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BMC Psychology Oct 2023This study aimed to evaluate the correlation between parental attachment, resilience, postpartum traumatic stress disorder (PTSD), and maternal-infant bonding at 1 to 3...
AIMS
This study aimed to evaluate the correlation between parental attachment, resilience, postpartum traumatic stress disorder (PTSD), and maternal-infant bonding at 1 to 3 months postpartum. The mediation effect of resilience and PTSD on the postpartum parental attachment and maternal-infant bond was also evaluated.
DESIGN
A cross-sectional research design was used.
METHODS
A total of 400 postpartum women examined at a tertiary hospital in Wuhan from January 2021 to June 2021 were enrolled in the study. At about 1 to 3 months after giving birth, the women were asked to complete the Postpartum Bonding Questionnaire (PBQ), Connor-Davidson Resilience scale(CD-RISC), PTSD CheckList-Civilian version (PCL-C), and the Parental Bonding Instrument (PBI). The data were summarized using descriptive statistics. Mediation analyse and the Spearman correlation (r) were used to correlate the resilience and PTSD questionnaire scores.
RESULTS
The care attachment dimension was significantly associated with resilience (r = 0.24, p < 0.01), PTSD (r = - 0.27, p < 0.01), and maternal-infant bonding (r = 0.10, p < 0.01), and the overprotection attachment dimension was significantly associated with resilience (r = - 0.11, p < 0.01), PTSD (r = 0.33, p < 0.01), and maternal-infant bonding (r = 0.16, p < 0.01). Resilience and PTSD can mediate the relationship between attachment and maternal-infant bonding.
CONCLUSION
Parental attachment, resilience, and PTSD significantly affect maternal-infant bonding at 1 to 3 months postpartum.
IMPACT
This study demonstrated that new interventions aimed at addressing PTSD symptoms and improving resilience might increase parental attachment and maternal-infant bonding after birth. However, further research is required to evaluate the success of these interventions.
Topics: Pregnancy; Female; Humans; Infant; Mother-Child Relations; Cross-Sectional Studies; Postpartum Period; Mothers; Parents; Stress Disorders, Post-Traumatic; Stress Disorders, Traumatic; Object Attachment
PubMed: 37891637
DOI: 10.1186/s40359-023-01370-5 -
BMC Pregnancy and Childbirth Dec 2023Pregnancy causes physiological changes to the maternal organ systems that can be regarded as a cardiometabolic stress test for women. Preeclampsia, a pregnancy...
BACKGROUND
Pregnancy causes physiological changes to the maternal organ systems that can be regarded as a cardiometabolic stress test for women. Preeclampsia, a pregnancy complication characterized by new onset of hypertension in combination with proteinuria or end-organ dysfunction, affects approximately 2-8% of pregnancies. Adverse pregnancy outcomes, including preeclampsia, have been described as a failed stress test and have been consistently linked with increased risk of cardiovascular disease later in life. The postpartum period is therefore often regarded as a window of opportunity for cardiovascular disease prevention. However, we lack knowledge about how women with preeclampsia experience current postpartum care in the Norwegian health system. The aim of this qualitative study is to uncover women's perspectives and preferences regarding postpartum follow-up.
METHODS
Semi-structured telephone interviews were conducted with 17 women following a six-month lifestyle intervention study. Participants were 9-20 months postpartum, following a pregnancy complicated by preeclampsia. Data were analyzed using Malterud's systematic text condensation.
RESULTS
We identified five themes, each with 2-3 subthemes, that demonstrate how women with recent preeclampsia experience postpartum follow-up: (1) fear and uncertainty (a body out of balance and facing an uncertain future), (2) a conversation on lifestyle - not really that difficult (preeclampsia as a gateway, a respectful approach, and a desire for more constructive feedback), (3) when your own health is not a priority (a new everyday life, out of focus, and lack of support), (4) motivation for lifestyle changes (an eye opener, lack of intrinsic motivation, and a helping hand), and (5) lack of structured and organized follow-up (there should be a proper system, a one-sided follow-up care, and individual variation in follow-up care).
CONCLUSIONS
Findings from this study highlight the need for more systematic postpartum follow-up for women after a pregnancy complicated by preeclampsia. Further research is required to explore the potential use of standardized guidelines and routine invitations to postpartum care. Furthermore, exploring health care professionals' experiences is crucial to ensure their engagement in postpartum care after complicated pregnancies.
Topics: Pregnancy; Female; Humans; Pre-Eclampsia; Cardiovascular Diseases; Follow-Up Studies; Postpartum Period; Qualitative Research; Pregnancy Complications
PubMed: 38049716
DOI: 10.1186/s12884-023-06146-8 -
Annals of Behavioral Medicine : a... Sep 2023Postpartum weight retention is associated with adverse health among both civilian and military women. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Postpartum weight retention is associated with adverse health among both civilian and military women.
