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Sananès J, Pire S, Feki A, Boulvain M, Faltin DL. Antenatal, Intrapartum and Postpartum Interventions for Preventing Postpartum Urinary and Faecal Incontinence: An Umbrella Overview of Cochrane Systematic Reviews. J Clin Med 2023; 12:6037. [PMID: 37762976 PMCID: PMC10531825 DOI: 10.3390/jcm12186037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Post-partum, women can suffer from urinary and faecal incontinence. It is important to assess interventions to prevent this problem. Cochrane systematic reviews summarize the data available from systematic reviews of randomized trials assessing interventions. We conducted an umbrella overview of Cochrane systematic reviews encompassing antenatal, intrapartum and postpartum interventions for preventing postpartum urinary and faecal incontinence. We searched the Cochrane Database of Systematic Reviews on the 9 May 2023. Results: Our search identified nine Cochrane reviews providing results. Data for urinary and faecal incontinence were available from 77 (72%) trials and included 51,113 women. The reviews assessed antenatal digital perineal massage, pelvic floor muscle training, techniques for repairing anal sphincter tears, routine use of episiotomy, use of endoanal ultrasound prior to repairing perineal tears, caesarean versus vaginal delivery (overall, for breech and for twins), and vaginal delivery with forceps or vacuum. Only the use of a vacuum instead of forceps if an assisted vaginal delivery is needed, the use of an endo-anal ultrasound prior to repairing perineal tears and postpartum pelvic floor muscle training suggest a reduction in postpartum incontinence. Due to the small number of relevant reviews, a consequence of the relatively small number of primary studies, the effect of almost all the tested interventions was found to be imprecise.
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Affiliation(s)
- Juliette Sananès
- Department of Obstetrics and Gynecology, HFR—Cantonal Hospital of Fribourg, 1752 Villars-sur-Glânes, Switzerland
| | - Sophie Pire
- Department of Obstetrics and Gynecology, HFR—Cantonal Hospital of Fribourg, 1752 Villars-sur-Glânes, Switzerland
| | - Anis Feki
- Department of Obstetrics and Gynecology, HFR—Cantonal Hospital of Fribourg, 1752 Villars-sur-Glânes, Switzerland
| | - Michel Boulvain
- Department of Obstetrics and Gynecology, HFR—Cantonal Hospital of Fribourg, 1752 Villars-sur-Glânes, Switzerland
| | - Daniel L. Faltin
- Department of Obstetrics and Gynecology, HFR—Cantonal Hospital of Fribourg, 1752 Villars-sur-Glânes, Switzerland
- Centre de Périnéologie Dianuro Geneva, 1227 Carouge, Switzerland
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Sarbaz M, Mousavi Baigi SF, Manouchehri Monazah F, Dayani N, Kimiafar K. The trend of normal vaginal delivery and cesarean sections before and after implementing the health system transformation plan based on ICD-10 in the northeast of Iran: A cross-sectional study. Health Sci Rep 2023; 6:e1131. [PMID: 36923373 PMCID: PMC10009419 DOI: 10.1002/hsr2.1131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/22/2023] [Accepted: 02/13/2023] [Indexed: 03/14/2023] Open
Abstract
Background and Aims Concerning the growing rate of cesarean sections (CSs) worldwide, encouraging normal vaginal deliveries (NVDs) and mitigating CS rates is a necessity. This study investigated the status of delivery in hospitals affiliated with the Mashhad University of Medical Sciences (MUMS) before and after implementing health system transformation plan (HSTP). Methods A cross-sectional study was conducted in 2017 in the obstetrics and gynecology ward in four MUMS teaching hospitals. Data were extracted from hospital information systems (HISs) based on the International Classification of Diseases (ICD-10) and analyzed in SPSS VE10 software. Results The results revealed a significant difference between the rate of NVDs and CSs before and after HSTP, such that implementing this plan in MUMS hospitals has raised the rate of NVDs by 4%. Except for the age groups of less than 15 and 36-40 years, the difference between NVD and CS was significant in different age groups before and after HSTP. The rate of NVD significantly increased within 2 months after implementing HSTP. Furthermore, the difference in the rate of previous CS before and after implementing HSTP was significant (p < 0.001). Conclusion The results of this study show the positive impact of the implementation of the HSTP on CS reduction and NVD increase in the studied hospitals. Since the studied hospitals were teaching and concerning the different costs of NVD and CS between the public and private hospitals, it is recommended to study all hospitals with the obstetrics and gynecology ward to precisely assess the success of HSTP in encouraging NVD.
