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Anaesthesia, Critical Care & Pain... Feb 2024Postpartum pain is associated with impaired maternal recovery and may influence mother-infant bonding. (Observational Study)
Observational Study
INTRODUCTION
Postpartum pain is associated with impaired maternal recovery and may influence mother-infant bonding.
METHODS
Participants who underwent a vaginal or cesarean delivery were assessed 24 h postpartum. Postpartum pain intensity was measured using the Verbal Numeric Score (VNS) (0-10) and classified as non-severe (<8) or severe pain (≥8). Maternal-infant bonding was evaluated using the Post-Partum Bonding Questionnaire (PBQ; 0-125), with a score > 5 defining impaired bonding. Demographic data included age, BMI, parity, education level, economic status, partnership, prior history of depression, familial history of depression, desire to breastfeed, epidural analgesia during labor, rooming in, and Edinburgh Postnatal Depression Scale (EPDS). Data were analyzed using 2 separate multivariable logistic regression models for vaginal and cesarean deliveries, where maximum postpartum pain was the independent variable and impaired postpartum bonding was the dependent variable and controlled for the other factors collected.
RESULTS
Severe postpartum pain (VNS ≥ 8) showed no significant relationship with impaired bonding when controlling for confounding variables. In vaginal deliveries, there was an association between a history of depression and impaired bonding (Odds Ratio 2.2 [1.07-4.65], p = 0.04) and EPDS > 10 and impaired bonding (OR 11.5 [3.2-73.6], p < 0.001). For cesarean deliveries, rooming in with the baby had a protective effect (OR 11.5 [3.2-73.6], p < 0.001).
CONCLUSIONS
Contrary to expectations, severe postpartum pain did not influence maternal-infant binding in the cohort of patients with vaginal and cesarean deliveries. Instead, factors such as maternal mental health and rooming-in practices appeared to exert more significant influence.
CLINICAL TRIAL REGISTRATION
NCT05206552.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Pain; Postpartum Period; Mother-Child Relations
PubMed: 37865216
DOI: 10.1016/j.accpm.2023.101315 -
The Veterinary Clinics of North... Jul 2023This article reviews the history of clinical hypocalcemia and the evolving definition of subclinical hypocalcemia, targeting a concept for consideration that not all... (Review)
Review
This article reviews the history of clinical hypocalcemia and the evolving definition of subclinical hypocalcemia, targeting a concept for consideration that not all hypocalcemia is negative. With a goal of presenting bovine practitioners information to assist with individual animal hypocalcemia diagnosis and treatment as well as herd-level monitoring and prevention, we present current methods of direct calcium measurement, therapeutic interventions for clinical hypocalcemia, and postpartum calcium supplementation options and their efficacy. We encourage veterinarians to understand calcium dynamics in the immediate postpartum period and evaluate how individual cow therapy and herd prevention protocols can assist with supporting calcium regulation.
Topics: Female; Cattle; Animals; Calcium; Hypocalcemia; Cattle Diseases; Lactation; Postpartum Period
PubMed: 37032301
DOI: 10.1016/j.cvfa.2023.02.009 -
British Journal of Sports Medicine Jul 2023
Topics: Female; Pregnancy; Humans; Sports; Athletes; Occupations; Postpartum Period
PubMed: 37399320
DOI: 10.1136/bjsports-2023-107256 -
Journal of Mammary Gland Biology and... Jul 2023The onset of pregnancy marks the start of offspring development, and represents the key physiological event that induces re-organization and specialization of breast... (Review)
Review
The onset of pregnancy marks the start of offspring development, and represents the key physiological event that induces re-organization and specialization of breast tissue. Such drastic tissue remodeling has also been linked to epithelial cell transformation and the establishment of breast cancer (BC). While patient outcomes for BC overall continue to improve across subtypes, prognosis remains dismal for patients with gestational breast cancer (GBC) and post-partum breast cancer (PPBC), as pregnancy and lactation pose additional complications and barriers to several gold standard clinical approaches. Moreover, delayed diagnosis and treatment, coupled with the aggressive time-scale in which GBC metastasizes, inevitably contributes to the higher incidence of disease recurrence and patient mortality. Therefore, there is an urgent and evident need to better understand the factors contributing to the establishment and spreading of BC during pregnancy. In this review, we provide a literature-based overview of the diagnostics and treatments available to patients with BC more broadly, and highlight the treatment deficit patients face due to gestational status. Further, we review the current understanding of the molecular and cellular mechanisms driving GBC, and discuss recent advances in model systems that may support the identification of targetable approaches to block BC development and dissemination during pregnancy. Our goal is to provide an updated perspective on GBC, and to inform critical areas needing further exploration to improve disease outcome.
