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International Journal of Gynaecology... Apr 2024The current study aimed to address and rank which exercise-based interventions are preferable to standard care/no therapy or another exercise intervention for postpartum... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The current study aimed to address and rank which exercise-based interventions are preferable to standard care/no therapy or another exercise intervention for postpartum depression (PPD) management and provide estimates for future definitive evidence.
METHODS
The authors systematically searched PubMed, Embase, the Web of Science, PsycInfo, and ClinicalTrails.gov for randomized controlled trials (RCTs) on exercise-based interventions for PPD from their inception to May 9, 2023. Included were RCTs of exercise-based interventions for PPD with at least 4 weeks' duration. The pooled effects of intervention comparisons were generated by the Bayesian random-effects model, and the quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development, and Evaluations framework.
RESULTS
Twelve RCTs (1260 women; mean age, 20-35 years) comparing exercise-based interventions with usual care/no therapy were included. Exercise effectively treats depressive symptoms (standard mean difference [SMD], -0.81 [95% confidence interval (CI), -1.20 to -0.42], P < 0.001). Pram walking was significantly associated with a reduction of depressive symptoms during the postpartum period (SMD, -1.00 [95% CI, -2.60 to -0.10], P = 0.020), as well as yoga (SMD, -0.73 [95% CI, -1.84 to -0.43], P < 0.001) and supervised mixed exercise (SMD, -0.77 [95% CI, -1.67 to -0.01], P = 0.041) compared with usual care/no therapy. In indirect comparisons, pram walking (surface under the cumulative ranking curve, 58.9%) was better than yoga (SMD, -0.28 [95% CI, -1.86 to 1.22], P = 0.322) and supervised mixed exercise (SMD, -0.23 [95% CI, -1.59 to 1.12], P = 0.358). However, the difference was not statistically significant. The confidence in evidence was very low to moderate.
CONCLUSION
In women with PPD, all commonly prescribed physical exercises were effective alternative or complementary treatments. However, pram walking may perform better in improving the symptoms of PPD.
Topics: Female; Humans; Young Adult; Adult; Quality of Life; Depression, Postpartum; Network Meta-Analysis; Exercise; Depression
PubMed: 37688384
DOI: 10.1002/ijgo.15091 -
Psychiatry Research Oct 2023Positive allosteric modulators of γ-aminobutyric acid-A (GABA) receptors, or GABAkines, play important roles in the treatment of depression, epilepsy, insomnia, and... (Meta-Analysis)
Meta-Analysis
Positive allosteric modulators of γ-aminobutyric acid-A (GABA) receptors, or GABAkines, play important roles in the treatment of depression, epilepsy, insomnia, and other disorders. Recently, some new GABAkines (zuranolone and brexanolone) have been administrated to patients with major depressive disorder (MDD) or postpartum depression (PPD) in randomized controlled trials (RCTs). This study aims to systematically review and examine the efficacy and safety of zuranolone or brexanolone for treatment of depression. A systematic literature retrieval was conducted through August 20, 2023. RCTs evaluating the efficacy and safety of zuranolone or brexanolone for treatment of depression were included. Eight studies (nine reports) were identified in the study. The percentages of patients with PPD achieving Hamilton Depression Rating Scale (HAM-D) response and remission were significantly higher after brexanolone or zuranolone administration compared with placebo at different points. The percentages of patients with MDD achieving HAM-D response and remission were significantly increased during the zuranolone treatment period compared with placebo. In addition, zuranolone caused more adverse events in patients with MDD compared with placebo. Our findings support the effects of brexanolone on improving the core symptoms of depression in patients with PPD, and the potential of zuranolone in treating patients with MDD or PPD.
Topics: Female; Humans; Antidepressive Agents; Depression, Postpartum; Depression; Randomized Controlled Trials as Topic; Depressive Disorder, Major
PubMed: 37683318
DOI: 10.1016/j.psychres.2023.115450 -
Early Intervention in Psychiatry Oct 2023Postpartum depression is prevalent worldwide and seriously endangers maternal and child health. Previous studies have demonstrated the effectiveness of psychological and... (Review)
Review
Identifying the common elements of psychological and psychosocial interventions for preventing postpartum depression: Application of the distillation and matching model to 37 winning protocols from 36 intervention studies.
AIM
Postpartum depression is prevalent worldwide and seriously endangers maternal and child health. Previous studies have demonstrated the effectiveness of psychological and psychosocial intervention programmes in preventing postpartum depression. However, the literature offers limited practice guidance. Therefore, this study aimed to deeply analyse prior findings to gather rich evidence-based information on this topic.
