to first artificial insemination (AI) and first AI conception rate were recorded. Nutritional status postpartum was evaluated by blood chemical analysis. Based on AUC(glu) changes from Pre21 to Pre10, cows were classified into either the AUC-up group (AUC(glu) increase, n=5) or the AUC-down group (AUC(glu) decrease, n=10). There was no difference in the decrease in blood glucose at 30 min after insulin injection between groups, although glucose recovery from 30 to 60 min during the ITT was slow at Pre10 in the AUC-up group. The AUC-up group had a higher number of days to first AI and high glucose, total protein, globulin, γ-glutamyltransferase, triacylglycerol levels and a low albumin-globulin ratio at the 14th day postpartum. The present study infers that prepartum slow glucose recovery rather than insulin sensitivity might increase the potential for subclinical health problems postpartum and thus suppress reproductive performance. During the prepartum transition period, glucose dynamics in the ITT can be considered as a new indicator for the postpartum metabolic status and reproductive performance of dairy cows.

  11. Expression of vascular endothelial growth factor receptors and their ligands in rat uterus during the postpartum involution period.

    PubMed

    Sağsöz, H; Liman, N; Alan, E

    2015-07-01

    Vascular endothelial growth factor (VEGF) and its specific receptors, FLt1/fms, Flk1/KDR and FLt4, play important roles in vasculogenesis, and physiological and pathological angiogenesis. Whether angiogenic growth factors are involved in regulating angiogenic processes during the postpartum involution period (PP) of the rat uterus is unknown. We used immunohistochemistry to analyze the expression levels of VEGF, the fms-like tyrosine kinase 1 (FLt1/fms), the kinase insert domain-containing region 1 (Flk1/KDR), Fms-related tyrosine kinase 4 (FLt4) and vascular endothelial growth inhibitor (VEGI) in the rat uterus during the days 1, 3, 5, 10 and 15 of the PP to determine the temporal and spatial expressions of VEGF and its receptors during the PP. Throughout the PP, cytoplasmic and membrane staining of VEGI, VEGF and their receptors were observed in the lumens, crypts and glandular epithelial cells as well as in connective tissue and vascular endothelial and smooth muscle cells in the endometrium. We found that the intensity of the immunoreactions in the endometrium varied with the morphological changes that occurred during involution. Immunoreactions for VEGI, VEGF and their receptor, Flk1/KDR, in the luminal epithelial cells were stronger than those in the glandular epithelial and stromal cells, particularly during PP 1, 3 and 5, which suggests that these peptides may contribute to re-epithelialization of the endometrium. On the other hand, Flt1/fms immunoreactivity was strong mainly in the stromal cells during the PP. The presence of VEGF and its receptors (FLt1/fms, Flk1/KDR, FLt4) in the stromal cells and blood vessels during the PP suggests that they may contribute to regulating stromal repair and angiogenesis in the involuting uterus of the rat.

  12. Periods of activity cycles in late-type stars

    NASA Technical Reports Server (NTRS)

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

    1983-01-01

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

  13. Pulmonary artery stump thrombosis developed during the late postoperative period

    PubMed Central

    Kaya, Seyda Ors; Samancilar, Ozgur; Ceylan, Kenan Can

    2016-01-01

    A 73-year-old man underwent left pneumonectomy for squamous cell lung carcinoma 3 years ago. The postoperative and follow-up periods were uneventful. A thrombus was detected in the left pulmonary artery stump during the last chest computed tomography (CT) scan. Anticoagulant treatment was applied: intravenous heparin for 3 days followed by oral warfarin. The follow-up chest CT examination revealed regression in the size of the thrombus.

  14. Trachoma in late Greek antiquity and the early Byzantine periods.

    PubMed

    Trompoukis, Constantinos; Kourkoutas, Dimitrios

    2007-12-01

    Trachoma is an ancient disease that has survived until the present day and represents the most common cause of infectious blindness globally. This study reviews the main Greek medical sources of the period from the 1st to 7th century AD and presents the medical knowledge relating to trachoma, including its definition, clinical features, diagnosis, complications, and treatment. It was widely accepted that trachoma was a disease of the palpebral conjunctiva, and the different stages of trachoma were described in detail. However, it is unclear whether the stages of trichiasis and pannus were identified as trachoma complications. The extensive references to the treatment of trachoma during the Byzantine period provide a strong argument for the case that trachoma was one of the most serious and common eye diseases. Both surgical and pharmaceutical treatments were often applied at the same time. Occasionally, surgical treatment could be rather dramatic, involving the use of stiff fig leaves or a chisel. Nevertheless, the prognosis was always poor, and the disease developed over the years until it threatened the cornea.

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

    PubMed

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

    2007-01-01

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

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

    PubMed

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

    2007-01-01

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

  17. 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

  18. [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

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

    NASA Astrophysics Data System (ADS)

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

    1980-06-01

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

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

    SciTech Connect

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

    1992-01-01

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

  1. Unrestricted feed intake during the dry period impairs the postpartum oxidation and synthesis of fatty acids in the liver of dairy cows.

    PubMed

    Murondoti, A; Jorritsma, R; Beynen, A C; Wensing, T; Geelen, M J H

    2004-03-01

    The purpose of this study was to determine the activities of key hepatic enzymes of fatty acid synthesis and oxidation in cows that had excessive body fat at parturition. Dairy cows were allocated to either an experimental group or a control group. All cows were offered a total mixed ration with an energy content of 6.6 MJ of net energy for lactation per kilogram of dry matter and consisting of corn silage, beet pulp, rapeseed meal, and soybean meal. Control cows were restricted to 6.8 kg/dry matter of the mixed ration in the dry period. Experimental cows had unrestricted access to the mixed ration during the dry period to increase body fat and induce fatty liver postpartum. Blood and liver samples were collected 1 wk before and 1, 2, and 4 wk after parturition. Before parturition, neither the serum nonesterifled fatty acids nor the hepatic triacylglycerol concentrations differed between experimental and control cows. After parturition, the values for these variables were greater in experimental cows than in control cows. Plasma 3-hydroxybutyrate increased sharply after parturition in the experimental group. In liver, the activity of acetyl-CoA carboxylase was already significantly lower in the experimental group before parturition. After parturition, the activities of acetyl-CoA carboxylase and fatty acid synthase dropped in the experimental group. The activity of 3-hydroxy-acyl-CoA dehydrogenase in liver was less in experimental cows following parturition. Hepatic citrate synthase activity increased only in the control group after parturition. Unrestricted feed intake before parturition reduces de novo fatty acid synthesis as well as fatty acid oxidation after parturition. The reduction in fatty acid oxidation following parturition may contribute to postpartum accumulation of triacylglycerol in the livers of cows with unrestricted access to feed during the dry period.

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

    PubMed

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

    2015-05-01

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

  3. Relationship between the degree of insulin resistance during late gestation and postpartum performance in dairy cows and factors that affect growth and metabolic status of their calves

    PubMed Central

    KAWASHIMA, Chiho; MUNAKATA, Megumi; SHIMIZU, Takashi; MIYAMOTO, Akio; KIDA, Katsuya; MATSUI, Motozumi

    2016-01-01

    This study aimed to investigate the effects of insulin resistance (IR) during the close-up dry period on the metabolic status and performance of dairy cows as well as to determine the effects on body weight (BW) and metabolic status of their calves. An insulin tolerance test (ITT) was conducted by administering 0.05 IU/kg BW of insulin to 34 multiparous Holstein cows at 3 weeks prepartum. Blood samples were collected at 0, 30, 45 and 60 min after insulin injection, and cows were divided into two groups based on the time required for glucose to reach the minimum levels [non-IR (NIR), 45 min (n=28); and IR, 60 min (n=6)]. Blood or milk sampling and body condition score (BCS) estimation were performed twice weekly during the experimental period. Blood samples from calves were collected immediately after birth. Cows with IR showed lower BCS (P<0.05) and serum urea nitrogen (P<0.05) and glucose concentration (P=0.05) before calving, and lower serum non-esterified fatty acid concentration (P<0.05) and milk yield (P<0.05) and earlier resumption of luteal activity (P<0.05) after calving; their calves showed lower BW (P<0.05) and plasma insulin-like growth factor-I concentration (P<0.001) and higher plasma insulin concentration (P<0.05). In conclusion, IR at 3 weeks prepartum in dairy cows is related to postpartum metabolic status and performance along with growth and metabolic status of their calves. PMID:26781705

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

    PubMed

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

    2016-01-01

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

  5. MR imaging of maternal diseases of the abdomen and pelvis during pregnancy and the immediate postpartum period.

    PubMed

    Leyendecker, John R; Gorengaut, Vladislav; Brown, Jeffrey J

    2004-01-01

    Magnetic resonance (MR) imaging provides multiplanar large field-of-view images of the body with excellent soft-tissue contrast and without ionizing radiation. As a result, MR imaging is increasingly being used to image the maternal abdomen and pelvis during and immediately after pregnancy. Results of rapid T1- and T2-weighted imaging are often diagnostic, and blood vessels, ductal structures, and the urinary tract can frequently be visualized without intravenous administration of contrast material. Until more conclusive safety data become available, MR imaging should be reserved for cases in which results of ultrasonography are inconclusive and patient care depends on further imaging. In the setting of acute abdomen during pregnancy, MR imaging allows identification of areas of inflammation, abscess formation, hemorrhage, and bowel obstruction. MR imaging also helps determine the organ of origin, extent, and composition of maternal neoplasms and is useful in evaluation of müllerian duct anomalies and abnormalities of placental formation, position, and implantation. Many postpartum complications such as retained products of conception and uterine dehiscence may be diagnosed with MR imaging when results of other modalities are indeterminate.

  6. 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

  7. 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

  8. 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

  9. Effects of different polyunsaturated fatty acid supplementations during the postpartum periods of early lactating dairy cows on milk yield, metabolic responses, and reproductive performances.

    PubMed

    Dirandeh, E; Towhidi, A; Zeinoaldini, S; Ganjkhanlou, M; Ansari Pirsaraei, Z; Fouladi-Nashta, A

    2013-02-01

    during 40 dpp could be a good treatment for early postpartum periods, and a shift to omega-3 fatty acids until 40 d after AI can be considered as a strategy for improving fertility in lactating dairy cows.

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

    PubMed

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

    2005-05-26

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

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

    PubMed

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

    2005-05-26

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

  12. Metabotropic Glutamate Receptor 3 Is Downregulated and Its Expression Is Shifted From Neurons to Astrocytes in the Mouse Lateral Septum During the Postpartum Period

    PubMed Central

    Zhao, Changjiu; Gammie, Stephen C.

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

  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. Magnetic cycles and rotation periods of late-type stars from photometric time series

    NASA Astrophysics Data System (ADS)

    Suárez Mascareño, A.; Rebolo, R.; González Hernández, J. I.

    2016-10-01

    Aims: We investigate the photometric modulation induced by magnetic activity cycles and study the relationship between rotation period and activity cycle(s) in late-type (FGKM) stars. Methods: We analysed light curves, spanning up to nine years, of 125 nearby stars provided by the All Sky Automated Survey (ASAS). The sample is mainly composed of low-activity, main-sequence late-A to mid-M-type stars. We performed a search for short (days) and long-term (years) periodic variations in the photometry. We modelled the light curves with combinations of sinusoids to measure the properties of these periodic signals. To provide a better statistical interpretation of our results, we complement our new results with results from previous similar works. Results: We have been able to measure long-term photometric cycles of 47 stars, out of which 39 have been derived with false alarm probabilities (FAP) of less than 0.1 per cent. Rotational modulation was also detected and rotational periods were measured in 36 stars. For 28 stars we have simultaneous measurements of activity cycles and rotational periods, 17 of which are M-type stars. We measured both photometric amplitudes and periods from sinusoidal fits. The measured cycle periods range from 2 to 14 yr with photometric amplitudes in the range of 5-20 mmag. We found that the distribution of cycle lengths for the different spectral types is similar, as the mean cycle is 9.5 yr for F-type stars, 6.7 yr for G-type stars, 8.5 yr for K-type stars, 6.0 yr for early M-type stars, and 7.1 yr for mid-M-type stars. On the other hand, the distribution of rotation periods is completely different, trending to longer periods for later type stars, from a mean rotation of 8.6 days for F-type stars to 85.4 days in mid-M-type stars. The amplitudes induced by magnetic cycles and rotation show a clear correlation. A trend of photometric amplitudes with rotation period is also outlined in the data. The amplitudes of the photometric variability

  19. Dietary arginine silicate inositol complex during the late laying period of quail at different environmental temperatures.

    PubMed

    Onderci, M; Sahin, N; Sahin, K; Balci, T A; Gursu, M F; Juturu, V; Kucuk, O

    2006-04-01

    Arginine silicate inositol complex (ASIdagger; arginine 49.5%, silicon 8.2%, inositol 25%) is a novel material which is a bioavailable source of silicon and arginine. ASI offers potential benefits for vascular and bone health. Poor eggshell quality has been a major economic concern to commercial egg producers. Poor egg quality, skeletal abnormalities and architectural deterioration of bone tissue are common problems under hot conditions and in older birds. The effects of ASI supplementation on egg production, egg quality, levels of osteocalcin (OC) and bone mineral content were investigated in heat-stressed Japanese quail during the later part of the laying period. The birds were randomly assigned to six treatment groups consisting of six replicates of five birds each in a 2 x 3 factorial arrangement of treatments (temperatures, ASI levels). The birds were kept in wire cages in a temperature-controlled room at either 22 degrees C (TN) or 34 degrees C (HS) for 8 h/d and fed either a basal (control) diet or the basal diet supplemented with either 500 or 1000 g of ASI/kg. Heat exposure reduced egg production, egg quality and bone mineralisation when the basal diet was fed. ASI supplementation had no effect on feed intake or egg production under TN or HS conditions. However, ASI supplementation increased egg weight, shell thickness, shell weight and Haugh unit in both TN and HS groups during the late laying period. Bone mineral density (BMD) was significantly improved by ASI supplementation in both TN and HS groups. Serum osteocalcin (OC) concentrations and alkaline phosphatase (ALP) activity increased linearly with dietary ASI supplementation during the late laying period. The amount of calcium and phosphorus in the excreta decreased, while ash, mineral content, calcium and phosphorus concentrations in tibia increased in ASI-supplemented quail in both TN and HS groups during the late laying period. ASI supplementation significantly improved egg quality and bone

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

    NASA Astrophysics Data System (ADS)

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

    2015-01-01

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

  1. Hantavirus pulmonary syndrome in a postpartum woman

    PubMed Central

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

    2016-01-01

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

  2. 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

  3. 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.

  4. 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

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

    PubMed

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

    2012-12-01

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

  6. 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

  7. 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.

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

    PubMed

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

    2005-06-01

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

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

    PubMed

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

    2005-06-01

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

  10. Short report: cysticercosis in an Egyptian mummy of the late Ptolemaic period.

    PubMed

    Bruschi, Fabrizio; Masetti, Massimo; Locci, Maria Teresa; Ciranni, Rosalba; Fornaciari, Gino

    2006-04-01

    We describe here an ancient case of cysticercosis that was discovered in an Egyptian mummy of a young woman of about 20 years of age who lived in the late Ptolemaic period (second to first centuries b.c.). On removal of the stomach and its rehydration, a cystic lesion in the stomach wall was observed by naked eye. Microscopical examination of sections of this lesion revealed a cystic structure, with a wall, with numerous projecting eversions, a characteristic feature of the larval stage (cysticercus) of the human tapeworm Taenia solium (or "pig tapeworm"). Immunohistochemical testing with serum from a T. solium-infected human confirmed the identity of the cyst. This finding is the oldest on record of the antiquity of this zoonotic parasite. This observation also confirms that, in Hellenistic Egypt, the farming of swine, along with man an intermediate host of this parasite, was present, and supports other archeological evidence. PMID:16606991

  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. [The emergence of Korean modern hospitals: hospitals in the late period of Chosun Dynasty].

    PubMed

    Cho, Woo Hyun; Park, Chong Yon; Park, Chun Sun

    2002-06-01

    Hospitals are confronting in the transforming or reforming period to cope with the rapid social and environmental changes worldwide. By the researches in the history of Korean health, we could understand the context of the introduction of Western medicine and institutions to Korea. However there have been few studies on the historical review of hospitals in relations to their roles in the modern medicine. This article is to review the issues around the rise of modern hospitals in Korean history of health affairs. The introduction of Western medicine in Korea was on the road with the establishment of Kwanghyewon, the Royal Hospital, which was possible due to favorable conditions under the Korean socio-political background for the emerging and accepting the entirely new medical system. And also the emergence of modern and transformed the Korean traditional health system from the fundamentals through the corruption of the old dynasty to nowadays. Most national health affairs including medical services, prevention of diseases, health promotion, and the training of health personnels have performed along with the development of modern hospitals, which have the roots in the period after the end of 19th century. Thus the Korean history of health care around the end of 19th century and beginning of 20th century could be defined as a period of emergence of modern hospitals. The hospitals also have played core roles in establishing the Korean modern health system and culture. Compared to the cases of Western countries, Korean modern hospitals were emerged with the exogenous factors in the turbulence of political and cultural changes in the world system. In sum, Korean modern hospitals in the period of late Chosun have the great meaning in that they are the beginning point to shape the current Korean health care system and the driving forces or carriers of this new system. PMID:12619632

  13. [The emergence of Korean modern hospitals: hospitals in the late period of Chosun Dynasty].

    PubMed

    Cho, Woo Hyun; Park, Chong Yon; Park, Chun Sun

    2002-06-01

    Hospitals are confronting in the transforming or reforming period to cope with the rapid social and environmental changes worldwide. By the researches in the history of Korean health, we could understand the context of the introduction of Western medicine and institutions to Korea. However there have been few studies on the historical review of hospitals in relations to their roles in the modern medicine. This article is to review the issues around the rise of modern hospitals in Korean history of health affairs. The introduction of Western medicine in Korea was on the road with the establishment of Kwanghyewon, the Royal Hospital, which was possible due to favorable conditions under the Korean socio-political background for the emerging and accepting the entirely new medical system. And also the emergence of modern and transformed the Korean traditional health system from the fundamentals through the corruption of the old dynasty to nowadays. Most national health affairs including medical services, prevention of diseases, health promotion, and the training of health personnels have performed along with the development of modern hospitals, which have the roots in the period after the end of 19th century. Thus the Korean history of health care around the end of 19th century and beginning of 20th century could be defined as a period of emergence of modern hospitals. The hospitals also have played core roles in establishing the Korean modern health system and culture. Compared to the cases of Western countries, Korean modern hospitals were emerged with the exogenous factors in the turbulence of political and cultural changes in the world system. In sum, Korean modern hospitals in the period of late Chosun have the great meaning in that they are the beginning point to shape the current Korean health care system and the driving forces or carriers of this new system.

  14. 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

  15. 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 ...

  16. 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…

  17. Treatment of Class II, Division 2 in the late growth period.

    PubMed

    Eberhard, H; Hirschfelder, U

    1998-01-01

    The "Deckbiss" with skeletal Class II jaw relationship sometimes presents a considerable therapeutic problem, particularly in the late growth period (DP3U), as regards the coordination of dental and skeletal treatment objectives. An effective treatment approach was demonstrated: a modified Herbst appliance used simultaneously with fixed appliances in the maxilla. The sample comprised 12 male (14.0 +/- 0.9 years old) and 10 female (12.3 +/- 0.4 years old) patients. Correction of the distal occlusion was achieved in all patients by means of the Herbst appliance, which was removed after an average time period of 6.4 +/- 0.2 months. In the mandible the multibracket appliances were then immediately inserted, and Class II elastics were used for retention. Maximum anchorage was required in the maxilla as well as in the mandible. Complete diagnostic records were made at the beginning of the treatment as well as 6 and 12 months later, in order to document skeletal and dental changes. A dental and skeletal Class I relationship was achieved in all cases. A significant improvement was recorded in the vertical jaw base relationship; this was still stable after a period of 12 months. In the dental area in particular, a so-called high-pull headgear effect (intrusion and distalization 16, 26) and intrusion of teeth 34, 44 were registered. Only a minor protrusion of the mandibular incisors was observed. Reinforcement of the bands reduced the failure rate significantly. The Herbst appliance does not represent a standard treatment for Class II. Its indication range is limited.

  18. 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

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

    NASA Astrophysics Data System (ADS)

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

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

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

    PubMed

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

    2004-01-15

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

  1. 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

  2. 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.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

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

    2015-09-30

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

  5. A risk score to identify HIV-infected women most likely to become lost to follow-up in the postpartum period.

    PubMed

    Bengtson, Angela M; Chibwesha, Carla J; Westreich, Daniel; Mubiana-Mbewe, Mwangelwa; Chi, Benjamin H; Miller, William C; Mapani, Muntanga; Pence, Brian W; Musonda, Patrick; Stringer, Jeffrey Sa; Pettifor, Audrey

    2016-08-01

    Access to lifelong combination antiretroviral therapy (cART) is expanding among HIV-infected pregnant and breastfeeding women throughout sub-Saharan Africa (SSA). For this strategy to meaningfully improve maternal HIV outcomes, retention in HIV care is essential. We developed a risk score to identify women with high likelihood of loss to follow-up (LTFU) at 6 months postpartum from HIV care, using data from public health facilities in Lusaka, Zambia. LTFU was defined as not presenting for HIV care within 60 days of the last scheduled appointment. We used logistic regression to assess demographic, obstetric and HIV predictors of LTFU and to develop a simple risk score. Sensitivity and specificity were assessed at each risk score cut-point. Among 2029 pregnant women initiating cART between 2009 and 2011, 507 (25%) were LTFU by 6 months postpartum. Parity, education, employment status, WHO clinical stage, duration of cART during pregnancy and number of antenatal care visits were associated with LTFU (p-value < .10). A risk score cut-point of 11 (42nd percentile) had 85% sensitivity (95% CI 82%, 88%) and 22% specificity (95% CI 20%, 24%) to detect women LTFU and would exclude 20% of women from a retention intervention. A risk score cut-point of 18 (69th percentile) identified the 23% of women with the highest probability of LTFU and had sensitivity 32% (95% CI 28%, 36%) and specificity 80% (95% CI 78%, 82%). A risk score approach may be useful to triage a subset of women most likely to be LTFU for targeted retention interventions. PMID:26887526

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  8. 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

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

    NASA Astrophysics Data System (ADS)

    Mozaffari, S. Mohammad

    2013-11-01

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

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

    PubMed

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

    2007-06-01

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

  11. 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…

  12. 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

  13. 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);…

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

    PubMed

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

    2009-01-01

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

  15. 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.

  16. 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.

  17. Cluster Subtypes Appropriate for Preventing Postpartum Smoking Relapse

    PubMed Central

    Simonelli, Mary Colleen; Velicer, Wayne F

    2011-01-01

    Objective While the majority of women quit smoking either before or during pregnancy, 60 to 80% relapse in the postpartum period. The objective of this research was to examine postpartum women who quit smoking during their pregnancies and to determine the predictive factors for relapse in the postpartum period by identifying different subgroups that predict risk of relapse. Method One hundred forty four postpartum women who were abstinent at the time of delivery were recruited. Data regarding the Acquisition Stage of Change, Decisional Balance and Situational Temptations to Smoke were assessed in the immediate postpartum period. Based on their intention to remain abstinent, 121 women identified in the acquisition-Precontemplation (aPC) group comprised the study sample. Smoking status was assessed again at 2-months postpartum Results A cluster analysis was performed to idenitfy subgroups of the acquisition-Precontemplation (aPC) group. Four subgroups were identified and were labeled Most Protected, Ambivalent, Risk Denial, and High Risk. Logistic regression was performed to establish external validity of the clusters. The clusters and exclusive breastfeeding were the only statistically significant variables associated with relapse at 2-months postpartum. Conclusions The results confirmed the clusters identified in previous prevention research with both adolescents and postpartum women, The cluster profiles can serve to guide the development of a tailored intervention program. PMID:22136873

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    PubMed

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

    2015-12-01

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

  20. 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 ...

