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Iranpour S, Kheirabadi GR, Esmaillzadeh A, Heidari-Beni M, Maracy MR. Association between sleep quality and postpartum depression. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 21:110. [PMID: 28250787 PMCID: PMC5322694 DOI: 10.4103/1735-1995.193500] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 07/24/2016] [Accepted: 08/10/2016] [Indexed: 11/12/2022]
Abstract
Background: The objective of this study was an investigation of the association between depression and sleep quality. Materials and Methods: This cross-sectional study was performed on 360 delivered women that referred to thirty health-care centers in Ardabil, Iran. The Standard Pittsburgh Sleep Quality Index questionnaire was used to the investigation of sleep quality. We used the Edinburgh Postnatal Depression Questionnaire to assess postpartum depression. Logistic regression was used to examine the association of sleep quality with postpartum depression. Results: Chance of depression in women with poor sleep quality was 3.34 times higher than those with good sleep quality (odds ratio = 3.34; 95% confidence interval: 2.04–5.48; P < 0.001). After controlling for some risk factors, an association observed between sleep quality and depression in postpartum women. Conclusion: we found an association between sleep quality in women who had given birth in the last 3 months and symptoms of postpartum depression.
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Affiliation(s)
- Sohrab Iranpour
- Department of Public Health, Faculty of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Gholam Reza Kheirabadi
- Behavioral Sciences Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran
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52
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Li J, Yin H, Bibus DM, Byelashov OA. The role of Omega-3 docosapentaenoic acid in pregnancy and early development. EUR J LIPID SCI TECH 2016. [DOI: 10.1002/ejlt.201600076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Juan Li
- Omega Protein Corporation; Houston; TX USA
| | | | - Douglas M. Bibus
- University of Minnesota; Minneapolis; MN USA
- Lipid Technologies; LLC.; Austin MN USA
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Sereshti M, Nahidi F, Simbar M, Bakhtiari M, Zayeri F. An Exploration of the Maternal Experiences of Breast Engorgement and Milk Leakage after Perinatal Loss. Glob J Health Sci 2016; 8:53876. [PMID: 27157167 PMCID: PMC5064060 DOI: 10.5539/gjhs.v8n9p234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022] Open
Abstract
Introduction and Purpose: Perinatal loss is one of the toughest events of life. Physiological milk secretion after perinatal loss adds to complicacy of the hardships of the event. The present study is aimed at exploring women’s experience with breast problems and milk leakage after perinatal loss. Methods: The Study was carried out through explorative quality approach with 18 participants. Sampling method was purposeful and selecting the participants from widest variety was ensured. Data gathering was through deep semi-structured interview and data analyses were done by conventional content analysis. Reliability and validity of the data were ensured by collecting data from a wide range of participants and frequent revisions. Findings: Data analysis indicated four themes including beyond pain, longing being mother, insufficiency of provided information and coping Strategies, and beliefs and values regarding milk leakage and breast engorgement. Conclusion: The findings suggested that health care givers needed to inform the patients about probability milk leakage and breast engorgement and remedies to reduce pains and problems of breast engorgement.
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Affiliation(s)
- M Sereshti
- Shahid Beheshti University of Medical Sciences,Tehran,iran.
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Deans C, Reay R, Buist A. Addressing the mother–baby relationship in interpersonal psychotherapy for depression: an overview and case study. J Reprod Infant Psychol 2016. [DOI: 10.1080/02646838.2016.1221502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Human milk and breastfeeding: An intervention to mitigate toxic stress. Nurs Outlook 2016; 65:58-67. [PMID: 27502763 DOI: 10.1016/j.outlook.2016.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 06/30/2016] [Accepted: 07/04/2016] [Indexed: 01/07/2023]
Abstract
The American Academy of Nursing has identified toxic stress in childhood as a health policy concern of high priority. Adult diseases (e.g., obesity, diabetes, hypertension and cardiovascular disease) should be viewed as developmental disorders that begin early in life that could be reduced with the alleviation of toxic stress in childhood. The provision of human milk/breastfeeding is an evidence-based intervention that may hold the greatest potential to mitigate the effects of toxic stress from the moment of birth. Assisting families to make an informed choice to initiate and continue breastfeeding from birth has the potential to address both the disparity in the quality of nutrition provided infants and the economic stress experienced by families who purchase formula. The Expert Panel on Breastfeeding endorses initiatives to improve the initiation, duration, and exclusivity of breastfeeding to mitigate the effects of toxic stress in this call to action for research to build the evidence to support these critical relationships.
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56
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Maternal alterations in the proteome of the medial prefrontal cortex in rat. J Proteomics 2016; 153:65-77. [PMID: 27233742 DOI: 10.1016/j.jprot.2016.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/19/2016] [Accepted: 05/10/2016] [Indexed: 12/14/2022]
Abstract
Proteomic differences between rat dams and control mothers deprived of their pups immediately after delivery were investigated in the medial prefrontal cortex (mPFC). A 2-D DIGE minimal dye technique combined with LC-MS/MS identified 32 different proteins that showed significant changes in expression in the mPFC, of which, 25 were upregulated and 7 were downregulated in dams. The identity of one significantly increased protein, the small heat-shock protein alpha-crystallin B chain (Cryab), was confirmed via Western blot analysis. Alpha-crystallin B chain was distributed in scattered cells in the mPFC, as demonstrated by immunohistochemistry. Furthermore, it was found to be localized in parvalbumin-containing neurons using double labeling. The elevation of its mRNA level in rat dams was also demonstrated via RT-PCR. The functional classification of the altered proteins was conducted using the UniProt and Gene Ontology protein databases. The identified proteins predominantly participate in synaptic transport and plasticity, neuron development, oxidative stress and apoptosis, and cytoskeleton organization. A common regulator and target analysis of these proteins determined using the Elsevier Pathway Studio Platform suggests that protein level changes associated with pup nursing are driven by growth factors and cytokines, while the MAP kinase pathway was identified as a common target. A high proportion of the proteins that were found to be altered in the mPFC are associated with depression. BIOLOGICAL SIGNIFICANCE The behavior and emotional state of females change robustly when they become mothers. The brain, which governs these changes, may also undergo molecular alterations in mothers. As no proteomics approaches have been applied regarding maternal changes in the brain, we addressed this issue in the mPFC as this brain area is the uppermost cortical center of maternal control and the associated mood changes. The high number of protein-level alterations found between mothers taking care of their litter and those without pups indicates that pup nursing is associated with cortical protein-level changes. Alterations in proteins participating in synaptic transport, plasticity and neuron development suggest neuroplastic changes in the maternal brain. In turn, the relatively high number of altered proteins in the mPFC associated with depression suggests that the physiological effects of the protein-level alterations in the maternal mPFC could promote the incidence of postpartum depression. Cryab, a protein confirmed to be increased during maternal behaviors, was selectively found in parvalbumin cells, which, as fast-spiking interneurons, are associated with depression. The function of Cryab should be further investigated to establish whether it can be used to identify drug targets for future drug development.
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57
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Baeza C. Chronic Mastitis, Mastalgia, and Breast Pain. CLINICAL LACTATION 2016. [DOI: 10.1891/2158-0782.7.1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Whereas the management of acute mastitis seems clear, there is little scientific evidence to support management of chronic mastitis/breast pain. This article reviews bacteriological findings, their possible meanings, and their use in clinical settings. Clinical experience, newer and more accurate microbiological techniques, and the growing knowledge about our metagenome have many insights to offer.