PURPOSE
The current study evaluated a stepped-care weight management intervention, Moms Fit 2 Fight, adapted for use in a pregnant and postpartum military population.
METHODS
Active duty women and other TRICARE beneficiaries (N = 430) were randomized to one of three conditions: gestational weight gain only (GWG-only) intervention (n =144), postpartum weight loss only (PPWL-only) intervention (n =142), or a combined GWG + PPWL intervention (n = 144). Those participants who received the PPWL intervention (i.e., the PPWL-only and GWG+PPWL conditions) were combined consistently with the pre-registered protocol and compared to those participants who did not receive the PPWL intervention in the primary analyses. Primary outcome data (i.e., postpartum weight retention) were obtained at 6-months postpartum by unblinded data collectors, and intent-to-treat analyses were conducted.
RESULTS
Retention at 6-months postpartum was 88.4%. Participants who received the PPWL intervention retained marginally less weight (1.31 kg) compared to participants that received the GWG-only intervention (2.39 kg), with a difference of 1.08 kg (p = .07). None of the measured covariates, including breastfeeding status, were significantly associated with postpartum weight retention. Of the participants who received the PPWL intervention, 48.1% participants returned to their pre-pregnancy weight at 6-months postpartum, with no significant differences compared to those who received the GWG-only intervention.
CONCLUSIONS
A behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reduced postpartum weight retention.
CLINICAL TRIAL INFORMATION
The trial is registered on clinicaltrials.gov (NCT03057808).
Topics: Pregnancy; Female; Humans; Obesity; Gestational Weight Gain; Military Personnel; Life Style; Pregnancy Complications; Postpartum Period; Weight Loss; Overweight; Body Mass Index
PubMed: 37061829
DOI: 10.1093/abm/kaad014 -
BMC Women's Health Aug 2023Postpartum hemorrhage, anemia, and iron deficiency are important health problems. Using safe, cheap, and available methods to reduce the amount of hemorrhage after... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Postpartum hemorrhage, anemia, and iron deficiency are important health problems. Using safe, cheap, and available methods to reduce the amount of hemorrhage after childbirth can be effective for the mother's health during this period. Therefore, this study was conducted to determine the effect of date fruit consumption on the amount of hemorrhage after natural childbirth.
METHODS
This randomized clinical trial was conducted on 98 women referred to the maternity ward of Al-Zahra Hospital in Rasht using the available sampling method. The primary outcome was postpartum hemorrhage, measured using the Pictorial Blood Loss Assessment Chart (PBLAC). Two hours after delivery, 100 g of date fruits were given to the intervention group, and the amount of hemorrhage was recorded during the first 24 h. Comparison between the two groups was done with the Mann-Whitney test with the Hodges-Lehmann estimator and corresponding exact conditional nonparametric confidence interval (CI) as effect estimate. A P < 0.05 was considered significant.
RESULTS
The median of postpartum hemorrhage after normal delivery in the date and control groups was 35.0 [interquartile range (IQR): 22.0 to 39.8] and 39.0 [IQR: 27.5 to 64.5], respectively. Using the Hodges-Lehmann estimator, on average, the median postpartum hemorrhage in the date group was 9.0 (95% CI: 2.00-18.0) units lower than the control group (P = 0.009).
CONCLUSION
Consumption of dates effectively reduces the amount of hemorrhage after natural childbirth; thus, consuming this fruit during postpartum period is recommended. Also to confirm the findings, it is recommended to conduct similar studies in this field.
TRIAL REGISTRATION
This trial was registered with the Iranian Registry of Clinical Trials; https://www.irct.ir/trial/59197 (IRCT20210607051505N2) on 31/10/2021.
Topics: Pregnancy; Female; Humans; Postpartum Hemorrhage; Phoeniceae; Iran; Delivery, Obstetric; Postpartum Period
PubMed: 37612639
DOI: 10.1186/s12905-023-02604-9 -
Frontiers in Public Health 2023Ambient heat exposure is increasing due to climate change and is known to affect the health of pregnant and postpartum women, and their newborns. Evidence for the...
BACKGROUND
Ambient heat exposure is increasing due to climate change and is known to affect the health of pregnant and postpartum women, and their newborns. Evidence for the effectiveness of interventions to prevent heat health outcomes in east Africa is limited. Codesigning and integrating local-indigenous and conventional knowledge is essential to develop effective adaptation to climate change.
METHODS
Following qualitative research on heat impacts in a community in Kilifi, Kenya, we conducted a two-day codesign workshop to inform a set of interventions to reduce the impact of heat exposure on maternal and neonatal health. Participants were drawn from a diverse group of purposively selected influencers, implementers, policy makers, service providers and community members. The key domains of focus for the discussion were: behavioral practices, health facilities and health system factors, home environment, water scarcity, and education and awareness. Following the discussions and group reflections, data was transcribed, coded and emerging intervention priorities ranked based on the likelihood of success, cost effectiveness, implementation feasibility, and sustainability.