  1. Committee Opinion No. 670 Summary: Immediate Postpartum Long-Acting Reversible Contraception.

    PubMed

    2016-08-01

    Immediate postpartum long-acting reversible contraception (LARC) has the potential to reduce unintended and short-interval pregnancy. Women should be counseled about all forms of postpartum contraception in a context that allows informed decision making. Immediate postpartum LARC should be offered as an effective option for postpartum contraception; there are few contraindications to postpartum intrauterine devices and implants. Obstetrician-gynecologists and other obstetric care providers should discuss LARC during the antepartum period and counsel all pregnant women about options for immediate postpartum initiation. Education and institutional protocols are needed to raise clinician awareness and to improve access to immediate postpartum LARC insertion. Obstetrician-gynecologists and other obstetric care providers should incorporate immediate postpartum LARC into their practices, counsel women appropriately about advantages and risks, and advocate for institutional and payment policy changes to support provision. PMID:27454730

  2. Committee Opinion No. 670: Immediate Postpartum Long-Acting Reversible Contraception.

    PubMed

    2016-08-01

    Immediate postpartum long-acting reversible contraception (LARC) has the potential to reduce unintended and short-interval pregnancy. Women should be counseled about all forms of postpartum contraception in a context that allows informed decision making. Immediate postpartum LARC should be offered as an effective option for postpartum contraception; there are few contraindications to postpartum intrauterine devices and implants. Obstetrician-gynecologists and other obstetric care providers should discuss LARC during the antepartum period and counsel all pregnant women about options for immediate postpartum initiation. Education and institutional protocols are needed to raise clinician awareness and to improve access to immediate postpartum LARC insertion. Obstetrician-gynecologists and other obstetric care providers should incorporate immediate postpartum LARC into their practices, counsel women appropriately about advantages and risks, and advocate for institutional and payment policy changes to support provision. PMID:27454734

  3. 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

  4. 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

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

    USGS Publications Warehouse

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

    2008-01-01

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

  6. 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.

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

    PubMed Central

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

    2008-01-01

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

  8. Assimilating Continental Mean Temperatures to Reconstruct the Climate of the Late Pre-industrial Period

    NASA Astrophysics Data System (ADS)

    Matsikaris, A.; Widmann, M.; Jungclaus, J. H.

    2015-12-01

    Climate reconstructions for the pre-instrumental period are either based on climate proxy data or on numerical simulations. However, both approaches are associated with substantial uncertainties. In principle, the best state estimates can be expected by employing data assimilation (DA) techniques, which systematically combine the empirical information from proxy data with the representation of the processes that govern the climate system given by climate models. Here, an ensemble-based DA method is performed to reconstruct the climate of the period 1750-1850 AD, and the performance is evaluated on large and small spatial scales. We use a low-resolution version of the Max Planck Institute for Meteorology's MPI-ESM model and assimilate the PAGES 2K continental mean temperature reconstructions for the Northern Hemisphere (NH). The ensembles are generated sequentially for sub-periods based on the analysis of previous sub-periods. The assimilation has good skill for large-scale temperatures, but there is no agreement between the DA analysis and proxy-based reconstructions for small-scale temperature variability within Europe or with reconstructions for the North Atlantic Oscillation (NAO) index. To explain the lack of added value in the DA, a Maximum Covariance Analysis (MCA) of links between NH temperature and sea level pressure (SLP) is performed on a control run with MPI-ESM. The analysis shows that the Northern Annular Mode (NAM) is the pattern that is most closely linked to the NH continental temperatures. This link is reproduced in the assimilation run for winter, spring and annual means, providing potential for constraining the NAM/NAO phase and in turn, for regional temperature variability in the DA. It is shown that the lack of actual skill for these aspects is likely due to the fact that either the link might be too weak, as the continental mean temperatures are not the best predictors for the NAM (they are reconstructed by many proxies in locations not linked

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

    PubMed

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

    2015-01-01

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

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

    PubMed

    Medoff, Marshall H

    2014-01-01

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

  11. 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).…

  12. [CARDIOVASCULAR SYSTEM REACTIVITY IN PRENATALLY STRESSED RATS DURING THE LATE PERIOD OF ONTOGENESIS].

    PubMed

    Khudaverdyan, A; Saroyan, M; Khudaverdyan, D

    2015-09-01

    Systolic, diastolic blood pressure and heart rate were determined in normal rats and those exposed to influence of chronic stress during gestation. Data were registered six months after the birth and in 5, 24 and 48 hours after their immobilization. Analysis of the data showed that in rats undergoing stress, recorded systolic, diastolic blood pressure and heart rate both before and during all periods of immobilization were significantly below than in control group. It is concluded that the maximum limit of motor activity in the prenatally stressed rats accompanied by a decrease in the values ​​recorded performance of the cardiovascular system, which is reflecting the decrease in these animals reactivity of the cardiovascular system, and thus the adaptive capacity for action of stress factors.

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

    PubMed

    Nash, Christopher M; Allen, Victoria M

    2015-05-01

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

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

    NASA Astrophysics Data System (ADS)

    Matsikaris, Anastasios; Widmann, Martin; Jungclaus, Johann

    2016-06-01

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

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

    PubMed

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

    2012-08-01

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

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

    PubMed

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

    2012-08-01

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

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

    PubMed

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

    2015-04-01

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

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

    PubMed

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

    2011-10-01

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

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

    PubMed

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

    2011-10-01

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

  20. 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.

  1. Dairy cows affected by ketosis show alterations in innate immunity and lipid and carbohydrate metabolism during the dry off period and postpartum.

    PubMed

    Zhang, Guanshi; Hailemariam, Dagnachew; Dervishi, Elda; Goldansaz, Seyed Ali; Deng, Qilan; Dunn, Suzanna M; Ametaj, Burim N

    2016-08-01

    The objective of this investigation was to search for alterations in blood variables related to innate immunity and carbohydrate and lipid metabolism during the transition period in cows affected by ketosis. One hundred multiparous Holstein dairy cows were involved in the study. Blood samples were collected at -8, -4, week of disease diagnosis (+1 to +3weeks), and +4weeks relative to parturition from 6 healthy cows (CON) and 6 cows with ketosis and were analyzed for serum variables. Results showed that cows with ketosis had greater concentrations of serum β-hydroxybutyric acid (BHBA), interleukin (IL)-6, tumor necrosis factor (TNF), serum amyloid A (SAA), and lactate in comparison with the CON animals. Serum concentrations of BHBA, IL-6, TNF, and lactate were greater starting at -8 and -4weeks prior to parturition in cows with ketosis vs those of CON group. Cows with ketosis also had lower DMI and milk production vs CON cows. Milk fat also was lower in ketotic cows at diagnosis of disease. Cows affected by ketosis showed an activated innate immunity and altered carbohydrate and lipid metabolism several weeks prior to diagnosis of disease. Serum IL-6 and lactate were the strongest discriminators between ketosis cows and CON ones before the occurrence of ketosis, which might be useful as predictive biomarkers of the disease state.

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

    PubMed

    Olson, Tonia; Bowen, Angela

    2014-01-01

    Increasing attention is being paid to the possible connection between infant feeding practices and postpartum depression. Nurses caring for women and their families in the postpartum period might wonder how to best support the breastfeeding relationship if a woman has a history of depression. Using evidence from the scientific literature, this article dispels some myths regarding breastfeeding and depression, and provides suggested dialogue nurses can use when counseling women about depression and breastfeeding. PMID:25145719

  3. 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.

  4. 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…

  5. 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.

  6. Periodization

    PubMed Central

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

    2010-01-01

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

  7. Heterogeneity of postpartum depression: a latent class analysis

    PubMed Central

    2016-01-01

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

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

    PubMed

    Aarif, Ovais; Aggarwal, Anjali

    2015-10-15

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

  9. Expression of an isoform of the testis-specific estrogen sulfotransferase in the murine placenta during the late gestational period.

    PubMed

    Takehara, K; Kubushiro, K; Iwamori, Y; Tsukazaki, K; Nozawa, S; Iwamori, M

    2001-10-15

    Cytosolic sulfotransferases play essential roles in regulating the activities and transfer of steroids. To evaluate their biological significance in the murine uterus and placenta during the course of gestation, we determined their activities with several steroids as substrates. Activated estrogen sulfotransferase (EST) was found in the placenta and uterus during the late gestational period. Reverse-transcribed cDNA of murine placental EST (mpEST) was isolated from mouse placenta at 18 days of gestation and its expression in the tissue coincided with a change in its enzyme activity. The open-reading frame of mpEST encodes a protein composed of 296 amino acids with a predicted molecular mass of 35.5 kDa and was revealed to be an isoform of the murine testis-specific EST gene (99.7%). Also, the amino acid sequence of mpEST showed 49.6 and 77.9% homology with human placental and endometrial EST, respectively, showing that it corresponds to human endometrial EST. COS-7 cells transfected with mpEST exhibited sulfotransferase activity with the phenolic hydroxy groups of steroids and artificial substrates. The best acceptor substrate was estrogen.

  10. 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

  11. 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

  12. 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

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

    The main objectives of this study was to reconstruct climate impact on the functioning of Lake Łukie and its catchment (Łęczna Włodawa Lake District, East European Plain) during Late Glacial period. In order to reconstruct climatic fluctuations and corresponding ecosystem responses, we analysed lake sediments for pollen, subfossil Cladocera, plant macrofossils and chemical composition of the sediment. Of these, plant macrofossils and Cladocera were used to infer minimum and mean July temperatures and ordination analysis was used to examine biotic community shifts. Multiproxy analyses of late-glacial sediments of Lake Łukie clearly show that the main driver of aquatic and terrestrial ecosystems as well as geomorphological processes in the catchment was climate variation. The history of the lake initiated during the Older Dryas. In that period, Łęczna Włodawa Lake District was covered by open habitats dominated by grasses (Poaceae), humid sites were occupied by tundra plant communities with less clubmoss (Selaginella selaginoides), dry sites by dominated by steppe-like vegetation with light-demanding species such as Helianthemum, Artemisia, Chenopodiaceae, and juniper bushes (Juniperus). Cold climate limited the growth and development of organisms in the lake, Cladocera community species composition was poor, with only few species present there all the time. During this time period, permafrost was still present in the ground limiting infiltration of rainwater and causing high erosion in the catchment area. Surface runoff is confirmed by the presence of sclerotia of Cenococcum geophilum and high terrigenous silica content. The warming of the early Allerød caused a remarkable change in the natural environment of this area. This is in accordance with the temperature rise reconstructed with the use of plant macrofossils though the Cladocera reconstruction did not recorded the rise than. This temperature increase resulted in turnover of vegetation in the

  14. Exercise during pregnancy and the postpartum period.

    PubMed

    2003-06-01

    The physiologic and morphologic changes of pregnancy may interfere with the ability to engage safely in some forms of physical activity. A woman's overall health, including obstetric and medical risks, should be evaluated before prescribing an exercise program. Generally, participation in a wide range of recreational activities appears to be safe during pregnancy; however, each sport should be reviewed individually for its potential risk, and activities with a high risk of falling or those with a high risk of abdominal trauma should be avoided during pregnancy. Scuba diving also should be avoided throughout pregnancy because the fetus is at an increased risk for decompression sickness during this activity. In the absence of either medical or obstetric complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women.

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

    ERIC Educational Resources Information Center

    Oplatka, Izhar

    2010-01-01

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

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

    PubMed

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

    2015-10-01

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

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

    ERIC Educational Resources Information Center

    Abu-Rabia, Salim; Kehat, Simona

    2004-01-01

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

  18. Conceptualizations of postpartum depression by public-sector health care providers in Mexico.

    PubMed

    Place, Jean Marie S; Billings, Deborah L; Blake, Christine E; Frongillo, Edward A; Mann, Joshua R; deCastro, Filipa

    2015-04-01

    In this article we describe the knowledge frameworks that 61 physicians, nurses, social workers, and psychologists from five public-sector health care facilities in Mexico used to conceptualize postpartum depression. We also demonstrate how providers applied social and behavioral antecedents in their conceptualizations of postpartum depression. Using grounded theory, we identify two frameworks that providers used to conceptualize postpartum depression: biochemical and adjustment. We highlight an emerging model of the function of social and behavioral antecedents within the frameworks, as well as the representation of postpartum depression by symptoms of distress and the perception among providers that these symptoms affected responsibilities associated with motherhood. The results provide a foundation for future study of how providers' conceptualizations of postpartum depression might affect detection and treatment practices and might be useful in the development of training materials to enhance the quality of care for women who experience any form of distress in the postpartum period.

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

    NASA Astrophysics Data System (ADS)

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

    2015-05-01

    To improve estimates of the extent of ocean oxygenation during the late Ediacaran Period, we measured the U and Mo isotope compositions of euxinic (anoxic and sulfidic) organic-rich mudrocks (ORM) of Member IV, upper Doushantuo Formation, South China. The average δ238U of most samples is 0.24 ± 0.16‰ (2SD; relative to standard CRM145), which is slightly higher than the average δ238U of 0.02 ± 0.12‰ for restricted Black Sea (deep-water Unit I) euxinic sediments and is similar to a modeled δ238U value of 0.2‰ for open ocean euxinic sediments in the modern well-oxygenated oceans. Because 238U is preferentially removed to euxinic sediments compared to 235U, expanded ocean anoxia will deplete seawater of 238U relative to 235U, ultimately leading to deposition of ORM with low δ238U. Hence, the high δ238U of Member IV ORM points to a common occurrence of extensive ocean oxygenation ca. 560 to 551 Myr ago. The Mo isotope composition of sediments deposited from strongly euxinic bottom waters ([H2S]aq >11 μM) either directly records the global seawater Mo isotope composition (if Mo removal from deep waters is quantitative) or represents a minimum value for seawater (if Mo removal is not quantitative). Near the top of Member IV, δ98Mo approaches the modern seawater value of 2.34 ± 0.10‰. High δ98Mo points to widespread ocean oxygenation because the preferential removal of isotopically light Mo to sediments occurs to a greater extent in O2-rich compared to O2-deficient marine environments. However, the δ98Mo value for most Member IV ORM is near 0‰ (relative to standard NIST SRM 3134 = 0.25‰), suggesting extensive anoxia. The low δ98Mo is at odds with the high Mo concentrations of Member IV ORM, which suggest a large seawater Mo inventory in well-oxygenated oceans, and the high δ238U. Hence, we propose that the low δ98Mo of most Member IV ORM was fractionated from contemporaneous seawater. Possible mechanisms driving this isotope fractionation include

  20. 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).

  1. 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…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  3. 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

  4. 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

  5. The Earth-Moon system during the late heavy bombardment period - Geochemical support for impacts dominated by comets

    NASA Astrophysics Data System (ADS)

    Gråe Jørgensen, Uffe; Appel, Peter W. U.; Hatsukawa, Yuichi; Frei, Robert; Oshima, Masumi; Toh, Yosuke; Kimura, Atsushi

    2009-12-01

    The solid planets assembled 4.57 Gyr ago during a period of less than 100 Myr, but the bulk of the impact craters we see on the inner planets formed much later, in a narrow time interval between 3.8 and 3.9 Gyr ago, during the so-called late heavy bombardment (LHB). It is not certain what caused the LHB, and it has not been well known whether the impactors were comets or asteroids, but our present study lend support to the idea that it was comets. Due to the Earth's higher gravity, the impactors will have hit the Earth with ˜twice the energy density that they hit the Moon, and the bombardment will have continued on Earth longer than on the Moon. All solid surface of the Earth will have been completely covered with craters by the end of the LHB. However, almost nothing of the Earth's crust from even the end of this epoch, is preserved today. One of the very few remnants, though, is exposed as the Isua greenstone belt (IGB) and nearby areas in Western Greenland. During a field expedition to Isua, we sampled three types of metasedimentary rocks, deposited ˜3.8 billion years ago, that contain information about the sedimentary river load from larger areas of surrounding land surfaces (mica-schist and turbidites) and of the contemporaneous seawater (BIF). Our samples show evidence of the LHB impacts that took place on Earth, by an average of a seven times enrichment (150 ppt) in iridium compared to present-day ocean crust (20 ppt). The clastic sediments show slightly higher enrichment than the chemical sediments, which may be due to contamination from admixtures of mafic (proto-crustal) sources. We show that this enrichment is in agreement with the lunar cratering rate and a corresponding extraterrestrial LHB contribution to the Earth's Hadean-Eoarchean crust, provided the bulk of the influx was cometary (i.e., of high velocity and low in CI abundance), but not if the impactors were meteorites (i.e. had velocities and abundances similar to present-day Earth

  6. 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.

  7. 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.

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

    USGS Publications Warehouse

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

    2013-01-01

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

  9. 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

  10. 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.

  11. 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…

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  14. 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.

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

    PubMed Central

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

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Vasilyan, Davit; Böhme, Madelaine; Winklhofer, Michael

    2010-05-01

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

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

    ERIC Educational Resources Information Center

    Ringdahl, Erika N.

    2002-01-01

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

  18. 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…

  19. PTSD and postpartum mental health in a sample of Caucasian, Asian, and Pacific Islander women.

    PubMed

    Onoye, Jane M; Goebert, Deborah; Morland, Leslie; Matsu, Courtenay; Wright, Tricia

    2009-12-01

    To better understand the role of posttraumatic stress disorder (PTSD) in postpartum health, this study investigates the relationship of PTSD and associated perinatal behavioral risk factors in a sample of Caucasian, Asian, and Pacific Islander women. As part of a larger longitudinal study, 54 women (18-35 years of age) were interviewed at their postpartum clinic visit for PTSD, anxiety, depression, and alcohol and substance use. PTSD and subclinical PTSD during the postpartum period were associated with behavioral health risks, with PTSD at the onset of pregnancy being a predictor of postpartum PTSD by a factor of three. Women with PTSD and subclinical PTSD were more likely to also experience stress (73%), anxiety (64%), and depression (73%) during the postpartum period compared to those without PTSD. No significant differences were found by ethnicity for postpartum PTSD, depression, or anxiety. Regardless of ethnicity or PTSD status, one in four women in the sample had a probable mental health disorder or risk behavior of some type during the postpartum period. Given the rates of associated mental health risks with PTSD, these findings suggest further research examining the fluctuations of PTSD symptomatology throughout each pregnancy trimester to determine its role as a potential mediator during the perinatal period. Further research is also needed to elucidate the role of ethnic or cultural differences in trauma and PTSD and perinatal health.

  20. 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

  1. 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

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  3. Postpartum safety: a patient-centered approach to fall prevention.

    PubMed

    Lockwood, Suzy; Anderson, Kandace

    2013-01-01

    Falls in the perinatal setting have received minimal attention and have not been well documented. Women are at risk for falling following vaginal or cesarean birth, especially during initial attempts at ambulation. Recently, a women's hospital that averages over 500 births per month recorded a postpartum fall rate that exceeded the national mean for adult surgical patient falls. A fall prevention team (FPT) of five nurses was formed with a goal to decrease the incidence of postpartum patient falls to zero within the following 7 months. A patient-centered fall prevention strategy was developed. The results of this project have laid the foundation for additional research of a program that will consider not only prevention of falls in a healthy population but also the development of a risk assessment tool specific to women in the immediate postpartum period.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2005-04-12

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

  6. Effects of feeding dried distillers grains with solubles (DDGS) on meat quality at the late stage of the fattening period of Holstein steers.

    PubMed

    Nade, Toshihiro; Uchida, Kyouhei; Omori, Kouhei; Matsubayashi, Kenta; Kimura, Nobuhiro

    2012-04-01

    Feeding dried distillers grains with solubles (DDGS) during the late stage of the fattening period of Holstein steers was studied in regard to the influence on meat quality. Sixteen Holstein steers approximately 18 months old were used in this study. Eight animals were fed commercial concentrated feed for the entire fattening period. The other eight animals were fed 15% DDGS in the concentrated feed for 3 months before slaughtering. The moisture, ether extract and crude protein from both groups was approximately the same. The thiobarbituric acid reactive substance (TBA) value of storage for 7 days at 5°C from the animals fed DDGS showed a tendency to be lower (P = 0.059). The change in the TBA value during storage was also lower for the animals not fed DDGS (P < 0.05). There were no differences in the subcutaneous fat color between the two groups. The a*(measure of redness) and b*(measure of yellowness) of the M. longissimus from the animals fed DDGS showed a tendency to be lower (P = 0.051, 0.070). The fatty acid composition of the M. longissimus, subcutaneous and perirenal fat were not widely influenced by the feeding of DDGS. It is suggested that feeding 15% DDGS during the late stage of the fattening period for Holstein steers reduced the oxidation of the beef.

  7. Maternal treadmill exercise during pregnancy decreases anxiety and increases prefrontal cortex VEGF and BDNF levels of rat pups in early and late periods of life.

    PubMed

    Aksu, Ilkay; Baykara, Basak; Ozbal, Seda; Cetin, Ferihan; Sisman, Ali Riza; Dayi, Ayfer; Gencoglu, Celal; Tas, Aysegul; Büyük, Erkan; Gonenc-Arda, Sevil; Uysal, Nazan

    2012-05-16

    In a previous study we demonstrated that, regular aerobic exercise during pregnancy decreased maternal deprivation induced anxiety. The purpose of this study is to investigate whether the positive effects of maternal exercise on the male and female offspring's early and late period of life. Half of the test subjects in each group were evaluated when they were 26 days old, and the other half were evaluated when they were 4 months old. The anxiety levels of maternally exercised groups were less than the control groups in both sexes and in both prepubertal and adult periods. The locomotor activity more increased in females. The prefrontal VEGF and BDNF levels were greater for both age groups and sexes in the maternally exercised group compared to control group. Moreover, there was a strong positive correlations between prefrontal cortex BDNF levels and results of open field tests; and VEGF levels and results of elevated plus maze tests. There was no difference in serum corticosterone levels between groups. These results indicate that maternal exercise during pregnancy may protect the pups from anxiety in early and late periods of life, and affects the prefrontal cortex positively.

  8. 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

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

    PubMed Central

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

    2012-01-01

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

  10. 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 ...

  11. 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

  12. uPA, uPAR and TGFβ₁ expression during early and late post myocardial infarction period in rat myocardium.

    PubMed

    Stavropoulou, Anastasia; Philippou, Anastassios; Halapas, Antonios; Sourla, Antigone; Pissimissis, Nikolaos; Koutsilieris, Michael

    2010-01-01

    The expression patterns of transforming growth factor beta 1 (TGFβ₁), urokinase-type plasminogen activator (uPA) and uPA receptor (uPAR) were analysed after artery ligation-induced myocardial infarction (MI) in the rat myocardium. uPA and uPAR expressions were significantly increased both at transcriptional and protein level during early phase post MI period (uPA at 1 hour and uPAR at 24 hours post infarction). TGFβ1 mRNA expression profile revealed a significant increase of TGFβ1 expression from day 4 up to 8 weeks post infarction. These data suggest that the need for an increasing TGFβ₁ bioavailability during the post-infarction period in rat myocardium is achieved in the early post MI period by an increased expression of uPA/uPAR proteolytic system (indirect activation of latent TGFβ₁) and in the late post MI period by direct regulation of TGFβ₁ expression. It is therefore concluded that differential regulation of the TGFβ₁ bioavailability may be a crucial step of the repair mechanisms during the post MI infarction period in the rat myocardium.

  13. 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.

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

    PubMed

    Svenningsen, Sine Lo; Semsey, Szabolcs

    2014-10-01

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

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

    PubMed

    Svenningsen, Sine Lo; Semsey, Szabolcs

    2014-10-01

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

  16. Determining an Optimal Testing Strategy for Infants at Risk for Mother-to-child Transmission of HIV-1 During the Late Postnatal Period

    PubMed Central

    Brown, Elizabeth; Chi, Benjamin H.; Read, Jennifer S.; Taha, Taha E.; Sharma, Usha; Hoffman, Irving F.; Pikora, Cheryl; Goldenberg, Robert; Fiscus, Susan A.

    2009-01-01

    Objectives To determine the optimal time for a second HIV-1 nucleic acid amplification assay to detect late postnatal transmission of HIV-1 (first negative test at 4–8 weeks of age) in resource limited settings. Design A longitudinal analysis of data from HPTN 024 Methods Children born to HIV-1 infected mothers enrolled in the HIV Prevention Trial Network trial 024 (HPTN 024) were tested for HIV-1 infection at six intervals within the first year of life. Mothers and infants received nevirapine prophylaxis. We estimated the probability of being alive and having a positive test in each interval after 4–8 weeks and at 30 days post-weaning, conditional on having acquired HIV during the late postnatal period. The interval with the highest probability was taken to be the optimal visit interval. Results A total of 1609 infants from HPTN 024 had at least one HIV-1 diagnostic test and were included in the analysis. We found that testing at one month after weaning or 12 months of age (whichever comes first), identified 81% of those infected during the late postnatal period (after 4–8 weeks) through breastfeeding. In total, 93% (95% CI: 89,98) of all infected infants would be detected if tests were performed at these two time points. Conclusions In resource-limited settings, HIV-1 PCR testing at 4–8 weeks followed by a second test at one month after weaning or at one year of age (whichever comes first), led to the identification of the vast majority of HIV-1 infected infants. PMID:18981773

  17. 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.

  18. 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

  19. The postrest performance of laying hens subjected to early or late water restriction during the feed withdrawal period.