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58
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New evidence on breastfeeding and postpartum depression: the importance of understanding women's intentions. Matern Child Health J 2015; 19:897-907. [PMID: 25138629 PMCID: PMC4353856 DOI: 10.1007/s10995-014-1591-z] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed to identify the causal effect of breastfeeding on postpartum depression (PPD), using data on mothers from a British survey, the Avon Longitudinal Study of Parents and Children. Multivariate linear and logistic regressions were performed to investigate the effects of breastfeeding on mothers' mental health measured at 8 weeks, 8, 21 and 32 months postpartum. The estimated effect of breastfeeding on PPD differed according to whether women had planned to breastfeed their babies, and by whether they had shown signs of depression during pregnancy. For mothers who were not depressed during pregnancy, the lowest risk of PPD was found among women who had planned to breastfeed, and who had actually breastfed their babies, while the highest risk was found among women who had planned to breastfeed and had not gone on to breastfeed. We conclude that the effect of breastfeeding on maternal depression is extremely heterogeneous, being mediated both by breastfeeding intentions during pregnancy and by mothers' mental health during pregnancy. Our results underline the importance of providing expert breastfeeding support to women who want to breastfeed; but also, of providing compassionate support for women who had intended to breastfeed, but who find themselves unable to.
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60
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Purdy IB, Craig JW, Zeanah P. NICU discharge planning and beyond: recommendations for parent psychosocial support. J Perinatol 2015; 35 Suppl 1:S24-8. [PMID: 26597802 PMCID: PMC4660049 DOI: 10.1038/jp.2015.146] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 09/18/2015] [Indexed: 11/16/2022]
Abstract
Parents will interact with a multitude of teams from various disciplines during their child's admission to the neonatal intensive care unit. Recognition of the emotional stressors experienced by these parents is a first step in working to provide the crucial support and parenting skills needed for bonding and caring for their infant from admission through discharge and beyond. Family-centered care involves time-sensitive two-way communication between parents and the multidisciplinary team members who coordinate care transition by providing emotional, educational, medical and home visitor support for these families. To do this well, a thoughtful exchange of information between team members and parents is essential to identify psychosocial stress and ameliorate family concerns. Parents will need emotional and educational support and follow-up resources. Establishing individualized, flexible but realistic, pre- and post-discharge plans with parents is needed to start their healthy transition to home and community.
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Affiliation(s)
- I B Purdy
- Division of Neonatology, Department of Pediatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - J W Craig
- School of Occupational Therapy, Brenau University, Gainesville, GA, USA
| | - P Zeanah
- Cecil Picard Center for Child Development and College of Nursing and Allied Sciences, University of Louisiana, Lafayette, LA, USA
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61
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Ahn S, Corwin EJ. The association between breastfeeding, the stress response, inflammation, and postpartum depression during the postpartum period: Prospective cohort study. Int J Nurs Stud 2015; 52:1582-90. [PMID: 26143358 PMCID: PMC4540671 DOI: 10.1016/j.ijnurstu.2015.05.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/16/2015] [Accepted: 05/19/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND Research suggests that exclusive breastfeeding may have a stress-protective role in postpartum depression; however, less is known about the underlying mechanisms by which this protection may occur or whether the protective relationship holds for women who mix breast and bottle feeding. OBJECTIVES To examine patterns of the stress response, inflammation, and depressive symptoms among women predominantly breastfeeding or bottle feeding their infants at 6 months postpartum. DESIGN A part of a larger longitudinal study across 6 months postpartum investigating the psychoneuroimmunology (PNI) of postpartum depression. SETTING Prenatal clinics and community. PARTICIPANTS One hundred nineteen postpartum women who met inclusion/exclusion criteria and followed up from the prenatal period to postpartum 6 months. METHODS Data were collected during seven home visits occurring during the 3rd trimester (weeks 32-36) and on postpartum days 7 and 14, months 1, 2, 3, and 6. Women completed stress and depression surveys and provided blood for pro- (IL-1β, IL-6, IL-8, TNF-a, IFN-γ) and anti-inflammatory (IL-10) cytokines, and collected saliva for diurnal cortisol. RESULTS Self-report of predominant breastfeeding during 6 months postpartum ranged from 91.9% at day 7 to 70.6% at month 6 postpartum. There were no associations between the pattern of feeding and depressive symptoms. Biological differences, however, existed between the groups, with levels of salivary cortisol at 8 AM and 8:30 AM at month 6 higher and levels of IL-6 at month 6 lower in women who primarily breastfed compared to those who primarily bottle fed their infants after controlling for confounding variables. CONCLUSIONS Breastfeeding was not related to postpartum depression however differences in stress and inflammatory markers are apparent at month 6 postpartum.
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Affiliation(s)
- Sukhee Ahn
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea.
| | - Elizabeth J Corwin
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Room 244, Atlanta, GA 30322, United States.
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Boddy AM, Fortunato A, Wilson Sayres M, Aktipis A. Fetal microchimerism and maternal health: a review and evolutionary analysis of cooperation and conflict beyond the womb. Bioessays 2015; 37:1106-18. [PMID: 26316378 PMCID: PMC4712643 DOI: 10.1002/bies.201500059] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The presence of fetal cells has been associated with both positive and negative effects on maternal health. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. We use cooperation and conflict theory to generate testable predictions about domains in which fetal microchimerism may enhance maternal health and those in which it may be detrimental. This framework suggests that fetal cells may function both to contribute to maternal somatic maintenance (e.g. wound healing) and to manipulate maternal physiology to enhance resource transmission to offspring (e.g. enhancing milk production). In this review, we use an evolutionary framework to make testable predictions about the role of fetal microchimerism in lactation, thyroid function, autoimmune disease, cancer and maternal emotional, and psychological health. Also watch the Video Abstract.
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Affiliation(s)
- Amy M Boddy
- Department of Psychology, Arizona State University, Tempe, AZ, USA.,Center for Evolution and Cancer, University of California San Francisco, San Francisco, CA, USA
| | - Angelo Fortunato
- Center for Evolution and Cancer, University of California San Francisco, San Francisco, CA, USA
| | - Melissa Wilson Sayres
- Center for Evolution and Medicine, The Biodesign Institute, Arizona State University, Tempe, AZ, USA.,School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Athena Aktipis
- Department of Psychology, Arizona State University, Tempe, AZ, USA.,Center for Evolution and Cancer, University of California San Francisco, San Francisco, CA, USA.,Center for Evolution and Medicine, The Biodesign Institute, Arizona State University, Tempe, AZ, USA
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63
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Kao JC, Johnson J, Todorova R, Zlotnick C. The Positive Effect of a Group Intervention to Reduce Postpartum Depression on Breastfeeding Outcomes in Low-Income Women. Int J Group Psychother 2015; 65:445-58. [PMID: 26076207 PMCID: PMC4470302 DOI: 10.1521/ijgp.2015.65.3.445] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study examined, as a secondary analysis, whether a group interpersonal psychotherapy (IPT) intervention focused on preventing postpartum depression by strengthening social support and building interpersonal skills during the transition to motherhood positively affected breastfeeding outcomes among low-income women. The intervention-Reach Out, Stand strong, Essentials for new mothers (ROSE)-taught participants the importance of self-care and assertive help seeking to be better able to sustain breastfeeding practices. Ninety-nine pregnant women were randomized to ROSE plus standard care or to standard care alone. Though women in both conditions had similar breastfeeding initiation rates, women in ROSE had longer breastfeeding duration (median days breastfed: 54 vs. 21). Results suggest ROSE may positively affect breastfeeding.