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Affiliation(s)
- Masoumeh Sarbaz
- Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences Mashhad University of Medical Sciences Mashhad Iran
| | - Seyyedeh Fatemeh Mousavi Baigi
- Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences Mashhad University of Medical Sciences Mashhad Iran.,Student Research Committee Mashhad University of Medical Sciences Mashhad Iran
| | - Fereshte Manouchehri Monazah
- Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences Mashhad University of Medical Sciences Mashhad Iran
| | - Nooshin Dayani
- Department of Medical Informatics, School of Medicine Mashhad University of Medical Sciences Mashhad Iran
| | - Khalil Kimiafar
- Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences Mashhad University of Medical Sciences Mashhad Iran
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Liu S, Jin Y, Li H, Zeng T, Zhou G, Yu L, Fan Y, Lei X. Associations of Musical Activities and Positive Affect With Fear of Childbirth: A Structural Equation Modeling Approach. Front Public Health 2022; 10:906996. [PMID: 35784209 PMCID: PMC9247401 DOI: 10.3389/fpubh.2022.906996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/16/2022] [Indexed: 11/20/2022] Open
Abstract
Background Fear of childbirth is a prevalent issue among women, with a wide range of interventions to dispel it. Here we explored a novel and beneficial intervention and one possible influence mechanism of it. Methods The cross-sectional study recruited 1,053 pregnant women from one tertiary-grade A class hospital between March to August 2021. The questionnaire included demographic characteristics, a self-made musical activities questionnaire, the Positive affect subscale, and the Childbirth Attitudes Questionnaire. We parceled the eight musical activities into three items by item parceling methodology. The associations of musical activities and positive affect with fear of childbirth were evaluated by a structural equation modeling approach. Results Our analyses demonstrated the effectiveness of musical activities, which was notably correlated with the increase in positive affect (β = 0.309, P < 0.01). On the contrary, positive affect predicted a decrease in fear of childbirth (β = −0.085, P = 0.019). Additionally, positive affect mediated the effect of musical activities on fear of childbirth (β = −0.026, P = 0.030). However, the direct effect of musical activities on fear of childbirth was not found (β = 0.029, P = 0.514). Conclusions Relying on musical activities alone may not be adequate to alleviate the fear of childbirth, and positive affect played a pivotal role between musical activities and fear of childbirth. The results showed that musical activities would be an effective non-pharmaceutical way to alleviate the fear of childbirth and positive affect can not be ignorant in future childbirth fear reduction programs.
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Affiliation(s)
- Shidi Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Yi Jin
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Hongmei Li
- Obstetrics and Gynecology Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tingting Zeng
- Obstetrics and Gynecology Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ge Zhou
- Obstetrics and Gynecology Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lili Yu
- Obstetrics and Gynecology Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yao Fan
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
- Yao Fan
| | - Xun Lei
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
- *Correspondence: Xun Lei
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Michel C, Blottière HM. Neonatal Programming of Microbiota Composition: A Plausible Idea That Is Not Supported by the Evidence. Front Microbiol 2022; 13:825942. [PMID: 35783422 PMCID: PMC9247513 DOI: 10.3389/fmicb.2022.825942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
Underpinning the theory “developmental origins of health and disease” (DOHaD), evidence is accumulating to suggest that the risks of adult disease are in part programmed by exposure to environmental factors during the highly plastic “first 1,000 days of life” period. An elucidation of the mechanisms involved in this programming is challenging as it would help developing new strategies to promote adult health. The intestinal microbiome is proposed as a long-lasting memory of the neonatal environment. This proposal is supported by indisputable findings such as the concomitance of microbiota assembly and the first 1,000-day period, the influence of perinatal conditions on microbiota composition, and the impact of microbiota composition on host physiology, and is based on the widely held but unconfirmed view that the microbiota is long-lastingly shaped early in life. In this review, we examine the plausibility of the gut microbiota being programmed by the neonatal environment and evaluate the evidence for its validity. We highlight that the capacity of the pioneer bacteria to control the implantation of subsequent bacteria is supported by both theoretical principles and statistical associations, but remains to be demonstrated experimentally. In addition, our critical review of the literature on the long-term repercussions of selected neonatal modulations of the gut microbiota indicates that sustained programming of the microbiota composition by neonatal events is unlikely. This does not exclude the microbiota having a role in DOHaD due to a possible interaction with tissue and organ development during the critical windows of neonatal life.