    PubMed

    Christmas, R B; Harms, R H

    1983-12-01

    Two experiments initiated in December and April were conducted to determine the effect of water restriction on the performance of force-rested hens. Birds used in this study were housed in cages and were 74 weeks of age at the beginning of each study. Treatment assignments were 1) no water restriction, 2) water restriction on Days 1 and 2 (48 hr), and 3) water restriction on Days 9 and 10 (48 hr). All birds were subjected to identical 10 day feed withdrawal periods, were fed low protein and low calcium recovery diets to Day 35, and then were placed on a standard postrest feeding system for six 28-day production periods. With only three exceptions, within-experiment differences in postrest performance due to water restriction treatment were not significant regardless of criteria evaluated or season of force-rest initiation. When water was restricted on Days 9 and 10 in the experiment initiated in April, hens laid at a significantly lower rate with significantly heavier eggs than others in the same experiment. Hens that experienced either water restriction treatment during the April force-rest had poorer feed conversion when expressed in terms of egg numbers. Feed intake, feed conversion on a weight-for-weight basis, egg specific gravity, and mortality were not affected by water restriction treatment, regardless of season. Water restriction was not necessary for a successful force-rest of laying hens, and, in fact, could be detrimental when instituted in the later part of the feed withdrawal period in warm weather.

  20. Late Neogene East Asian monsoon: from winter to summer dominated sub-regime and periodicity transition from 100 kyr to 41 kyr

    NASA Astrophysics Data System (ADS)

    Li, F.; Rousseau, D.-D.; Wu, N.; Hao, Q.; Pei, Y.

    2009-04-01

    More and more evidence indicates that the onset of the East Asian (EA) monsoon can be traced back to the Oligocene-Miocene boundary (at about 23 Ma). However, the process of its evolution is still less well known until now. Here we investigate its late Neogene evolution by analyzing a terrestrial mollusk sequence, from the Chinese Loess Plateau (CLP), covering the period between 7.1 and 3.5 Ma. Considering the modern ecological requirements of these organisms, we were able to define two groups of cold-aridiphilous (CA) and thermo-humidiphilous (TH) species, representing the EA winter and summer monsoon variations, respectively, as previously defined in the Quaternary glacial-interglacial cycles. Variations in these two groups indicate two different monsoon dominated periods during 7.1-3.5 Ma. First, between 7.1 and 5.5 Ma, the EA winter monsoon, with a 100 kyr periodicity, was dominant. Second, between 5.1 and 4 Ma, the EA summer monsoon dominated, with a 41 kyr periodicity. Furthermore, our mollusk record yields valuable evidence for a late Miocene-Pliocene transition of about 400 kyr from winter monsoon dominated towards summer monsoon dominated, associated with a periodicity transition from weak 100 kyr to 41 kyr. The strengthened winter monsoon interval, with a 100 kyr periodicity, is coeval with orbital-scale global ice volume changes, in conjunction with the uplift of the Tibetan Plateau which probably reinforced the winter monsoon sub-regime. Conversely, closures of the Panama and Indonesian seaways, associated with changes in obliquity between 5.1 and 4 Ma, are probably major forcing factors for the observed dominant summer monsoon with 41 kyr frequency, favoring heat and moisture transports between low and high latitudes to allow TH mollusks to grow and develop in the CLP. The transition from a 100 kyr dominated interval towards a 41 kyr dominated one is contrary to the mid-Pleistocene transition (MPT), which corresponds to ice volume expansion at high

  1. 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.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

  4. Development of the vitamin A-storing cell in mouse liver during late fetal and neonatal periods.

    PubMed

    Matsumoto, E; Hirosawa, K; Abe, K; Naka, S

    1984-01-01

    Vitamin A-storing cells in perinatal mouse liver were studied by chemical and autoradiographic analyses of exogenous vitamin A. The amount of retinyl palmitate in the fetal liver increased significantly following oral administration of retinyl acetate to the mother, suggesting the existence of storage sites of the vitamin in fetal liver. Light microscope semi-serial autoradiography of the fetal liver on the 15th day of gestation showed that 3H-vitamin A administered to the mother was incorporated into cells distributed exclusively along the hepatic blood vessels and the blood islands. Mitotic figures of the labeled cells were frequently observed. Electron microscope autoradiography revealed that the vitamin was incorporated into lipid droplets, rough endoplasmic reticulum and Golgi apparatus of the fibroblast-like cells in close apposition to the endothelial cells. The labeled cells differed in their ultrastructure from the vitamin A-storing cells (Ito cells) of the adult liver. In the later gestational period, silver grains tended to be more concentrated in lipid droplets, and the cytological features of the labeled cells became similar to those of the vitamin A-storing cells. Both retinyl palmitate content and the labeling of lipid droplets increased rapidly in the liver of neonates after commencement of suckling. The labeled cells had the same appearance as the vitamin A-storing cells (Ito cells). It is concluded that vitamin A transported across the placenta is taken up in the fetal liver by the cells distributed along the blood vessels, and that these cells proliferate in accordance with vascular development and gradually take on the characteristics of vitamin A-storing cells during the perinatal period. A defensive role of the vitamin A-storing cell against the toxic effects of vitamin A is also suggested. PMID:6476398

  5. 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…

  6. 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…

  7. [Clinical study for the evaluation of the tolerability of O-(beta-hydroxy-ethyl)-rutoside in the treatment of hemorrhoids during the 3d trimester of pregnancy and in the postpartum period].

    PubMed

    Benzi, G; Vanzulli, A; Pozzi, E; Acerboni, S

    1992-11-01

    Hemorrhoidal disease is particularly frequent in the last trimester of pregnancy and immediately after birth. The aim of the present study was to evaluate the efficacy and tolerability of high doses of O-(beta-hydroxyethyl)-rutoside in patients affected by this pathology. Forty-two women with hemorrhoid varices of varying severity which had appeared during the last trimester of pregnancy or immediately post-partum were treated by administering 3 g/day of the substance in question for 14 consecutive days. At the start and end of treatment a series of clinical and objective parameters were measured and at the end of treatment efficacy and tolerability were assessed. The latter was found to be excellent; in fact, it was not necessary to suspend treatment in any of the subjects treated. Clinical efficacy, assessed by the researcher, was judged to be positive in 95% of cases treated. Clinical improvements in the parameters examined were statistically significant (p < 0.01). The results obtained confirm the value of oral therapy using O-(beta-hydroxyethyl)-rutoside in pregnant or puerperal patients since the preparation was found to be efficacious and easily managed, above all significantly reducing pain, subjectively the most urgent symptom to be treated.

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

    NASA Astrophysics Data System (ADS)

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

    2007-12-01

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

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

    PubMed Central

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

    2015-01-01

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

  10. Mother-Child Affect and Emotion Socialization Processes Across the Late Preschool Period: Predictions of Emerging Behavior Problems.

    PubMed

    2011-11-01

    The current study examined concurrent and longitudinal relations between maternal negative affective behavior and child negative emotional expression in preschool age children with (n = 96) or without (n = 126) an early developmental risk, as well as the predictions of later behavior problems. Maternal negative affective behavior, child externalizing emotional expression, and child internalizing emotional expression were observed during a number of lab tasks at child ages 4 and 5, and child externalizing and internalizing behavior problems were assessed via maternal questionnaire at age 6. Path analyses using structural equation modeling were utilized to test the relations among the variables at ages 4, 5, and 6. A parent-driven model of emotion socialization emerged, wherein stronger relations were found among maternal negative affect and child externalizing emotions and behaviors than among maternal negative affect and child internalizing emotions and behaviors. Early child risk did not appear to alter the overall emotion socialization process, although higher levels of maternal and child negativity were observed for the children with a developmental risk. Results underscore the complexity of emotion socialization processes throughout the preschool period.

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

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

    In the U.S., the last ~300 years have been a period of progressive and widespread resource exploitation, ecosystem degradation, and habitat destruction. In southern New England, the European Colonists thrived on the spread of slave-based plantation farming, which peaked ~1750 in RI. They produced commodities such as livestock, apples, onions, flax, and dairy. Trees felled to produce the necessary pasture- and farm-land were quickly used as lumber for boards, planks, timber, and barrels. In 1793, Slater Mill, located on the Blackstone River at the head of Narragansett Bay, was the first mill in the U.S to spin yarn using water power, making it the birthplace of the U.S Industrial Revolution. The ensuing urbanization drove the human population of the watershed up from ~50,000 in 1790 to more than 2 million by the year 2000. More recently, the Bay has experienced episodic hypoxic events [1]. These events correlate well with spatial and temporal patterns of nutrients and productivity [2] suggesting that human-induced increases in nutrient nitrogen and phosphorus are responsible for eutrophication-induced oxygen depletion [3]. However, these post-Colonial land use changes have yet to be characterized within the longer context of Native American land use practices, mainly due to the lack of historical records for the period. Additionally, the impact of this ecosystem disturbance on the Bay has not been fully described. Here we present results based on sedimentary profiles of biomarkers diagnostic for soil delivery to marine systems, branched glycerol dialykl glycerol tetraethers, and pollen for disturbance taxa, that suggest land use change began in the Bay's watershed 300 years before European contact. This contradicts long standing ideas regarding the land use practices of local tribes but agrees with new archaeological findings suggesting large semi-permanent settlements and widespread horticulture of maize may have been the norm at this time. We also show results of

  12. 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

  13. 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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

    The objective of this study was to determine the effects of chromium methionine (Cr-Met) chelate supplementation on blood metabolites and fatty acid profile of beef from Holstein steers during late fattening period. Fifteen Holstein steers were allotted randomly into two groups including the control (non Cr-Met feeding, NCM, ave. body weight [BW] = 483±25.7 kg) and the treatment (Cr-Met feeding for 4 months, 4CM, ave. BW = 486±27.5 kg) group. The feeding amount of Cr-Met to animals was limited to 400 ppb/cow/d and was supplemented to total mixed ration. No difference in blood albumin, alkaline phosphatase, urea-nitrogen, calcium, creatine, glucose, total protein, triglyceride, and cholesterol were observed between the treatment groups (p>0.05). The level of high density lipoprotein was higher in the 4CM group than the NCM group, whereas low density lipoprotein was lower in the 4CM group (p<0.05). The fatty acid composition (caprate, laurate, myristate, pentadecanoate, palmitate, palmitoleate, margarate, cis-11 heptadodecanoate, stearate, oleate, trans-vaccenate, linoleate, cis-11 eicosenoate, docosa hexaenoic acid, and docosa pentaenoic acid) of the beef showed no difference between the two groups (p>0.05). The arachidonic acid level tended to be higher in the 4CM than the NCM group (p = 0.07). Cr-Met had no influence (p>0.05) on the ratio of saturated, unsaturated, unsaturated/saturated, monounsaturated/saturated and polyunsaturated/saturated fatty acids whereas the ratio of polyunsaturated fatty acids (PUFA) in the 4CM group was comparatively higher than the NCM group (p<0.05). This study concluded that feeding Cr-Met supplementation in 400 ppb/d to Holstein steers for 4 months during late fattening period can improve some blood metabolites and beef quality by increasing PUFA and gamma-linoleate compositions of beef. PMID:26950869

  17. 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

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

    PubMed

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

    2011-06-01

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

  19. 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

  20. Postpartum contraception: An exploratory study of lactation consultants’ knowledge and practices☆,☆☆

    PubMed Central

    Dunn, Kathleen; Bayer, Lisa L.; Mody, Sheila K.

    2016-01-01

    Objective Lactation consultants interact with women during the postpartum period; however, they may not have comprehensive education on postpartum contraception and the impact on breastfeeding. The aims of this study were to assess lactation consultants’ knowledge and practices about postpartum contraception and assess whether lactation consultants are interested in more education on postpartum contraception. Study Design We distributed a 30-question survey to self-identified lactation consultants and recruited participants via email, social media and at the 2015 California Breastfeeding Summit. Results We surveyed a total of 194 lactation consultants. Seventy-seven percent (137/177) stated they offer advice about postpartum contraception and its impact on breastfeeding. The majority of lactation consultants felt the theoretical or proven risks outweighed the benefits or there was an unacceptable health risk for the progestin-only pill 76.3% (100/131), progestin injection 90.1% (118/131) and progestin implant 93.1% (122/131) if used within 21 days of delivery. Although 68.7% (92/134) reported prior education on postpartum contraception, 82.1% (110/134) reported wanting more education on this topic, specifically in the form of a webinar 61.9% (83/134). Only 29.9% (40/134) reported knowledge of the United States Centers for Disease Control and Prevention 2011 Medical Eligibility Criteria for Contraceptive Use (USMEC) guidance for postpartum contraception. Conclusion There is a disconnect between the USMEC guidance and lactation consultanyts’ knowledge regarding the safety of immediate postpartum contraception. Implications: This study explores lactation consultants’ knowledge and practices about postpartum contraception, demonstrating that more evidence-based education is needed on this topic. PMID:26996737

  1. 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

  2. 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

  3. 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.

  4. 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

  5. [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

  6. 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

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

    PubMed

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

    2012-09-01

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

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

    PubMed

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

    2013-06-01

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

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

    PubMed

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

    2013-06-01

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

  10. Determinants of breast-feeding and post-partum amenorrhoea in Orissa.

    PubMed

    Srinivasan, K; Pathak, K B; Pandey, A

    1989-07-01

    A life table analysis is made of the duration of breast-feeding and post-partum amenorrhoea in Orissa, India, taking one variable at a time using data from a baseline survey of fertility and mortality (BSFM) conducted on the lines of the World Fertility Survey. Then a multivariate (proportional hazard) analysis showed that socioeconomic factors including residence, caste status and education influence the breast-feeding and post-partum amenorrhoea periods. There was no effect of maternal age on the length of breast-feeding, but mean length of post-partum amenorrhoea varied with age. The durations of breast-feeding and post-partum amenorrhoea are strongly related. PMID:2768294

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2016-04-01

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

  15. Hormonal effects on women's facial masculinity preferences: the influence of pregnancy, post-partum, and hormonal contraceptive use.

    PubMed

    Cobey, Kelly D; Little, Anthony C; Roberts, S Craig

    2015-01-01

    Here, we investigate changes in women's facial masculinity preferences across pregnancy and the post-partum period. The majority of previous research demonstrating changes in women's masculinity preferences has examined the impact of hormonal variation across the female menstrual cycle. Hormonal changes experienced during pregnancy and the post-partum period, critical periods in women's reproductive life histories, are considerably more extreme than the variation that occurs across the menstrual cycle, suggesting that differences in preferences may also be displayed during these times. We find that women's preference for masculinity in men's faces, but not women's faces, decreases in the post-partum period relative to pregnancy. Furthermore, when compared to a sample of nulliparous control participants, post-partum participants showed different masculinity preferences compared with women who were using hormonal contraception, with the direction of this difference dependent upon the sex of the face assessed.

  16. Sociodemographic, perinatal, behavioral, and psychosocial predictors of weight retention at 3 and 12 months postpartum.

    PubMed

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

    2010-10-01

    Postpartum weight retention plays an important role in the pathway leading to obesity among women of childbearing age. The objective of this study was to examine predictors of moderate (1-10 pounds) and high (>10 pounds) postpartum weight retention using data from a prospective pregnancy cohort that followed women into the postpartum period; n = 688 and 550 women at 3 and 12 months, respectively. Analysis included descriptive statistics and predictive modeling using log-binomial techniques. The average weight retained at 3 and 12 months postpartum in this population was 9.4 lb (s.d. = 11.4) and 5.7 lb (s.d. = 13.2), respectively. At 3 months postpartum, prepregnancy weight, gestational weight gain, and hours slept during the night were associated with moderate or high weight retention, whereas having an infant hospitalized after going home and scoring in the upper 75th percentile of the Eating Attitudes Test (EAT) were associated only with high weight retention. At 12 months postpartum, prepregnancy weight, gestational weight gain, and maternal education were associated with moderate weight retention; and gestational weight gain, maternal age, race, employment status, and having an infant hospitalized at birth were associated with high weight retention. The results of this study illustrate the importance of prepregnancy weight and gestational weight gain in predicting postpartum weight retention. Furthermore, given the lack of successful intervention studies that exist to date to help women lose weight in the postpartum period, the results of this study may help to inform future interventions that focus on such aspects as hours of sleep, dealing with stress associated with a hospitalized infant, and nonclinical eating disorder symptomatology.

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

    PubMed Central

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

    2010-01-01

    Postpartum weight retention plays an important role in the pathway leading to obesity among women of childbearing age. The objective of this study was to examine predictors of moderate (1–10 pounds) and high (>10 pounds) postpartum weight retention using data from a prospective pregnancy cohort that followed women into the postpartum period; n=688 and 550 women at 3 and 12 months, respectively. Analysis included descriptive statistics and predictive modeling using log-binomial techniques. The average weight retained at 3 and 12 months postpartum in this population was 9.4 lbs (SD=11.4) and 5.7 lbs (SD=13.2) respectively. At 3- months postpartum, prepregnancy weight, gestational weight gain, and hours slept during the night were associated with moderate or high weight retention while having an infant hospitalized after going home and scoring in the upper 75th percentile of the eating attitudes test were associated only with high weight retention. At 12- months postpartum, prepregnancy weight, gestational weight gain and maternal education were associated with moderate weight retention and gestational weight gain, maternal age, race, employment status, and having an infant hospitalized at birth were associated with high weight retention. The results of this study illustrate the importance of prepregnancy weight and gestational weight gain in predicting postpartum weight retention. Furthermore, given the lack of successful intervention studies that exist to date to help women lose weight in the postpartum period, the results of this study may help to inform future interventions that focus on such aspects as hours of sleep, dealing with stress associated with a hospitalized infant, and non-clinical eating disorder symptomatology. PMID:20035283

  18. Impact of maternal undernutrition during the periconceptional period, fetal number, and fetal sex on the development of the hypothalamo-pituitary adrenal axis in sheep during late gestation.

    PubMed

    Edwards, L J; McMillen, I Caroline

    2002-05-01

    Evidence from epidemiologic, clinical, and experimental studies has shown that a suboptimal intrauterine environment during early pregnancy can alter fetal growth and gestation length and is associated with an increased prevalence of adult hypertension and cardiovascular disease. It has been postulated that maternal nutrient restriction may act to reprogram the development of the pituitary-adrenal axis, resulting in excess glucocorticoid exposure and adverse health outcomes in later life. It is unknown, however, whether maternal nutrient restriction during the periconceptional period alters the development of the fetal pituitary-adrenal axis or whether the effects of periconceptional undernutrition can be reversed by the provision of an adequate level of maternal nutrition throughout the remainder of pregnancy. We have investigated the effect of restricted periconceptional nutrition (70% of control feed allowance) from 60 days before until 7 days after mating and the effect of restricted gestational nutrition from Day 8 to 147 of gestation on the development of the fetal hypothalamo-pituitary adrenal (HPA) axis in the sheep. In these studies, we have also investigated the effects of fetal number and sex on the pituitary-adrenal responses to periconceptional and gestational undernutrition. In ewes maintained on a control diet throughout the periconceptional and gestational periods, fetal plasma ACTH concentrations were higher and the prepartum surge in cortisol occurred earlier in singletons compared with twins. Plasma ACTH concentrations were also significantly higher in male compared with female singletons, and in twin fetuses, the prepartum surge in cortisol concentrations occurred earlier in males than in females. Periconceptional undernutrition resulted in higher fetal plasma concentrations of ACTH between 110 and 145 days of gestation and a significantly greater cortisol response to a bolus dose of corticotropin-releasing hormone in twin, but not singleton

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

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

    PubMed

    Mollard, Elizabeth K

    2014-09-01

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

  1. Paternal postpartum depression: what health care providers should know.

    PubMed

    Musser, Anna K; Ahmed, Azza H; Foli, Karen J; Coddington, Jennifer A

    2013-01-01

    Paternal postpartum depression (PPD) is a clinically significant problem for families that is currently underscreened, underdiagnosed, and undertreated. Maternal PPD is a well-known condition and has been extensively researched. In comparison, PPD in fathers and its potential effects on the family are not widely recognized. Studies have shown the importance of optimal mental health in fathers during the postpartum period. Negative effects of paternal PPD affect marital/partner relationships, infant bonding, and child development. To promote optimal health for parents and children, pediatric nurse practitioners must stay up to date on this topic. This article discusses the relationship of paternal PPD to maternal PPD; the consequences, signs, and symptoms; and the pediatric nurse practitioner's role in assessing and managing paternal PPD.

  2. Blastomycosis and Pregnancy: An Unusual Postpartum Disease Course.

    PubMed

    Surprenant, David; Kaniszewska, Monika; Hutchens, Kelli; Go, Christine; O'Keefe, Paul; Swan, James; Tung, Rebecca

    2015-01-01

    Blastomyces dermatitidis is responsible for systemic mycoses. It is predominantly caused by inhalation of spores and often manifests as pneumonia, which can potentially disseminate; however, direct cutaneous inoculation may also occur. Blastomycosis in the perigravid period is exceedingly rare. The partial immunosuppressive state induced by pregnancy can engender more severe infections and is associated with a risk of vertical transmission. Published cases describe postpartum symptomatic improvement accompanying immune reconstitution, even in the absence of treatment. We present a 31-year-old gravid female with multifocal cutaneous blastomycosis. After delivering a healthy full-term infant with no evidence of congenital infection, the patient's cutaneous lesions continued to worsen. At 6 weeks postpartum she was treated with oral itraconazole and demonstrated clinical improvement after 5 months of therapy. This case highlights the importance of prompt disease recognition, understanding of risk factors and initiation of appropriate antifungal therapy of blastomycotic infection occurring in the unique setting of pregnancy. PMID:26120305

  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. Contraceptive use, amenorrhea, and breastfeeding in postpartum women.

    PubMed

    Laukaran, V H; Winikoff, B

    1985-01-01

    Data from a 1981-1982 survey of infant feeding practices in four developing countries are used to analyze the relationship of amenorrhea, lactation, and time since childbirth with contraceptive use. The relationship was first explored using contingency table analysis. Logistic regression analysis was then performed to control for the effects of background variables. Models were tested separately for oral contraceptive users and users of other methods. Analysis showed a strong, independent, and consistent negative relationship between amenorrhea and contraceptive use. Women who were less than four months postpartum were also less likely to use contraceptives. The strength of the association with amenorrhea outweighed all other variables, including demographic correlates of contraceptive use. A negative relationship between breastfeeding and contraceptive use was found only for users of oral contraceptives. It is possible that women in the immediate postpartum period, especially those who are lactating and amenorrheic, are not as highly motivated to use contraception as had been supposed.

