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BMC Pregnancy and Childbirth May 2016Perinatal depression has a significant impact on both mother and child. However, the influence of hormonal changes during pregnancy and the postpartum period remains... (Review)
Review
BACKGROUND
Perinatal depression has a significant impact on both mother and child. However, the influence of hormonal changes during pregnancy and the postpartum period remains unclear. This article provides a systematic review of studies examining the effects of maternal cortisol function on perinatal depression.
METHOD
A systematic search was conducted of six electronic databases for published research on the relationship between cortisol and perinatal depression. The databases included; MEDLINE complete, PsychINFO, SCOPUS, Psychology and Behavioural Sciences, Science Direct and EBSCO, for the years 1960 to May 2015. Risk of bias was assessed and data extraction verified by two investigators.
RESULTS
In total, 47 studies met criteria and studies showed considerable variation in terms of methodology including sample size, cortisol assays, cortisol substrates, sampling processes and outcome measures. Those studies identified as higher quality found that the cortisol awakening response is positively associated with momentary mood states but is blunted in cases of major maternal depression. Furthermore, results indicate that hypercortisolemia is linked to transient depressive states while hypocortisolemia is related to chronic postpartum depression.
DISCUSSION AND CONCLUSION
Future research should aim to improve the accuracy of cortisol measurement over time, obtain multiple cortisol samples in a day and utilise diagnostic measures of depression. Future studies should also consider both antenatal and postnatal depression and the differential impact of atypical versus melancholic depression on cortisol levels, as this can help to further clarify the relationship between perinatal depression and maternal cortisol function across pregnancy and the postpartum period.
Topics: Depression, Postpartum; Female; Humans; Hydrocortisone; Postpartum Period; Pregnancy
PubMed: 27245670
DOI: 10.1186/s12884-016-0915-y -
Comprehensive Physiology Jun 2016Successfully rearing young places multiple demands on the mammalian female. These are met by a wide array of alterations in maternal physiology and behavior that are... (Review)
Review
Successfully rearing young places multiple demands on the mammalian female. These are met by a wide array of alterations in maternal physiology and behavior that are coordinated with the needs of the developing young, and include adaptations in neuroendocrine systems not directly involved in maternal behavior or lactation. In this article, attenuations in the behavioral and neuroendocrine responses to stressors, the alterations in metabolic pathways facilitating both increased food intake and conservation of energy, and the changes in fertility that occur postpartum are described. The mechanisms underlying these processes as well as the factors that contribute to them and the relative contributions of these stimuli at different times postpartum are also reviewed. The induction and maintenance of the adaptations observed in the postpartum maternal brain are dependent on mother-young interaction and, in most cases, on suckling stimulation and its consequences for the hormonal profile of the mother. The peptide hormone prolactin acting on receptors within the brain makes a major contribution to changes in metabolic pathways, suppression of fertility and the attenuation of the neuroendocrine response to stress during lactation. Oxytocin is also released, both into the circulation and in some hypothalamic nuclei, in response to suckling stimulation and this hormone has been implicated in the decrease in anxiety behavior seen in the early postpartum period. The relative importance of these hormones changes across lactation and it is becoming increasingly clear that many of the adaptations to motherhood reviewed here reflect the outcome of multiple influences. © 2016 American Physiological Society. Compr Physiol 6:1493-1518, 2016.
Topics: Adaptation, Physiological; Affect; Animals; Brain; Eating; Energy Metabolism; Female; Fertility; Hormones; Humans; Lactation; Neurosecretory Systems; Postpartum Period; Stress, Psychological
PubMed: 27347899
DOI: 10.1002/cphy.c150036 -
Community Practitioner : the Journal of... May 2015
Review
Topics: Female; Humans; Postpartum Period; Pregnancy; Psychotic Disorders; Puerperal Disorders; Risk
PubMed: 26364332
DOI: No ID Found -
Maternal Sleep in Pregnancy and Postpartum Part I: Mental, Physical, and Interpersonal Consequences.Current Psychiatry Reports Mar 2019Sleep is a critical restorative behavior which occupies approximately one third of people's lives. Extensive data link sleep health with disease and mortality risk in... (Review)
Review
PURPOSE OF REVIEW
Sleep is a critical restorative behavior which occupies approximately one third of people's lives. Extensive data link sleep health with disease and mortality risk in the general population. During pregnancy and following childbirth, unique factors contribute to overall sleep health. In addition, there are unique implications of poor sleep during these time periods.
