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Alternative Therapies in Health and... Jun 2024This study investigated the impact of the use of a family-based delivery room on primiparous women's clinical outcomes and psychological well-being during childbirth. It...
Comparison of Clinical Outcomes and Postpartum Psychological Status Scores in Primiparous Women Delivered with Family Members in a Family-Based Room vs Women Delivered in a General Ward.
BACKGROUND
This study investigated the impact of the use of a family-based delivery room on primiparous women's clinical outcomes and psychological well-being during childbirth. It addressed the growing interest in family-centered care and assessed the effectiveness of a family-based room in providing a supportive environment for delivery.
OBJECTIVE
We aimed to compare the clinical outcomes and postpartum scores regarding the psychological status of primiparous women who delivered with their families in a home-based labor ward and women who delivered in a general labor ward.
METHODS
In this retrospective study, 158 primiparous women, recruited between October 2021 and July 2022, were categorized into 2 groups based on their choice of delivery room: a family group (n=77) and a general group (n=81). Baseline data, indicators related to maternal role adjustment, pregnancy outcomes, psychological status, self-efficacy and quality of life (QoL) data were collected and compared between the 2 groups.
RESULTS
More women in the family group were well- and generally adapted than in the general group, and fewer were poorly adapted than in the general group (P < .05). There were more spontaneous deliveries in the family group than in the general group, and fewer cesarean deliveries, postpartum hemorrhages and cases of neonatal asphyxia than in the general group; lower postpartum Numerical Rating Scale (NRS) scores and higher Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores than in the general group, with notably better pregnancy outcomes in the family group (P < .05). Postpartum State Anxiety Inventory (S-AI) and Edinburgh Postnatal Depression Scale (EPDS) scores in the family group (50.25±1.58 and 8.02±0.35, respectively) were remarkably lower than in the general group (59.89±1.98 and 9.84±0.69, respectively) (P < .05). The family group exhibited a postpartum score of self-efficacy higher compared with the general group (P < .05). The QoL score in the family group was noticeably higher than in the general group (P < .05). The time of colostrum secretion in the family group was significantly earlier compared with the control group, and milk production within 48 hours postpartum was significantly higher in the family group (P < .05).
CONCLUSION
The family-based delivery room model significantly enhanced maternal role adaptation, increased the rate of spontaneous delivery, reduced the risk for cesarean conversion and diminished adverse maternal and infant outcomes. In addition, it substantially improved postpartum psychological status and positively influenced maternal self-efficacy and QoL. These findings hold significant reference value for maternal care practices.
PubMed: 38836737
DOI: No ID Found -
Neonatology Today Apr 2024The COVID-19 pandemic posed challenges to measuring mother-infant interactions, a critical outcome for many interventions to support mothers with postpartum depression...
PURPOSE
The COVID-19 pandemic posed challenges to measuring mother-infant interactions, a critical outcome for many interventions to support mothers with postpartum depression symptoms and their new infants. The current study describes the process and lessons learned from implementing a remote assessment of mother-infant interactions during the pandemic.
DESCRIPTION
At the onset of the COVID-19 pandemic, we pivoted from in-person to using two different strategies to remotely assess mother-infant interactions: (1) participants independently recorded and uploaded videos of free-play with their child; and (2) research team conducted a live-video recording of the free-play.
ASSESSMENT
We found initial barriers including technical and video quality issues but overall, a remote option could increase enrollment and retention rates in a sample of postpartum women across various racial/ethnic groups and economic levels.
CONCLUSION
Our experiences in conducting remote assessments with postpartum women add to growing evidence for the feasibility and validity of remote visits. This showed how our methods can be implemented in future research and in practice with postpartum mothers and their infants.
PubMed: 38836047
DOI: No ID Found -
Frontiers in Immunology 2024Depressive syndrome (DS) is a common complication during pregnancy and the postpartum period, and is triggered by multiple organic/genetic and environmental factors....