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

    SciTech Connect

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

    1994-04-01

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

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

    PubMed

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

    2016-06-01

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

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

    PubMed

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

    2016-06-01

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

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

    PubMed

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

    2015-06-01

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

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

    PubMed Central

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

    2016-01-01

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

  12. An Integrated Intervention in Pregnant African Americans Reduces Postpartum Risk: A Randomized Trial

    PubMed Central

    El-Mohandes, Ayman A.E.; Kiely, Michele; Joseph, Jill G.; Subramanian, Siva; Johnson, Allan A.; Blake, Susn M.; Gantz, Marie G.; El-Khorazaty, M. Nabil

    2010-01-01

    Objective To evaluate the efficacy of an integrated multiple risk intervention delivered mainly during pregnancy, in reducing such risks (smoking, environmental tobacco smoke exposure, depression and intimate partner violence) postpartum. Design Data from this randomized controlled trial were collected prenatally and on average 10 weeks postpartum in six prenatal care sites in the District of Columbia. African Americans were screened, recruited and randomly assigned to the behavioral intervention or usual care. Clinic-based, individually tailored counseling was delivered to intervention women. The outcome measures were number of reisks reported postpartum and reduction of these risks between baseline and postpartum. Results The intervention was effective in significantly reducing the number of risks reported in the postpartum period. In Bivariate analyses, the intervention group was more successful in resolving all risks (47% compared with 35%, p=0.007), number needed to treat=9, 95% confidence interval [CI] 5-31) and in resolving some risks (63% compared with 54%, p=0.009), number needed to treat=11, 95% CI 7-43) as compared with the usual care group. In logistical regression analyses, women in the intervention group were more likely to resolve all risks (OR=1.86, 95% CI: 1.25-2.75) and in resolving at least one risk (OR=1.6, 95% CI: 1.15-2.22). Conclusions An integrated multiple risk factor intervention addressing psychosocial and behavioral risks delivered mainly during pregnancy can have beneficial effects in risk reduction postpartum. PMID:18757660

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

    SciTech Connect

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

    1989-04-01

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

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

    PubMed

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

    2014-09-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    PubMed

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

    2015-12-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-12-01

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

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

    PubMed

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

    2016-05-01

    The objectives were to determine the effects of supplemental fat (no oilseed vs. oilseed) during late gestation and the source of fat (canola vs. sunflower seed), on dry matter intake (DMI), plasma metabolite concentrations, milk production and composition, calf birth weight, postpartum health disorders, ovarian function and reproductive performance in dairy cows. Pregnant Holstein cows, blocked by body condition and parity, were assigned to 1 of 3 diets containing rolled canola seed (high in oleic acid; n=43) or sunflower (high in linoleic acid; n=45) at 8% of dry matter, or no oilseed (control; n=43), for the last 35±2 d of pregnancy. After calving, all cows received a common lactation diet. Blood samples were collected at wk -3 (i.e., 2 wk after initiation of prepartum diets) and at wk +1, +2, +3, +4 and +5 postpartum to determine the concentration of fatty acids (mEq/dL), β-hydroxybutyrate (mg/dL), and glucose (mg/dL). Ovarian ultrasonography was performed twice weekly to determine the first appearance of dominant (10mm) and preovulatory-size (≥16mm) follicles, and ovulation. Uterine inflammatory status based on the proportion of polymorphonuclear leukocytes (PMN; subclinical endometritis: >8% PMN) was assessed at d 25±1 postpartum. Significant parity by treatment interactions were observed for DMI and milk yield. Prepartum oilseed supplementation, more specifically sunflower seed supplementation, increased postpartum DMI in primiparous cows without affecting prepartum DMI or milk yield. Contrarily, in multiparous cows, prepartum oilseed supplementation decreased both prepartum and postpartum DMI and milk yield during the first 2 wk. Regardless of parity, prepartum feeding of canola reduced postpartum DMI compared with those fed sunflower. Mean fatty acids concentrations at wk -3 were greater in cows given supplemental oilseed than those fed no oilseeds. Gestation length and calf birth weight were increased in cows given supplemental oilseed prepartum

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

    PubMed

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

    2016-05-01

    The objectives were to determine the effects of supplemental fat (no oilseed vs. oilseed) during late gestation and the source of fat (canola vs. sunflower seed), on dry matter intake (DMI), plasma metabolite concentrations, milk production and composition, calf birth weight, postpartum health disorders, ovarian function and reproductive performance in dairy cows. Pregnant Holstein cows, blocked by body condition and parity, were assigned to 1 of 3 diets containing rolled canola seed (high in oleic acid; n=43) or sunflower (high in linoleic acid; n=45) at 8% of dry matter, or no oilseed (control; n=43), for the last 35±2 d of pregnancy. After calving, all cows received a common lactation diet. Blood samples were collected at wk -3 (i.e., 2 wk after initiation of prepartum diets) and at wk +1, +2, +3, +4 and +5 postpartum to determine the concentration of fatty acids (mEq/dL), β-hydroxybutyrate (mg/dL), and glucose (mg/dL). Ovarian ultrasonography was performed twice weekly to determine the first appearance of dominant (10mm) and preovulatory-size (≥16mm) follicles, and ovulation. Uterine inflammatory status based on the proportion of polymorphonuclear leukocytes (PMN; subclinical endometritis: >8% PMN) was assessed at d 25±1 postpartum. Significant parity by treatment interactions were observed for DMI and milk yield. Prepartum oilseed supplementation, more specifically sunflower seed supplementation, increased postpartum DMI in primiparous cows without affecting prepartum DMI or milk yield. Contrarily, in multiparous cows, prepartum oilseed supplementation decreased both prepartum and postpartum DMI and milk yield during the first 2 wk. Regardless of parity, prepartum feeding of canola reduced postpartum DMI compared with those fed sunflower. Mean fatty acids concentrations at wk -3 were greater in cows given supplemental oilseed than those fed no oilseeds. Gestation length and calf birth weight were increased in cows given supplemental oilseed prepartum

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

    NASA Astrophysics Data System (ADS)

    de Boer, B.; Dolan, A. M.; Bernales, J.; Gasson, E.; Goelzer, H.; Golledge, N. R.; Sutter, J.; Huybrechts, P.; Lohmann, G.; Rogozhina, I.; Abe-Ouchi, A.; Saito, F.; van de Wal, R. S. W.

    2015-05-01

    In the context of future climate change, understanding the nature and behaviour of ice sheets during warm intervals in Earth history is of fundamental importance. The late Pliocene warm period (also known as the PRISM interval: 3.264 to 3.025 million years before present) can serve as a potential analogue for projected future climates. Although Pliocene ice locations and extents are still poorly constrained, a significant contribution to sea-level rise should be expected from both the Greenland ice sheet and the West and East Antarctic ice sheets based on palaeo sea-level reconstructions. Here, we present results from simulations of the Antarctic ice sheet by means of an international Pliocene Ice Sheet Modeling Intercomparison Project (PLISMIP-ANT). For the experiments, ice-sheet models including the shallow ice and shelf approximations have been used to simulate the complete Antarctic domain (including grounded and floating ice). We compare the performance of six existing numerical ice-sheet models in simulating modern control and Pliocene ice sheets by a suite of five sensitivity experiments. We include an overview of the different ice-sheet models used and how specific model configurations influence the resulting Pliocene Antarctic ice sheet. The six ice-sheet models simulate a comparable present-day ice sheet, considering the models are set up with their own parameter settings. For the Pliocene, the results demonstrate the difficulty of all six models used here to simulate a significant retreat or re-advance of the East Antarctic ice grounding line, which is thought to have happened during the Pliocene for the Wilkes and Aurora basins. The specific sea-level contribution of the Antarctic ice sheet at this point cannot be conclusively determined, whereas improved grounding line physics could be essential for a correct representation of the migration of the grounding-line of the Antarctic ice sheet during the Pliocene.

  3. Isotopic evidence for divergent diets and mobility patterns in the Atacama Desert, northern Chile, during the Late Intermediate Period (AD 900-1450).

    PubMed

    Santana-Sagredo, Francisca; Lee-Thorp, Julia A; Schulting, Rick; Uribe, Mauricio

    2015-03-01

    The decline of the Tiwanaku state saw the emergence of two new cultures-Pica-Tarapacá and Atacama-during the Late Intermediate Period in northern Chile. Archeological evidence suggests that both groups practised maize agriculture and pastoralism, but that their interaction zones differed significantly. Marine resources are common at Pica-Tarapacá sites, even those far from coast, while Atacama sites in the desert oases and precordilleran area seem to have directed their networks towards the highlands. Here we apply stable carbon, nitrogen, and oxygen isotope analysis on human bone and enamel to test dietary patterns and residential mobility at two sites, Pica 8 and Quitor 6, representing the Pica-Tarapacá and Atacama cultures, respectively. Our results show that diet at the two sites indeed differed: significant but variable consumption of marine resources and maize is indicated at Pica 8, despite being an inland site, while diet at Quitor 6 was based mainly on terrestrial resources. The use of seabird guano and llama dung as fertilizers and extreme aridity may have contributed to the high nitrogen isotope values observed in Pica 8 humans. The δ(18) O values in Pica 8 individuals are generally lower than for Quitor in spite of its greater distance from the Andes. All three isotopes suggest the presence of at least five nonlocals in the 30 measured at Pica 8. This evidence for human mobility is consistent with the high levels of trade and interaction observed in the archeological record, and begins to quantify the degree of movement of specific individuals. PMID:25385676

  4. Isotopic evidence for divergent diets and mobility patterns in the Atacama Desert, northern Chile, during the Late Intermediate Period (AD 900-1450).

    PubMed

    Santana-Sagredo, Francisca; Lee-Thorp, Julia A; Schulting, Rick; Uribe, Mauricio

    2015-03-01

    The decline of the Tiwanaku state saw the emergence of two new cultures-Pica-Tarapacá and Atacama-during the Late Intermediate Period in northern Chile. Archeological evidence suggests that both groups practised maize agriculture and pastoralism, but that their interaction zones differed significantly. Marine resources are common at Pica-Tarapacá sites, even those far from coast, while Atacama sites in the desert oases and precordilleran area seem to have directed their networks towards the highlands. Here we apply stable carbon, nitrogen, and oxygen isotope analysis on human bone and enamel to test dietary patterns and residential mobility at two sites, Pica 8 and Quitor 6, representing the Pica-Tarapacá and Atacama cultures, respectively. Our results show that diet at the two sites indeed differed: significant but variable consumption of marine resources and maize is indicated at Pica 8, despite being an inland site, while diet at Quitor 6 was based mainly on terrestrial resources. The use of seabird guano and llama dung as fertilizers and extreme aridity may have contributed to the high nitrogen isotope values observed in Pica 8 humans. The δ(18) O values in Pica 8 individuals are generally lower than for Quitor in spite of its greater distance from the Andes. All three isotopes suggest the presence of at least five nonlocals in the 30 measured at Pica 8. This evidence for human mobility is consistent with the high levels of trade and interaction observed in the archeological record, and begins to quantify the degree of movement of specific individuals.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

    stressors, psychiatric disturbance in the mother and an unwanted pregnancy. Child abuse was also strongly associated with a history of childhood violence in the mother or her partner, previous child abuse by the mother's partner, a poor relationship between the mother and her parents, low self-esteem in the mother and lack of attendance at prenatal classes. Postpartum abuse of the mother was also associated with a history of abuse of the mother, prenatal care not started until the third trimester and alcohol or drug abuse by the mother or her partner (class A evidence). Child abuse had a fair (class B) association with poor marital adjustment or satisfaction, current or past abuse of the mother and alcohol or drug abuse by the mother or her partner. There was class B evidence supporting an association between abuse of the mother and poor marital adjustment, traditional sex-role expectations, a history of childhood violence in the mother or her partner and low self-esteem in the mother. Postpartum depression was most strongly associated with poor marital adjustment, recent life stressors, antepartum depression (class A evidence), but was also associated with lack of social support, abuse of the mother and a history of psychiatric disorder in the mother (class B evidence). Marital dysfunction was associated with poor marital adjustment before the birth and traditional sex-role expectations (class A evidence), and physical illness was correlated with recent life stressors (class B evidence). CONCLUSIONS: Psychosocial risk factors during the antenatal period may herald postpartum morbidity. Research is required to determine whether detection of these risk factors may lead to interventions that improve postpartum family outcomes. PMID:8634957

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

    PubMed

    Tienken, Reka; Kersten, Susanne; Frahm, Jana; Meyer, Ulrich; Locher, Lena; Rehage, Jürgen; Huber, Korinna; Kenéz, Ákos; Sauerwein, Helga; Mielenz, Manfred; Dänicke, Sven

    2015-01-01

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

  12. 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

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

    PubMed

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

    2015-12-01

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

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

    NASA Astrophysics Data System (ADS)

    de Boer, B.; Dolan, A. M.; Bernales, J.; Gasson, E.; Goelzer, H.; Golledge, N. R.; Sutter, J.; Huybrechts, P.; Lohmann, G.; Rogozhina, I.; Abe-Ouchi, A.; Saito, F.; van de Wal, R. S. W.

    2014-11-01

    In the context of future climate change, understanding the nature and behaviour of ice sheets during warm intervals in Earth history is of fundamental importance. The Late-Pliocene warm period (also known as the PRISM interval: 3.264 to 3.025 million years before present) can serve as a potential analogue for projected future climates. Although Pliocene ice locations and extents are still poorly constrained, a significant contribution to sea-level rise should be expected from both the Greenland ice sheet and the West and East Antarctic ice sheets based on palaeo sea-level reconstructions. Here, we present results from simulations of the Antarctic ice sheet by means of an international Pliocene Ice Sheet Modeling Intercomparison Project (PLISMIP-ANT). For the experiments, ice-sheet models including the shallow ice and shelf approximations have been used to simulate the complete Antarctic domain (including grounded and floating ice). We compare the performance of six existing numerical ice-sheet models in simulating modern control and Pliocene ice sheets by a suite of four sensitivity experiments. Ice-sheet model forcing fields are taken from the HadCM3 atmosphere-ocean climate model runs for the pre-industrial and the Pliocene. We include an overview of the different ice-sheet models used and how specific model configurations influence the resulting Pliocene Antarctic ice sheet. The six ice-sheet models simulate a comparable present-day ice sheet, although the models are setup with their own parameter settings. For the Pliocene simulations using the Bedmap1 bedrock topography, some models show a small retreat of the East Antarctic ice sheet, which is thought to have happened during the Pliocene for the Wilkes and Aurora basins. This can be ascribed to either the surface mass balance, as the HadCM3 Pliocene climate shows a significant increase over the Wilkes and Aurora basin, or the initial bedrock topography. For the latter, our simulations with the recently

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

    NASA Astrophysics Data System (ADS)

    de Boer, Bas; Dolan, Aisling; Bernales, Jorge; Gasson, Edward; Goelzer, Heiko; Golledge, Nick; Sutter, Johannes; Huybrechts, Phillipe; Lohmann, Gerrit; Rogozhina, Irina; Abe-Ouchi, Ayako; Saito, Fuyuki; van de Wal, Roderik

    2015-04-01

    In the context of future climate change, understanding the nature and behaviour of ice sheets during warm intervals in Earth history is of fundamental importance. The Late-Pliocene warm period (also known as the PRISM interval: 3.264 to 3.025 million years before present) can serve as a potential analogue for projected future climates. Although Pliocene ice locations and extents are still poorly constrained, a significant contribution to sea-level rise should be expected from both the Greenland ice sheet and the West and East Antarctic ice sheets based on palaeo sea-level reconstructions. Here, we present results from simulations of the Antarctic ice sheet by means of an international Pliocene Ice Sheet Modeling Intercomparison Project (PLISMIP-ANT). For the experiments, ice-sheet models including the shallow ice and shelf approximations have been used to simulate the complete Antarctic domain (including grounded and floating ice). We compare the performance of six existing numerical ice-sheet models in simulating modern control and Pliocene ice sheets by a suite of four sensitivity experiments. Ice-sheet model forcing fields are taken from the HadCM3 atmosphere-ocean climate model runs for the pre-industrial and the Pliocene. We include an overview of the different ice-sheet models used and how specific model configurations influence the resulting Pliocene Antarctic ice sheet. The six ice-sheet models simulate a comparable present-day ice sheet, although the models are setup with their own parameter settings. For the Pliocene simulations using the Bedmap1 bedrock topography, some models show a small retreat of the East Antarctic ice sheet, which is thought to have happened during the Pliocene for the Wilkes and Aurora basins. This can be ascribed to either the surface mass balance, as the HadCM3 Pliocene climate shows a significant increase over the Wilkes and Aurora basin, or the initial bedrock topography. For the latter, our simulations with the recently

  16. Postpartum depression: psychoneuroimmunological underpinnings and treatment

    PubMed Central

    Anderson, George; Maes, Michael

    2013-01-01

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

  17. Effect of propylene glycol on adipose tissue mobilization in postpartum over-conditioned Holstein cows.

    PubMed

    Bjerre-Harpøth, V; Storm, A C; Eslamizad, M; Kuhla, B; Larsen, M

    2015-12-01

    Our objective was to investigate the quantitative and qualitative effects of propylene glycol (PG) allocation on postpartum adipose tissue mobilization in over-conditioned Holstein cows. Nine ruminally cannulated and arterially catheterized cows were, at parturition, randomly assigned to a ruminal pulse dose of either 500g of tap water (n=4) or 500g of PG (n=5) once a day. The PG was given with the morning feeding for 4 wk postpartum (treatment period), followed by a 4-wk follow-up period. All cows were fed the same prepartum and postpartum diets. At -16 (±3), 4 (±0), 15 (±1) and 29 (±2) days in milk (DIM), body composition was determined using the deuterium oxide dilution technique, liver and subcutaneous adipose tissue biopsies were collected, and mammary gland nutrient uptake was measured. Weekly blood samples were obtained during the experiment and daily blood samples were taken from -7 to 7 DIM. Postpartum feed intake and milk yield was not affected by PG allocation. The body content of lipid was not affected by treatment, but tended to decrease from 4 to 29 DIM with both treatments. Except for the first week postpartum, no difference in plasma nonesterified fatty acids concentration was noted between treatments in the treatment period. Yet, PG allocation resulted in decreased plasma concentrations of β-hydroxybutyrate (BHB) and increased plasma concentrations of glucose. In the follow-up period, plasma concentrations of nonesterified fatty acids, glucose, and BHB did not differ between treatments. Additionally, the change in abundance of proteins in adipose tissue biopsies from prepartum to 4 DIM was not affected by treatment. In conclusion, the different variables to assess body fat mobilization were concurrent and showed that a 4-wk postpartum PG allocation had limited effect on adipose tissue mobilization. The main effect was an enhanced glucogenic status with PG. No carry-over effect of PG allocation was recorded for production or plasma metabolites

  18. The role of oxytocin in mothers' theory of mind and interactive behavior during the perinatal period.

    PubMed

    MacKinnon, Anna L; Gold, Ian; Feeley, Nancy; Hayton, Barbara; Carter, C Sue; Zelkowitz, Phyllis

    2014-10-01

    The present longitudinal study examined the relations between plasma oxytocin, theory of mind, and maternal interactive behavior during the perinatal period. A community sample of women was assessed at 12-14 weeks gestation, 32-34 weeks gestation, and 7-9 weeks postpartum. Oxytocin during late pregnancy was significantly positively correlated with a measure of theory of mind, and predicted theory of mind ability after controlling for parity, maternal education, prenatal psychosocial risk, and general anxiety, measured during the first trimester. Theory of mind was associated with less remote and less depressive maternal interactive behavior. Oxytocin, across all time points, was not directly related to maternal interactive behavior. However, there was a significant indirect effect of oxytocin during late pregnancy on depressive maternal behavior via theory of mind ability. These preliminary findings suggest that changes in the oxytocinergic system during the perinatal period may contribute to the awareness of social cues, which in turn plays a role in maternal interactive behavior.

  19. Late Maternal Deaths and Deaths from Sequelae of Obstetric Causes in the Americas from 1999 to 2013: A Trend Analysis

    PubMed Central

    de Cosio, Federico G.; Sanhueza, Antonio; Soliz, Patricia N.; Becerra-Posada, Francisco; Espinal, Marcos A.

    2016-01-01

    Background Data on maternal deaths occurring after the 42 days postpartum reference time is scarce; the objective of this analysis is to explore the trend and magnitude of late maternal deaths and deaths from sequelae of obstetric causes in the Americas between 1999 and 2013, and to recommend including these deaths in the monitoring of the Sustainable Development Goals (SDGs). Methods Exploratory data analysis enabled analyzing the magnitude and trend of late maternal deaths and deaths from sequelae of obstetric causes for seven countries of the Americas: Argentina, Brazil, Canada, Colombia, Cuba, Mexico and the United States. A Poisson regression model was developed to compare trends of late maternal deaths and deaths from sequelae of obstetric causes between two periods of time: 1999 to 2005 and 2006 to 2013; and to estimate the relative increase of these deaths in the two periods of time. Findings The proportion of late maternal deaths and deaths from sequelae of obstetric causes ranged between 2.40% (CI 0.85% – 5.48%) and 18.68% (CI 17.06% – 20.47%) in the seven countries. The ratio of late maternal deaths and deaths from sequelae of obstetric causes per 100,000 live births has increased by two times in the region of the Americas in the period 2006-2013 compared to the period 1999-2005. The regional relative increase of late maternal death was 2.46 (p<0.0001) times higher in the second period compared to the first. Interpretation Ascertainment of late maternal deaths and deaths from sequelae of obstetric causes has improved in the Americas since the early 2000’s due to improvements in the quality of information and the obstetric transition. Late and obstetric sequelae maternal deaths should be included in the monitoring of the SDGs as well as in the revision of the International Classification of Diseases’ 11th version (ICD-11). PMID:27626277

  20. Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period

    PubMed Central

    Tomfohr, Lianne M.; Buliga, Elena; Letourneau, Nicole L.; Campbell, Tavis S.; Giesbrecht, Gerald F.

    2015-01-01

    Objective: The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories. Design, Setting, and Participants: Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1; < 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period. Results: Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period. Conclusions: Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period. Citation: Tomfohr LM, Buliga E, Letourneau NL, Campbell TS, Giesbrecht GF

  1. 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

  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 prevalence of early postpartum psychiatric morbidity in Dubai: a transcultural perspective.

    PubMed

    Abou-Saleh, M T; Ghubash, R

    1997-05-01

    There have been numerous studies of the prevalence of postpartum psychiatric illness and its putative risk factors in Western Europe and North America, but very few studies have been undertaken in developing countries, including the Arab world. A total of 95 women admitted to the New Dubai Hospital in Dubai, United Arab Emirates, for childbirth were studied. All subjects were assessed in the postpartum period using clinical and socio-cultural instruments, namely the Self-Reporting Questionnaire (SRQ) on day 2 and the Edinburgh Postnatal Depression Scale (EPDS) on day 7 after delivery. The prevalence of psychiatric morbidity was 24% according to the SRQ and 18% according to the EPDS. A number of psychosocial factors emerged as putative risk factors for postpartum psychiatric disturbance, including depressive illness. It is concluded that the prevalence of postpartum psychiatric morbidity and its risk factors in this Arab culture are similar to the results obtained in numerous previous studies conducted in industrialized countries. These findings have implications for the early detection and care of women at risk for postpartum psychiatric illness.

  4. 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.

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

    PubMed Central

    Pope, Carley J.; Mazmanian, Dwight

    2016-01-01

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

  6. Urban minority women’s perceptions of and preferences for postpartum contraceptive counseling

    PubMed Central

    Yee, Lynn; Simon, Melissa

    2011-01-01

    Objective Focused antenatal contraceptive counseling about postpartum contraception may reduce the risk of contraceptive nonuse and misuse, although the optimal timing, content, and communication style of such counseling remain controversial. This study used an in-depth qualitative approach in a population of young, postpartum, urban minority women in order to examine women’s perspectives toward the optimal provision of comprehensive contraceptive counseling. Methods Brief surveys and semi-structured interviews were conducted with 30 consenting postpartum women. In-person one-on-one interviews were then reviewed for themes, using an iterative process. Qualitative analysis techniques identifying emergent themes were applied to interview data. Results In this cohort of African American (63%) and Hispanic (37%) women (median age 26), 73% had unplanned pregnancies. Women preferred frequent, short sessions of provider-initiated comprehensive contraceptive counseling throughout the antepartum period with reinforcement of decisions while postpartum. Participants valued patient-centered counseling that is inclusive of all appropriate methods and personalized to individual needs. Conclusion We recommend that frequent, provider-initiated, multiple-modality discussions of appropriate postpartum contraceptive options should take place throughout pregnancy in an open, individualized manner. Further work should address the long-term effects of improved patient-centered antenatal contraceptive counseling on rates of unintended pregnancy. PMID:21323851

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

    PubMed

    Pope, Carley J; Mazmanian, Dwight

    2016-01-01

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

  8. 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

  9. What Clinical Interventions Have Been Implemented to Prevent or Reduce Postpartum Hypertension Readmissions? A Clin-IQ

    PubMed Central

    O’Meara, Sara; Lepic, Molly

    2016-01-01

    A literature review was conducted to determine what clinical interventions have been studied and implemented to prevent and/or reduce postpartum hypertension readmissions. Appropriate verbal and printed educational materials should be given to the patient prior to discharge with use of the “teach back” method. Patients and health care providers within the multidisciplinary team should be educated on the warning signs and symptoms of worsening hypertensive disease and when to appropriately involve the obstetrician. The use of text messaging may be useful in preventing hospital readmissions by increasing patient follow-up and compliance and appropriately managing patients in the postpartum period. Treating postpartum patients with furosemide may decrease blood pressure and prevent postpartum hypertension and the need for antihypertensive therapy.

  10. What Clinical Interventions Have Been Implemented to Prevent or Reduce Postpartum Hypertension Readmissions? A Clin-IQ

    PubMed Central

    O’Meara, Sara; Lepic, Molly

    2016-01-01

    A literature review was conducted to determine what clinical interventions have been studied and implemented to prevent and/or reduce postpartum hypertension readmissions. Appropriate verbal and printed educational materials should be given to the patient prior to discharge with use of the “teach back” method. Patients and health care providers within the multidisciplinary team should be educated on the warning signs and symptoms of worsening hypertensive disease and when to appropriately involve the obstetrician. The use of text messaging may be useful in preventing hospital readmissions by increasing patient follow-up and compliance and appropriately managing patients in the postpartum period. Treating postpartum patients with furosemide may decrease blood pressure and prevent postpartum hypertension and the need for antihypertensive therapy. PMID:27695701

  11. Timing and characteristics of Late Pleistocene and Holocene wetter periods in the Eastern Desert and Sinai of Egypt, based on 14C dating and stable isotope analysis of spring tufa deposits

    NASA Astrophysics Data System (ADS)

    Hamdan, Mohamed A.; Brook, George A.

