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Trends in Neurosciences Feb 2017Ten to twenty percent of postpartum women experience anxiety or depressive disorders, which can have detrimental effects on the mother, child, and family. Little is... (Review)
Review
Ten to twenty percent of postpartum women experience anxiety or depressive disorders, which can have detrimental effects on the mother, child, and family. Little is known about the neural correlates of these affective disorders when they occur in mothers, but they do have unique neural profiles during the postpartum period compared with when they occur at other times in a woman's life. Given that the neural systems affected by postpartum anxiety and depression overlap and interact with the systems involved in maternal caregiving behaviors, mother-infant interactions are highly susceptible to disruption. Thus, there is an intricate interplay among maternal mental health, the mother-infant relationship, and the neurobiological mechanisms mediating them that needs to be the focus of future study.
Topics: Animals; Anxiety; Depression; Humans; Maternal Behavior; Mother-Child Relations; Mothers; Postpartum Period
PubMed: 28129895
DOI: 10.1016/j.tins.2016.11.009 -
Nature Reviews. Disease Primers Apr 2018Pregnancy is a complex and vulnerable period that presents a number of challenges to women, including the development of postpartum psychiatric disorders (PPDs). These... (Review)
Review
Pregnancy is a complex and vulnerable period that presents a number of challenges to women, including the development of postpartum psychiatric disorders (PPDs). These disorders can include postpartum depression and anxiety, which are relatively common, and the rare but more severe postpartum psychosis. In addition, other PPDs can include obsessive-compulsive disorder, post-traumatic stress disorder and eating disorders. The aetiology of PPDs is a complex interaction of psychological, social and biological factors, in addition to genetic and environmental factors. The goals of treating postpartum mental illness are reducing maternal symptoms and supporting maternal-child and family functioning. Women and their families should receive psychoeducation about the illness, including evidence-based discussions about the risks and benefits of each treatment option. Developing effective strategies in global settings that allow the delivery of targeted therapies to women with different clinical phenotypes and severities of PPDs is essential.
Topics: Antidepressive Agents; Anxiety; Comorbidity; Humans; Mass Screening; Mental Disorders; Mothers; Postpartum Period; Quality of Life
PubMed: 29695824
DOI: 10.1038/nrdp.2018.22 -
Current Psychiatry Reports Apr 2022Suicide is a leading cause of death in the perinatal period (pregnancy and 1 year postpartum). We review recent findings on prevalence, risk factors, outcomes, and... (Review)
Review
PURPOSE OF REVIEW
Suicide is a leading cause of death in the perinatal period (pregnancy and 1 year postpartum). We review recent findings on prevalence, risk factors, outcomes, and prevention and intervention for suicide during pregnancy and the first year postpartum.
RECENT FINDINGS
Standardization of definitions and ascertainment of maternal deaths have improved identification of perinatal deaths by suicide and risk factors for perinatal suicide. Reports of a protective effect of pregnancy and postpartum on suicide risk may be inflated. Clinicians must be vigilant for risk of suicide among their perinatal patients, especially those with mental health diagnoses or prior suicide attempts. Pregnancy and the year postpartum are a time of increased access to healthcare for many, offering many opportunities to identify and intervene for suicide risk. Universal screening for suicide as part of assessment of depression and anxiety along with improved access to mental health treatments can reduce risk of perinatal suicide.
Topics: Female; Humans; Maternal Mortality; Parturition; Postpartum Period; Pregnancy; Pregnancy Complications; Suicide, Attempted
PubMed: 35366195
DOI: 10.1007/s11920-022-01334-3 -
Archivos Espanoles de Urologia Feb 2023Urinary incontinence in the postpartum period is related to biomechanical and hormonal changes that occur during the obstetric period and also related to perineal trauma... (Review)
Review
BACKGROUND
Urinary incontinence in the postpartum period is related to biomechanical and hormonal changes that occur during the obstetric period and also related to perineal trauma during childbirth. Physiotherapy is currently presented as one of the conservative options for the treatment of urinary incontinence at this stage, so this review aims to go over scientific literature to assess the effect of physiotherapy on postpartum urinary incontinence.
MATERIAL AND METHODS
In February 2022, a bibliographic search was carried out in PubMed, Scopus, Medline, PeDRO and Sport Discuss databases. Studies published within the last 10 years and randomized clinical trials that used physiotherapy techniques for the treatment of postpartum urinary incontinence were identified, but those articles that differ from the objective of the work and those that were duplicated in the databases were excluded.
RESULTS
Out of the 51 articles identified, 8 were finally included that fit the criteria and the subject of the study. Regarding the intervention, we have found that all the articles refer to pelvic floor muscle training. In addition to urinary incontinence, these studies evaluated other variables such as strength, resistance, quality of life and sexual function, obtaining significant results in 6 out of all the studies consulted.
CONCLUSIONS
Pelvic floor muscle training is beneficial for the treatment of urinary incontinence in the postpartum period, then supervised and controlled exercise combined with a home training routine is recommended. It is not clear whether the benefits are maintained over time.