INTRODUCTION
Depressive syndrome (DS) is a common complication during pregnancy and the postpartum period, and is triggered by multiple organic/genetic and environmental factors. Clinical and biochemical follow-up is essential for the early diagnosis and prognosis of DS. The protozoan Toxoplasma gondii causes infectious damage to the fetus during parasite primary-infection. However, in long-term infections, pregnant women develop immune protection to protect the fetus, although they remain susceptible to pathological or inflammatory effects induced by T. gondii. This study aimed to investigate plasma inflammatory biomarkers in pregnant women seropositive and seronegative for T. gondii, with diagnoses of minor and moderate/severe DS.
METHODS
Pregnant women (n=45; age=18-39 years) were recruited during prenatal care at health centers in Ouro Preto, Minas Gerais, Brazil. Participants were asked to complete a socio-demographic questionnaire to be submitted to well-standardized DS scale calculators (Beck Depression Inventory Questionnaire, Edinburgh Postnatal Depression Scale, and Major Depressive Episode Module). Additionally, 4 mL of blood was collected for plasma neuroserpin, CCL2, IL-17A, and IL-33 analysis.
RESULTS
Pregnant volunteers with chronic T. gondii contact were all IgG+ (44%; n=21) and exhibited increased plasma IL-33, IL-17A, and neuroserpin levels, but not CCL2, compared to uninfected pregnant women. Using Beck's depression inventory, we observed an increase in plasma IL-17A and IL-33 in women with T. gondii infeCction diagnosed with mild DS, whereas neuroserpin was associated with minor and moderate/severe DS.
DISCUSSION
Our data suggest a close relationship between DS in pregnant women with chronic T. gondii infection and neurological conditions, which may be partially mediated by plasma neuroserpin, IL-33, and IL-17A levels.
Topics: Humans; Female; Pregnancy; Interleukin-17; Adult; Toxoplasmosis; Biomarkers; Interleukin-33; Young Adult; Toxoplasma; Adolescent; Pregnancy Complications, Parasitic; Depression
PubMed: 38835777
DOI: 10.3389/fimmu.2024.1394456 -
Frontiers in Psychiatry 2024Understanding the mechanisms underlying maternal postpartum depression (PPD) and its effects on offspring development is crucial. However, research on the association...
INTRODUCTION
Understanding the mechanisms underlying maternal postpartum depression (PPD) and its effects on offspring development is crucial. However, research on the association between maternal PPD, gut microbiota, and offspring neurodevelopment remains limited. This study aimed to examine the association of maternal PPD symptoms with early gut microbiome, gut metabolome, and neurodevelopment in infants at 6 months.
METHODS
Maternal PPD symptoms were assessed using the Edinburgh Postpartum Depression Scale (EPDS) at 42 days postpartum. Infants stool samples collected at 42 days after birth were analyzed using 16S rRNA sequencing and liquid chromatography-mass spectrometry (LC-MS) detection. Infant neurodevelopment was measured at 6 months using the Ages and Stages Questionnaire, Third Edition (ASQ-3). Correlations between gut microbiota, metabolites and neurodevelopment were identified through co-occurrence network analysis. Finally, mediation analyses were conducted to determine potential causal pathways.
RESULTS
A total of 101 mother-infant dyads were included in the final analysis. Infants born to mothers with PPD symptoms at 42 days postpartum had lower neurodevelopmental scores at 6 months. These infants also had increased alpha diversity of gut microbiota and were abundant in and , while depleted abundance of , , and Furthermore, alterations were observed in metabolite levels linked to the Alanine, aspartate, and glutamate metabolic pathway, primarily characterized by decreases in N-Acetyl-L-aspartic acid, L-Aspartic acid, and L-Asparagine. Co-occurrence network and mediation analyses revealed that N-Acetyl-L-aspartic acid and L-Aspartic acid levels mediated the relationship between maternal PPD symptoms and the development of infant problem-solving skills.