RESULTS
Twenty one participants participated in the codesign discussions. Accessibility to water supplies, social behavior-change campaigns, and education were ranked as the top three most sustainable and effective interventions with the highest likelihood of success. Prior planning and contextualizing local set-up, cross-cultural and religious practices and budget considerations are important in increasing the chances of a successful outcome in codesign.
CONCLUSION
Codesign of interventions on heat exposure with diverse groups of participants is feasible to identify and prioritize adaptation interventions. The codesign workshop was used as an opportunity to build capacity among facilitators and participants as well as to explore interventions to address the impact of heat exposure on pregnant and postpartum women, and newborns. We successfully used the codesign model in co-creating contextualized socio-culturally acceptable interventions to reduce the risk of heat on maternal and neonatal health in the context of climate change. Our interventions can be replicated in other similar areas of Africa and serve as a model for co-designing heat-health adaptation.
Topics: Infant, Newborn; Pregnancy; Humans; Female; Kenya; Hot Temperature; Educational Status; Africa, Eastern; Postpartum Period
PubMed: 37719738
DOI: 10.3389/fpubh.2023.1146048 -
Comprehensive Psychiatry Apr 2024Peripartum depression (PPD) is a major depression disorder (MDD) episode with onset during pregnancy or within four weeks after childbirth, as defined in DSM-5. However,... (Review)
Review
BACKGROUND
Peripartum depression (PPD) is a major depression disorder (MDD) episode with onset during pregnancy or within four weeks after childbirth, as defined in DSM-5. However, research suggests that PPD may be a distinct diagnosis. The goal of this study was to summarize the similarities and differences between PPD and MDD by synthesizing the current research on PPD diagnosis concerning different clinical features and give directions for improving diagnosis of PPD in clinical practice.
METHODS
To lay the groundwork for this narrative review, several databases were searched using general search phrases on PPD and its components of clinical diagnosis.
RESULTS
When compared to MDD, peripartum depression exhibits several distinct characteristics. PPD manifests with a variety of symptoms, i.e., more anxiety, psychomotor symptoms, obsessive thoughts, impaired concentration, fatigue and loss of energy, but less sad mood and suicidal ideation, compared to MDD. Although PPD and MDD prevalence rates are comparable, there are greater cross-cultural variances for PPD. Additionally, PPD has some distinct risk factors and mechanisms such as distinct ovarian tissue expression, premenstrual syndrome, unintended pregnancy, and obstetric complications.
CONCLUSION
There is a need for more in-depth research comparing MDD with depression during pregnancy and the entire postpartum year. The diagnostic criteria should be modified, particularly with (i) addition of specific symptoms (i.e., anxiety), (ii) onset specifier extending to the first year following childbirth, (iii) and change the peripartum onset specifier to either "pregnancy onset" or "postpartum onset". Diagnostic criteria for PPD are further discussed.
Topics: Pregnancy; Female; Humans; Depression, Postpartum; Depression; Peripartum Period; Depressive Disorder, Major; Postpartum Period; Risk Factors
PubMed: 38306851
DOI: 10.1016/j.comppsych.2024.152456 -
Midwifery Nov 2023Depression is a prevalent mental disorder in the postpartum period, with consequences for both the mother and her offspring. However, longitudinal studies determining...
OBJECTIVE
Depression is a prevalent mental disorder in the postpartum period, with consequences for both the mother and her offspring. However, longitudinal studies determining the moments of greatest vulnerability and severity of depression during the postpartum period are scarce. The aims of this research were to determine the prevalence and trajectories of probable depression and major depression during the first year postpartum.
DESIGN
Longitudinal study.
SETTING
Interviews were conducted personally at three times: 2 months, 6 months and 1 year postpartum.
PARTICIPANTS
561 postpartum women.
MEASUREMENTS AND FINDINGS
Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Structured Clinical Interview (SCID) for the Diagnostic and Statistical Manual of Mental Disorders (DSM). Descriptive and comparative analyses have been carried out. The prevalence of probable depression at 2 months, 6 months and 1 year postpartum, using a cut-off point ≥ 10, was 30.3%, 26.0% and 25.3%, respectively; and that of major depression using SCID was 10.3%, 10.9% and 14.8, respectively. The prevalence of probable depression was highest at 2 months postpartum and that of major depression at 1 year postpartum. Probable depression followed a downward trajectory and major depression followed an upward trajectory.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
The clinical relevance of this research is that it has made it possible to demonstrate that depression is very prevalent in the first year postpartum and that, far from subsiding, the prevalence remains very high even at 1 year postpartum. Our findings highlight the importance of taking mental health care into account throughout at least the first year postpartum.