METHODS
Using the distillation and matching model, we conducted a systematic review of psychological and psychosocial interventions used to effectively prevent postpartum depression. Four researchers trained in coding system independently read eligible studies and identified reliable (Cohen's kappa >0.40) and frequently occurring (frequency ≥3 winning study groups) practice elements.
RESULTS
Our review included 36 studies containing 37 winning study groups. Fourteen practice elements were identified and subsequently divided into six categories: postpartum practical problems-related, social support-related, interpersonal psychotherapy-related, cognitive behavioural therapy-related, labour trauma-related and non-specific techniques. The most common practice elements were baby care skills and mother-infant bonding/interaction enhancement. Inter-rater reliability averaged 0.86, ranging from 0.48 to 1.
CONCLUSION
The practice elements identified in this study provide rich evidence-based information that can guide clinical practitioners in selecting or developing effective, realistically available intervention programmes.
Topics: Child; Female; Humans; Cognitive Behavioral Therapy; Depression, Postpartum; Distillation; Psychosocial Intervention; Psychotherapy; Reproducibility of Results
PubMed: 37680169
DOI: 10.1111/eip.13462 -
Midwifery Oct 2023Postpartum depression (PPD) is associated with various adverse health outcomes among mothers and babies. Meta-synthesis can improve our understanding of postpartum... (Meta-Analysis)
Meta-Analysis
Postpartum depression (PPD) is associated with various adverse health outcomes among mothers and babies. Meta-synthesis can improve our understanding of postpartum women's experiences. However, the meta-analysis of PPD among Chinese women is limited. Therefore, a meta-analysis was conducted to evaluate the prevalence of PPD among Chinese women and if and how traditional culture may exacerbate PPD. Qualitative studies on the experiences of Chinese women with PPD were searched from database establishment until May 2022 in ten databases. The meta-ethnography reporting guidelines and framework was applied to the writing and reporting of this review. The protocol for this systematic review was registered with the International Prospective Register of Systematic Reviews (CRD42022323388). 2321 studies were retrieved, and 11 studies qualified for the meta-synthesis. The final five themes extracted and re-conceptualized from these studies were as follows: the gap between expectation and reality, conflicts with family, physical and mental frustrations, critical needs for coping with changes, and measures against PPD. Chinese women with PPD frequently feel vulnerable physically, mentally, or both after childbirth and often have conflicts with their families due to the influence of traditional Chinese culture. Family relationships and social support often are factors preventing women from seeking help.
Topics: Female; Humans; Depression, Postpartum; East Asian People; Mothers; Qualitative Research; Systematic Reviews as Topic
PubMed: 37659150
DOI: 10.1016/j.midw.2023.103795 -
Journal of Advanced Nursing Feb 2024This study aimed to systematically identify, appraise and synthesize qualitative evidence which explored fathers' experiences and perspectives of their partners'... (Review)
Review
AIMS
This study aimed to systematically identify, appraise and synthesize qualitative evidence which explored fathers' experiences and perspectives of their partners' postpartum psychosis.
DESIGN
Qualitative evidence synthesis (QES).
DATA SOURCES
Seven databases (CINAHL, PsycINFO, Medline, Scopus, Google Scholar, ProQuest Dissertations and Open Grey) were systematically searched for qualitative studies from each database's inception to the 17th of February 2022.
REVIEW METHODS
Studies that utilized a qualitative research design to explore fathers' experiences and perspectives of their partners' postpartum psychosis were included. Studies were appraised using the Critical Appraisal Skills Programme to determine their methodological quality. Qualitative data were extracted and synthesized using the process of thematic synthesis to form analytical themes.
RESULTS
Eleven reports (seven journal articles and four theses), representing six unique qualitative studies were included in the review. Two analytical themes and eight subthemes were identified. The analytical themes were 'a sense of loss across multiple domains of their lives', and 'informational and emotional support needs'.
CONCLUSION
Postpartum psychosis is a severe mental health condition which also impacts the woman's partner. Fathers experienced an array of emotions which they attributed to a lack of knowledge and understanding of postpartum psychosis. The development of appropriate support structures is needed to better support fathers in supporting their partners.
REPORTING METHOD
This review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement and ENTREQ reporting guidelines.
PATIENT OR PUBLIC CONTRIBUTION
There was no patient or public contribution.