CONCLUSIONS
Maternal PPD symptoms are associated with alterations in the gut microbiota and neurodevelopment in infants. This study provides new insights into potential early intervention for infants whose mother experienced PPD. Further research is warranted to elucidate the biological mechanisms underlying these associations.
PubMed: 38835546
DOI: 10.3389/fpsyt.2024.1385229 -
Archives of Women's Mental Health Jun 2024This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation...
PURPOSE
This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation (giving the baby any breastmilk during the first week of life) and breastfeeding maintenance (giving the baby breastmilk for at least 6 months), and a greater likelihood of reporting breastfeeding problems.
METHODS
We analyzed data from the Norwegian Mother, Father, and Child cohort study (MoBa), N = 78,307. Mothers reported a lifetime history of depression during the second trimester of pregnancy, and current symptoms of depression during the third trimester using the Hopkins Symptoms Checklist short version (SCL-8). At six months postpartum, mothers self-reported breastfeeding initiation, maintenance, and difficulties.
RESULTS
Using binary logistic regression analyses, we report that a lifetime history of depression is associated with a lower likelihood of breastfeeding initiation (OR = 0.751, 95%CI = 0.650-0.938), breastfeeding maintenance (OR = 0.712, 95%CI = 0.669-0.785), and a greater likelihood of breastfeeding difficulties (OR = 1.86, 95%CI = 1.72-2.06). Similarly, prenatal depression was associated with a lower likelihood of breastfeeding initiation (OR = 0.904, 95%CI = 0.878-0.929), breastfeeding maintenance (OR = 0.929, 95%CI = 0.920-0.938), and a greater likelihood of breastfeeding difficulties (OR = 1.10, 95%CI = 1.09-1.12). Results remained largely unchanged when covaried for several confounding variables, including medication use.
CONCLUSION
We provide novel evidence that pre-conception and prenatal symptoms of depression are associated with breastfeeding outcomes. This information could be used to identify women very early in pregnancy who may need additional support with breastfeeding. There is also a need to fully understand the biopsychosocial mechanisms that mediate the relationship between depression prior to birth and breastfeeding outcomes.
PubMed: 38834917
DOI: 10.1007/s00737-024-01479-5 -
Journal of Obstetric, Gynecologic, and... Jun 2024To explore the relationship between symptoms of postpartum depression and the number of remote visitations among mothers of infants in the NICU.
OBJECTIVE
To explore the relationship between symptoms of postpartum depression and the number of remote visitations among mothers of infants in the NICU.
DESIGN
Retrospective cohort study.
SETTING
NICU in a medical university in Iwate, Japan.
PARTICIPANTS
A total of 89 mothers of infants who spent more than 1 month in the NICU from June 2021 to December 2022.
METHODS
Participants completed the Edinburgh Postnatal Depression Scale (EPDS) at 4 days and 1 month after birth. We used a one-way analysis of variance with Tukey-Kramer or Games-Howell post hoc tests to examine differences in postpartum depression among three groups based on the frequency of remote visitation: frequent visitation, rare visitation, or no visitation.
RESULTS
Of the 89 mothers, 41 scored 9 points or higher on the EPDS conducted 4 days after birth; among them, 14 did not visit, 13 rarely visited, and 14 frequently visited the NICU remotely through a web camera. The rare visitation group had significantly higher EPDS scores 1 month after birth (M = 9.7, SD = 5.2) than the frequent (M = 5.3, SD = 3.7) and no visitation (M = 5.1, SD = 4.2) groups (p < .05). The rare visitation group demonstrated lower improvement on the EPDS than the frequent and no visitation groups (nonsignificant).
CONCLUSION
It is unclear whether remote visitation reduces symptoms of postpartum depression; however, the frequency of remote visitation could be assessed to identify at-risk mothers in need of social support.
PubMed: 38834172
DOI: 10.1016/j.jogn.2024.05.136 -
Archives of Women's Mental Health Jun 2024The COVID-19 pandemic may have affected the mental health of pregnant and postpartum women, influencing the duration of exclusive breastfeeding and the child's...