Topics: Female; Humans; Depression; Longitudinal Studies; Depressive Disorder, Major; Prevalence; Depression, Postpartum; Postpartum Period
PubMed: 37672853
DOI: 10.1016/j.midw.2023.103808 -
South African Medical Journal =... Sep 2023
Topics: Female; Humans; Depression, Postpartum; South Africa; Depression; Postpartum Period; Communication; Health Knowledge, Attitudes, Practice
PubMed: 37882124
DOI: 10.7196/SAMJ.2023.v113i9.1438 -
PloS One 2023Social support for postpartum women helps mothers to recover from childbirth and fosters healthy infant development. However, the impacts of reduced interpersonal...
Social support for postpartum women and associated factors including online support to reduce stress and depression amidst COVID-19: Results of an online survey in Thailand.
BACKGROUND
Social support for postpartum women helps mothers to recover from childbirth and fosters healthy infant development. However, the impacts of reduced interpersonal interactions inflicted by the COVID-19 outbreak on available social support for postpartum women have received little attention. Therefore, this study aimed to examine the levels of social support provided to postpartum women and associated factors in Thailand during the COVID-19 pandemic.
METHODS
A cross-sectional study was conducted from July to October 2021 using an anonymous online questionnaire. The responses of 840 eligible women up to six months postpartum in Thailand were obtained. The maternity social support scale was used to measure social support. Multivariate logistic regression was used to analyse the factors associated with social support among postpartum women.
RESULTS
About 57% of women reported to receive high support. Women in the high social support group were more likely to be married (aOR:2.70; 95% CI:1.57-4.66), have a university education or above (1.88; 1.35-2.64), have an intended pregnancy (2.06; 1.34-3.16), good health (2.01; 1.44-2.81), good sleep quality (1.62; 1.14-2.31), receive counsel from peers or family (1.56; 1.13-2.16), and use internet or social media to reduce stress and depression (1.51; 1.08-2.11). Meanwhile, women in the high social support group were significantly less likely to feed complementary foods to infants within 24 hours of completing the survey (0.28; 0.15-0.52).
CONCLUSIONS
The results of this study indicated that more than half of the women reported high support and illustrated the important role played by family, peers, and professionals as well as online and remote channels in providing postpartum informational and emotional support during the pandemic. Online platforms and remote support may be considered to provide social support to postpartum women during a pandemic such as COVID-19.
Topics: Child; Female; Pregnancy; Humans; COVID-19; Depression; Thailand; Cross-Sectional Studies; Pandemics; Postpartum Period; Social Support; Depression, Postpartum; Surveys and Questionnaires
PubMed: 37498895
DOI: 10.1371/journal.pone.0289250 -
Journal of Affective Disorders Mar 2024Maternal symptoms of depression and anxiety during pregnancy and early postnatal years are suggested to impose differential negative effects on child's socio-emotional...
Maternal symptoms of depression and anxiety during pregnancy and early postnatal years are suggested to impose differential negative effects on child's socio-emotional development depending on the characteristics of the symptoms, such as timing, intensity, and persistence. The aim of this study was to identify trajectories of maternal depressive and anxiety symptoms from pregnancy until 2 years postpartum and to examine their relationship with child socio-emotional problems and competence at 2 and 5 years of age. The sample included 1208 mother-infant dyads from FinnBrain Birth Cohort study. Latent growth mixture modelling (LGMM) was utilized to model the trajectories of maternal depressive symptoms, measured using the Edinburgh Postnatal Depression Scale (EPDS), and general anxiety, measured with Symptom Checklist-90 (SCL-90) at 14, 24, and 34 weeks' gestation (gw) and at 3, 6 and 24 months postpartum. Maternal depression was also assessed at 12 months. Child socio-emotional problems and competence were evaluated using the Brief Infant Toddler Social Emotional Assessment (BITSEA) at 2 years and Strengths and Difficulties Questionnaire (SDQ) at 5 years. Relevant background factors and maternal concurrent symptomatology were controlled for. The trajectories of maternal depressive and anxiety symptoms were associated negatively with differential aspects of child long term socio-emotional outcomes from early toddlerhood to preschool years. The trajectories of depressive symptoms and high-level persistent symptoms that continued from pregnancy to two years of child age had the strongest negative association with child outcomes. This highlights the importance of identifying and treating maternal symptomatology, especially that of depression, as early as possible.
Topics: Female; Pregnancy; Infant; Child, Preschool; Humans; Cohort Studies; Emotions; Mothers; Anxiety; Postpartum Period; Depression; Depression, Postpartum
PubMed: 38184113
DOI: 10.1016/j.jad.2023.12.076