IMPACT
WHAT PROBLEM DID THIS STUDY ADDRESS?: Fathers play a pivotal role in supporting their partner who has postpartum psychosis, and a supportive father has a positive impact on the mental health of the mother. Several qualitative studies have explored fathers' experiences of their partners' psychosis. This QES integrated findings from these studies to gain a deeper understanding and knowledge of the father's experience. WHAT ARE THE MAIN FINDINGS?: Fathers reported a significant sense of loss across multiple domains of their lives, from a perceived loss of their relationship with their partner to a loss of the future they had planned together. Fathers experienced an array of emotions, such as fear and shock which they attributed to their lack of knowledge and awareness of postpartum psychosis. WHERE AND ON WHOM WILL THIS RESEARCH HAVE AN IMPACT?: This review provides a deeper insight and understanding into the father's experiences and perspectives of their partners' postpartum psychosis. This insight can inform healthcare professionals and policymakers in the development of appropriate support structures which meet the needs of this population. The provision of appropriate support structures could have a positive impact on the father's well-being and ability to support their partner.
Topics: Female; Humans; Male; Puerperal Disorders; Psychotic Disorders; Mothers; Qualitative Research; Fathers; Postpartum Period
PubMed: 37658618
DOI: 10.1111/jan.15832 -
Medicine Aug 2023This systematic review and meta-analysis aimed to evaluate the clinical effectiveness of low-dose aspirin combined with calcium supplements for the prevention of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This systematic review and meta-analysis aimed to evaluate the clinical effectiveness of low-dose aspirin combined with calcium supplements for the prevention of preeclampsia.
METHODS
China National Knowledge Infrastructure, VIP, Wanfang, PubMed, EMBASE, and Cochrane Library databases were searched from inception until December 2022. Randomized controlled trials investigating the preventive use of aspirin in combination with calcium supplementation for preeclampsia in high-risk pregnant women were included. The quality of the literature was evaluated, and a meta-analysis was conducted using RevMan 5.3 software to analyze the clinical efficacy of low-dose aspirin combined with calcium supplementation in preventing preeclampsia.
RESULTS
Seven randomized controlled trials were included in this meta-analysis, and compared with the control group, the experimental group had lower incidence rates of preeclampsia with gestational hypertension (odds ratios [OR]: 0.17, 95% confidence interval [CI]: 0.11-0.28), preeclampsia (OR: 0.20, 95% CI: 0.10-0.37), gestational hypertension (OR: 0.15, 95% CI: 0.07-0.31), preterm birth (OR: 0.26, 95% CI: 0.16-0.44), postpartum hemorrhage (OR: 0.15, 95% CI: 0.08-0.27), and fetal growth restriction (OR: 0.16, 95% CI: 0.08-0.33).
CONCLUSION
Compared with aspirin alone, low-dose aspirin combined with calcium supplementation was more effective in preventing preeclampsia, reduced the risk of preterm birth and postpartum hemorrhage, and promoted fetal growth. This intervention has clinical value and should be considered for high-risk pregnant women.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Calcium; Pre-Eclampsia; Hypertension, Pregnancy-Induced; Postpartum Hemorrhage; Premature Birth; Calcium, Dietary; Aspirin; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 37653760
DOI: 10.1097/MD.0000000000034620 -
Reproduction in Domestic Animals =... Nov 2023Mastitis is a common condition in rabbit (Oryctolagus cuniculus) does, especially in rabbitries where mammae inflammations are the leading pathological expression of... (Review)
Review
Mastitis is a common condition in rabbit (Oryctolagus cuniculus) does, especially in rabbitries where mammae inflammations are the leading pathological expression of Staphylococcus aureus infections in reproductive females. It affects both the litter and the lactating female, including subsequent lactations. Non-septic (i.e. galactostasis and cystic mastitis) and septic (i.e. Mastitis acuta; including Mastitis gangrenosa; and Mastitis chronica) mammary inflammations are acknowledged; however, the literature is scarce regarding non-septic inflammations or subclinical mastitis. Thus, the present systematic review highlights and summarizes the existing data concerning mastitis in rabbit does, including diagnosis and treatment plans.