Topics: Pregnancy; Female; Humans; Breast Neoplasms; Postpartum Period; Prognosis; Lactation; Models, Biological
PubMed: 37450228
DOI: 10.1007/s10911-023-09546-w -
European Journal of Sport Science Aug 2023We explored the association of physical fitness (PF) during pregnancy with maternal body composition indices along pregnancy and postpartum period. The study comprised...
We explored the association of physical fitness (PF) during pregnancy with maternal body composition indices along pregnancy and postpartum period. The study comprised 159 pregnant women (32.9 ± 4.7 years old). Assessments were carried out at the 16th and 34th gestational weeks (g.w.) and six weeks postpartum. Cardiorespiratory fitness (CRF), muscular strength (absolute and relative values) and flexibility were measured. Body composition indices were obtained by using dual-energy X-ray absorptiometry at postpartum. The results, after adjusting for potential covariates at the 16th g.w., indicated that greater CRF was associated with lower postpartum indices total fat mass, android and gynoid fat mass (all, < 0.05). Greater absolute upper-body muscular strength was associated with greater pre-pregnancy body mass index (BMI), gestational weight gain (GWG); and postpartum indices body weight, BMI, lean mass, fat free mass, fat mass, gynoid fat mass, T-score and Z-score bone mineral density (BMD) (all, < 0.05). Greater upper-body flexibility was associated with lower pre-pregnancy BMI; and postpartum indices body weight, BMI, lean mass, fat free mass, fat mass, android fat mass and gynoid fat mass, and with greater GWG (all, < 0.05). At the 34th g.w., greater CRF was additionally associated with greater postpartum T-score and Z-score BMD (both, < 0.05). In conclusion, this study reveals that greater PF levels, especially during early pregnancy, may promote a better body composition in the postpartum period. Therefore, clinicians and health promoters should encourage women to maintain or improve PF levels from early pregnancy.
Topics: Pregnancy; Female; Humans; Adult; Body Composition; Postpartum Period; Physical Fitness; Gestational Weight Gain; Absorptiometry, Photon; Body Mass Index
PubMed: 35986555
DOI: 10.1080/17461391.2022.2115405 -
Revue Medicale Suisse Oct 2023Headache is a common complaint in the postpartum period and is benign in most cases. Physiological adaptations during pregnancy and childbirth put women at risk of...
Headache is a common complaint in the postpartum period and is benign in most cases. Physiological adaptations during pregnancy and childbirth put women at risk of secondary headaches and the clinician must be able to identify them at an early stage. The management algorithm described in this article provides a systematic assessment based on 4 key points: the clinical presentation, which refers to specific clinical pictures or severity criteria, the clinical context and the evolution of symptoms focusing on potential complications and known associations between different diseases. Indications for imaging (CT or MRI) and possible treatments during breastfeeding are also detailed.
Topics: Pregnancy; Female; Humans; Headache; Postpartum Period; Breast Feeding; Parturition
PubMed: 37850805
DOI: 10.53738/REVMED.2023.19.846.1922 -
Journal of Midwifery & Women's Health 2023Physical activity is important for improving and maintaining overall health across the life span, including during and after pregnancy. Achieving recommended levels of...