RECENT FINDINGS
Poor maternal sleep may contribute to risk for adverse birth outcomes as well as poor maternal physical and mental health in pregnancy, postpartum, and longer term during childrearing. Moreover, the extent to which notable racial disparities in sleep contribute to disparities in adverse perinatal health outcomes remains to be fully explicated. Part I of this two-part review details these implications of poor sleep for mental health, physical health outcomes, and relationship functioning, while Part II delves into biological mechanisms as well as treatment approaches.
Topics: Female; Humans; Interpersonal Relations; Mental Health; Postpartum Period; Pregnancy; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 30826881
DOI: 10.1007/s11920-019-0999-y -
BMC Pregnancy and Childbirth Jul 2023Complications in the postpartum period pose substantial risks to women and can result in significant maternal morbidity and mortality. However, there is much less...
BACKGROUND
Complications in the postpartum period pose substantial risks to women and can result in significant maternal morbidity and mortality. However, there is much less attention on postpartum care compared to pregnancy and childbirth. The goal of this study was to gather information on women's knowledge of postpartum care and complications, recovery practices after childbirth, perceived barriers to receiving care during the postpartum period, and educational needs in four health centers. The findings can inform the development of appropriate curriculum and interventions for postnatal care education in similar settings.
METHODS
A descriptive qualitative study design was employed. Eight focus group discussions were conducted among 54 postpartum women who delivered in four health centers in Sagnarigu District in Tamale, Ghana. Audio recordings of focus group data were transcribed and translated, and thematic analysis was conducted.
RESULTS
There were six main themes that emerged from the focus group discussions: 1) baby focused postpartum care; 2) postpartum practices; 3) inadequate knowledge ofpostpartum danger signs; 4) barriers to accessing postpartum care 5) experiences of poor mental health; and 6) need for postpartum education.
CONCLUSIONS
Postpartum care for women in this study was primarily perceived as care of the baby post-delivery and missing key information on physical and mental health care for the mother. This can result in poor adjustment postpartum and critically, a lack of knowledge on danger signs for common causes of morbidity and mortality in the postpartum period. Future research needs to understand how to communicate important information on postpartum mental and physical health to better protect mothers in the region.
Topics: Pregnancy; Female; Humans; Postnatal Care; Postpartum Period; Mothers; Parturition; Qualitative Research
PubMed: 37420215
DOI: 10.1186/s12884-023-05813-0 -
The American Journal of Nursing Jan 2024An urgent need to make pregnancy, birth, and the postpartum period safer.
An urgent need to make pregnancy, birth, and the postpartum period safer.
Topics: Female; Pregnancy; Humans; Maternal Health; Postpartum Period
PubMed: 38126827
DOI: 10.1097/01.NAJ.0001004912.26518.2c -
Physiology & Behavior Jan 2024Pregnancy is a transformative phase marked by significant behavioral and physiological changes. Substantial changes in pregnancy-related hormones are thought to induce... (Meta-Analysis)
Meta-Analysis Review
Pregnancy is a transformative phase marked by significant behavioral and physiological changes. Substantial changes in pregnancy-related hormones are thought to induce changes in chemosensory perception, as often observed in non-human animals. However, empirical behavioral research on pregnancy-related olfactory or gustatory changes has not yet reached a consensus. This PROSPERO pre-registered systematic review and meta-analysis evaluated published data of olfactory and gustatory changes in pregnant individuals, across the three pregnancy trimesters and postpartum period. Our comprehensive search strategy identified 20 relevant studies, for inclusion in the meta-analysis. The meta-analysis revealed that pregnant individuals, regardless of trimester, performed significantly poorer in terms of odour identification, however, no difference was detected between non-pregnant controls and women postpartum. Additionally, pregnant women in the second and third trimester rated olfactory stimuli to be more intense. A slight decline in odour pleasantness ratings was observed amongst those in the second trimester. No major difference was observed between pregnant and non-pregnant subjects in terms of gustatory functions, except the first trimester appeared to be associated with increased pleasantness for the sweet taste. Post-hoc meta-regression analyses revealed that pregnancy stage was a significant predictor for observed effect size for odour intensity ratings, but not for odour identification scores. These findings provide valuable insights into the interplay between pregnancy and chemosensory perception, highlighting systematic physiological changes due to pregnancy. Healthcare providers can also utilize the knowledge of sensory shifts to better support pregnant women in making appropriate dietary choices, managing sense-related discomfort, and leading to potential sensory interventions. Overall, this research enhances our comprehension of sensory shifts during pregnancy, benefiting maternal health and pregnancy-related care.