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Affiliation(s)
| | - Jennifer Johnson
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Caron Zlotnick
- Warren Alpert Medical School of Brown University, Providence, RI, USA
- Director of Behavioral Medicine Research, Women and Infants Hospital, Providence, RI, USA
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Gingnell M, Bannbers E, Moes H, Engman J, Sylvén S, Skalkidou A, Kask K, Wikström J, Sundström-Poromaa I. Emotion Reactivity Is Increased 4-6 Weeks Postpartum in Healthy Women: A Longitudinal fMRI Study. PLoS One 2015; 10:e0128964. [PMID: 26061879 PMCID: PMC4465482 DOI: 10.1371/journal.pone.0128964] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 05/01/2015] [Indexed: 01/31/2023] Open
Abstract
Marked endocrine alterations occur after delivery. Most women cope well with these changes, but the postpartum period is associated with an increased risk of depressive episodes. Previous studies of emotion processing have focused on maternal–infant bonding or postpartum depression (PPD), and longitudinal studies of the neural correlates of emotion processing throughout the postpartum period in healthy women are lacking. In this study, 13 women, without signs of post partum depression, underwent fMRI with an emotional face matching task and completed the MADRS-S, STAI-S, and EPDS within 48 h (early postpartum) and 4–6 weeks after delivery (late postpartum). Also, data from a previous study including 15 naturally cycling controls assessed in the luteal and follicular phase of the menstrual cycle was used. Women had lower reactivity in insula, middle frontal gyrus (MFG), and inferior frontal gyrus (IFG) in the early as compared to the late postpartum assessment. Insular reactivity was positively correlated with anxiety in the early postpartum period and with depressive symptoms late postpartum. Reactivity in insula and IFG were greater in postpartum women than in non-pregnant control subjects. Brain reactivity was not correlated with serum estradiol or progesterone levels. Increased reactivity in the insula, IFG, and MFG may reflect normal postpartum adaptation, but correlation with self-rated symptoms of depression and anxiety in these otherwise healthy postpartum women, may also suggest that these changes place susceptible women at increased risk of PPD. These findings contribute to our understanding of the neurobiological aspects of the postpartum period, which might shed light on the mechanisms underlying affective puerperal disorders, such as PPD.
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Affiliation(s)
- Malin Gingnell
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Elin Bannbers
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Harmen Moes
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Jonas Engman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Sara Sylvén
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Kristiina Kask
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Johan Wikström
- Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden
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65
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Kim Y, Ahn S. A Review of Postpartum Depression: Focused on Psychoneuroimmunological Interaction. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2015; 21:106-114. [PMID: 37684816 DOI: 10.4069/kjwhn.2015.21.2.106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/07/2015] [Accepted: 05/24/2015] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this review was to describe a psychoneuroimmunology (PNI) framework for postpartum depression (PPD) and discuss its implications for nursing research and practice for postpartum women. METHODS This study explored the role of hypothalamic-pituitary-adrenal (HPA) axis and inflammation as possible mediators of risk factors for PPD through literature review. RESULTS From this PNI view, human bodies are designed to respond with the reciprocal interactions among the neuro-endocrine and immune system when they are faced with physical or psychological stressors. Chronic stress induces alterations in the function of HPA axis, and a chronic low-grade inflammatory response is associated with depression. The dysfunctions of cytokines and HPA axis have been observed during the postpartum period. Stress promotes glucocorticoid receptor resistance, which can promote inflammatory responses. This, in turn, can contribute to the pathophysiology of depression. This can especially affect populations at vulnerable time-points, such as women in the postpartum. CONCLUSION From a PNI perspective, well-designed prospective research evaluating the role of stress and inflammation as an etiology of PPD and the effect of stress reduction is warranted to prevent PPD.
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Affiliation(s)
- Yunmi Kim
- College of Nursing, Gachon University, Incheon, Korea
| | - Sukhee Ahn
- College of Nursing, Gachon University, Incheon, Korea
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66
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Hughes A, Gallagher S, Hannigan A. A Cluster Analysis of Reported Sleeping Patterns of 9-Month Old Infants and the Association with Maternal Health: Results from a Population Based Cohort Study. Matern Child Health J 2015; 19:1881-9. [DOI: 10.1007/s10995-015-1701-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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67
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Yim IS, Tanner Stapleton LR, Guardino CM, Hahn-Holbrook J, Dunkel Schetter C. Biological and psychosocial predictors of postpartum depression: systematic review and call for integration. Annu Rev Clin Psychol 2015; 11:99-137. [PMID: 25822344 PMCID: PMC5659274 DOI: 10.1146/annurev-clinpsy-101414-020426] [Citation(s) in RCA: 377] [Impact Index Per Article: 41.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Postpartum depression (PPD) adversely affects the health and well being of many new mothers, their infants, and their families. A comprehensive understanding of biopsychosocial precursors to PPD is needed to solidify the current evidence base for best practices in translation. We conducted a systematic review of research published from 2000 through 2013 on biological and psychosocial factors associated with PPD and postpartum depressive symptoms. Two hundred fourteen publications based on 199 investigations of 151,651 women in the first postpartum year met inclusion criteria. The biological and psychosocial literatures are largely distinct, and few studies provide integrative analyses. The strongest PPD risk predictors among biological processes are hypothalamic-pituitary-adrenal dysregulation, inflammatory processes, and genetic vulnerabilities. Among psychosocial factors, the strongest predictors are severe life events, some forms of chronic strain, relationship quality, and support from partner and mother. Fully integrated biopsychosocial investigations with large samples are needed to advance our knowledge of PPD etiology.
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Affiliation(s)
- Ilona S Yim
- Department of Psychology and Social Behavior, University of California, Irvine, California 92697;
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68
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Mazaheri MA, Rabiei L, Masoudi R, Hamidizadeh S, Nooshabadi MRR, Najimi A. Understanding the factors affecting the postpartum depression in the mothers of Isfahan city. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2014; 3:65. [PMID: 25077158 PMCID: PMC4113998 DOI: 10.4103/2277-9531.134784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Depression is one of the most common and specific problems during pregnancy and after it. Maternal postpartum depression compromises mother's health and affects social relationship, and has negative effect on infant development. The aim of this study was to investigate the prevalence of postpartum depression and its related factors in Isfahanian mothers. MATERIALS AND METHODS This is a cross - sectional study. The study populations were 133 women who at the last 8-4 weeks of labor referred to Isfahan health centers. Demographic information and obstetric and Beck Depression Inventory were applied. Three categories emerged according to the degree of scale: Mild, moderate, and severe depression. Statistical analysis was used with the Pearson correlation and linear regression in SPSS version 18. RESULTS A total of 73 mothers had mild depression (10-19) and 56 had moderate depressions (20-29). Among the factors related to depression such as maternal education, financial status, unwanted pregnancy, premenstrual syndrome, and maternal occupational history, there was a significant correlation with postpartum depression (P > 0.05). Variables in the regression analysis include maternal education, financial status, unwanted pregnancy, history of premenstrual syndrome, maternal occupation, type of delivery, history of miscarriage, and having a satisfaction with baby gender. And, a total of 27.7% variance explains the postpartum depression. Among these factors, the predictive variables of maternal education, type of delivery, financial condition, unwanted pregnancy, premenstrual syndrome, and maternal occupational history were significant in the meantime; the prediction of unplanned pregnancy was more than other variables (ß = 0.24). CONCLUSIONS With attention to factors associated with postpartum depression, the healthcare planner will help to better manage the problem. The results of this study will help to better understand the factors influencing mothers in the labor process, and mothers in the labor process, experiences minimum mental health disorders.
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Affiliation(s)
- Maryam Amidi Mazaheri
- Departments of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leili Rabiei
- Departments of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Masoudi
- Department of Nursing, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Saeid Hamidizadeh
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Arash Najimi
- Departments of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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69
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Figueiredo B, Canário C, Field T. Breastfeeding is negatively affected by prenatal depression and reduces postpartum depression. Psychol Med 2014; 44:927-936. [PMID: 23822932 DOI: 10.1017/s0033291713001530] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND This prospective cohort study explored the effects of prenatal and postpartum depression on breastfeeding and the effect of breastfeeding on postpartum depression. METHOD The Edinburgh Postpartum Depression Scale (EPDS) was administered to 145 women at the first, second and third trimester, and at the neonatal period and 3 months postpartum. Self-report exclusive breastfeeding since birth was collected at birth and at 3, 6 and 12 months postpartum. Data analyses were performed using repeated-measures ANOVAs and logistic and multiple linear regressions. RESULTS Depression scores at the third trimester, but not at 3 months postpartum, were the best predictors of exclusive breastfeeding duration (β = -0.30, t = -2.08, p < 0.05). A significant decrease in depression scores was seen from childbirth to 3 months postpartum in women who maintained exclusive breastfeeding for ⩾3 months (F 1,65 = 3.73, p < 0.10, η p 2 = 0.05). CONCLUSIONS These findings suggest that screening for depression symptoms during pregnancy can help to identify women at risk for early cessation of exclusive breastfeeding, and that exclusive breastfeeding may help to reduce symptoms of depression from childbirth to 3 months postpartum.