INTRODUCTION
Physical activity is important for improving and maintaining overall health across the life span, including during and after pregnancy. Achieving recommended levels of physical activity can be challenging during pregnancy and the postpartum period. The US Office of Disease Prevention and Health Promotion sought to promote physical activity during and after pregnancy through the development of health education materials for the Move Your Way campaign. Research was conducted with pregnant and postpartum people to learn what types of messages and materials would encourage physical activity in these populations.
METHODS
Participants were recruited from 3 regions of the United States to participate in 90-minute virtual focus groups. Eligible participants were aged 18 years or older and either pregnant or 6 weeks to 1 year postpartum. Participants were asked questions about their beliefs, attitudes, and perceptions about physical activity and prompted to provide feedback on health promotion messages and images. Sessions were recorded, transcribed, and analyzed for key themes.
RESULTS
Twenty-four focus groups were conducted with 48 pregnant participants and 52 postpartum participants. Sixteen sessions were conducted in English and 8 were conducted in Spanish. Most participants had questions about how much physical activity is recommended, and many cited their health care provider as a trusted source of information. Participants responded positively to materials that acknowledged the uniqueness of each pregnant or postpartum experience, referenced gradually increasing physical activity levels, highlighted the benefits of physical activity, focused on safety, addressed common barriers, and displayed realistic representations of physical activity.
DISCUSSION
There is an opportunity to improve messaging about physical activity during and after pregnancy. To better promote physical activity, perinatal health care providers and other health professionals can share information about recommended amounts of physical activity, communicate the benefits, and promote realistic and achievable physical activity messages that address common barriers in these populations.
Topics: Pregnancy; Female; Humans; United States; Postpartum Period; Exercise; Health Promotion; Delivery of Health Care; Focus Groups; Qualitative Research
PubMed: 37288762
DOI: 10.1111/jmwh.13513 -
JAMA Dec 2023
Topics: Female; Humans; Cardiovascular Diseases; Cardiovascular System; Health Status; Postpartum Period; Risk Factors; United States
PubMed: 37966864
DOI: 10.1001/jama.2023.19192 -
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 -
Australian Journal of Primary Health Jul 2023The lack of access to and uptake of postpartum contraception is a key contributor to an estimated 121million unintended pregnancies worldwide. Research on counselling...
BACKGROUND
The lack of access to and uptake of postpartum contraception is a key contributor to an estimated 121million unintended pregnancies worldwide. Research on counselling and women's preferences for postpartum contraception is scarce in Australia. We therefore aimed to explore Australian women's experiences of, and preferences for, accessing postpartum contraceptive counselling.
METHOD
In this qualitative study, English-speaking women of reproductive age (18-40years) with at least one child under the age of 5years were recruited via social media to participate in a semi-structured telephone interview. Interviews focussed on women's experiences of, and preferences for, postpartum contraception. The interviews were audio-recorded, transcribed, coded and thematically analysed.
RESULTS
Twenty women participated. Most did not receive in-depth contraceptive counselling antenatally or postnatally, though had brief discussions with their GPs or obstetricians at the 6-week postnatal check. Participants felt some counselling throughout their antenatal and postnatal care would have been useful, particularly those who experienced medical complications perinatally. Most participants expressed a general preference for their GP or a midwife to provide such counselling, rather than an obstetrician or nurse, and they noted characteristics such as compassion, trust and care as being particularly important.
CONCLUSION
The provision of postpartum contraceptive counselling could be enhanced in Australia. Contraceptive uptake in the postpartum period may be promoted by ensuring consistent and routine provision of contraceptive counselling for women antenatally and postnatally by their maternity carers.
Topics: Child; Pregnancy; Female; Humans; Adolescent; Young Adult; Adult; Child, Preschool; Australia; Postpartum Period; Contraception; Contraceptive Agents; Counseling
PubMed: 36265546
DOI: 10.1071/PY22163