BACKGROUND
The COVID-19 pandemic may have affected the mental health of pregnant and postpartum women, influencing the duration of exclusive breastfeeding and the child's neuropsychomotor development.
RESEARCH AIM
To evaluate the influence of COVID-19 on the mental health of postpartum women, on the protein and antioxidant profile of breast milk, on the duration of exclusive breastfeeding and on the neuropsychomotor development of their infants.
METHODS
Observational study, prospective cohort, with 180 postpartum women. Psychosocial status was assessed by changes in mood and lifestyle; trait and state anxiety, and postpartum depression. Breastfeeding time and neuropsychomotor development were determined at the three-month well-child consultation based on the child's health record and the WHO Anthro software. 5 ml of mature breast milk were collected from the full breast of the lactating women.
RESULTS
There was no difference between the prevalence of anxious traits and states and postpartum depression among seropositive and negative postpartum women for COVID-19. There was no difference in the prevalence of time and type of breastfeeding, and of normal and delayed neuropsychomotor development between seropositive and negative postpartum women for COVID-19. The fact that the baby smiles and raises and keeps his head elevated were associated with lower chances of an anxious state among postpartum women (OR: 0.23; OR: 0.28 and OR: 0.20, respectively).
CONCLUSIONS
The need for more studies to investigate the influence of the COVID-19 pandemic on the mental health of postpartum women, breastfeeding and the neuropsychomotor development of babies is highlighted, given the importance of breast milk for the growth and development of babies.
PubMed: 38832981
DOI: 10.1007/s00737-024-01478-6 -
Frontiers in Public Health 2024Perinatal depression affects the physical and mental health of pregnant women. It also has a negative effect on children, families, and society, and the incidence is...
BACKGROUND
Perinatal depression affects the physical and mental health of pregnant women. It also has a negative effect on children, families, and society, and the incidence is high. We constructed a cost-utility analysis model for perinatal depression screening in China and evaluated the model from the perspective of health economics.
METHODS
We constructed a Markov model that was consistent with the screening strategy for perinatal depression in China, and two screening strategies (screening and non-screening) were constructed. Each strategy was set as a cycle of 3 months, corresponding to the first trimester, second trimester, third trimester, and postpartum. The state outcome parameters required for the model were obtained based on data from the National Prospective Cohort Study on the Mental Health of Chinese Pregnant Women from August 2015 to October 2016. The cost parameters were obtained from a field investigation on costs and screening effects conducted in maternal and child health care institutions in 2020. The cost-utility ratio and incremental cost-utility ratio of different screening strategies were obtained by multiplicative analysis to evaluate the health economic value of the two screening strategies. Finally, deterministic and probabilistic sensitivity analyses were conducted on the uncertain parameters in the model to explore the sensitivity factors that affected the selection of screening strategies.
RESULTS
The cost-utility analysis showed that the cost of the screening strategy was 129.54 yuan, 0.85 quality-adjusted life years (QALYs) could be obtained, and the average cost per QALY gained was 152.17 yuan. In the non-screening (routine health care) group, the average cost was 171.80 CNY per person, 0.84 QALYs could be obtained, and the average cost per QALY gained was 205.05 CNY. Using one gross domestic product in 2021 as the willingness to pay threshold, the incremental cost-utility ratio of screening versus no screening (routine health care) was about -3,126.77 yuan, which was lower than one gross domestic product . Therefore, the screening strategy was more cost-effective than no screening (routine health care). Sensitivity analysis was performed by adjusting the parameters in the model, and the results were stable and consistent, which did not affect the choice of the optimal strategy.
CONCLUSION
Compared with no screening (routine health care), the recommended perinatal depression screening strategy in China is cost-effective. In the future, it is necessary to continue to standardize screening and explore different screening modalities and tools suitable for specific regions.