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Affiliation(s)
- B Figueiredo
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - C Canário
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - T Field
- University of Miami Medical School, Miami, FL, USA
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Assarian F, Moravveji A, Ghaffarian H, Eslamian R, Atoof F. The association of postpartum maternal mental health with breastfeeding status of mothers: a case-control study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e14839. [PMID: 24829776 PMCID: PMC4005438 DOI: 10.5812/ircmj.14839] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 12/17/2013] [Accepted: 02/02/2014] [Indexed: 11/16/2022]
Abstract
Background: Maternal health status might have an important effect on breastfeeding, growth, and general health of the infants. Objectives: This study was conducted to assess the association between maternal mental health and breastfeeding status of mothers in Kashan province. Patients and Methods: This case-control study was conducted on 458 mothers in two groups of unsuccessful breastfeeding (case) and successful breastfeeding (control) attending Kashan province health clinics. In this study, the GHQ questionnaire and clinical interview were employed to collect data. The data were statistically analyzed using Chi-square and Fisher’s exact tests. Results: It was found that mothers of the case group had a greater susceptibility to depression than those of the control group, that is, breastfeeding status was directly associated with susceptibility to depression (P = 0.001, OR = 5.48). Furthermore, there was a significant association between basic characteristics such as maternal occupational status (P = 0.04) or their educations (P = 0.006) with breastfeeding. Besides, clinical interview revealed that mixed depression and anxiety disorder was the most prevalent type of psychological disorder in the case group. Conclusions: Screening depression during pregnancy and postpartum period appeared to be necessary and it should be incorporated into prenatal and postnatal care due to its influence on mothers’ successful breastfeeding.
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Affiliation(s)
- Fatemeh Assarian
- Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Alireza Moravveji
- Social Determinants of Health Research Center, Department of Community Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding Author: Alireza Moravveji, Social Determinants of Health Research Center, Department of Community Medicine, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615420001, Fax: +98-9132634208, E-mail:
| | - Hamideh Ghaffarian
- Deputy of Health, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Reihaneh Eslamian
- Student Research Committee, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Fatemeh Atoof
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, IR Iran
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Fair C, Wiener L, Zadeh S, Albright J, Mellins CA, Mancilla M, Tepper V, Trexler C, Purdy J, Osherow J, Lovelace S, Kapetanovic S. Reproductive health decision-making in perinatally HIV-infected adolescents and young adults. Matern Child Health J 2014; 17:797-808. [PMID: 22736033 DOI: 10.1007/s10995-012-1070-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a "think tank" session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed.
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Hahn-Holbrook J, Haselton MG, Dunkel Schetter C, Glynn LM. Does breastfeeding offer protection against maternal depressive symptomatology?: A prospective study from pregnancy to 2 years after birth. Arch Womens Ment Health 2013; 16:411-22. [PMID: 23749095 PMCID: PMC3818091 DOI: 10.1007/s00737-013-0348-9] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 03/27/2013] [Indexed: 11/29/2022]
Abstract
Mothers who breastfeed typically exhibit lower levels of depressive symptomatology than mothers who do not. However, very few studies have investigated the directionality of this relationship. Of the prospective studies published, all but one focus exclusively on whether maternal depression reduces rates of subsequent breastfeeding. This study again examines this relationship, but also the reverse-that breastfeeding might predict lower levels of later depression. Using multilevel modeling, we investigated the relationship between breastfeeding and self-reported depressive symptomatology in 205 women followed prenatally and at 3, 6, 12, and 24 months after birth. Consistent with previous research, women with prenatal depressive symptomatology weaned their infants 2.3 months earlier, on average, than women without such symptomatology. We also found, however, that women who breastfed more frequently at 3 months postpartum showed greater subsequent declines in depressive symptomatology over time compared to women who breastfed less frequently, resulting in lower absolute levels of depressive symptoms by 24 months postpartum, controlling for important confounds. In sum, these findings are consistent with a bidirectional association between breastfeeding and depression, with prenatal depression predicting less breastfeeding soon after birth and breastfeeding predicting declines in maternal depression up to 2 years after birth. We discuss mechanisms that could potentially explain these associations and avenues for future research.
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Affiliation(s)
- Jennifer Hahn-Holbrook
- Department of Psychology and the Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA, USA,
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Osborne LM, Monk C. Perinatal depression--the fourth inflammatory morbidity of pregnancy?: Theory and literature review. Psychoneuroendocrinology 2013; 38:1929-52. [PMID: 23608136 PMCID: PMC4376311 DOI: 10.1016/j.psyneuen.2013.03.019] [Citation(s) in RCA: 175] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 03/20/2013] [Accepted: 03/21/2013] [Indexed: 01/22/2023]
Abstract
Perinatal depression is one of the leading causes of maternal morbidity and mortality. The biological etiology of this disorder remains in question, despite considerable research into the contributions of hormonal imbalance, the role of monoamines, and dysregulation of the HPA axis. Because inflammation is known to be associated with major depression in men and non-perinatal women as well as with other important morbidities of pregnancy (such as preeclampsia, preterm birth, and gestational diabetes), and because these morbidities may correlate with perinatal depression, inflammation may be a common physiological pathway that can also help explain perinatal depression. In this paper, we review the theoretical background of inflammation in perinatal depression and then review the literature concerning immune and inflammatory factors in the etiology and course of perinatal depression. We close with recommendations for future studies in this still relatively unexplored area. Identification and understanding of a common pathophysiology between other pregnancy morbidities and perinatal depression would link physical and mental well-being, likely leading to better treatment and prevention.
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Affiliation(s)
- Lauren M Osborne
- Department of Psychiatry, Columbia University/New York State Psychiatric Institute, 1051 Riverside Drive, Box 89, New York, NY 10032, USA.
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Figueiredo B, Dias CC, Brandão S, Canário C, Nunes-Costa R. Breastfeeding and postpartum depression: state of the art review. J Pediatr (Rio J) 2013; 89:332-8. [PMID: 23791236 DOI: 10.1016/j.jped.2012.12.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 12/13/2012] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To review the literature on the association between breastfeeding and postpartum depression. SOURCES A review of literature found on MEDLINE/PubMed database. SUMMARY OF FINDINGS The literature consistently shows that breastfeeding provides a wide range of benefits for both the child and the mother. The psychological benefits for the mother are still in need of further research. Some studies point out that pregnancy depression is one of the factors that may contribute to breastfeeding failure. Others studies also suggest an association between breastfeeding and postpartum depression; the direction of this association is still unclear. Breastfeeding can promote hormonal processes that protect mothers against postpartum depression by attenuating cortisol response to stress. It can also reduce the risk of postpartum depression, by helping the regulation of sleep and wake patterns for mother and child, improving mother's self-efficacy and her emotional involvement with the child, reducing the child's temperamental difficulties, and promoting a better interaction between mother and child. CONCLUSIONS Studies demonstrate that breastfeeding can protect mothers from postpartum depression, and are starting to clarify which biological and psychological processes may explain this protection. However, there are still equivocal results in the literature that may be explained by the methodological limitations presented by some studies.
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Affiliation(s)
- Bárbara Figueiredo
- Aggregation Escola de Psicologia, Universidade do Minho, Braga, Portugal.