    2015-12-01

    There is very little dated evidence on wet periods in the Eastern Desert and Sinai Peninsula of Egypt during the Late Pleistocene and Holocene. To obtain such information, we have studied the petrography, isotope geochemistry and AMS radiocarbon ages of mostly relict tufas deposited by springs draining perched ground water bodies in metamorphic and volcanic rocks. The tufas unconformably overly Precambrian basic igneous rocks (basalt, diabase and gabbro). As the ages of tufa carbonate are frequently older than the true ages of the deposits because of the incorporation of old, 14C-dead carbon, we have dated both the carbonate matrix and insoluble organic material of the tufas. These ages show that the tufas were largely formed during two broad time periods, the most recent from 12,058 to 6678 cal yr BP (African Humid Period), and the other from ˜31,200-22,500 cal yr BP, with preferential growth during the coldest times of this period namely during Heinrich Events 2 and 3 (H2 and H3) and the Last Glacial Maximum (LGM). The time span between 19,000-9000 cal yr BP, including the YD and H1, appears to have been relatively more arid than the earlier LGM or H2 periods or the later Holocene. The Late Pleistocene tufas are depleted in 18O relative to the Holocene tufas and were deposited at a lower temperature (˜14.0°-20.8 °C vs. 18.4°-23.4 °C). We believe that the Holocene tufas in the Sinai were formed by rainfall from the Mediterranean and those in the southern part of the Eastern Desert by African monsoon rainfall derived from the Red Sea-Gulf of Aden and Indian Ocean. In contrast, the moisture that fed the Late Pleistocene tufas, which are depleted in 18O relative to Holocene deposits, and progressively depleted from north to south, was probably brought by the Westerlies from the Atlantic-Mediterranean Sea when the Westerly circulation was pushed southwards during the coldest periods of the Late Pleistocene. Periods of tufa deposition correlate with major

  12. 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

  13. Effects of space flight on ovarian-hypophyseal function in postpartum rats.

    PubMed

    Burden, H W; Zary, J; Lawrence, I E; Jonnalagadda, P; Davis, M; Hodson, C A

    1997-03-01

    The effect of space flight in a National Aeronautics and Space Administration (NASA) shuttle was studied in pregnant rats. Rats were launched on day 9 of gestation and recovered on day 20 of gestation. On day 20 of gestation, rats were unilaterally hysterectomized and subsequently allowed to go to term and deliver vaginally. There was no effect of space flight on pituitary and ovary mass postpartum. In addition, space flight did not alter healthy and atretic ovarian antral follicle populations, fetal wastage in utero, plasma concentrations of progesterone and luteinizing hormone (LH) or pituitary content of follicle stimulating hormone (FSH). Space flight significantly increased plasma concentrations of FSH and decreased pituitary content of LH at the postpartum sampling time. Collectively, these data show that space flight, initiated during the postimplantation period of pregnancy, and concluded before parturition, is compatible with maintenance of pregnancy and has minimal effects on postpartum hypophyseal parameters; however, none of the ovarian parameters examined was altered by space flight.

  14. Post-partum low-back pain of an uncommon origin: a case report.

    PubMed

    Sansone, Valerio; McCleery, Jocelyn; Bonora, Cristina

    2013-01-01

    Low-back pain is a common complaint during pregnancy and the post-partum period, and it may be due to a variety of conditions. Among these, a frequently overlooked cause is a sacral fracture. We report the case of a 37 year old woman, suffering from post-partum low-back pain which had not responded to treatment. Though rare, a sacral stress fracture must be considered in cases of prolonged low-back or sacral pain in pregnant or post-partum women. Plain radiographs are frequently inconclusive and MRI is the imaging technique of choice. Capacitive coupling electric fields (CCEF) seemed to be effective in treating pain and in reducing the patient's recovery time.

  15. Effects of Space Flight on Ovarian-Hypophyseal Function in Postpartum Rats

    NASA Technical Reports Server (NTRS)

    Burden, H. W.; Zary, J.; Lawrence, I. E.; Jonnalagadda, P.; Davis, M.; Hodson, C. A.

    1997-01-01

    The effect of space flight in a National Aeronautics and Space Administration (NASA) shuttle was studied in pregnant rats. Rats were launched on day 9 of gestation and recovered on day 20 of gestation. On day 20 of gestation, rats were unilaterally hysterectomized and subsequently allowed to go to term and deliver vaginally. There was no effect of space flight on pituitary and ovary mass postpartum. In addition, space flight did not alter healthy and atretic ovarian antral follicle populations, fetal wastage in utero, plasma concentrations of progesterone and luteinizing hormone (LH) or pituitary content of follicle stimulating hormone (FSH). Space flight significantly increased plasma concentrations of FSH and decreased pituitary content of LH at the postpartum sampling time. Collectively, these data show that space flight, initiated during the postimplantation period of pregnancy, and concluded before parturition, is compatible with maintenance of pregnancy and has minimal effects on postpartum hypophyseal parameters; however, none of the ovarian parameters examined was altered by space flight.

  16. 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

  17. 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.

  18. Chronic Cocaine Exposure During Pregnancy Increases Postpartum Neuroendocrine Stress Responses

    PubMed Central

    Williams, Sarah K.; Barber, John S.; Jamieson-Drake, Abigail W.; Enns, Jordan A.; Townsend, Leah B.; Walker, Cheryl H.; Johns, Josephine M.

    2012-01-01

    The cycle of chronic cocaine (CC) use and withdrawal results in increased anxiety, depression and disrupted stress-responsiveness. Oxytocin and corticosterone (CORT) interact to mediate hormonal stress responses and can be altered by cocaine use. These neuroendocrine signals play important regulatory roles in a variety of social behaviours, specifically during the postpartum period, and are sensitive to disruption by CC exposure in both clinical settings and preclinical models. To determine whether CC exposure during pregnancy affected behavioural and hormonal stress response in the early postpartum period in a rodent model, Sprague-Dawley rats were administered cocaine daily (30 mg/kg) throughout gestation (days 1–20). Open field test (OFT) and forced swim test (FST) behaviours were measured on postpartum day 5. Plasma CORT concentrations were measured prior to and following testing throughout the test day, while plasma and brain oxytocin concentrations were measured post-testing only. Results indicated increased CORT response following the OFT in CC-treated dams (p≤ 0.05). CC-treated dams also exhibited altered FST behaviour (p≤ 0.05), suggesting abnormal stress responsiveness. Peripheral, but not central, oxytocin levels were increased by cocaine treatment (p≤ 0.05). Peripheral oxytocin and CORT increased following the FST regardless of treatment condition (p≤ 0.05). Changes in stress-responsiveness, both behaviourally and hormonally may underlie some deficits in maternal behaviour, thus a clearer understanding of CC’s effect on the stress response system may potentially lead to treatment interventions which could be relevant to clinical populations. Additionally, these results indicate that CC treatment can have long-lasting effects on peripheral oxytocin regulation in rats, similar to changes observed in persistent social behaviour and stress-response deficits in clinical populations. PMID:22309318

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

    PubMed Central

    Quon, Anita; Davidge, Sandra T.

    2016-01-01

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

  20. COMMON PROBLEMS OF BREASTFEEDING IN THE POSTPARTUM PERIOD

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Breastfeeding a healthy infant is often accompanied by challenges. Some may be predictable, while others are unexpected. These problems may accompany the normal anxiety of first-time parents, who rarely appreciate the intensity of care infants require. Reassurance and guidance often will enable moth...

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

    PubMed

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

    2005-03-15

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

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

    PubMed

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

    2005-03-15

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

  3. 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

  4. 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

  5. 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

  6. 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

  7. Advance distribution of misoprostol for prevention of postpartum hemorrhage (PPH) at home births in two districts of Liberia

    PubMed Central

    2014-01-01

    Background A postpartum hemorrhage prevention program to increase uterotonic coverage for home and facility births was introduced in two districts of Liberia. Advance distribution of misoprostol was offered during antenatal care (ANC) and home visits. Feasibility, acceptability, effectiveness of distribution mechanisms and uterotonic coverage were evaluated. Methods Eight facilities were strengthened to provide PPH prevention with oxytocin, PPH management and advance distribution of misoprostol during ANC. Trained traditional midwives (TTMs) as volunteer community health workers (CHWs) provided education to pregnant women, and district reproductive health supervisors (DRHSs) distributed misoprostol during home visits. Data were collected through facility and DRHS registers. Postpartum interviews were conducted with a sample of 550 women who received advance distribution of misoprostol on place of delivery, knowledge, misoprostol use, and satisfaction. Results There were 1826 estimated deliveries during the seven-month implementation period. A total of 980 women (53.7%) were enrolled and provided misoprostol, primarily through ANC (78.2%). Uterotonic coverage rate of all deliveries was 53.5%, based on 97.7% oxytocin use at recorded facility vaginal births and 24.9% misoprostol use at home births. Among 550 women interviewed postpartum, 87.7% of those who received misoprostol and had a home birth took the drug. Sixty-three percent (63.0%) took it at the correct time, and 54.0% experienced at least one minor side effect. No serious adverse events reported among enrolled women. Facility-based deliveries appeared to increase during the program. Conclusions The program was moderately effective at achieving high uterotonic coverage of all births. Coverage of home births was low despite the use of two channels of advance distribution of misoprostol. Although ANC reached a greater proportion of women in late pregnancy than home visits, 46.3% of expected deliveries did not

  8. 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

  9. 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

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

    PubMed Central

    Hounton, Sennen; Winfrey, William; Barros, Aluisio J. D.; Askew, Ian

    2015-01-01

    Background The first 12 months following childbirth are a period when a subsequent pregnancy holds the greatest risk for mother and baby, but also when there are numerous contacts with the healthcare system for postnatal care for mother and baby (immunisation, nutrition, etc.). The benefits and importance of postpartum family planning are well documented. They include a reduction in risk of miscarriage, as well as mitigation of (or protection against) low birth weight, neonatal and maternal death, preterm birth, and anaemia. Objectives The objectives of this paper are to assess patterns and trends in the use of postpartum family planning at the country level, to determine whether postpartum family planning is associated with birth interval and parity, and to identify the health services most closely associated with postpartum family planning after adjusting for socio-economic characteristics. Design Data were used from Demographic and Health Surveys that contain a reproductive calendar, carried out within the last 10 years, from Ethiopia, Malawi, and Nigeria. All women for whom the calendar was completed and who gave birth between 57 and 60 months prior to data collection were included in the analysis. For each of the births, we merged the reproductive calendar with the birth record into a survey for each country reflecting the previous 60 months. The definition of the postpartum period in this paper is based on a period of 3 months postpartum. We used this definition to assess early adoption of postpartum family planning. We assessed variations in postpartum family planning according to demographic and socio-economic variables, as well as its association with various contact opportunities with the health system [antenatal care (ANC), childbirth in facilities, immunisation, etc.]. We did simple descriptive analysis with tabular, graphic, and ‘equiplot’ displays and a logistic regression controlling for important background characteristics. Results Overall

  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. 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

  13. Prepartum and Postpartum Rumen Fluid Microbiomes: Characterization and Correlation with Production Traits in Dairy Cows

    PubMed Central

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

    2014-01-01

    Microbes present in the rumen of dairy cows are essential for degradation of cellulosic and nonstructural carbohydrates of plant origin. The prepartum and postpartum diets of high-producing dairy cows are substantially different, but in what ways the rumen microbiome changes in response and how those changes may influence production traits are not well elucidated. Here, we sequenced the 16S and 18S rRNA genes using the MiSeq platform to characterize the prepartum and postpartum rumen fluid microbiomes in 115 high-producing dairy cows, including both primiparous and multiparous animals. Discriminant analysis identified differences between the microbiomes of prepartum and postpartum samples and between primiparous and multiparous cows. 18S rRNA sequencing revealed an overwhelming dominance of the protozoan class Litostomatea, with over 90% of the eukaryotic microbial population belonging to that group. Additionally, fungi were relatively more prevalent and Litostomatea relatively less prevalent in prepartum samples than in postpartum ones. The core rumen microbiome (common to all samples) consisted of 64 bacterial taxa, of which members of the genus Prevotella were the most prevalent. The Chao1 richness index was greater for prepartum multiparous cows than for postpartum multiparous cows. Multivariable models identified bacterial taxa associated with increased or reduced milk production, and general linear models revealed that a metagenomically based prediction of productivity is highly associated with production of actual milk and milk components. In conclusion, the structure of the rumen fluid microbiome shifts between the prepartum and first-week postpartum periods, and its profile within the context of this study could be used to accurately predict production traits. PMID:25501481

  14. Plasticity and constraint in response to early-life stressors among late/final Jomon period foragers from Japan: evidence for life history trade-offs from incremental microstructures of enamel.

    PubMed

    Temple, Daniel H

    2014-12-01

    This study evaluates two hypotheses that address how Late/Final Jomon period people responded to early-life stress using linear enamel hypoplasia (LEH) and incremental microstructures of enamel. The first hypothesis predicts that Jomon people who experienced early-life stressors had greater physiological competence in responding to future stress events (predictive adaptive response). The second hypothesis predicts that Jomon people traded-off in future growth and maintenance when early investment in growth and survival was required (plasticity/constraint). High resolution tooth impressions were collected from intact, anterior teeth and studied under an engineer's measuring microscope. LEH were identified based on accentuated perikymata and depressions in the enamel surface profile. Age of formation for each LEH was estimated by summing counts of perikymata and constants associated with crown initiation and cuspal enamel formation times. The relationship between age-at-first-defect formation, number of LEH, periodicity between LEH, and mortality was evaluated using multiple regression and hazards analysis. A significant, positive relationship was found between age-at-death relative to age-at-first-defect formation and a significant, negative relationship was found between number of LEH relative to age-at-first-defect formation. Individuals with earlier forming defects were at a significantly greater risk of forming defects at later stages of development and dying at younger ages. These results suggest that Late/Final Jomon period foragers responded to early-life stressors in a manner consistent with the plasticity/constraint hypothesis of human life history. Late/Final Jomon period individuals were able to survive early-life stressors, but this investment weakened responses to future stress events and exacerbated mortality schedules. PMID:25156299

  15. The Postpartum Depressive State in Relation to Perceived Rearing: A Prospective Cohort Study

    PubMed Central

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

    2012-01-01

    Background The relationship between perceived rearing and the postpartum depressive state remains unclear. We aimed to examine whether perceived rearing is a risk factor for postpartum depression as measured by the Edinburgh Postnatal Depression Scale (EPDS), and whether the score of perceived rearing is affected by depressive mood (the state dependency of perceived rearing). Methods Pregnant women (n = 448, mean age 31.8±4.2 years) completed the EPDS as a measure of depressive state in early pregnancy (T1), late pregnancy (around 36 weeks), and at 1 month postpartum (T2), and the Parental Bonding Instrument (PBI) at T1 as a measure of perceived rearing. Changes in the EPDS and the PBI scores from T1 to T2 were compared between the non depressive (ND) group and the postpartum depressive (PD) group. Results There were no significant differences in any PBI category for perceived rearing between the ND and PD groups at T1. EPDS scores did not change significantly from T1 to T2 in the ND group but increased significantly in the PD group. The PBI maternal care score increased significantly in the ND group (p<0.01), while decreasing in the PD group (p<0.05). Additionally, in both the ND and PD groups, significant negative correlation was observed regarding change in the EPDS and PBI maternal care scores from T1 to T2 (r = −0.28, p = 0.013). Conclusions The present study suggests that perceived rearing is not a strong risk factor for postpartum depression as measured by the EPDS. Furthermore, the results indicated the state dependency of the PBI maternal care score. PMID:23185582

  16. Unmet need for family planning in Nepal during the first two years postpartum.

    PubMed

    Mehata, Suresh; Paudel, Yuba Raj; Mehta, Ranju; Dariang, Maureen; Poudel, Pradeep; Barnett, Sarah

    2014-01-01

    Contraceptive use during the postpartum period is critical for maternal and child health. However, little is known about the use of family planning and the determinants in Nepal during this period. This study explored pregnancy spacing, unmet need, family planning use, and fertility behaviour among postpartum women in Nepal using child level data from the Nepal Demographic and Health Surveys 2011. More than one-quarter of women who gave birth in the last five years became pregnant within 24 months of giving birth and 52% had an unmet need for family planning within 24 months postpartum. Significantly higher rates of unmet need were found among rural and hill residents, the poorest quintile, and Muslims. Despite wanting to space or limit pregnancies, nonuse of modern family planning methods by women and returned fertility increased the risk of unintended pregnancy. High unmet need for family planning in Nepal, especially in high risk groups, indicates the need for more equitable and higher quality postpartum family planning services, including availability of range of methods and counselling which will help to further reduce maternal, perinatal, and neonatal morbidity and mortality in Nepal. PMID:25003125

  17. Unmet Need for Family Planning in Nepal during the First Two Years Postpartum

    PubMed Central

    Dariang, Maureen

    2014-01-01

    Contraceptive use during the postpartum period is critical for maternal and child health. However, little is known about the use of family planning and the determinants in Nepal during this period. This study explored pregnancy spacing, unmet need, family planning use, and fertility behaviour among postpartum women in Nepal using child level data from the Nepal Demographic and Health Surveys 2011. More than one-quarter of women who gave birth in the last five years became pregnant within 24 months of giving birth and 52% had an unmet need for family planning within 24 months postpartum. Significantly higher rates of unmet need were found among rural and hill residents, the poorest quintile, and Muslims. Despite wanting to space or limit pregnancies, nonuse of modern family planning methods by women and returned fertility increased the risk of unintended pregnancy. High unmet need for family planning in Nepal, especially in high risk groups, indicates the need for more equitable and higher quality postpartum family planning services, including availability of range of methods and counselling which will help to further reduce maternal, perinatal, and neonatal morbidity and mortality in Nepal. PMID:25003125

  18. Lying behavior and postpartum health status in grazing dairy cows.

    PubMed

    Sepúlveda-Varas, P; Weary, D M; von Keyserlingk, M A G

    2014-10-01

    Many cows have difficulty making the transition from pregnancy to lactation, as evidenced by the high incidence of disease that occurs in the weeks after calving. Changes in lying behavior can be used as an indicator of illness, yet no work to date has evaluated this relationship in dairy cows on pasture. The objectives of this study were to describe the lying behavior of grazing dairy cows during the first 3 wk after calving and determine the relationships between transition diseases and lying behavior. Our convenience sample included 227 multiparous and 47 primiparous Holstein cows from 6 commercial farms. Cows were recruited as they calved during the spring calving period. Electronic data loggers (Hobo Pendant G Acceleration, Onset Computer Corp., Pocasset, MA) recorded lying behavior at 1-min intervals. Diseases were recorded up to 21 d in milk, and cows were subsequently categorized into 3 health categories: (1) healthy, not lame and had no other signs of clinical (retained placenta, milk fever, metritis, mastitis) or subclinical (ketosis, hypocalcemia) postpartum diseases; (2) lame, identified as being clinically or severely lame with no other signs of clinical or subclinical postpartum disease; and (3) sick, diagnosed as having one or more clinical postpartum diseases (with or without a subclinical disease) but not lame. This last group was further divided into 2 groups: those that were diagnosed with a single clinical health event and those diagnosed with more than one clinical event. Lying behavior differed between primiparous and multiparous cows; primiparous cows divided their lying time into more bouts than did multiparous cows (9.7 ± 0.54 vs. 8.4 ± 0.26 bouts/d) and spent less time lying down than multiparous cows (7.5 ± 0.38 h/d vs. 8.5 ± 0.19 h/d). Lying behavior was also affected by illness; primiparous cows that developed more than one clinical disease, excluding lameness, spent more time lying, and tended to have longer lying bouts in the days

  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. 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

  1. 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

  2. Postpartum depression among women with unintended pregnancy

    PubMed Central

    Brito, Cynthia Nunes de Oliveira; Alves, Sandra Valongueiro; Ludermir, Ana Bernarda; de Araújo, Thália Velho Barreto

    2015-01-01

    OBJECTIVE To analyze the association between unintended pregnancy and postpartum depression. METHODS This is a prospective cohort study conducted with 1,121 pregnant aged 18 to 49 years, who attended the prenatal program devised by the Brazilian Family Health Strategy, Recife, PE, Northeastern Brazil, between July 2005 and December 2006. We interviewed 1,121 women during pregnancy and 1,057 after childbirth. Unintended pregnancy was evaluated during the first interview and postpartum depression symptoms were assessed using the Edinburgh Postnatal Depression Screening Scale. The crude and adjusted odds ratios for the studied association were estimated using logistic regression analysis. RESULTS The frequency for unintended pregnancy was 60.2%; 25.9% presented postpartum depression symptoms. Those who had unintended pregnancies had a higher likelihood of presenting this symptoms, even after adjusting for confounding variables (OR = 1.48; 95%CI 1.09;2.01). When the Self Reporting Questionnaire (SRQ-20) variable was included, the association decreased, however, remained statistically significant (OR = 1.42; 95%CI 1.03;1.97). CONCLUSIONS Unintended pregnancy showed association with subsequent postpartum depressive symptoms. This suggests that high values in Edinburgh Postnatal Depression Screening Scale may result from unintended pregnancy. PMID:26083941

  3. 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.

  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. PMID:26961005

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

    PubMed

    Brauer, M M; Burnstock, G; Thrasivoulou, C; Cowen, T

    1998-11-01

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

  6. Periodic isolation of the southern coastal plain of South Africa and the evolution of modern humans over late Quaternary glacial to interglacial cycles

    NASA Astrophysics Data System (ADS)

    Compton, J. S.

    2012-04-01

    Humans evolved in Africa, but where in Africa and by what mechanisms remain unclear. The evolution of modern humans over the last million years is associated with the onset of major global climate fluctuations, glacial to interglacial cycles, related to the build up and melting of large ice sheets in the Northern Hemisphere. During interglacial periods, such as today, warm and wet climates favored human expansion but during cold and dry glacial periods conditions were harsh and habitats fragmented. These large climate fluctuations periodically expanded and contracted African ecosystems and led to human migrations to more hospitable glacial refugia. Periodic isolation of relatively small numbers of humans may have allowed for their rapid evolutionary divergence from the rest of Africa. During climate transitions these divergent groups may have then dispersed and interbred with other groups (hybridization). Two areas at the opposite ends of Africa stand out as regions that were periodically isolated from the rest of Africa: North Africa (the Maghreb) and the southern coastal plain (SCP) of South Africa. The Maghreb is isolated by the Sahara Desert which periodically greens and is reconnected to the rest of Africa during the transition from glacial to interglacial periods. The SCP of South Africa is isolated from the rest of Africa by the rugged mountains of the Cape Fold Belt associated with inedible vegetation and dry climates to the north. The SCP is periodically opened when sea level falls by up to 130 m during glacial maxima to expose the present day submerged inner continental shelf. A five-fold expansion of the SCP receiving more rainfall in glacial periods may have served as a refuge to humans and large migratory herds. The expansive glacial SCP habitat abruptly contracts, by as much as one-third in 300 yr, during the rapid rise in sea level associated with glacial terminations. Rapid flooding may have increased population density and competition on the SCP to

  7. Pharmacokinetics of Tenofovir During Pregnancy and Postpartum

    PubMed Central

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

    2016-01-01

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

  8. CoRoT 101186644: A transiting low-mass dense M-dwarf on an eccentric 20.7-day period orbit around a late F-star. Discovered in the CoRoT lightcurves

    NASA Astrophysics Data System (ADS)

    Tal-Or, L.; Mazeh, T.; Alonso, R.; Bouchy, F.; Cabrera, J.; Deeg, H. J.; Deleuil, M.; Faigler, S.; Fridlund, M.; Hébrard, G.; Moutou, C.; Santerne, A.; Tingley, B.

    2013-05-01

    We present the study of the CoRoT transiting planet candidate 101186644, also named LRc01_E1_4780. Analysis of the CoRoT lightcurve and the HARPS spectroscopic follow-up observations of this faint (mV = 16) candidate revealed an eclipsing binary composed of a late F-type primary (Teff = 6090 ± 200 K) and a low-mass, dense late M-dwarf secondary on an eccentric (e = 0.4) orbit with a period of ~20.7 days. The M-dwarf has a mass of 0.096 ± 0.011 M⊙, and a radius of 0.104-0.006+0.026 R⊙, which possibly makes it the smallest and densest late M-dwarf reported so far. Unlike the claim that theoretical models predict radii that are 5-15% smaller than measured for low-mass stars, this one seems to have a radius that is consistent and might even be below the radius predicted by theoretical models. Based on observations made with the 1-m telescope at the Wise Observatory, Israel, the Swiss 1.2-m Leonhard Euler telescope at La Silla Observatory, Chile, the IAC-80 telescope at the Observatory del Teide, Canarias, Spain, and the 3.6-m telescope at La Silla Observatory (ESO), Chile (program 184.C-0639).