Topics: Female; Animals; Rabbits; Lactation; Inflammation; Mastitis; Reproduction; Staphylococcal Infections
PubMed: 37650360
DOI: 10.1111/rda.14466 -
Reproductive Sciences (Thousand Oaks,... Feb 2024Pregnant women are encouraged to reduce sitting time and replace it with physical activity. Complications arising during pregnancy include gestational hypertension,... (Review)
Review
Pregnant women are encouraged to reduce sitting time and replace it with physical activity. Complications arising during pregnancy include gestational hypertension, preeclampsia, gestational diabetes mellitus (GDM), and prenatal and postpartum depression. In this systematic review, we examined effects of sedentary behavior on the health of pregnant women. We conducted a systematic review with PubMed from year 2000 to identify the relationship between a sedentary lifestyle and psychological effects, occurrence of GDM, gestational hypertension, and preeclampsia. Data extracted included sedentary time of pregnant women, psychological effects, occurrence of GDM, gestational hypertension, and preeclampsia as outcomes. Among the 200 studies retrieved, 11 were finally included after screening. The mean age of eligible pregnant women ranged from 28.5 to 32.9 years. Five studies were extracted with outcomes of psychological effects on the mother, five with GDM, and one with gestational hypertension/preeclampsia. Longer sedentary time was associated with increased risks of prepartum/postpartum depression in three of five studies and GDM in three of five studies. No association was found between sedentary behavior and the risk for gestational hypertension/preeclampsia. Higher sedentary behavior in the second trimester of pregnancy was likely to be associated with postpartum depression. Longer sitting time may increase the risk of prenatal or postnatal depression and GDM, but no relationship was proven for gestational hypertension and preeclampsia in one study. High sedentary behavior in the second trimester may have psychological impacts. The number of studies was small and further research is needed to statistically evaluate impacts of sedentary behavior during pregnancy.
Topics: Pregnancy; Female; Humans; Adult; Sedentary Behavior; Pregnant Women; Pre-Eclampsia; Depression, Postpartum; Hypertension, Pregnancy-Induced; Diabetes, Gestational
PubMed: 37644379
DOI: 10.1007/s43032-023-01321-w -
Journal of Integrative and... Feb 2024Preventing postpartum depression (PPD) is a public health goal. The scientific literature has demonstrated the short-term efficacy of Mindfulness-Based Interventions... (Meta-Analysis)
Meta-Analysis Review
Mindfulness-Based Interventions During Pregnancy and Long-Term Effects on Postpartum Depression and Maternal Mental Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Preventing postpartum depression (PPD) is a public health goal. The scientific literature has demonstrated the short-term efficacy of Mindfulness-Based Interventions (MBIs) delivered during pregnancy on PPD. Nevertheless, the long-term outcomes of MBIs are still unclear. Systematic review and meta-analysis of randomized controlled trials (RCTs). Four databases were searched to identify RCTs focused on describing the efficacy of MBIs on PPD and published in English up to February 2022. The study was conducted globally. Pregnant women who received MBIs. MBIs were delivered during pregnancy in the included RCTs. Data collection and analysis effect size were combined using a random-effects model. The reporting in this study was consistent with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Six studies were included. The overall effect size significantly reduced PPD symptoms severity in the MBI group versus the control group in the first 3 months after childbirth (standardized mean difference = -0.26; 95% confidence interval = -0.51 to -0.01; = 30.65%). The effects of MBIs were significant in women who started MBIs with a low risk of developing PPD. MBIs delivered during pregnancy have long-term benefits for PPD. Further studies focused on testing MBIs starting during pregnancy and lasting over the postpartum and modulating the intensity of delivering MBIs based on the risk for developing PPD are needed to inform the practice with solid evidence.
Topics: Pregnancy; Female; Humans; Mental Health; Mindfulness; Depression, Postpartum; Randomized Controlled Trials as Topic; Postpartum Period
PubMed: 37638799
DOI: 10.1089/jicm.2023.0114 -
Animal Reproduction Science Sep 2023Mastitis is a rare condition that can be diagnosed in female cats of all breeds and ages. It is usually caused by bacterial agents and is frequently encountered... (Review)
Review
Mastitis is a rare condition that can be diagnosed in female cats of all breeds and ages. It is usually caused by bacterial agents and is frequently encountered secondarily in feline mammary fibroepithelial hyperplasia (FEH). If left untreated, it can peril both the queen and her kittens. Therefore, a reliable and quick diagnosis is the primary key to successful treatment. Conventional diagnosis consists of a clinical and ultrasound evaluation of the queen's mammary glands. However, there is a lack of literature specifically focused on mastitis in queens. Consequently, the present review brings forth the existing knowledge regarding mammary gland inflammations in cats, with the goal of improving current clinical evaluation and treatment plans.
Topics: Cats; Animals; Female; Inflammation; Mastitis; Cat Diseases
PubMed: 37586155
DOI: 10.1016/j.anireprosci.2023.107318