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Figueiredo B, Dias CC, Brandão S, Canário C, Nunes-Costa R. Breastfeeding and postpartum depression: state of the art review. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2013. [DOI: 10.1016/j.jpedp.2012.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Lanari M, Prinelli F, Adorni F, Di Santo S, Faldella G, Silvestri M, Musicco M. Maternal milk protects infants against bronchiolitis during the first year of life. Results from an Italian cohort of newborns. Early Hum Dev 2013; 89 Suppl 1:S51-7. [PMID: 23809352 DOI: 10.1016/s0378-3782(13)70016-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Bronchiolitis is one of the primary causes of hospitalization in infancy. We evaluated the effect of breastfeeding on the occurrence of hospitalization for bronchiolitis in the first year of life. METHODS In a prospective cohort study, 1,814 newborns of =33 weeks of gestational age (wGA) were enrolled in 30 Italian Neonatology Units and followed-up for 1 year to assess hospitalizations for bronchiolitis. Children were grouped as 'never breastfed' and 'ever breastfed'; these latter were further divided into those 'exclusively breastfed' and 'breastfed associated with milk formula'. The risk of hospitalization for bronchiolitis was evaluated with survival analysis, and hazard ratios (HR) with 95% confidence interval [95% CI] were calculated. RESULTS Among enrolled newborns 22.9% were 'never breastfed'; in the breastfed group, 65% were 'exclusively breastfed' and 35% were 'breastfed with associated milk formula'. At 12 months of age, the risk of hospitalization for bronchiolitis was significantly higher in the 'never breastfed' group (HR: 1.57; 95% CI: 1.00-2.48). 'Breastfed associated with formula milk' and 'exclusively breastfed' groups were at similar risk of hospitalization for bronchiolitis. This observed protective effect of maternal milk was not explained by the higher prevalence of conditions able to increase the risk of bronchiolitis among 'never breastfed newborns'. CONCLUSIONS Breastfeeding, even in association with formula milk, reduces the risk of hospitalization for bronchiolitis during the first year of life. Encouraging breastfeeding might be an effective/inexpensive measure of prevention of lower respiratory tract infections in infancy.
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Affiliation(s)
- Marcello Lanari
- Pediatrics and Neonatology Unit, Imola Hospital, Imola, Italy
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Skalkidou A, Hellgren C, Comasco E, Sylvén S, Sundström Poromaa I. Biological aspects of postpartum depression. ACTA ACUST UNITED AC 2013. [PMID: 23181531 DOI: 10.2217/whe.12.55] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In comparison with the vast epidemiological literature on postpartum depression (PPD), relatively few studies have examined the biological aspects of the disorder. However, research into the biological mechanisms of PPD is a challenging task, as normal pregnancy and the postpartum period cause adaptive endocrine changes, which would otherwise be considered pathological in nonpregnant women. This review focuses on the adaptive changes of childbearing and nursing, which ultimately may put women at increased risk of PPD. In light of the normal physiology, the authors also attempt to describe the current evidence of the biological changes associated with the development of depression in the postpartum period, including ovarian steroids, the hypothalamic-pituitary-adrenal axis, the serotonergic neurotransmitter system, the thyroid system and inflammatory markers. In addition, current knowledge on candidate genes associated with PPD is reviewed.
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Affiliation(s)
- Alkistis Skalkidou
- Department of Women's & Children's Health, Uppsala University, 751 85, Uppsala, Sweden
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Kendall-Tackett K, Cong Z, Hale TW. Depression, sleep quality, and maternal well-being in postpartum women with a history of sexual assault: a comparison of breastfeeding, mixed-feeding, and formula-feeding mothers. Breastfeed Med 2013; 8:16-22. [PMID: 23249130 DOI: 10.1089/bfm.2012.0024] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Women with a history of sexual assault are at increased risk for sleep difficulties and depression in their first year of motherhood. Breastfeeding improves sleep parameters and lowers risk of depression for women in general. However, it is unknown whether breastfeeding is related to maternal depression, sleep quality, and maternal well-being in sexual assault survivors. We examined the association between sexual assault and several indices of sleep, depression, and maternal well-being in a large sample of sexual assault survivors in the first year postpartum. We also explored whether feeding method was related to our outcome variables for both sexually assaulted and non-assaulted women. SUBJECTS AND METHODS A sample of 6,410 mothers of infants 0-12 months old participated in the online Survey of Mothers' Sleep and Fatigue; 994 women had a history of sexual assault. RESULTS As predicted, women with a history of sexual assault had a number of sleep difficulties, increased risk of depression, and overall poorer subjective well-being than their non-assaulted counterparts. However, sexual assault survivors who were breastfeeding were at lower risk on all of the sleep and depression parameters than sexual assault survivors who were mixed or formula feeding. CONCLUSIONS Sexual assault has a pervasive negative effect on new mothers' sleep quality and risk of depression. However, these negative effects were less severe for the breastfeeding mothers than they were for the mixed- or formula-feeding mothers.
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Parker W, Ollerton J. Evolutionary biology and anthropology suggest biome reconstitution as a necessary approach toward dealing with immune disorders. Evol Med Public Health 2013; 2013:89-103. [PMID: 24481190 PMCID: PMC3868394 DOI: 10.1093/emph/eot008] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 04/01/2013] [Indexed: 02/06/2023] Open
Abstract
Industrialized society currently faces a wide range of non-infectious, immune-related pandemics. These pandemics include a variety of autoimmune, inflammatory and allergic diseases that are often associated with common environmental triggers and with genetic predisposition, but that do not occur in developing societies. In this review, we briefly present the idea that these pandemics are due to a limited number of evolutionary mismatches, the most damaging being 'biome depletion'. This particular mismatch involves the loss of species from the ecosystem of the human body, the human biome, many of which have traditionally been classified as parasites, although some may actually be commensal or even mutualistic. This view, evolved from the 'hygiene hypothesis', encompasses a broad ecological and evolutionary perspective that considers host-symbiont relations as plastic, changing through ecological space and evolutionary time. Fortunately, this perspective provides a blueprint, termed 'biome reconstitution', for disease treatment and especially for disease prevention. Biome reconstitution includes the controlled and population-wide reintroduction (i.e. domestication) of selected species that have been all but eradicated from the human biome in industrialized society and holds great promise for the elimination of pandemics of allergic, inflammatory and autoimmune diseases.
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Affiliation(s)
- William Parker
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA and Department of Environmental and Geographical Sciences, School of Science and Technology, University of Northampton, Newton Building, Avenue Campus, Northampton NN2 6JD, UK
| | - Jeff Ollerton
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA and Department of Environmental and Geographical Sciences, School of Science and Technology, University of Northampton, Newton Building, Avenue Campus, Northampton NN2 6JD, UK
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McClellan HL, Hepworth AR, Garbin CP, Rowan MK, Deacon J, Hartmann PE, Geddes DT. Nipple pain during breastfeeding with or without visible trauma. J Hum Lact 2012; 28:511-21. [PMID: 22689707 DOI: 10.1177/0890334412444464] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Nipple pain is a major cause of early weaning. The causes of nipple pain are diverse, and most treatments involve experience-based assessment. There is little knowledge of the intensity or variation in pain experienced by breastfeeding women. Given the high breastfeeding initiation rates, it is important to evaluate pain experienced by lactating women in detail. OBJECTIVE To investigate and compare the pain experienced by breastfeeding women using objective measures. METHODS The type, effect, and severity of pain were measured using the McGill Pain Questionnaire, Brief Pain Inventory, and Visual Analogue Scale, respectively, for 2 groups of breastfeeding women. One group were experiencing persistent nipple pain despite treatment, and the other had obvious signs of nipple trauma. RESULTS Pain intensity and interference scores were highly variable for both groups. Mothers with nipple trauma reported significantly higher mean pain intensity and breastfeeding interference. Higher pain intensity scores were related to higher interference scores. After accounting for pain intensity, higher interference with general activity, mood, and sleep interference was related to longer duration of pain. There was no difference in MPQ class scores. CONCLUSIONS The ramifications of nipple pain extend far beyond the act of breastfeeding, particularly for women whose pain lasts several months. Given the lack of evidence-based treatments, it is not surprising that pain is a major contributor to premature weaning. Further research into the causes of nipple pain is necessary to enable the implementation of effective interventions, thus reducing further complications such as infection and postnatal depression. Detailed pain analysis may assist in assessing the success of these interventions.