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

    PubMed Central

    Kwon, Jung Hye; Lee, Jeong Jae

    2008-01-01

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

  10. Plasma progesterone and blood metabolite profiles in post-partum small east African zebu cows.

    PubMed

    Tegegne, A; Entwistle, K W; Mukasa-Mugerwa, E

    1993-05-01

    Plasma progesterone profiles were used to monitor post-partum reproductive activity in 12 Small East African zebu (Bos indicus) cows allocated to either supplementary or no supplementary feeding (control) with continuous or restricted (twice daily) suckling regimes. Intact bulls were used for breeding. Blood samples were collected 3 times a week for 33 weeks to determine plasma progesterone levels. Weekly blood samples were also used to determine blood metabolite concentrations. Plasma progesterone levels remained below 1 ng/ml in all cows until week 12 post-partum. Only 5 cows showed ovarian activity over the 33 week period. Cows that cycled expressed irregular and short-lived progesterone rises (> 1 ng/ml) lasting 8 to 12 days prior to establishment of normal patterns of progesterone secretion where progesterone levels ranged from 8 to 10 ng/ml in cows with normal cycles. Plasma total protein, albumin, globulin, blood urea nitrogen and glucose levels varied over time without consistent trends, and were not influenced by either supplementary feeding of suckling regimes, nor differed between cyclic and acyclic cows. It was concluded that extended post-partum anoestrus, conception failure and early embryonic mortality were responsible for lowered reproductive efficiency in zebu cows. Blood metabolite concentrations were not good indicators of nutritional status and were not related to post-partum ovarian activity. PMID:8236477

  11. The Technical and Financial Effects of Parenteral Supplementation with Selenium and Vitamin E during Late Pregnancy and the Early Lactation Period on the Productivity of Dairy Cattle

    PubMed Central

    Bayril, T.; Yildiz, A. S.; Akdemir, F.; Yalcin, C.; Köse, M.; Yilmaz, O.

    2015-01-01

    This study aimed to determine the effects of parenteral selenium (Se) and vitamin E supplementation on economic impact, milk yield, and some reproductive parameters in high-yield dairy cows in the dry period and in those at the beginning of lactation. At the beginning of the dry period, cows (n = 323) were randomly divided into three groups as follows: Treatment 1 (T1), Treatment 2 (T2), and Control (C). Cows in group T1 received this preparation 21 days before calving and on calving day, and cows in group T2 received it only on calving day. The cows in the control group did not receive this preparation. Supplementation with Se increased Se serum levels of cows treated at calving day (p<0.05). Differences in milk yield at all weeks and the electrical conductivity values at the 8th and 12th weeks were significant (p<0.05). Supplementation with Se and Vitamin E decreased the incidence of metritis, the number of services per conception and the service period, but had no effects on the incidence of retained fetal membrane. A partial budgeting analysis indicated that Se supplementation was economically profitable; cows in group T1 averaged 240.6$ per cow, those in group T2 averaged 224.6$ per cow. Supplementation with Se and Vitamin E has been found to increase serum Se levels, milk yield, and has positive effects on udder health by decreasing milk conductivity values and incidence of sub-clinical mastitis. PMID:26104521

  12. The relationship between ovarian steroids and uterine estrogen receptors during late pregnancy

    SciTech Connect

    Cathey, T.M.; Chung, Kyung W. )

    1991-01-01

    Although a direct interdependence exists between the ovarian steroids, estrogen and progesterone, the exact role of these two hormones during pregnancy, especially late pregnancy, is not completely understood. Investigations have been conducted to determine whether the circulating levels of progesterone and estrogen or changes in the ratio of progesterone/estrogen in relation to the concentration of uterine estrogen receptors are associated with triggering parturition. Ninety-day old female rats were sacrificed at gestation days 14, 16, 18, 20 and two days post-partum. The plasma levels of estradiol and progesterone were measured by solid-phase radioimmunoassay. Uterine cytosol was subjected to a charcoal binding assay to determine the concentration of estrogen receptors. Our findings demonstrate that there is a significant drop in both plasma progesterone and estradiol during late pregnancy. Also indicated is a significant increase in uterine estrogen receptors throughout late pregnancy. Finally, during this period there is a direct correlation between the shift in the progesterone/estrogen ratio and the increase in the concentration of uterine estrogen receptors in late pregnancy.

  13. 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

  14. Factors affecting spontaneous reduction of corpora lutea and twin embryos during the late embryonic/early fetal period in multiple-ovulating dairy cows.

    PubMed

    López-Gatius, F; García-Ispierto, I; Hunter, R H F

    2010-02-01

    Spontaneous reduction of advanced twin embryos has been described in high-producing, Holstein-Fresian (Bos taurus) dairy herds. The first objective of the current study was to determine whether management and cow factors could have an effect on such a reduction in twin pregnancies during the early fetal period. Because loss of a corpus luteum was noted in cows suffering twin reduction, we expanded our study to include multiple-ovulating cows carrying singletons. Pregnancy was diagnosed and confirmed from Days 28 to 34 and 56 to 62 postinsemination. Sixty-nine (23.5%) of 293 pregnant cows with two corpora lutea carrying singletons and 132 (28.4%) of 464 twin pregnancies recorded on first pregnancy diagnosis subsequently lost one of the corpora lutea or one of the embryos, respectively. Thirty-four (25.8%) of the 132 twin pregnancies suffering embryo reduction lost one corpus luteum along with the embryo. Corpus luteum reduction always occurred in the ovary ipsilateral to the gravid horn suffering embryo reduction. Binary logistic regressions were performed considering corpus luteum and embryo reduction as dependent variables in single and twin pregnancies, respectively, and several management- and cow-related factors as independent variables. In cows carrying singletons, the risk of corpus luteum reduction was 14.3 (1/0.07) times lower for a given herd, whereas the interaction season by laterality significantly affected corpus luteum reduction such that in cows with two corpora lutea ipsilateral to the horn of pregnancy, the risk of reduction decreased during the winter period. In cows carrying twins, ipsilateral twin pregnancies were 3.45 (1/0.29) times more likely to undergo the loss of one embryo than bilateral twin pregnancies. As an overall conclusion, both corpora lutea and embryos were vulnerable to the effects of stress factors during the early fetal period in cows maintaining their pregnancies. A strong unilateral relationship between the corpus luteum and

  15. Nighttime Breastfeeding Behavior Is Associated with More Nocturnal Sleep among First-Time Mothers at One Month Postpartum

    PubMed Central

    Doan, Therese; Gay, Caryl L.; Kennedy, Holly P.; Newman, Jack; Lee, Kathryn A.

    2014-01-01

    Study Objective: To describe sleep duration and quality in the first month postpartum and compare the sleep of women who exclusively breastfed at night to those who used formula. Methods: We conducted a longitudinal study in a predominantly low-income and ethnically diverse sample of 120 first-time mothers. Both objective and subjective measures of sleep were obtained using actigraphy, diary, and self-report data. Measures were collected in the last month of pregnancy and at one month postpartum. Infant feeding diaries were used to group mothers by nighttime breastfeeding behavior. Results: Mothers who used at least some formula at night (n = 54) and those who breastfed exclusively (n = 66) had similar sleep patterns in late pregnancy. However, there was a significant group difference in nocturnal sleep at one month postpartum as measured by actigraphy. Total nighttime sleep was 386 ± 66 minutes for the exclusive breastfeeding group and 356 ± 67 minutes for the formula group. The groups did not differ with respect to daytime sleep, wake after sleep onset (sleep fragmentation), or subjective sleep disturbance at one month postpartum. Conclusion: Women who breastfed exclusively averaged 30 minutes more nocturnal sleep than women who used formula at night, but measures of sleep fragmentation did not differ. New mothers should be encouraged to breastfeed exclusively since breastfeeding may promote sleep during postpartum recovery. Further research is needed to better understand how infant feeding method affects maternal sleep duration and fragmentation. Citation: Doan T; Gay CL; Kennedy HP; Newman J; Lee KA. Nighttime breastfeeding behavior is associated with more nocturnal sleep among first-time mothers at one month postpartum. J Clin Sleep Med 2014;10(3):313-319. PMID:24634630

  16. Reproductive performance in dairy cows following postpartum treatment with gonadotrophin releasing hormone and/or prostaglandin: a field trial.

    PubMed Central

    Etherington, W G; Bosu, W T; Martin, S W; Cote, J F; Doig, P A; Leslie, K E

    1984-01-01

    Three hundred and five Holstein Friesian cows were given either 250 micrograms gonadotrophin releasing hormone (GnRH) or saline on day 15 postpartum followed by 500 micrograms cloprostenol or saline on day 24 postpartum. Four treatment groups were formed using random allocation: Group I -- placebo (Day 15)/placebo (Day 24), Group II -- GnRH (Day 15)/placebo (Day 24), Group III -- placebo (Day 15)/cloprostenol (Day 24), Group IV -- GnRH (Day 15)/cloprostenol (Day 24). Double blind techniques were used during the follow-up period. Rectal palpation, to assess uterine involution and ovarian activity was performed just prior to each treatment and again at 28 days postpartum. In addition blood samples were collected at 15, 24 and 28 days postpartum for measurement of plasma progesterone. There were no significant differences among treatment groups with respect to services per conception, number of heats detected before first service and culling for infertility. Cows treated only with GnRH had an increased calving to first estrus and calving to first breeding interval, and tended to have an increased calving to conception interval. Treatment with cloprostenol significantly decreased calving to conception and calving to first observed estrus intervals. Treatment with GnRH on day 15 postpartum resulted in a significant increase in the subsequent incidence of pyometra and prebreeding anestrus. On the other hand, cloprostenol treatment on day 24 postpartum resulted in a decreased incidence of pyometra, regardless of GnRH treatment and a decreased incidence of prebreeding anestrus in GnRH treated cows compared to cows receiving only GnRH at day 15 postpartum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6383577

  17. Postpartum Sacral Stress Fracture: An Atypical Case Report

    PubMed Central

    Speziali, Andrea; Tei, Matteo Maria; Placella, Giacomo; Chillemi, Marco; Cerulli, Giuliano

    2015-01-01

    Sacral stress fractures are common in elderly people. However, sacral stress fracture should be always screened in the differential diagnoses of low back pain during the postpartum period. We present a case of sacral fracture in a thirty-six-year-old woman with low back pain and severe right buttock pain two days after cesarean section delivery of a 3.9 Kg baby. The diagnosis was confirmed by MRI and CT scan, while X-ray was unable to detect the fracture. Contribution of mechanical factors during the cesarean section is not a reasonable cause of sacral fracture. Pregnancy and lactation could be risk factors for sacral stress fracture even in atraumatic delivery such as cesarean section. Our patient had no risk factors for osteoporosis except for pregnancy and lactation. Transient or focal osteoporosis is challenging to assess and it cannot be ruled out even if serum test and mineral density are within the normal range. PMID:26246926

  18. 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

  19. 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.

  20. 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.

  1. 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

  2. Chronologic evidence for multiple periods of loess deposition during the Late Pleistocene in the Missouri and Mississippi River Valley, United States: Implications for the activity of the Laurentide ice sheet

    USGS Publications Warehouse

    Forman, S.L.; Bettis, E. Arthur; Kemmis, T.J.; Miller, B.B.

    1992-01-01

    The loess stratigraphy of the mid-continental U.S. is an important proxy record for the activity of the Laurentide Ice Sheet in North America. One of the most outstanding problems is deciphering the age of loess deposits in this area during the late Pleistocene. Radiocarbon dating of snails and thermoluminescence dating of the fine-silt fraction (4-11 ??m) from loess at the Loveland Loess type section, Loveland, Iowa and a recent excavation at the Pleasant Grove School section. Madison County, Illinois provide new chronologic control on loess deposition in the Mississippi/Missouri River Valley chronology indicates that the Loveland Loess is Illinoian in age (135??20 ka) but is not correlative with the Teneriffe Silt which is dated to 77 ?? 8 ka. Concordant radiocarbon and thermoluminescence age estimates demonstrate that the Roxana Silt and a correlative loess in Iowa, the Pisgah Formation, is probably 40-30 ka old. These age estimates in conjunction with previous results indicate that there were four periods of loess deposition during the last 150 ka at 25-12 ka, 45-30 ka, 85-70 ka and at ca. 135 ?? 20 ka. This chronology of loess deposition supports the presence of both a late Illinoian and early Wisconsinan loess and associated soils. Thus, there may be more than one soil in the loess stratigraphy of the mid-continental U.S. with morphologies similar to the Sangamon Soil. The last three periods of loess deposition may be correlative with periods of elevated dust concentrations recorded in the Dye 3 ice core from southern Greenland. This is particularly significant because both areas possibly had the same source for eolian particles. Reconstructions of atmospheric circulation for glacial periods show a southerly deflected jet stream that could have transported dust from the mid-continental USA to southern Greenland. Lastly, the inferred record of loess deposition is parallel to a chronology for deglaciation of the Laurentide Ice Sheet deciphered from chronologic

  3. 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

  4. Fordyce happiness program and postpartum depression

    PubMed Central

    Rabiei, Leili; Mazaheri, Maryam Amidi; Masoudi, Reza; Hasheminia, Sayed Ali Mohammad

    2014-01-01

    Background: Postpartum depression is endangering the health of mothers and has negative impacts on the evolution of social communication and newborns evolution. This study was conducted to determine the effects of Fordyce Happiness program on the postpartum depression. Materials and Methods: This quasi-experimental intervention carried out on postpartum mothers that referred to 4 health centers in Isfahan. A total of 133 mothers were selected by convenient sampling and then randomly allocated in two groups (63 and 70 mothers for intervention and control respectively). Maternal depression 3 times before, immediate and 1 months after intervention in both groups was evaluated with Beck Depression Inventory-II-Persian standardized questionnaires. Educational sessions based on the Fordyce happiness program were conducted for intervention group. Data was analyzed in SPSS17 (SPSS Inc, Chicago, Illinois) descriptive and analytic statistical tests at significance level of 0.05. Results: No significant differences in demographic variables between the two groups (P ≥ 0.05). No significant differences in depression scores in the two groups before training. However after 2 months a significant difference in depression score was observed between two groups (control group: 19.38 ± 3.94; intervention group: 16.24 ± 4.8; P < 0.001). Furthermore in intervention group showed significant differences in depression scores before and after intervention (19.15 ± 3.41 and 16.24 ± 4.83; P < 0.001). However in the control group had not any significant change. Conclusion: Fordyce happiness program was effective in reducing postpartum depression in our study. With attention to the effectiveness and low cost of this program, it is recommended that this program might be considered for all mothers after childbirth in health centers or other community-based settings. PMID:24949034

  5. 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

  6. Clinical guidelines for postpartum women and infants in primary care–a systematic review

    PubMed Central

    2014-01-01

    Background While many women and infants have an uneventful course during the postpartum period, others experience significant morbidity. Effective postpartum care in the community can prevent short, medium and long-term consequences of unrecognised and poorly managed problems. The use of rigorously developed, evidence-based guidelines has the potential to improve patient care, impact on policy and ensure consistency of care across health sectors. This study aims to compare the scope and content, and assess the quality of clinical guidelines about routine postpartum care in primary care. Methods PubMed, the National Guideline Clearing House, Google, Google Scholar and relevant college websites were searched for relevant guidelines. All guidelines regarding routine postpartum care published in English between 2002 and 2012 were considered and screened using explicit selection criteria. The scope and recommendations contained in the guidelines were compared and the quality of the guidelines was independently assessed by two authors using the AGREE II instrument. Results Six guidelines from Australia (2), the United Kingdom (UK) (3) and the United States of America (USA) (1), were included. The scope of the guidelines varied greatly. However, guideline recommendations were generally consistent except for the use of the Edinburgh Postnatal Depression Scale for mood disorder screening and the suggested time of routine visits. Some recommendations lacked evidence to support them, and levels or grades of evidence varied between guidelines. The quality of most guidelines was adequate. Of the six AGREE II domains, applicability and editorial independence scored the lowest, and scope, purpose and clarity of presentation scored the highest. Conclusions Only one guideline provided comprehensive recommendations for the care of postpartum women and their infants. As well as considering the need for region specific guidelines, further research is needed to strengthen the evidence

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

    PubMed Central

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

    2015-01-01

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

  8. [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

  9. Interrelationships between postpartum events, hormonal therapy, reproductive abnormalities and reproductive performance in dairy cows: a path analysis.

    PubMed Central

    Etherington, W G; Martin, S W; Dohoo, I R; Bosu, W T

    1985-01-01

    Path analysis was used to determine the interrelationships between postpartum administration of gonadotrophin releasing hormone and cloprostenol and the occurrence of reproductive disease and reproductive performance in dairy cows. The data analysed were those collected on 226 Holstein-Friesian cows calving in a commercial dairy herd during a 17 month period (May 1, 1981 to October 1, 1982). Cows administered gonadotrophin releasing hormone at day 15 postpartum experienced an improved rate of uterine involution as determined by rectal palpation nine days later. Although this improved rate of uterine involution reduced the risk of pyometritis, it actually directly delayed conception. Also, gonadotrophin releasing hormone therapy directly resulted in an increased incidence of pyometritis which in turn resulted in an increase incidence of cystic ovarian disease and anestrus. The occurrence of these abnormalities resulted in increased intervals from calving to first observed estrus, first service and conception. In addition to this effect, the administration of gonadotrophin releasing hormone was also associated with increased plasma progesterone concentrations at days 24 and 28 postpartum which delayed conception. Cloprostenol therapy at day 24 postpartum resulted in a decreased plasma progesterone concentration at day 28 postpartum which was directly and indirectly associated with a decrease in the calving to conception interval. The indirect effects were mediated by a reduction in days to first estrus. Cloprostenol therapy also directly resulted in a decreased calving to first observed estrus interval for reasons not attributable to the level of progesterone at day 28. PMID:3899335

  10. 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

  11. 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

  12. Effects of yeast culture (Saccharomyces cerevisiae) on prepartum intake and postpartum intake and milk production of Jersey cows.

    PubMed

    Dann, H M; Drackley, J K; McCoy, G C; Hutjens, M F; Garrett, J E

    2000-01-01

    Yeast cultures (Saccharomyces cerevisiae; YC) have been added to diets for dry and lactating dairy cows to attempt to improve ruminal fermentation, potentially increasing dry matter intake (DMI) and milk yield. Jersey cows (14 primigravid and 25 multigravid) were fed total mixed rations prepartum and postpartum that were either supplemented or not supplemented with YC. The YC was a dried product that was top-dressed at 60 g/d for approximately 21 d prepartum and 140 d postpartum. The DMI was increased by YC during both the last 7 d prepartum (9.8 vs. 7.7 kg) and during the first 42 d of lactation (13.7 vs. 11.9 kg). The treatment-by-day interaction was significant for DMI during the first 21 d postpartum, indicating that cows supplemented with YC increased DMI more rapidly than did nonsupplemented cows. A significant treatment-by-day interaction indicated that cows supplemented with YC lost body weight less rapidly postpartum than did non-supplemented cows. A significant interaction of treatment by day indicated that cows supplemented with YC reached peak milk production more quickly than did nonsupplemented cows. However, total milk produced during the first 140 d of lactation did not differ. Concentrations of fat, protein, lactose, total solids, and urea N in milk, as well as somatic cell count, were not significantly affected by YC. Supplementation of YC increased DMI during the transition period and increased DMI postpartum.

  13. Spatial variability of the species composition, abundance, and productivity of the phytoplankton in the white sea in the late summer period

    NASA Astrophysics Data System (ADS)

    Ilyash, L. V.; Radchenko, I. G.; Kuznetsov, L. L.; Lisitzyn, A. P.; Martynova, D. M.; Novigatskiy, A. N.; Chul'Tsova, A. L.

    2011-02-01

    The species composition, cell concentration ( N), and biomass ( B) of the phytoplankton, as well as the chlorophyll a (Chl a) concentration, primary production ( PP), and the concentrations of the dissolved inorganic micronutrients (phosphorus, silica, nitrogen as nitrite), were estimated for Kandalaksha Bay (KB), Dvina Bay (DB), and the basin (Bas) of the White Sea in August of 2004. The micronutrient concentrations were lower compared to the average long-term values for the summer period. The Chl a concentration varies from 0.9 to 2.0 mg/m3 for most of the studied areas, reaching up to 7.5 mg/m3 in the Northern Dvina River estuary. The surface water layer of the DB was the most productive area, where the PP reached up to 270-375 mg C/(m3 day). The phytoplankton biomass varied from 11 to 205 mg C/m3 with the highest values observed in the Bas and DB. Three groups of stations were defined during the analysis of the phytoplankton's species composition similarity. The dinoflagellates Dinophysis norvegica and Ceratium fusus were particular to the phytoplankton assemblages in the KB; the diatom Ditylum brightwellii was particular to the upper and central parts of the DB. These three phytoplankton species were less abundant in the Bas.

  14. [Cytological and cytogenetic damages of spermatogonial cells in mice in the acute and late periods after irradiation by protons, helium ions, and gamma-rays].

    PubMed

    Fedorenko, B S; Vaglenov, A; Abrosimova, A N

    2010-01-01

    Experiments with small test animals have been carried out to study the survival rate of spermatogenic cells in the acute period after exposure to protons with the energy 9 GeV, helium ions with the energy 4 GeV/nucleon, and 60Co gamma radiation in doses of 0.5-7.5 Gy and the reciprocal translocation frequency in spermatocytes under meiosis at the diakinesis-metaphase-1 stage six months after the exposure of the animals to protons with the energy 50 MeV and 9 GeV, helium ions with the energy 4 GeV/nucleon, and 60Co gamma-radiation in doses of 0.5-4.0 Gy. It is shown that the dependence of the effect on the dose is linear or near to linear for all kinds of radiation used. Relative biological effectiveness coefficients of the accelerated nuclei obtained by correlating equally effective doses of the standard and investigated radiations turned out to be higher in survival rate of type B spermatogonium and amounted to 2.0 and 1.3 for 9 GeV protons and helium ions respectively. At the same time, the use of the nonparametric method to determine the RBE coefficients in the course of finding out the reciprocal translocation frequency in spermatocytes points to an increase in the RBE coefficients of charged particles from 1.0 to 2.0.

  15. Preventing postpartum depression: A meta-analytic review

    PubMed Central

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

    2014-01-01

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

  16. Postpartum deaths: piglet, placental, and umbilical characteristics.

    PubMed

    Rootwelt, V; Reksen, O; Farstad, W; Framstad, T

    2013-06-01

    The fetal growth of the piglet is highly dependent on its placenta, and the newborn piglet birth weight is highly associated with postpartum death. However, there is little information available in the literature on the assessment of the placenta in relation to postpartum death in piglets. The aim of this study was to evaluate the impact of the placental area and placental weight, status of the umbilical cord, and piglet birth characteristics, such as blood parameters, vitality score, and birth weight on postpartum death. All live born piglets in litters from 26 Landrace-Yorkshire sows were monitored during farrowing and the status of each was recorded, including placental area and placental weight and blood variables obtained from the piglets and umbilical veins. Out of the 386 live-born piglets, 16.8% died before weaning at 5 wk. Among these, 78.5% died within the first 3 d of life. Mean blood concentration of lactate was increased in piglets that did not survive to weaning (P = 0.003). Concentrations of hemoglobin and hematocrit were decreased (P < 0.001) compared with survivors. Piglets born with a broken umbilical cord had a reduced vitality score vs. piglets born with an intact umbilical cord (P = 0.021), and they had an increased probability of dying before weaning (P = 0.050). Mean birth weight, body mass index, placental area (P < 0.001), and placental weight (P = 0.020) were reduced in piglets that died before weaning vs. those that survived. Birth weight and placental area were furthermore negatively associated with live litter size. Blood concentrations of IgG and albumin recorded at d 1 were decreased in piglets that died before weaning (P < 0.01), and blood concentration of albumin was positively associated with placental area (P < 0.001). We conclude that placental area and placental weight, status of the umbilical cord, birth weight, body mass index, blood concentrations of lactate, hemoglobin, and hematocrit recorded at birth, and blood

  17. The last interglacial period at Guantanamo Bay, Cuba and an estimate of late Quaternary tectonic uplift rate in a strike-slip regime

    NASA Astrophysics Data System (ADS)

    Schweig, E. S.; Muhs, D. R.; Simmons, K. R.; Halley, R. B.