Topics: Pregnancy; Female; Humans; Quality of Life; Exercise Therapy; Pelvic Floor; Urinary Incontinence; Postpartum Period; Physical Therapy Modalities
PubMed: 36914417
DOI: 10.56434/j.arch.esp.urol.20237601.2 -
Journal of Obstetric, Gynecologic, and... Jan 2019
Topics: Female; Humans; Postnatal Care; Postpartum Period; Quality Improvement; United States; Women's Health; Women's Health Services
PubMed: 30543765
DOI: 10.1016/j.jogn.2018.12.001 -
Journal of Traditional Chinese Medicine... Feb 2020To investigate the effect of acupressure on postpartum low back pain (LBP), salivary cortisol, physical limitations, and postpartum depression. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate the effect of acupressure on postpartum low back pain (LBP), salivary cortisol, physical limitations, and postpartum depression.
METHODS
Participants were 70 postpartum women who were randomly assigned to either an intervention (n = 35) or a control (n = 35) group. The intervention group received 10 acupressure sessions (1 session per day, 5 d per week). The control group received 10 sham acupressure sessions. Outcomes were assessed using a visual analogue scale (LBP intensity), salivary cortisol values (LBP biomarker), and Chinese versions of the Roland-Morris Disability Questionnaire (daily activity limitations), Oswestry Disability Index (physical activity limitations), and the Edinburgh Postnatal Depression Scale (postpartum depression).
RESULTS
Participants in the intervention group had significantly lower levels of LBP intensity, daily activity limitations, physical activity limitations, and postpartum depression than those in the control group. There was no significant between-group difference in salivary cortisol.
CONCLUSION
Acupressure may reduce postpartum LBP intensity and limitations in daily and physical activity, and alleviate postpartum depressive symptoms. Acupressure should be offered in postpartum care settings as an alternative treatment for postpartum women with LBP.
Topics: Acupressure; Adult; Depression; Exercise; Female; Humans; Hydrocortisone; Low Back Pain; Pilot Projects; Postpartum Period; Saliva; Treatment Outcome
PubMed: 32227774
DOI: No ID Found -
Obstetrics and Gynecology Dec 2015Physical activity in all stages of life maintains and improves cardiorespiratory fitness, reduces the risk of obesity and associated comorbidities, and results in...
Physical activity in all stages of life maintains and improves cardiorespiratory fitness, reduces the risk of obesity and associated comorbidities, and results in greater longevity. Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements. Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy. Obstetrician-gynecologists and other obstetric care providers should carefully evaluate women with medical or obstetric complications before making recommendations on physical activity participation during pregnancy. Although frequently prescribed, bed rest is only rarely indicated and, in most cases, allowing ambulation should be considered. Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychologic well-being. An exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20-30 minutes per day on most or all days of the week should be developed with the patient and adjusted as medically indicated. Additional research is needed to study the effects of exercise on pregnancy-specific outcomes and to clarify the most effective behavioral counseling methods, and the optimal intensity and frequency of exercise. Similar work is needed to create an improved evidence base concerning the effects of occupational physical activity on maternal-fetal health.
Topics: Exercise; Female; Health Promotion; Humans; Motivational Interviewing; Occupational Health; Postnatal Care; Postpartum Period; Pregnancy; Pregnancy Complications; Prenatal Care
PubMed: 26595585
DOI: 10.1097/AOG.0000000000001214 -
Journal of Obstetric, Gynecologic, and... Jan 2019To evaluate the knowledge, attitudes, and beliefs of women during pregnancy and the postpartum period related to placentophagy.
OBJECTIVE
To evaluate the knowledge, attitudes, and beliefs of women during pregnancy and the postpartum period related to placentophagy.
DESIGN
Mixed methods study (cross-sectional survey and online discussions).
SETTING
We used social media to advertise the study to mother/parenting groups. Online discussion groups were conducted through Google Groups.
PARTICIPANTS
Women during pregnancy and in the postpartum period and placenta encapsulation specialists with Internet access.
METHODS
We summarized descriptive data and analyzed subgroups with the use of chi-square tests. We conducted a binary logistic regression to compare placentophagy with demographic variables and used constant comparative analysis to analyze online discussion group themes.
RESULTS
Overall, 271 of 1,088 (24.9%) respondents consumed their placentas. Canadian respondents and those who experienced pregnancy/birth-related complications were significantly (p < .05) less likely to consume their placentas than respondents from the United States (odds ratio = 0.48, 95% confidence interval [0.28, 0.82]) and those who had no complications (odds ratio = 0.56, 95% confidence interval [0.37, 0.85]). Increased iron stores (521/1,030, 50.6%), prevention of postpartum depression (519/1,030, 50.4%), and increased energy/decreased fatigue (460/1,030, 44.7%) were the most commonly listed perceived benefits. Infection and improper handling/preparation of the placenta were important concerns, and hospital policy was noted as a barrier to placentophagy.