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Abstract
INTRODUCTION The purpose was to investigate the possible correlation or predictive relationship between breastfeeding and Postpartum Depression (PPD). METHOD We conducted a prospective study in which 137 Arab women were assessed during pregnancy and postpartum. Current breastfeeding was correlated with postpartum outcomes (EPDS and MINI), employment, and use of formula at 2 and 4 months postpartum, as well as with other variables. RESULTS Women who were breastfeeding at 2 and 4 months had lower scores on EPDS (p < 0.0037 andp < 0.0001, respectively) and were less likely to be diagnosed with PPD at 4 months (p < 0.0025). Higher scores on EPDS and diagnosis of PPD at 2 months were predictive of lower rates of breastfeeding at 4 months (p < 0.0001 and p < 0.005, respectively). Women who were employed and using formula at 2 months were less likely to breastfeed at 4 months (p < 0.0001). Breastfeeding women at 2 months had lower scores on EPDS (p < 0.003) and were less likely to be diagnosed with PPD (p <0.05) at 4 months. DISCUSSION The results indicate that women who breastfeed their infants reduced their risk of developing PPD, with effects being maintained over the first 4 months postpartum. PPD may also decrease the rate of breastfeeding, suggesting a reciprocal relationship between these variables.
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Affiliation(s)
- Aisha Hamdan
- King Saud bin AbdulAziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
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Azar R, Mercer D. Mild depressive symptoms are associated with elevated C-reactive protein and proinflammatory cytokine levels during early to midgestation: a prospective pilot study. J Womens Health (Larchmt) 2012; 22:385-9. [PMID: 23046044 DOI: 10.1089/jwh.2012.3785] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We examined depressive symptoms, C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels during early to-midgestation. METHODS We measured depressive symptoms on the Patient Health Questionnaire-9 (PHQ-9), and serum CRP, IL-6, and TNF-α levels twice in 27 pregnant women. RESULTS After adjustment, depressive symptoms prospectively (β=0.42, p<0.05 at 16-20 weeks of gestation) and concurrently (β=0.54, p<0.01 at 7-10 weeks of gestation) predicted elevated CRP [F (2, 14)=9.20, p=0.003, R(2)=0.57 and F (3, 15)=9.08, p=0.001, R(2)=0.64, respectively]. There were similar patterns of results for TNF-α (β=0.72, p<0.01) and IL-6 levels (β=0.39, p<0.05) at 7-10 weeks of gestation [F (2,19)=8.84, p=0.002, R(2)=0.48]. Furthermore, the association between depressive symptoms at 7-10 weeks of gestation and increased IL-6 levels at 16-20 weeks of gestation approached statistical significance. We confirmed the findings with the Wilcoxon signed rank test (IL-6: Z=2.44, p=0.015; TNF-α: Z=1.94, p=0.05; CRP: approached statistical significance). CONCLUSIONS These pilot data suggest that depressive symptoms may be associated with inflammatory markers during early to-midgestation.
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Affiliation(s)
- Rima Azar
- Psychobiology of Stress & Health Lab, Psychology Department, Mount Allison University, Sackville, New Brunswick, Canada.
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Records K, Keller C, Ainsworth B, Permana P. Instrument selection for randomized controlled trials: why this and not that? Contemp Clin Trials 2011; 33:143-50. [PMID: 21986392 DOI: 10.1016/j.cct.2011.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 09/20/2011] [Indexed: 10/17/2022]
Abstract
A fundamental linchpin for obtaining rigorous findings in quantitative research involves the selection of survey instruments. Psychometric recommendations are available for the processes for scale development and testing and guidance for selection of established scales. These processes are necessary to address the validity link between the phenomena under investigation, the empirical measures and, ultimately, the theoretical ties between these and the world views of the participants. Detailed information is most often provided about study design and protocols, but far less frequently is a detailed theoretical explanation provided for why specific instruments are chosen. Guidance to inform choices is often difficult to find when scales are needed for specific cultural, ethnic, or racial groups. This paper details the rationale underlying instrument selection for measurement of the major processes (intervention, mediator and moderator variables, outcome variables) in an ongoing study of postpartum Latinas, Madres para la Salud [Mothers for Health]. The rationale underpinning our choices includes a discussion of alternatives, when appropriate. These exemplars may provide direction for other intervention researchers who are working with specific cultural, racial, or ethnic groups or for other investigators who are seeking to select the 'best' instrument. Thoughtful consideration of measurement and articulation of the rationale underlying our choices facilitates the maintenance of rigor within the study design and improves our ability to assess study outcomes.
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Affiliation(s)
- Kathie Records
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, United States.
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Abstract
Maternal mental health research is a public health priority due to its impact on both maternal and child health. Despite the growing number of empirical studies in this area, particularly from developing countries, there is a paucity of synthetic review articles. Therefore, attempting to synthesize the existing literature in this area seems relevant to appraise the readers of the field's progress and to infer directions for future research. The present review aims to provide an overview of the literature on maternal mental health and its association with birth outcomes and child behavior. Specifically, the literature on mental health during pregnancy and in the postpartum period and its influence on birth outcomes and child behavior have been reviewed. Further, a conceptual and methodological evaluation of the existing literature has been provided to identify gaps in the literature and to suggest directions for future research.
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Affiliation(s)
- Veena A Satyanarayana
- Mental Health and Maternal and Child Health Divisions, St. John's Research Institute, Bangalore, Karnataka, India
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Kendall-Tackett K. Four research findings that will change what we think about perinatal depression. J Perinat Educ 2011; 19:7-9. [PMID: 21886416 DOI: 10.1624/105812410x530875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Research by health psychologists is changing what we know about perinatal depression. In this guest editorial, the author examines depression in pregnant and breastfeeding women in light of this recent research and describes four major findings that are influencing how we think about depression in new mothers: inflammation has an etiologic role in depression, a relationship exists between sleep disturbances and depression, breastfeeding protects maternal mental health, and all effective treatments for depression are anti-inflammatory interventions.
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Affiliation(s)
- Kathleen Kendall-Tackett
- KATHLEEN KENDALL-TACKETT is a clinical associate professor of pediatrics at Texas Tech University School of Medicine in Amarillo, Texas, and the editor-in-chief of Clinical Lactation, the official journal of the United States Lactation Consultant Association. Kendall-Tackett's Web site (www.uppitysciencechick.com) offers a forum for sharing current and noteworthy research in the field of health psychology
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An account of significant events influencing Australian breastfeeding practice over the last 40 years. Women Birth 2011; 24:97-104. [DOI: 10.1016/j.wombi.2010.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 08/25/2010] [Accepted: 08/26/2010] [Indexed: 11/22/2022]
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Abstract
The aims were to study the validity and test-retest reliability of the Early Trauma Inventory-Self Report (ETI-SR) and its short-form (ETI-SF), which retrospectively assess different childhood trauma, in a sample of Spanish postpartum women. A total of 227 healthy postpartum women completed the ETI-SR and ETI-SF. The longitudinal, expert, all data procedure was used as the external criterion for the assessment of childhood trauma. The ETI-SR and ETI-SF were also administered to a sample of 102 postpartum depressive women (DSM-IV) and the results were compared with those of the healthy postpartum sample. The area under the curve values of the ETI-SR and ETI-SF were 0.77 (95% confidence interval [CI], 0.71-0.84) and 0.78 (95% CI, 0.72-0.85), the internal consistencies of the 2 scales were 0.79 and 0.72, and the intraclass correlation coefficients were 0.92 (95% CI, 0.80-0.97) and 0.91 (95% CI, 0.78-0.96), all respectively. The ETI-SR and ETI-SF had higher test-retest reliability on all subscales. The ETI-SR and ETI-SF are shown to be valid and reliable instruments for assessing childhood trauma in postpartum women.