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Affiliation(s)
- Catherine Michel
- Nantes Université, INRAE, UMR 1280, PhAN, Nantes, France
- *Correspondence: Catherine Michel,
| | - Hervé M. Blottière
- Nantes Université, INRAE, UMR 1280, PhAN, Nantes, France
- Université Paris-Saclay, INRAE, MetaGenoPolis, Jouy-en-Josas, France
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Freeman RM, de Leeuw JW, Wilson PD. Maternal birth trauma and its consequences: time to raise awareness. Int Urogynecol J 2021; 32:1609-1610. [PMID: 34142180 DOI: 10.1007/s00192-021-04873-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- R M Freeman
- University Hospitals Plymouth NHS Trust, Plymouth, UK.
| | - J W de Leeuw
- Department of Obstetrics and Gynaecology, Ikazia Ziekenhuis, Rotterdam, the Netherlands
| | - P D Wilson
- University of Otago, Dunedin, New Zealand
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Escolano-Pérez E, Sánchez-López CR, Herrero-Nivela ML. Early Environmental and Biological Influences on Preschool Motor Skills: Implications for Early Childhood Care and Education. Front Psychol 2021; 12:725832. [PMID: 34484085 PMCID: PMC8414646 DOI: 10.3389/fpsyg.2021.725832] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/19/2021] [Indexed: 12/21/2022] Open
Abstract
Early motor skills underpin the more complex and specialized movements required for physical activity. Therefore, the design of interventions that enhance higher levels of early motor skills may encourage subsequent participation in physical activity. To do so, it is necessary to determine the influence of certain factors (some of which appear very early) on early motor skills. The objective of this study was to examine the influence of some very early environmental variables (delivery mode, feeding type during the first 4 months of life) and some biological variables (sex and age in months) on preschool motor skills, considered both globally and specifically. The sample was composed by 43 preschool students aged 5-6 years. The participant's parents completed an ad hoc questionnaire, reporting on delivery mode, feeding type, sex, and age in months. The children's motor skills were assessed using observational methodology in the school setting, while the children participated in their regular motor skills sessions. A Nomothetic/Punctual/Multidimensional observational design was used. Results revealed that certain preschool motor skills were specifically influenced by delivery mode, feeding type, sex, and age. Children born by vaginal delivery showed higher scores than children born via C-section in throwing (p = 0.000; d = 0.63); total control of objects (p = 0.004; d = 0.97); total gross motor skills (p = 0.005; d = 0.95); and total motor skills (p = 0.002; d = 1.04). Children who were exclusively breastfed outperformed those who were formula-fed in throwing (p = 0.016; d = 0.75); visual-motor integration (p = 0.005; d = 0.94); total control of objects (p = 0.002; d = 1.02); total gross motor skills (p = 0.023; d = 0.82); and total motor skills (p = 0.042; d = 0.74). Boys outperformed girls in throwing (p = 0.041; d = 0.74) and total control of objects (p = 0.024; d = 0.63); while the opposite occurred in static balance (p = 0.000; d = 1.2); visual-motor coordination (p = 0.020; d = 0.79); and total fine motor skills (p = 0.032; d = 0.72). Older children (aged 69-74 months) obtained higher scores than younger ones (aged 63-68 months) in dynamic balance (p = 0.030; d = 0.66); visual-motor integration (p = 0.034; d = 0.63); and total balance (p = 0.013; d = 0.75). Implications for early childhood care and education are discussed since this is a critical period for motor skill development and learning.
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Affiliation(s)
| | - Carmen Rosa Sánchez-López
- Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, San Cristóbal de La Laguna, Spain
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