CONCLUSION
Respondents who engaged in placentophagy were primarily motivated by unproven benefits, such as the prevention of postpartum depression and anemia, for which there are other management alternatives. Although placentophagy is gaining popularity, it remains unregulated, and safety and efficacy data are limited. A safe, standardized preparation process is needed to minimize potential harm before further efficacy studies can be done. Targeted educational material surrounding placentophagy is needed to improve woman-centered care.
Topics: Adult; Canada; Cross-Sectional Studies; Culture; Depression, Postpartum; Eating; Fatigue; Female; Health Knowledge, Attitudes, Practice; Humans; Maternal Behavior; Needs Assessment; Parturition; Placenta; Postpartum Period; Pregnancy; United States
PubMed: 30496722
DOI: 10.1016/j.jogn.2018.10.002 -
BMC Pregnancy and Childbirth Sep 2014Pregnancy-related physical changes can have a significant impact on a woman's body image. There is no synthesis of existing literature to describe the intricacies of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pregnancy-related physical changes can have a significant impact on a woman's body image. There is no synthesis of existing literature to describe the intricacies of women's experiences of their body, and relevant clinical implications.
METHODS
Four electronic databases were searched in February 2014 using predefined search terms. English-language, qualitative studies published between January 1992 and December 2013 exploring pregnancy and postpartum body image were included. Following quality appraisal, 17 papers were synthesised using the interpretive thematic synthesis approach within a social constructionist framework.
RESULTS
Three themes were highlighted: "Public Event: 'Fatness' vs. Pregnancy", "Control: Nature vs. Self", and "Role: Woman vs. Mother". Women perceived the pregnant body to be out of their control and as transgressing the socially constructed ideal, against which they tried to protect their body image satisfaction. Women perceived the physical manifestation of the mothering role as incongruent to their other roles as a wife or partner, or working woman. Body dissatisfaction dominated the postpartum period.
CONCLUSIONS
Women's perception of their pregnancy body image is varied and depends on the strategies they use to protect against social constructions of female beauty. Women have unrealistic expectations for their postpartum body, highlighting this as an area where women need better support. Attending to women's narratives about their pregnant body may identify at-risk women and provide an opportunity for health professionals to provide support to either address or accept body image dissatisfaction. Clinical communication training may enable health professionals to explore body image concerns with women and guide them in identifying ways of accepting or reducing any dissatisfaction.
Topics: Adaptation, Psychological; Body Image; Female; Gender Identity; Humans; Internal-External Control; Postpartum Period; Pregnancy; Social Desirability
PubMed: 25248649
DOI: 10.1186/1471-2393-14-330 -
Journal of Obstetric, Gynecologic, and... Mar 2022To examine the characteristics and effectiveness of lifestyle interventions for gestational diabetes mellitus (GDM) in pregnancy and the postpartum period to prevent... (Review)
Review
OBJECTIVE
To examine the characteristics and effectiveness of lifestyle interventions for gestational diabetes mellitus (GDM) in pregnancy and the postpartum period to prevent Type 2 diabetes.
DATA SOURCES
We conducted searches in seven databases, including Ovid MEDLINE, CINAHL, Ovid Embase, Cochrane Central, Web of Science, Ovid PsycInfo, and ProQuest Dissertations and Theses for articles published from inception to January 2021.
STUDY SELECTION
We included articles on controlled intervention studies in which researchers evaluated a lifestyle intervention provided during pregnancy and the postpartum period for women with or at risk for GDM that were published in English.
DATA EXTRACTION
Twelve articles that were reports of seven studies met the inclusion criteria. In some cases, more than one article was selected from the same study. For example, articles reported different outcomes from the same study. We extracted data with the use of a data collection form and compared and synthesized data on study design, purpose, sample, intervention characteristics, recruitment and retention, and outcomes.
DATA SYNTHESIS
All seven studies focused on weight management and/or healthy lifestyle behaviors (diet and physical activity). Outcomes included glucose regulation, weight, lifestyle behaviors, and knowledge. The interventions varied in duration/dosage, strategies, and modes of delivery. In four studies, researchers reported interventions that had significant effects on improving glucose regulation and/or weight change. Some characteristics from the four effective interventions included goal setting, individualized care, and good retention rates. In the other three studies, limitations included low rates of participant retention, lack of personalized interventions, and limited population diversity or lack of culturally sensitive care.
CONCLUSION
Lifestyle interventions provided during and after pregnancy to reduce the risk associated with GDM have the potential to improve outcomes. Health care counseling to promote healthy lifestyle behaviors related to the prevention of Type 2 diabetes is needed at different stages of maternity care for women with GDM. Additional high-quality studies are needed to address the limitations of current studies.
Topics: Diabetes Mellitus, Type 2; Diabetes, Gestational; Female; Humans; Life Style; Maternal Health Services; Postpartum Period; Pregnancy
PubMed: 34843670
DOI: 10.1016/j.jogn.2021.10.007