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88
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Thibeau S, D’Apolito K. Review of the Relationships Between Maternal Characteristics and Preterm Breastmilk Immune Components. Biol Res Nurs 2011; 14:207-16. [DOI: 10.1177/1099800411400064] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The immune properties of breastmilk are the most effective preventative means of reducing infant mortality through both passive and active immunity. Breastmilk for term infants has been linked to decreased incidence of respiratory and ear infections and gastrointestinal distress. This protection is even more important for the preterm infant. Prematurity is one of the leading causes of infant death in the United States. Hospitalized infant outcomes associated with consumption of breastmilk are shorter length of stay and decreased incidence of nosocomial infections and necrotizing enterocolitis (NEC). The presence of nosocomial infections and necrotizing enterocolitis increases risk of preterm mortality and morbidity as well as healthcare expenditures. However, breastmilk immunological components such as secretory immunoglobulin A, lactoferrin (LFT), and cytokines provide a framework of immunity that, in conjunction with nutritional support, significantly improves neonatal health. The relationship between maternal characteristics and breastmilk immune properties is central to further the understanding of the impact of breastmilk on preterm infant morbidity and mortality. The purpose of this article is to review the numerous immune components in breastmilk, the moderators of the immune components, and the relevance of these components to preterm/infant health. Exploration of the complexity of breastmilk immune components may direct future development of interventions to improve and sustain the immunological benefits of preterm breastmilk.
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Affiliation(s)
| | - Karen D’Apolito
- Neonatology Program, Vanderbilt University School of Nursing
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89
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Kendall-Tackett K. Long-chain omega-3 fatty acids and women's mental health in the perinatal period and beyond. J Midwifery Womens Health 2011; 55:561-7. [PMID: 20974418 DOI: 10.1016/j.jmwh.2010.02.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 02/17/2010] [Accepted: 02/18/2010] [Indexed: 11/30/2022]
Abstract
Recent research has shown that depression and a range of physical illnesses, including heart disease, metabolic syndrome, and type 2 diabetes, have an inflammatory etiology. The long-chain omega-3 fatty acids (omega-3s) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are found in fish and fish-oil products, may protect against these illnesses, in part because they lower inflammation. This article reviews the recent research on omega-3s and women's mental health, with a particular focus on the perinatal period. These studies include population studies examining fish consumption and studies testing the efficacy of EPA and DHA as treatments for depression. Although the findings are mixed, the majority of studies indicate that EPA has efficacy in treating depression either alone or in combination with DHA and/or antidepressant medications. The role of DHA alone in mental health is less clear, but it is generally combined with EPA and appears to have a beneficial effect. In moderate doses, EPA and DHA appear safe for pregnant and postpartum women, and they are well tolerated by patients.
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90
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Gossler SM. Use of complementary and alternative therapies during pregnancy, postpartum, and lactation. J Psychosoc Nurs Ment Health Serv 2010; 48:30-6. [PMID: 21053788 DOI: 10.3928/02793695-20100930-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 08/30/2010] [Indexed: 01/24/2023]
Abstract
The use of complementary and alternative therapies for depression is an issue of growing interest for practitioners who care for women. Postpartum depression is a serious and debilitating illness that affects many women, their infants, and families. Often, women do not report feelings of sadness or depression to their health care providers due to stigma. Some women have multiple concerns in using prescription drugs, especially if they are breastfeeding their infants. In addition, more women are educating themselves about the potential side and adverse effects of prescriptions drugs and are exploring complementary and alternative therapies. With the availability of information from multiple sources, whether accurate or not, women may be using these therapies inappropriately. Two major concerns in using complementary and alternative therapies are the purity and safety of the herbs and herbal formulations and the potential lack of communication between the client and health care provider.
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Affiliation(s)
- Sandra M Gossler
- University of Tennessee, College of Nursing, Knoxville, Tennessee 37996-4180, USA.
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91
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Rincon J, Pedreañez A, Viera N, Arcaya JL, Carrizo E, Mosquera J. Depressive status does not alter renal oxidative and immunological parameters during early diabetic nephropathy in rats. World J Biol Psychiatry 2010; 10:560-6. [PMID: 19536704 DOI: 10.1080/15622970903030336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Depression is frequently observed among patients with diabetes and depressive status has been associated to activation of inflammatory processes, suggesting a role of depression in the inflammatory events observed in diabetes. To test that proposal, it was studied the effect of depression induced by forced swimming test (FST) on the evolution of early diabetic nephropathy. Diabetes was induced by streptozotocin injection. Rats were submitted to FST for 15 days. Struggle time was determined during FST and motor activity previously to FST. Nitric oxide, malondialdehyde, reduced glutathione and catalase activity were measured in kidney homogenates by enzymatic and biochemical methods. Superoxide anion, monocyte/macrophage (ED-1 positive cells) and RAGE were determined by histochemical and immunohistochemical methods. Diabetic rats had decreased struggle time and locomotor activity at day 1 of FST. Both control and diabetic rats had those parameters decreased at day 15. Renal oxidative stress, RAGE expression and ED-1 cells were observed increased in diabetic animals. Those parameters were not significantly altered by FST. The depressive status does not alter oxidative and immune parameters during the early renal changes of diabetic nephropathy.
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Affiliation(s)
- Jaimar Rincon
- Instituto de Investigaciones Clinicas Dr. Americo Negrette, Maracaibo, Venezuela
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92
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Doering Runquist JJ, Morin K, Stetzer FC. Severe Fatigue and Depressive Symptoms in Lower-Income Urban Postpartum Women. West J Nurs Res 2009; 31:599-612. [DOI: 10.1177/0193945909333890] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to identify whether severe postpartum fatigue at 1 and 3 months postpartum was associated with depressive symptomatology at 6 months in lower-income urban women. A convenience sample of 43 lower-income postpartum women completed the Modified Fatigue Symptoms Checklist and Edinburgh Postpartum Depression scale at 1, 3, and 6 months postpartum. Participants who were severely fatigued at both 1 and 3 months postpartum were significantly more likely to exhibit depressive symptomatology at 6 months. Fatigue and depressive symptoms were moderately to strongly correlated at 1 ( r = .68), 3 ( r = .74), and 6 ( r = .70) months postpartum ( p = .001). Severe fatigue and depressive symptomatology often co-exist for months after childbirth. Future research should examine whether interventions to targeting severe postpartum fatigue in lower-income urban women may also effectively reduce depressive symptoms.
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93
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Chang JJ, Pien GW, Duntley SP, Macones GA. Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship? Sleep Med Rev 2009; 14:107-14. [PMID: 19625199 DOI: 10.1016/j.smrv.2009.05.001] [Citation(s) in RCA: 192] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 05/02/2009] [Accepted: 05/07/2009] [Indexed: 01/16/2023]
Abstract
Sleep duration in the population has been declining. Women occupy an increasingly prominent place in the work force without reducing most of their responsibilities at home. Consequently, sleep needs are often pushed to the bottom of women's daily priority list. Prior research has indicated that sleep deprivation is associated with higher levels of pro-inflammatory serum cytokines. This is important because higher plasma concentrations of pro-inflammatory serum cytokine levels are associated with postpartum depression and adverse birth outcomes such as preterm delivery. However, little research has directly examined how sleep deprivation may affect maternal and fetal outcomes. This review summarizes the existing data on the effect of sleep deprivation during pregnancy on maternal and fetal outcomes. We review supporting evidence for the hypotheses that sleep deprivation during pregnancy increases the risk of preterm delivery and postpartum depression, and that systemic inflammation is the causal mechanism in the association. Prior research on sleep in pregnancy has been limited by varying data collection methods, subjective self-reported sleep measures, small and non-representative samples, cross-sectional designs; descriptive or non-hypothesis driven studies. Future research with longitudinal study designs is needed to allow examination of the effect of sleep deprivation on adverse maternal and fetal outcomes.