    2015-12-01

    Guantanamo Bay, Cuba is an area dominated by a strike-slip tectonic regime and is therefore expected to have very low Quaternary uplift rates. We tested this hypothesis by study of an unusually well preserved emergent reef terrace around the bay. Up to 12 m of unaltered, growth-position reef corals are exposed at about 40 sections examined around ˜40 km of coastline. Maximum reef elevations in the protected, inner part of the bay are ˜11-12 m, whereas outer-coast shoreline angles of wave-cut benches are as high as ˜14 m. Fifty uranium-series analyses of unrecrystallized corals from six localities yield ages ranging from ˜134 ka to ˜115 ka, when adjusted for small biases due to slightly elevated initial 234U/238U values. Thus, ages of corals correlate this reef to the peak of the last interglacial period, marine isotope stage (MIS) 5.5. Previously, we dated the Key Largo Limestone to the same high-sea stand in the tectonically stable Florida Keys. Estimates of paleo-sea level during MIS 5.5 in the Florida Keys are ~6.6 to 8.3 m above present. Assuming a similar paleo-sea level in Cuba, this yields a long-term tectonic uplift rate of 0.04-0.06 m/ka over the past ~120 ka. This estimate supports the hypothesis that the tectonic uplift rate should be low in this strike-slip regime. Nevertheless, on the southeast coast of Cuba, east of our study area, we have observed flights of multiple marine terraces, suggesting either (1) a higher uplift rate or (2) an unusually well-preserved record of pre-MIS 5.5 terraces not observed at Guantanamo Bay.

  18. [The current state-of-the-art of the expert evaluation of medical documentation pertaining to the cases of death from an injury inflicted in a healthcare facility in the late; post-traumatic period].

    PubMed

    Kkovalev, A V; Naletova, D M; Belyansky, K D

    2016-01-01

    This article presents a concise review of the literature data concerning the modern methods for the expert evaluation of medical documentation as an object of forensic medical examination. The authors lay special emphasis on the practical significance of this issue for the scientifically sound substantiation of the results of forensic medical expertise carried out for the elucidation of the causes of death and the relationship between the injury and the outcome of the medical aid provided for its treatment. The expert evaluation of medical documentation is equally important for the assessment of the harm to health and the cause of death as a consequence of a thermal and/or mechanical injury inflicted during the hospital stay and in the late post-traumatic period.

  19. [The current state-of-the-art of the expert evaluation of medical documentation pertaining to the cases of death from an injury inflicted in a healthcare facility in the late; post-traumatic period].

    PubMed

    Kkovalev, A V; Naletova, D M; Belyansky, K D

    2016-01-01

    This article presents a concise review of the literature data concerning the modern methods for the expert evaluation of medical documentation as an object of forensic medical examination. The authors lay special emphasis on the practical significance of this issue for the scientifically sound substantiation of the results of forensic medical expertise carried out for the elucidation of the causes of death and the relationship between the injury and the outcome of the medical aid provided for its treatment. The expert evaluation of medical documentation is equally important for the assessment of the harm to health and the cause of death as a consequence of a thermal and/or mechanical injury inflicted during the hospital stay and in the late post-traumatic period. PMID:27358931

  20. Success Providing Postpartum Intrauterine Devices in Private-Sector Health Care Facilities in Nigeria: Factors Associated With Uptake

    PubMed Central

    Eluwa, George IE; Atamewalen, Ronke; Odogwu, Kingsley; Ahonsi, Babatunde

    2016-01-01

    ABSTRACT Background: Use of modern contraceptive methods in Nigeria remained at 10% between 2008 and 2013 despite substantive investments in family planning services. Many women in their first postpartum year, in particular, have an unmet need for family planning. We evaluated use of postpartum intrauterine device (IUD) insertion and determined factors associated with its uptake in Nigeria. Methods: Data were collected between May 2014 and February 2015 from 11 private health care facilities in 6 southern Nigerian states. Women attending antenatal care in participating facilities were counseled on all available contraceptive methods including the postpartum IUD. Data were abstracted from participating facility records and evaluated using a cross-sectional analysis. Categorical variables were calculated as proportions while continuous variables were calculated as medians with the associated interquartile range (IQR). Multivariate logistic regression analysis was used to identify factors associated with uptake of the postpartum IUD while controlling for potential confounding factors, including age, educational attainment, marital status, parity, number of living children, and previous use of contraception. Results: During the study period, 728 women delivered in the 11 facilities. The median age was 28 years, and most women were educated (73% had completed at least the secondary level). The majority (96%) of the women reported they were married, and the median number of living children was 3 (IQR, 2–4). Uptake of the postpartum IUD was 41% (n = 300), with 8% (n = 25) of the acceptors experiencing expulsion of the IUD within 6 weeks post-insertion. After controlling for potential confounding factors, several characteristics were associated with greater likelihood of choosing the postpartum IUD, including lower education, having a higher number of living children, and being single. Women who had used contraceptives previously were less likely to choose the

  1. Integration of family planning with maternal health services: an opportunity to increase postpartum modern contraceptive use in urban Uttar Pradesh, India

    PubMed Central

    Achyut, Pranita; Mishra, Anurag; Montana, Livia; Sengupta, Ranajit; Calhoun, Lisa M; Nanda, Priya

    2016-01-01

    Background Maternal health (MH) services provide an invaluable opportunity to inform and educate women about family planning (FP). It is expected that this would enable women to choose an appropriate method and initiate contraception early in the postpartum period. In this study we examined interactions with health providers for MH services, and the effect of FP information provision during these interactions on the postpartum use of modern contraceptive methods. Methods This study used midline data collected from 990 women who had delivered a live birth between January 2010 and the date of the midline survey in 2012. These women were asked a series of questions about their last delivery, including interactions with health providers during pregnancy, delivery and the postpartum period, if they received FP information during these interactions, and their contraceptive use during the postpartum period. Results The study found that FP information provision as part of antenatal care in the third trimester, delivery and the postpartum period have a positive association with postpartum modern contraceptive use in urban Uttar Pradesh. However, health providers often miss these opportunities. Despite a high proportion of women coming into contact with health providers when utilising MH services, only a small proportion received FP information during these interactions. Conclusions Integration of FP with MH services can increase postpartum modern contraceptive use. With the launch of the National Urban Health Mission, there now exists appropriate policy and programmatic environments for integration of FP and MH services in urban settings in India. However, this will require a concentrated effort both to enhance the capacity of health providers and encourage supportive supervision. PMID:26622056

  2. 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

  3. Postpartum haemorrhage in a woman with essential thrombocythemia carrying calreticulin mutation: a case report.

    PubMed

    Villani, Michela; Colaizzo, Donatella; Tiscia, Giovanni L; Chinni, Elena; Bodenizza, Carl'Antonio; Cascavilla, Nicola; Grandone, Elvira

    2016-09-01

    Coagulation disorder associated with essential thrombocythemia may exacerbate the prothrombotic state physiologically occurring during pregnancy. We report a case of a severe postpartum haemorrhage in a 35-year-old woman previously diagnosed with essential thrombocythemia and carrying the somatic calreticulin mutation. She was referred to our Thrombosis and Haemostasis Unit for pregnancy management. A treatment with low-dose aspirin was prescribed until the labour started, as the platelets count raised above 1000 × 10/l. At the time of bleeding, no residual placenta was detected at the revision of the uterine cavity.Although the postpartum is a high-risk period for thrombotic events, we have to carefully evaluate in women with essential thrombocythemia the likelihood of developing a hemorrhagic complication.

  4. Complications and pregnancy outcome following uterine compression suture for postpartum haemorrhage: a single centre experience.

    PubMed

    Liu, S; Mathur, M; Tagore, S

    2014-07-01

    In the treatment of postpartum haemorrhage from uterine atony, uterine compression sutures, such as the B-Lynch suture and its modifications have a role with the advantage of preservation of the uterus for fertility. There is however, a risk that apposition of the anterior and posterior walls of the uterus will impede drainage of lochia, resulting in undesirable complications. We undertook a five-year retrospective study of all women who underwent uterine compression sutures at the KK Women's and Children's Hospital, between 2008 and 2012. In total, 23 women had uterine compression sutures during the study period, of which, nineteen women managed to conserve their uterus. Our complication rate was 25%, which included persistent vaginal discharge, pyometra and endometritis. There were three conceptions, with two successful pregnancies. Our study shows uterine compression suture to be a safe and effective alternative to avoid hysterectomy with preservation of fertility at the time of major postpartum haemorrhage. The outcome of subsequent pregnancies is reassuring.

  5. Postpartum depression in women with epilepsy: Influence of antiepileptic drugs in a prospective study

    PubMed Central

    Galanti, Melanie; Newport, D. Jeffrey; Pennell, Page B.; Titchner, Denicia; Newman, Melanee; Knight, Bettina T.; Stowe, Zachary N.

    2013-01-01

    Patients with epilepsy are at high risk for major depressive disorder (MDD) and, according to one report, postpartum depression (PPD) as well. The study described here sought to determine the prevalence and risk factors for PPD among women with epilepsy. Fifty-six women with epilepsy participating in a prospective study of perinatal antiepileptic drug (AED) pharmacokinetics were included. Participants completed the Beck Depression Inventory (BDI) during pregnancy and the postpartum period. Fourteen participants (25.0%) had a postnatal BDI score ≥12 indicative of PPD. Logistic regression indicated that significant risk factors for PPD among women with epilepsy included multiparity (odds ratio = 12.5) and AED polytherapy (odds ratio = 9.3). The rate of PPD was unaffected by the use of specific AEDs. In conclusion, PPD rates are higher among women with epilepsy than the general population, particularly those who are multiparous or receiving AED polytherapy, and there is no evidence that AED selection modifies this risk. PMID:19854113

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

    PubMed

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

    2015-12-01

    Unmet need for contraception is highest within 12 months post-delivery, according to research. Using longitudinal data from the Nairobi Urban Health and Demographic Surveillance System, we assess the dynamics of contraceptive use during the postpartum period among women in Nairobi's slums. Results show that by 6 months postpartum, 83 percent of women had resumed sexual activity and 51 percent had resumed menses, yet only 49 percent had adopted a modern contraceptive method. Furthermore, almost half of women discontinued a modern method within 12 months of initiating use, with many likely to switch to another short-term method with high method-related dissatisfaction. Women who adopted a method after resumption of menses had higher discontinuation rates, though the effect was much reduced after adjusting for other variables. To reduce unmet need, effective intervention programs are essential to lower high levels of discontinuation and encourage switching to more effective methods. PMID:26643488

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

    PubMed Central

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

    2015-01-01

    Unmet need for contraception is highest within 12 months post‐delivery, according to research. Using longitudinal data from the Nairobi Urban Health and Demographic Surveillance System, we assess the dynamics of contraceptive use during the postpartum period among women in Nairobi's slums. Results show that by 6 months postpartum, 83 percent of women had resumed sexual activity and 51 percent had resumed menses, yet only 49 percent had adopted a modern contraceptive method. Furthermore, almost half of women discontinued a modern method within 12 months of initiating use, with many likely to switch to another short‐term method with high method‐related dissatisfaction. Women who adopted a method after resumption of menses had higher discontinuation rates, though the effect was much reduced after adjusting for other variables. To reduce unmet need, effective intervention programs are essential to lower high levels of discontinuation and encourage switching to more effective methods. PMID:26643488

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

    PubMed

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

    2015-12-01

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

  9. A rare cause of postpartum low back pain: pregnancy- and lactation-associated osteoporosis.

    PubMed

    Terzi, Rabia; Terzi, Hasan; Özer, Tülay; Kale, Ahmet

    2014-01-01

    Pregnancy- and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis. It results in severe low back pain in the last trimester of pregnancy and in the postpartum period, decreases in height, and fragility fractures, particularly in the vertebra. The current case report presents a 32-year-old patient who presented with back and low back pain that began in the last trimester of the pregnancy and worsened at two months postpartum and who was diagnosed with pregnancy- and lactation-associated osteoporosis after exclusion of other causes; the findings are discussed in view of the current literature. PLO is a rare clinical condition causing significant disability. PLO must be kept in mind in the differential diagnosis in patients presenting with low back pain during or after pregnancy. The patients must be evaluated for the risk factors of PLO, and an appropriate therapy must be initiated.

  10. 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…

  11. Long-Term Efficacy of Postpartum Intravenous Iron Therapy

    PubMed Central

    Zimmermann, Roland

    2014-01-01

    Background. The potential benefits of administering a dose of intravenous iron in patients with moderate postpartum anaemia rather than oral iron alone remains unproven. Aims. To determine whether a single injection of intravenous iron followed by a 6-week course of oral iron is as effective over 6 months in restoring normal haemoglobin levels and replenishing iron stores in women with moderate postpartum anaemia as a course of oral iron alone in women with mild postpartum anaemia. Materials and Methods. Retrospective two-arm cohort study in women with mild postpartum anaemia (haemoglobin 9.6–10.5 g/dL) prescribed iron daily for 6 weeks (N = 150) and women with moderate postpartum anaemia (haemoglobin 8.5–9.5 g/dL), given a single 500 mg injection of intravenous iron followed by iron daily for 6 weeks (N = 75). Haemoglobin and ferritin were measured 6 months postpartum. Results. Haemoglobin returned to similar mean levels in both groups. Ferritin levels were statistically significantly higher in the intravenous + oral group (57.7 ± 49.3 μg/L versus 32.9 ± 20.1 μg/L). Conclusions. Despite lower baseline haemoglobin, intravenous iron carboxymaltose was superior to oral iron alone in replenishing iron stores in moderate postpartum anaemia and may prove similarly beneficial in mild postpartum anaemia. PMID:25431768

  12. Committee opinion no. 530: access to postpartum sterilization.

    PubMed

    2012-07-01

    Postpartum tubal sterilization is one of the safest and most effective methods of contraception. Women who desire this type of sterilization typically undergo thorough counseling and informed consent during prenatal care and reiterate their desire for postpartum sterilization at the time of their hospital admission. Not all women who desire postpartum sterilization actually undergo the surgical procedure, and women with unfulfilled requests for postpartum sterilization have a high rate of repeat pregnancy (approaching 50%) within the following year. Potentially correctable barriers to obtaining postpartum sterilization include patient and health care provider factors, as well as hospital and health care system issues. Given the consequences of a missed procedure and the limited time frame in which it may be performed, postpartum sterilization should be considered an urgent surgical procedure. In addition, women with government insurance face barriers to sterilization procedures based on cumbersome consent requirements. The differences in the requirements surrounding consent for sterilization procedures based on the type of insurance a patient has must be addressed in order to establish fair and equitable access to sterilization procedures for all women. Policies and procedures that remove barriers to and increase efficiency in performing postpartum sterilization could reduce cancellations of the procedure. Improving consistency in accomplishing desired postpartum sterilization is an important strategy to reduce high rates of unintended pregnancy in the United States.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  14. Expression of fibroblast growth factor 21 in the liver of dairy cows in the transition period and during lactation.

    PubMed

    Schlegel, G; Ringseis, R; Keller, J; Schwarz, F J; Windisch, W; Eder, K

    2013-10-01

    Fibroblast growth factor 21 (FGF21) has been identified as a novel hormonal factor involved in the regulation of metabolic adaptations during energy deprivation. The present study aimed to investigate the expression of the FGF21 gene in the liver of dairy cows during the transition from pregnancy to lactation. Therefore, the relative mRNA abundance of FGF21 in liver biopsy samples of 20 dairy cows in late pregnancy (3 weeks pre-partum) and early lactation (1, 5, 14 weeks post-partum) was determined. It was observed that hepatic mRNA abundance of FGF21 at 1 week post-partum was dramatically increased (110-fold) compared to 3 weeks pre-partum (p < 0.001). With progress of lactation, mRNA concentration of FGF21 was declining; nevertheless, mRNA abundance at 5 and 14 weeks post-partum remained 25- and 10-fold increased compared to 3 weeks pre-partum (p < 0.001). Using a gene array technique, it was found that many genes involved in fatty acid oxidation, gluconeogenesis and ketogenesis were up-regulated during early lactation compared to late pregnancy. Moreover, there were positive linear correlations between hepatic mRNA concentration of FGF21 and mRNA concentrations of genes involved in ketogenesis as well as carnitine synthesis and carnitine uptake at various time-points during lactation, indicating that FGF21 could play a role in ketogenesis and carnitine metabolism in the liver of dairy cows (p < 0.05). In overall, the present study shows that expression of the FGF21 gene is strongly up-regulated during the transition period. It is assumed that the up-regulation of FGF21 might play an important role in the adaptation of liver metabolism during early lactation in dairy cows such as in other species.

  15. 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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-06-01

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

  18. [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.

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

    PubMed

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

    2016-06-01

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

  20. First postpartum estrus and pregnancy in the female collared peccary (Tayassu tajacu) from the amazon.

    PubMed

    Mayor, Pedro; Guimaraes, Diva Anelie; Lopez-Gatius, Fernando; Lopez-Bejar, Manel

    2006-11-01

    The onset of sexual cycle postpartum was described in the collared peccary (Tayassu tajacu). Serum progesterone and 17beta-estradiol profiles, vaginal smears and external genitalia were analyzed in 20 animals housed with their piglets during the first postpartum month. The appearance of external genitalia showed no variation in any of the females: a shallow, reddish vulva, and vaginal mucus were constant features throughout the study. Based on hormonal profiles and vaginal smear cell patterns, 16 (80%) of the 20 peccaries showed signs of estrus and were considered cycling. The remaining four females (20%) did no show signs of estrus confirmed by low levels of progesterone (0.9+/-0.4 ng/mL) during the first postpartum month. In the cycling peccaries, a serum 17beta-estradiol peak (53.4+/-8.1 pg/mL) was observed on Day 7+/-1 postpartum, along with a linear increase in progesterone concentration from 3 (4.3+/-2.6 ng/mL) to 11 (30.8+/-4.9 ng/mL) days after this estradiol peak. Proportions of the different cells of the vaginal epithelium also changed in these females: superficial plus intermediate cells amounted to 76% of the cell total between Days 6 and 9 postpartum, corresponding to the estradiol peak. Nine (56%) of the 16 cycling females mated, indicated by the presence of sperm cells in their vaginal smears, and 6 (67%) became pregnant, reaching term. Non-pregnant cycling females (n=10) showed a steady decrease in serum progesterone concentration from 11 to 23 days after the estradiol peak, when basal levels were attained and a new estradiol peak registered, indicating the resumption of cyclicity in these females. The time interval between the two estradiol peaks was 23.5+/-2.1 days in these females. In pregnant females, progesterone concentrations continued to rise to levels of 60 ng/mL (n=6) 23 days after mating. These findings indicate that the lactating collared peccary female can become cycling and fertile during the early postpartum period, and that a

  1. Effects of hypergravity on ovarian-hypophyseal function in antepartum and postpartum rats

    NASA Technical Reports Server (NTRS)

    Burden, Hubert W.; Zary, Joan T.; Hodson, Charles A.; Gregory, Heather L.; Baer, Lisa A.; Ronca, April E.

    2003-01-01

    BACKGROUND: Rats exposed to microgravity during the post-implantation phase of pregnancy had minimal alterations in ovarian and hypophyseal parameters during the antepartum and postpartum periods. In the current study, a similar parallel experimental design was employed to ascertain the effects of hypergravity on ovarian and hypophyseal function. HYPOTHESIS: We hypothesized that hypergravity exposure during the post-implantation stage of pregnancy would not alter antepartum and postpartum ovarian and hypophyseal function. METHODS: Pregnant rats were assigned to hypergravity (1.5 G, 1.75 G, or 2.0 G), rotational control, or stationary control groups (n = 10 each group) beginning on gestation day 11 and ending on day 20. Hypophyseal and ovarian analyses were conducted on 5 of the animals from each group at day 20. The remaining animals in each group were allowed to go to term and the same analyses were conducted 3 h postpartum. RESULTS: Hypergravity at all levels decreased the percent body mass gain from gestation day 11 to 20 (p < 0.05); however, the wet weight of the pituitaries and ovaries was not changed. There was no effect of hypergravity on the number of healthy or atretic antral follicles of any size at gestation day 20 or postpartum. The number of corpora lutea of pregnancy was decreased in all hypergravity groups, but the number of live fetuses at gestation day 20 or pups at term was not altered. Plasma concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, and progesterone were not changed at gestation day 20 or postpartum. Pituitary content of LH, FSH, and prolactin was not altered by hypergravity at gestation day 20, but LH content was significantly increased (p < 0.05) at 1.5 and 1.75 G postpartum. CONCLUSIONS: We conclude that hypergravity, up to and including 2.0 G, is compatible with maintenance of pregnancy and has minimal effects on hypophyseal parameters. Ovarian follicles are not altered by hypergravity, but

  2. 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

  3. 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

  4. Feeding infants directly at the breast during the postpartum hospital stay is associated with increased breastfeeding at 6 months postpartum: a prospective cohort study

    PubMed Central

    Forster, Della A; Johns, Helene M; McLachlan, Helen L; Moorhead, Anita M; McEgan, Kerri M; Amir, Lisa H

    2015-01-01

    Objective To explore whether feeding only directly from the breast in the first 24–48 h of life increases the proportion of infants receiving any breast milk at 6 months. Design A prospective cohort study. Setting Three maternity hospitals in Melbourne, Australia. Participants 1003 postpartum English-speaking women with a healthy singleton term infant, who intended to breast feed, were recruited between 2009 and 2011. Women were excluded if they or their infant were seriously ill. 92% (n=924) were followed up at 6 months postpartum. Primary and secondary outcome measures Main exposure variable —type of infant feeding in hospital up to time of study recruitment (24–48 h postpartum), categorised as ‘fed directly at the breast only’ or ‘received at least some expressed breast milk (EBM) or infant formula’. Primary outcome—proportion of infants receiving any breast milk feeding at 6 months postpartum. Secondary outcomes—proportion of infants receiving only breast milk feeding at 6 months; breast milk feeding duration; and maternal characteristics associated with giving any breast milk at 6 months. Results Infants who had fed only at the breast prior to recruitment were more likely to be continuing to have any breast milk at 6 months than those who had received any EBM and/or infant formula (76% vs 59%; adjusted OR 1.76, 95% CI 1.24 to 2.48 (adjusted for parity, type of birth, breastfeeding intention, breastfeeding problems at recruitment, public/private status, epidural for labour or birth, maternal body mass index and education)). Conclusions Healthy term infants that fed only directly at the breast 24–48 h after birth were more likely to be continuing to breast feed at 6 months than those who received any EBM and/or formula in the early postpartum period. Support and encouragement to initiate breastfeeding directly at the breast is important. PMID:25953728

  5. Late paternities.

    PubMed

    Cohen, Jean

    2007-06-01

    Late paternities are frequent. Very often these couples ask for medically assisted procreation. In general, it is considered that the couple should not be treated differently from the couple where the father is younger. Recent studies show a certain number of specific risks linked to the late paternities. Doctors and society do not act in the same way towards men and women: a 'sensible age' for women to no longer attempt pregnancy has been set in many countries at 42 years of age, whereas men aged 80 can benefit from IVF attempts and be reimbursed by the state or insurance companies. This is an obvious inequity. PMID:17579995

  6. Postpartum depression and help-seeking behavior.

    PubMed

    McGarry, Joanne; Kim, Han; Sheng, Xiaoming; Egger, Marlene; Baksh, Laurie

    2009-01-01

    The objective of this analysis was to investigate the demographic differences between women who report postpartum depression symptoms (PPDS) and seek help versus those who report symptoms but who do not seek help, using data from the Utah Pregnancy Risk Assessment Monitoring System (PRAMS) 2004 dataset. Overall, 14.7% of Utah women reported experiencing PPDS in 2004. Sixty percent of the women who reported having PPDS did not seek help. Seeking help for depression during pregnancy was associated with help-seeking behavior postpartum (adjusted odds ratio [aOR] = 0.1; 95% confidence interval [CI], 0.04-0.2). Other factors associated with seeking help included having an infant admitted to the intensive care unit (aOR = 0.4; 95% CI, 0.2-0.9) and rural residency (aOR = 0.3; 95% CI, 0.2-0.7). Nonwhite women were 12.1 times (95% CI, 3.0-48.5) more likely to not seek help for depression compared to white women. Further, Hispanic women (aOR = 3.2; 95% CI, 1.3-8.1) and women who experienced emotional abuse had increased odds of not seeking help (aOR = 2.9; 95% CI, 1.3-6.2). Nearly 15% of Utah women in this study reported PPDS, yet fewer than half sought help. Target populations, such as nonwhite, Hispanic, emotionally abused, and urban women, have been identified for public health interventions.

  7. Examination of premenstrual symptoms as a risk factor for depression in postpartum women

    PubMed Central

    Buttner, Melissa M.; Mott, Sarah L.; Pearlstein, Teri; Stuart, Scott; Zlotnick, Caron; O’Hara, Michael W.