Topics: Humans; Female; Cost-Benefit Analysis; Pregnancy; China; Mass Screening; Markov Chains; Depression; Decision Trees; Prospective Studies; Pregnancy Complications; Adult; Quality-Adjusted Life Years
PubMed: 38832225
DOI: 10.3389/fpubh.2024.1308867 -
Acta Obstetricia Et Gynecologica... Jun 2024Postpartum depression is one of the most common non-obstetric postnatal complications. As the microbiome (and gut-brain axis) as well as inflammation may be involved in...
INTRODUCTION
Postpartum depression is one of the most common non-obstetric postnatal complications. As the microbiome (and gut-brain axis) as well as inflammation may be involved in the mechanism, we aimed to assess if antibiotic or gastric acid inhibition use during pregnancy affects the risk of postpartum depression (clinical diagnosis and/or antidepressant use up to 1 year after childbirth).
MATERIAL AND METHODS
This population-based cohort study used first singleton pregnancy resulting in a live birth in Sweden from 2006 to 2016. Women with history of depression were excluded. Multivariable logistic regression models were used to assess the impact of antibiotics and gastric acid inhibitors and other risk factors, presented as odds ratios (ORs) with 95% confidence intervals (CI).
RESULTS
Overall, 29% of all 10 666 women with postpartum depression were exposed to antibiotics and 6.2% to gastric acid inhibitors, compared to, respectively, 21% and 3.2% of 613 205 women without postpartum depression. Antibiotic use during pregnancy was associated with postpartum depression (OR 1.43, 95% CI 1.37-1.49), particularly for quinolones and other antibacterials (including nitroimidazole derivatives). Gastric acid inhibition was associated with an even higher risk than antibiotics (OR 2.04, 95% CI 1.88-2.21). Both antibiotics and gastric acid inhibitors suggested higher risk with increased dose in a dose-response analysis.
CONCLUSIONS
The use of antibiotics and gastric acid inhibition drugs during pregnancy appeared to be associated with a higher risk of postpartum depression. However, it is important to consider that other predisposing factors could contribute to this increased risk, even after excluding individuals with a history of depression.
PubMed: 38831623
DOI: 10.1111/aogs.14864 -
Molecular Neurobiology Jun 2024The prevalence of depression in women increases during the postpartum period. We previously reported that subchronic exposure to social stress decreased passive coping...
The prevalence of depression in women increases during the postpartum period. We previously reported that subchronic exposure to social stress decreased passive coping in postpartum female mice. This study aimed to investigate whether noradrenaline regulation might regulate coping styles in mice. We first determined whether a different type of stress, subchronic physical stress, decreases passive coping in postpartum females. Postpartum female, virgin female, and male mice were exposed to subchronic restraint stress (restraint stress for 4 h for 5 consecutive days). Subchronic restraint stress decreased passive coping in postpartum females but not in virgin females and males in the forced swim and tail suspension tests. We next examined the neuronal mechanism by which subchronic stress decreases passive coping in postpartum female mice. Neuronal activity and expression of noradrenergic receptors in the medial prefrontal cortex (mPFC) were analyzed using immunohistochemistry and reverse transcription-quantitative polymerase chain reaction, respectively. The mPFC was manipulated using chemogenetics, knockdown, or an α adrenergic receptor (AR) antagonist. Immunohistochemistry revealed that subchronic restraint stress increased glutamatergic neuron activation in the mPFC via forced swim stress and decreased α AR expression in postpartum females. Chemogenetic activation of glutamatergic neurons in the mPFC, knockdown of αAR in the mPFC, and the α AR receptor antagonist atipamezole treatment decreased passive coping in postpartum females. Subchronic restraint stress decreased passive coping in postpartum females by increasing glutamatergic neuron activity in the mPFC through α AR attenuation. The noradrenergic regulation of the mPFC may be a new target for treating postpartum depression.
PubMed: 38829510
DOI: 10.1007/s12035-024-04240-2