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Affiliation(s)
- Jen Jen Chang
- Department of Community Health in Epidemiology, Saint Louis University School of Public Health, 3545 Lafayette Ave., Suite 300, St. Louis, MO 63104, USA.
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94
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Fanslow J, Silva M, Whitehead A, Robinson E. Pregnancy outcomes and intimate partner violence in New Zealand. Aust N Z J Obstet Gynaecol 2009; 48:391-7. [PMID: 18837845 DOI: 10.1111/j.1479-828x.2008.00866.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This study aims to describe pregnancy outcomes for a population-based sample of New Zealand women, and to explore the relationship between lifetime experience of intimate partner violence (IPV) and two non-birth pregnancy outcomes: spontaneous abortion (miscarriage) and termination of pregnancy (abortion). METHODS Face-to-face interviews were conducted with a random sample of 2391 women who had ever been pregnant, aged 18-64 years old, in two regions (urban and rural). Both outcome measures were determined by asking women if they had ever had a miscarriage or an abortion. Analyses were conducted using logistic regression. RESULTS Almost one in three ever-pregnant women reported having at least one miscarriage, and at least one in ten reported terminating a pregnancy. Even controlling for potential confounders, women who had ever experienced IPV were 1.4 times more likely to report they had ever had a miscarriage compared with women who had never experienced violence (P = 0.008), and were 2.5 times more likely to report they had ever had an abortion (P < 0.0001). Ethnicity was significantly associated with experiencing a miscarriage (Asian and Pacific women were less likely compared with European/Pākehā women), and having ever had an abortion (Asian women were 3.5 times more likely compared with Pākehā women). CONCLUSIONS In this population-based sample, miscarriage was relatively common, as was termination of pregnancy. IPV was significantly associated with both induced and spontaneous abortion. Healthcare settings that see women experiencing these pregnancy outcomes need to be cognisant of the link with current and historical IPV, and be able to respond to women appropriately.
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Affiliation(s)
- Janet Fanslow
- Social and Community Health, School of Population Health, Univesity of Auckland, Auckland, New Zealand
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95
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Kapetanovic S, Christensen S, Karim R, Lin F, Mack WJ, Operskalski E, Frederick T, Spencer L, Stek A, Kramer F, Kovacs A. Correlates of perinatal depression in HIV-infected women. AIDS Patient Care STDS 2009; 23:101-8. [PMID: 19196032 PMCID: PMC2856494 DOI: 10.1089/apc.2008.0125] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Maternal perinatal depression (PND) may interfere with effective perinatal HIV care. In order to begin examining the prevalence and characteristics of PND in HIV-infected women, we analyzed data from the medical records of all HIV-infected women who had received perinatal care in the Maternal-Child and Adolescent Center for Infectious Diseases and Virology at LAC/USC Medical Center from 1997 through 2006. Data from 273 individual women (328 live births) were analyzed. Demographic, medical history, psychosocial, pregnancy related, and HIV-related factors measured during the perinatal period were examined for an association with PND using multivariate logistic regression with generalized estimating equations to account for the within subject correlation due to multiple births per mother. The overall prevalence of PND was 30.8%. Multivariate analysis showed that PND was significantly associated with substance abuse during pregnancy (odds ratio [OR] = 2.81, 95% confidence interval [CI]: 1.35-5.82) and past history of psychiatric illness (OR = 3.72, 95% CI: 2.06-6.71). Compared to mothers with CD4 nadir greater than 500 cells/mm3, mothers with a CD4 nadir during pregnancy #200 cells=mm3 were 3.1 times more likely to experience PND (OR = 3.01, 95% CI: 1.32-6.88). Women who had antiretroviral (ARV) medications adherence problems during pregnancy were more likely to experience PND than women who were adherent (OR = 2.14, 95% CI: 1.08-4.23). These preliminary results suggest that rates of PND among HIV-infected women are substantial. We conclude that pregnant HIV-infected women should be routinely screened for PND. Prospective studies examining the bio-psycho-social markers of PND in HIV-infected women are indicated.
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Affiliation(s)
- Suad Kapetanovic
- USC/Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, HRA Building, Suite 300, Los Angeles, CA 90033, USA.
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96
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A depressive symptoms responsiveness model for differentiating fatigue from depression in the postpartum period. Arch Womens Ment Health 2008; 10:267-75. [PMID: 18084693 DOI: 10.1007/s00737-007-0208-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Accepted: 09/16/2007] [Indexed: 12/14/2022]
Abstract
Fatigue is both a symptom and a predictor of depression in women after childbirth. At the same time, postpartum fatigue is experienced by most non-depressed women. Health care providers experientially know that not all women who experience postpartum fatigue will manifest depression. However, while researchers agree that fatigue and depression are distinct concepts, they have not yet identified a means for describing or measuring this distinctness. A new model proposing how fatigue may be differentiated from depression after childbirth is presented. The Depressive Symptoms Responsiveness Model proposes that depression-related postpartum fatigue may potentially be differentiated from non-depression-related postpartum fatigue on the basis of whether depressive symptoms abate when fatigue is relieved. The ability to differentiate between fatigue and depression in postpartum women has the potential to improve women's health through improvements in practice and resource utilization. Furthermore, differentiation may lead to a better understanding of the role of fatigue in postpartum depression.
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97
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Campagne DM. Fact: antidepressants and anxiolytics are not safe during pregnancy. Eur J Obstet Gynecol Reprod Biol 2007; 135:145-8. [PMID: 17662516 DOI: 10.1016/j.ejogrb.2007.06.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2007] [Revised: 04/25/2007] [Accepted: 06/19/2007] [Indexed: 11/19/2022]
Abstract
Psychotropic medication is used by a growing number of women of reproductive age. Although necessary in some cases, in many others non-pharmacological treatments offer valid alternatives for the pregnant woman. The noxious effects of antidepressants and anxiolytics urge the physician to look for other solutions. The efficacy of alternative treatment is enhanced by early detection that requires monitoring for mood disorders from the earliest stages of pregnancy, and multidisciplinary professional care.
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Affiliation(s)
- Daniel M Campagne
- UNED University, Faculty of Psychology, Department of Personality, Evaluation and Psychological Treatment, Madrid, Spain.
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98
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Haku M. Breastfeeding: factors associated with the continuation of breastfeeding, the current situation in Japan, and recommendations for further research. THE JOURNAL OF MEDICAL INVESTIGATION 2007; 54:224-34. [PMID: 17878670 DOI: 10.2152/jmi.54.224] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
There are a number of research reports that address the various advantages that breastfeeding brings to mothers and children, as well as to families and society, and in addition to a number of physically positive effects, breastfeeding has an important role in terms of mental and psychological effects.Ninety-five % of mothers desire to breastfeed, which reflects social acceptance, but the actual breastfeeding rate of the first month after childbirth is 42%, which accounts for about a half of all mothers. Breastfeeding is a natural behavior, but it cannot be performed only by instinct, so mothers discontinue breastfeeding for various reasons. While these reasons for the discontinuation of breastfeeding have been studied in many countries, research regarding the usability of care to support breastfeeding is being conducted in other countries at a level that can be considered evidential, but not yet in Japan. In addition, the current situation is that breastfeeding is strongly promoted but the support provided remains inadequate for mothers who cannot breastfeed, regardless of whatever efforts they make. This article will review several factors associated with the continuation of breastfeeding and the current situation in Japan, with the intention of identifying desirable areas for further research.
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Affiliation(s)
- Mari Haku
- Post Graduate Course of Midwifery, The University of Tokushima, Tokushima, Japan
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