    2013-01-01

    PURPOSE Postpartum depression (PPD) is a significant public health concern with prevalence of major and minor depression reaching 20% in the first three postpartum months. Sociodemographic and psychopathology correlates of PPD are well-established; however, information on the relationship between premenstrual disorders and the development of PPD is less well-established. Thus, the aim of this study was to examine the role of premenstrual syndrome (PMS)/premenstrual dysphoric disorder (PMDD) as a risk factor for PPD. METHODS Premenstrual symptoms were assessed retrospectively using the Premenstrual Symptoms Screening Tool (PSST) and depression was diagnosed according to DSM-IV criteria and assessed using the HDRS. A two-stage screening procedure was applied. In the first stage, the PHQ-9 was employed. In the second stage, women endorsing ≥ 5 symptoms on the PHQ-9 were administered the SCID, HDRS, and PSST. RESULTS Hierarchical linear regression showed that history of depression and PMS/PMDD contributed an additional 2% of the variance (p < .001), beyond that of sociodemographic factor effects. The full model accounted for 13% of the variance in postpartum depressive symptoms. Using logistic regression, a significant association also emerged between PMS/PMDD and PPD (OR=1.97). CONCLUSIONS The findings of this study suggest that PMS/PMDD is an important risk factor for PPD. Women endorsing a history of PMS/PMDD should be monitored during the perinatal period. PMID:23296333

  8. Negative energy balance affects imprint stability in oocytes recovered from postpartum dairy cows.

    PubMed

    O'Doherty, Alan M; O'Gorman, Aoife; al Naib, Abdullah; Brennan, Lorraine; Daly, Edward; Duffy, Pat; Fair, Trudee

    2014-09-01

    Ovarian follicle development in post-partum, high-producing dairy cows, occurs in a compromised endogenous metabolic environment (referred to as negative energy balance, NEB). Key events that occur during oocyte/follicle growth, such as the vital process of genomic imprinting, may be detrimentally affected by this altered ovarian environment. Imprinting is crucial for placental function and regulation of fetal growth, therefore failure to establish and maintain imprints during oocyte growth may contribute to early embryonic loss. Using ovum pick-up (OPU), oocytes and follicular fluid samples were recovered from cows between days 20 and 115 post-calving, encompassing the NEB period. In a complimentary study, cumulus oocyte complexes were in vitro matured under high non-esterified fatty acid (NEFA) concentrations and in the presence of the methyl-donor S-adenosylmethionine (SAM). Pyrosequencing revealed the loss of methylation at several imprinted loci in the OPU derived oocytes. The loss of DNA methylation was observed at the PLAGL1 locus in oocytes, following in vitro maturation (IVM) in the presence of elevated NEFAs and SAM. Finally, metabolomic analysis of postpartum follicular fluid samples revealed significant differences in several branched chain amino acids, with fatty acid profiles bearing similarities to those characteristic of lactating dairy cows. These results provide the first evidence that (1) the postpartum ovarian environment may affect maternal imprint acquisition and (2) elevated NEFAs during IVM can lead to the loss of imprinted gene methylation in bovine oocytes.

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. Genetic analysis of patients with deep vein thrombosis during pregnancy and postpartum.

    PubMed

    Neki, Reiko; Fujita, Tomio; Kokame, Koichi; Nakanishi, Isao; Waguri, Masako; Imayoshi, Yuzo; Suehara, Noriyuki; Ikeda, Tomoaki; Miyata, Toshiyuki

    2011-08-01

    Deep vein thrombosis (DVT) is a serious pregnancy-related complication. Recent studies indicate that the genetic background for DVT differs with ethnicity. In our study, we enrolled 18 consecutive Japanese patients who had developed DVT during pregnancy and postpartum. We performed a genetic analysis of three candidate genes for DVT, protein S, protein C and antithrombin, in these patients. We found that four patients had missense mutations in the protein S gene, including the K196E mutation in two patients, the L446P mutation in one patient, and the D79Y and T630I mutations in one patient, as well as one patient with the C147Y mutation in the protein C gene. All five patients with genetic mutations had DVT in their first two trimesters. Nine of the patients without genetic mutations developed DVT in the first two trimesters, and four in the postpartum period. Thus, genetic mutations in the protein S gene were predominant in pregnant Japanese DVT women, and DVT in pregnant women with genetic mutations occurred more frequently at the early stage of pregnancy than postpartum. Considering the rapid decrease in protein S activity during pregnancy, we may need to assess thrombophilia in women before pregnancy.

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

    PubMed

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

    2014-07-01

    Active duty personnel in the U.S. Air Force (USAF) are required to pass periodic fitness assessments in order to facilitate and evaluate physical readiness. Pregnant women are exempt from testing but must take the fitness test 6 months after childbirth. However, evidence from prior research indicates that in the first 6 months postpartum, women may not achieve prepregnancy fitness levels and may be more vulnerable to mental and physical health problems. It is important for health care clinicians to understand how training for the USAF fitness test after childbirth may impact health and well-being. The purpose of this study was to develop a deep understanding of the experiences of postpartum USAF women as they train for their fitness assessment. Understanding was sought through a phenomenological study by interpreting the meaning of the lived experiences of 17 active duty women at two USAF bases. Two overarching patterns emerged from this analysis: "Striving to Perform under Pressure through Profound Life Transitions of Childbirth" and "Seeking Understanding from Others." These results provide insight into the challenges postpartum women encounter while training for their fitness assessments, and they can inform practices that facilitate efforts of women in returning to optimal fitness and well-being. PMID:25003862

  17. 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.

  18. Prenatal β-Endorphin as an Early Predictor of Postpartum Depressive Symptoms in Euthymic Women

    PubMed Central

    Yim, Ilona S.; Glynn, Laura M.; Schetter, Christine Dunkel; Hobel, Calvin J.; Chicz-DeMet, Aleksandra; Sandman, Curt A.

    2010-01-01

    Background After delivery, many women experience symptoms of postpartum depression (PPD), and early identification of women at risk is therefore important. The opioid peptide β-endorphin has been implicated in non-puerperal depression but its role in the development of PPD is unknown. Methods Three hundred and seven women with a singleton, full-term (>37.0 weeks’ GA) pregnancy were recruited early in pregnancy and followed up into the postpartum period. Blood samples were obtained at 15, 19, 25, 31 and 37 weeks’ gestational age (GA) and at 9 weeks postpartum for assessment of β-endorphin. Depressive symptoms were assessed with the Center for Epidemiological Studies – Depression scale at the last four pregnancy visits and with the Edinburgh Postnatal Depression Scale postpartum. Results Among women who were euthymic at 25 weeks’ GA, those who proceeded to develop PPD symptoms had higher levels of β-endorphin throughout pregnancy compared to women without PPD symptoms (all t > 2.11, p < .05). At each assessment, women above the cut-off score for β-endorphin were at more than three-fold risk for PPD symptoms (odds ratios 3.19 – 4.68) compared to women below the cut-off score. Limitations Self-report of depressive symptoms, no mental health history. Conclusions β-Endorphin may be a useful early predictor of PPD symptoms in women who do not report depressive symptoms in midpregnancy. If replicated, these findings have clinical implications for the identification and treatment of this at risk group and further suggest that some of the pathways leading to this complex disorder may be specific to subgroups of women. PMID:20051292

  19. 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

  20. Pregnancy associated glycoproteins (PAG) in postpartum cows, ewes, goats and their offspring.

    PubMed

    Haugejorden, G; Waage, S; Dahl, E; Karlberg, K; Beckers, J F; Ropstad, E

    2006-11-01

    Determination of plasma concentrations of pregnancy associated glycoproteins (PAG) has been used for early pregnancy diagnosis in cows. However, this is complicated by the presence of PAG in plasma for an extended period postpartum. The main objective of the present study was to investigate the postpartum elimination rates of pregnancy associated glycoproteins (PAG) in sheep, goats and cows in order to gain background information applicable to the use of PAG for pregnancy diagnosis in domestic ruminants. A second objective was to investigate whether PAG are transferred to the foetus and newborn, by measuring plasma PAG concentrations in calves, lambs and goat kids before and after colostrum feeding. PAG in the blood at parturition were eliminated by a first order process in the cows and ewes, while a two-step log-linear decline occurred in the goats. Estimated postpartum half-life of plasma PAG in the cows and ewes was 9 and 4.5 days, respectively. In the goats, half-lives were 3.6 and 7.5 days in the initial fast and terminal slow phase. Basal levels were reached 80-90 days postpartum in cows. Plasma PAG concentration can be used for pregnancy diagnosis from day 28 after AI, provided that the time interval from calving to AI is >60 days. Using a heterologous antibody RIA, we found 4 ng/mL to be the appropriate cut-off. Due to the presence of PAG residues from the previous gestation, the interval from AI to pregnancy diagnosis should increase by approximately 0.5 days beyond 28 days for each day of AI closer to calving than 60. Measurements in newborn ruminants suggested that PAG enter the foetal blood in utero and that colostral PAG are transferred to the newborn. Following the peak plasma concentration observed 1 day after birth in most of the animals, PAG were rapidly eliminated in a log-linear fashion.

  1. Relationship of monoamine oxidase-A distribution volume to postpartum depression and postpartum crying.

    PubMed

    Sacher, Julia; Rekkas, P Vivien; Wilson, Alan A; Houle, Sylvain; Romano, Leslie; Hamidi, Jinous; Rusjan, Pablo; Fan, Ian; Stewart, Donna E; Meyer, Jeffrey H

    2015-01-01

    Postpartum depression (PPD) has a prevalence rate of 13% and a similarly high proportion of women report a subclinical state of one or more major depressive episode symptoms. The aim was to investigate whether monoamine oxidase-A (MAO-A) VT, an index of MAO-A density, is increased in the prefrontal and anterior cingulate cortex (PFC and ACC), during PPD or when a PPD spectrum symptom, greater predisposition to crying, is present. MAO-A is an enzyme that increases in density after estrogen decline, and has several functions including creating oxidative stress, influencing apoptosis and monoamine metabolism. Fifty-seven women were recruited including 15 first-onset, antidepressant naive, PPD subjects, 12 postpartum healthy who cry due to sad mood, 15 asymptomatic postpartum healthy women, and 15 healthy women not recently pregnant. Each underwent [(11)C]-harmine positron emission tomography scanning to measure MAO-A VT. Both PPD and greater predisposition to crying were associated with greater MAO-A VT in the PFC and ACC (multivariate analysis of variance (MANOVA), group effect, F21,135=1.856; p=0.019; mean combined region elevation 21% and 14% in PPD and crying groups, respectively, relative to postpartum asymptomatic). Greater MAO-A VT in the PFC and ACC represents a new biomarker in PPD, and the PPD symptom of predisposition to crying. Novel strategies for preventing PPD (and some PPD symptoms) may be possible by avoiding environmental conditions that elevate MAO-A level and enhancing conditions that normalize MAO-A level. These findings also argue for clinical trials in PPD with the newer, well-tolerated MAO-A inhibitor antidepressants.

  2. Prenatal and postpartum care of women with substance use disorders.

    PubMed

    Gopman, Sarah

    2014-06-01

    The incidence of substance abuse in pregnancy is substantial and affects pregnancy health and outcomes. Multiple challenges exist in the identification of women with substance abuse disorders in pregnancy and the provision of care. A multidisciplinary approach has been shown to be most successful in providing comprehensive and effective care. This article outlines key aspects of prenatal and postpartum care, with a brief overview provided of intrapartum care. Issues covered include screening, opioid replacement therapy, comorbid medical and psychiatric conditions, environmental stressors, parenting preparation, pain management in labor and postpartum, breastfeeding guidance, prevention of relapse, and assistance with postpartum transition to primary care.

  3. 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.

  4. Rapunzel Syndrome: A Rare Postpartum Case

    PubMed Central

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

    2013-01-01

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

  5. Initiation of the primate ovarian cycle with emphasis on perimenarchial and postpartum events.

    PubMed

    Williams, R F; Hodgen, G D

    1983-01-01

    In collating the issues discussed in this review, we have summarized the initiation of the primate ovarian/menstrual cycle into two conceptual illustrations. Figure 27 depicts the progression of folliculogenesis in perimenarchial monkeys; Figure 28 compares the restoration of recruitment, selection, and maturation of the dominant follicle in postpartum monkeys, with and without an infant at breast. The following conclusions, some tentative or partial, seem warranted by the data. In perimenarchial monkeys: 1. The late pubertal cascade included progression toward greater ovarian asymmetry of estradiol secretion. 2. This asymmetry of estrogen synthesis may be indicative of recruitment and selection of the dominant follicle, even though ovulation is not yet achieved. 3. Quantitative and qualitative changes in pulsatile pituitary gonadotropin secretion accompany the onset of cyclic ovarian function. 4. The enhanced biological activity of LH, especially during the preovulatory surge induced by the instigation of estrogen positive feedback in the advanced postmenarchial interval, may be a critical development step toward normal ovulatory menstrual cycles. In postpartum monkeys: 1. Reestablishment of ovulatory cycles is a gradual process in non-nursing monkeys, with initial follicular growth supporting endometrial proliferation but failing to culminate in ovulation. Immediately thereafter, ovulatory menstrual cycles ensue. 2. After nursing and weaning, resumption of ovulation is prompt, with the first menses coming after the first luteal phase. 3. Gestation-induced refractoriness of the hypothalamic-pituitary unit to estrogen positive feedback or GnRH challenges is highly transient. 4. While nursing continues, inhibition of the H-P-O axis is absolute; but after weaning the reacquisition of its functional integrity is rapid. 5. Nursing sustains the block to estrogen positive feedback, probably emanating from a mechanism(s) distinctly unlike that imposed by the pregnancy

  6. Does Impulsiveness Moderate Response to Financial Incentives for Smoking Cessation Among Pregnant and Newly Postpartum Women?

    PubMed Central

    Lopez, Alexa A.; Skelly, Joan M.; White, Thomas J.; Higgins, Stephen T.

    2015-01-01

    We examined whether impulsiveness moderates response to financial incentives for cessation among pregnant smokers. All participants were randomized to either a condition wherein financial incentives were delivered contingent on smoking abstinence or to a control condition wherein incentives were delivered independent of smoking status. The study was conducted in two steps: First, we examined associations between baseline impulsiveness scores and abstinence at late pregnancy and 24-weeks postpartum as part of a planned prospective study of this topic using data from a recently completed, randomized controlled clinical trial (N = 118). Next, to increase statistical power, we conducted a second analysis collapsing results across that recent trial and two prior trials involving the same contingent incentive and control conditions (N = 236). Impulsivity was assessed using a delay discounting (DD) of hypothetical monetary rewards task in all three trials and Barratt Impulsiveness Scale (BIS) in the most recent trial. Neither DD nor BIS predicted antepartum or postpartum smoking status in the single or combined trials. Receiving abstinence-contingent incentives, lower baseline smoking rate (cigs/day), and a history of quit attempts pre-pregnancy predicted greater odds of antepartum abstinence across the single and combined trials. No variable predicted postpartum abstinence across the single and combined trials, although a history of antepartum quit attempts and receiving abstinence-contingent incentives predicted in the single and combined trials, respectively. Overall, this study provides no evidence that impulsiveness as assessed by DD or BIS moderates response to this treatment approach while underscoring a substantial association of smoking rate and prior quit attempts with abstinence across the contingent incentives and control treatment conditions. PMID:25730417

  7. [Correlation of hemogram changes during pregnancy of healthy women with postpartum blood transfusion].

    PubMed

    Li, Hui; Chen, Lin-Feng; Wang, Shu-Ying; Wang, Yan; Shi, Hong-Mei; Wang, De-Qing

    2012-10-01

    This study was aimed to explore the correlation of hemogram changes during pregnancy of healthy women with postpartum blood transfusion. The outpatient and inpatient information of expectant lying-in women in our hospitals was collected, the route blood test, lever and kidney function and blood coagulation function tests were performed from the 4th to the 10th month of pregnancy. The pregnant women without underlying diseases and non-elderly pregnant women with single fetus were selected as the subjects of study. They were divided into postpartum blood transfusion group and non-blood transfusion group. The white blood cell (WBC) count, hemoglobin (Hb) level, platelet (Plt) count, plateletocrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW) were compared in 2 groups. The results showed that 68 cases out of 450 expectant lying-in women received blood transfusion, among them 30 cases with complete data of puerperal transfusion were taken as blood transfusion group, the 28 cases of non transfusion puerperal as control group. There was no significant difference of hemogram changes between the two groups. However, there was a slight decline in Plt count and Hb level of late pregnant women. What is more, there was no correlation between Plt count change and the PCT, MPV and PDW. It is concluded that the changes of hemogram during pregnancy has no correlation with postpartum hemorrhage and blood transfusion in healthy pregnant women, the Plt count and Hb level of pregnant women slightly decline. Nevertheless, PCT, MPV and PDW are within the normal range.

  8. 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)

  9. Multimodal Sensory Distortions in Post-partum Exacerbation of Schizophrenia.

    PubMed

    Mehta, Urvakhsh Meherwan; Naveen Kumar, C; Venkatasubramanian, Ganesan; Thirthalli, Jagadisha

    2013-11-25

    Background: Sensory distortions of body image commonly occur during migraine, seizures, non-dominant cortical infarcts and hallucinogen abuse.Methods: We report the case of a 30-year-old woman with paranoid schizophrenia, presenting with post-partum onset multimodal sensory distortions in the absence of any neurological disorders or substance use.Results: Her symptoms involved persistent facial/body metamorphopsia (distorted images) and vocal paracousis (distorted voices), in the absence of visual hallucinations, illusions or agnosia. Neuropsychological assessments revealed deficits on visual processing tasks. Neuroimaging, electroencephalography and ophthalmological evaluation revealed no abnormalities. The multimodal sensory distortions responded to anti-psychotic treatment, paralleling improvement in other schizophrenia psychopathology, over a period of one month.Conclusion: Prominent and persistent multimodal sensory distortions like metamorphopsia and paracousis in the presence of psychotic symptoms warrant a detailed neurological and general medical work-up. These symptoms presenting in the absence of neurological or substance use disorders may be a component of schizophrenia. PMID:24275634

  10. Operative interventions in the management of major postpartum haemorrhage.

    PubMed

    Keriakos, R; Chaudhuri, S

    2012-01-01

    In many recent studies in the developed world, the incidence of postpartum haemorrhage (PPH) has been rising, though the mortality has come down, suggesting improvement in the management of this condition. Since the publication of the RCOG guidelines in 2009 for management of PPH and the Sheffield guidelines for the use of Rusch balloon along with the initial small case series (Keriakos and Mukhopadhyay 2006), many units have introduced the guidelines into clinical practice. This has led to the reduction of surgical intervention in our unit. Major PPH accounted for 1.6% of the total deliveries in our hospital. Surgical interventions accounted for 7.8% of these cases and only 0.1% of the total deliveries. Risk factors for PPH were identified in 83%. In this paper, we reviewed the management of all patients who had major PPH and failed medical management over a period of about 4 years. All surgical interventions including Rusch balloon, B-Lynch suture, radiological interventions and hysterectomy were described. An update to Rusch balloon guidelines and Sheffield guidelines for management of major PPH are appended. PMID:22185528

  11. 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

  12. Interactions between metabolic and reproductive functions in the resumption of postpartum fecundity

    PubMed Central

    Valeggia, Claudia; Ellison, Peter T.

    2012-01-01

    Lactation has long been recognized as a major determinant of interbirth intervals. The temporal pattern of nursing has been proposed as the mechanism behind lactational amenorrhea. We present a new model of the dynamic regulation of lactational amenorrhea that identifies maternal energy availability as the main determinant of ovarian resumption. Variation in the intensity of lactation remains a component of the model as a determinant of the absolute energetic cost of milk production. But maternal energy supply determines net energy availability; a larger energy supply leaves a greater net energy surplus than a smaller energy supply (lactation costs being equal). We characterize the hormonal postpartum profile of 70 lactating Toba women of Argentina. We use C-peptide, which reflects maternal insulin production, as a measure of energy availability. Initially low, insulin production rises as the postpartum period progresses, reflecting the declining metabolic load of lactation. A short period of supernormal insulin production precedes menstrual resumption. The high levels of insulin may play a role in stimulating the resumption of ovarian activity, which in turn may help to resolve the transient period of insulin resistance. The dynamics of insulin sensitivity during lactation would aid in synchronizing the resumption of ovarian function with a reduction in the energy demands of milk production. This hypothesis is supported by the sustained weight gain experienced by lactating women during the months preceding the first postpartum menses. The link between fecundity and energy balance could serve as a mechanism for adjusting the duration of lactational amenorrhea to the relative metabolic load of lactation. PMID:19298003

  13. Clinical care for opioid-using pregnant and postpartum women: the role of obstetric providers.

    PubMed

    Jones, Hendrée E; Deppen, Krisanna; Hudak, Mark L; Leffert, Lisa; McClelland, Carol; Sahin, Leyla; Starer, Jacquelyn; Terplan, Mishka; Thorp, John M; Walsh, James; Creanga, Andreea A

    2014-04-01

    We review clinical care issues that are related to illicit and therapeutic opioid use among pregnant women and women in the postpartum period and outline the major responsibilities of obstetrics providers who care for these patients during the antepartum, intrapartum, and postpartum periods. Selected patient treatment issues are highlighted, and case examples are provided. Securing a strong rapport and trust with these patients is crucial for success in delivering high-quality obstetric care and in coordinating services with other specialists as needed. Obstetrics providers have an ethical obligation to screen, assess, and provide brief interventions and referral to specialized treatment for patients with drug use disorders. Opioid-dependent pregnant women often can be treated effectively with methadone or buprenorphine. These medications are classified as pregnancy category C medications by the Food and Drug Administration, and their use in the treatment of opioid-dependent pregnant patients should not be considered "off-label." Except in rare special circumstances, medication-assisted withdrawal during pregnancy should be discouraged because of a high relapse rate. Acute pain management in this population deserves special consideration because patients who use opioids can be hypersensitive to pain and because the use of mixed opioid-agonist/antagonists can precipitate opioid withdrawal. In the absence of other indications, pregnant women who use opioids do not require more intense medical care than other pregnant patients to ensure adequate treatment and the best possible outcomes. Together with specialists in pain and addiction medicine, obstetricians can coordinate comprehensive care for pregnant women who use opioids and women who use opioids in the postpartum period.

  14. Incidence of postpartum infection after vaginal delivery in Viet Nam.

    PubMed

    Ngoc, Nguyen T N; Sloan, Nancy L; Thach, Tran S; Liem, Le K B; Winikoff, Beverly

    2005-06-01

    This study assessed the incidence of postpartum infection which is rarely clinically evaluated and is probably underestimated in developing countries. This prospective study identified infection after vaginal delivery by clinical and laboratory examinations prior to discharge from hospital and again at six weeks postpartum in Ho Chi Minh City, Viet Nam. Textbook definitions, physicians' diagnoses, symptomatic and verbal autopsy definitions were used for classifying infection. Logistic regression was used for determining associations of postpartum infection with socioeconomic and reproductive characteristics. In total, 978 consecutive, eligible consenting women were followed up at 42+/-7 (range 2-45) days postpartum (not associated with incidence). Ninety-eight percent took 'prophylactic' antibiotics. The most conservative estimate of the incidence of postpartum infection was 1.7%. The incidence of serious infection was 0.5%, but increased to 4.6% when verbal autopsy and symptomatic definitions were used. Postpartum infection, particularly serious infection, is greatly underestimated. Just preventing or treating infection could have a substantial impact on reducing maternal mortality in developing countries. PMID:16117363

  15. Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates

    PubMed Central

    Orsolini, Laura; Valchera, Alessandro; Vecchiotti, Roberta; Tomasetti, Carmine; Iasevoli, Felice; Fornaro, Michele; De Berardis, Domenico; Perna, Giampaolo; Pompili, Maurizio; Bellantuono, Cesario

    2016-01-01

    Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide has been considered a relatively rare event during the perinatal period. However, in some mental disorders (i.e., postpartum depression, bipolar disorder, postpartum psychosis, etc.) have been reported a higher risk of suicidal ideation, suicide attempt, or suicide. Therefore, a complete screening of mothers’ mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors, and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk factors, and an overview about the main clinical correlates associated with the suicidal behavior during the pregnancy and postpartum period. Practical recommendations have been provided as well. PMID:27570512

  16. Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates.

    PubMed

    Orsolini, Laura; Valchera, Alessandro; Vecchiotti, Roberta; Tomasetti, Carmine; Iasevoli, Felice; Fornaro, Michele; De Berardis, Domenico; Perna, Giampaolo; Pompili, Maurizio; Bellantuono, Cesario

    2016-01-01

    Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide has been considered a relatively rare event during the perinatal period. However, in some mental disorders (i.e., postpartum depression, bipolar disorder, postpartum psychosis, etc.) have been reported a higher risk of suicidal ideation, suicide attempt, or suicide. Therefore, a complete screening of mothers' mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors, and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk factors, and an overview about the main clinical correlates associated with the suicidal behavior during the pregnancy and postpartum period. Practical recommendations have been provided as well. PMID:27570512

  17. 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