Topics: Pregnancy; Female; Humans; Postpartum Period; Smell; Taste Perception; Diet; Odorants
PubMed: 37890603
DOI: 10.1016/j.physbeh.2023.114388 -
Journal of Obstetric, Gynecologic, and... May 2022I applied a systematic ethical decision-making approach to evaluate how health care professionals in hospital settings should provide infant feeding support after...
I applied a systematic ethical decision-making approach to evaluate how health care professionals in hospital settings should provide infant feeding support after childbirth. Human milk is recommended as the optimal source of nutrition for infants because of the health benefits it provides for infants and their lactating parents. However, health consequences of insufficient oral intake in infants and psychological distress in the lactating parent may occur when infant feeding does not go according to plan. Infant feeding support should be provided in a way that is objective, sensitive, individualized, equitable, and supportive of autonomy and avoids harm. I provide recommendations for ethical infant feeding support that can be applied by individual health care professionals and on postpartum units in hospitals.
Topics: Breast Feeding; Female; Hospitals; Humans; Infant; Lactation; Milk, Human; Postpartum Period
PubMed: 35460604
DOI: 10.1016/j.jogn.2022.03.001 -
Nursing For Women's Health Feb 2023Bipolar disorder (BPD) is a lifelong mental health condition characterized by symptoms of mania, depression, and often anxiety. BPD can have detrimental consequences for...
Bipolar disorder (BPD) is a lifelong mental health condition characterized by symptoms of mania, depression, and often anxiety. BPD can have detrimental consequences for individuals during pregnancy and the postpartum period, as well as for their offspring. This is often due to underdiagnosis and/or misdiagnosis as unipolar depression. There is a high incidence of first episodes of BPD in pregnant and postpartum persons. Perinatal care providers need to routinely screen for BPD and assess for relapse among those with a previous diagnosis during the pregnancy and postpartum periods. Medication management is complex and must be considered in the context of an individual's risk factors and perceptions about treatment as well as the limited evidence regarding fetal safety, using a shared decision-making model. Collaboration, consultation, and/or referral to mental health care providers are essential for managing acute and chronic BPD symptoms.
Topics: Pregnancy; Female; Humans; Bipolar Disorder; Parturition; Postpartum Period; Anxiety Disorders; Anxiety
PubMed: 36528074
DOI: 10.1016/j.nwh.2022.11.001 -
Nursing For Women's Health Jun 2022To explore birth and at-home postpartum experiences of individuals with lower extremity nerve injury (LENI) related to childbirth.
OBJECTIVE
To explore birth and at-home postpartum experiences of individuals with lower extremity nerve injury (LENI) related to childbirth.
DESIGN
Mixed-methods, descriptive, cross-sectional survey with open-ended questions.
SETTING
Closed Facebook support group.
PARTICIPANTS
Two hundred-thirty individuals who experienced LENI during childbirth.
MEASUREMENTS
Two research team members developed the online LENI survey that incorporated suggestions from LENI support group leaders. We used descriptive statistics, linear regression, and Kaplan-Meier survival curves to summarize the quantitative data and used content analysis for open-ended items.
RESULTS
We described labor, birth, and postpartum characteristics in our sample, including immediate and long-term LENI symptoms. Falls resulting from LENI were common in the hospital (55.6%) and at home (75.6%). At discharge home, respondents reported low confidence in their ability to care for themselves and their infants as well as high levels of dependence on others. There was an 89.6% prevalence of depression in the first month at home. Approximately 80% of participants rated their degree of healing at 5 years as 80% to 100% healed. Content analysis yielded six themes: (a) Grieving Loss of Current and Future Life; (b) Caregiver Responses That Helped or Hindered; (c) Being in Danger; (d) Experiencing Emotional Turmoil; (e) Dealing With Family, Marital, and Financial Difficulties; and (f) Finding Strength, Overcoming Obstacles, and Experiencing Personal Growth.
CONCLUSION
Participants in our sample reported a very high rate of falls, anxiety, and depression at home. Nurses should recognize LENI symptoms, take action to prevent falls, and offer accurate information and referrals.
Topics: Anxiety; Cross-Sectional Studies; Depression, Postpartum; Female; Humans; Infant; Lower Extremity; Parturition; Postpartum Period; Pregnancy
PubMed: 35500638
DOI: 10.1016/j.nwh.2022.03.009