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Wang M, Ji Y, Chen S, Wang M, Lin X, Yang M. Effect of mode of delivery on postpartum weight retention: A systematic review and meta-analysis. Midwifery 2024; 132:103981. [PMID: 38574440 DOI: 10.1016/j.midw.2024.103981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE Retention of weight gained over pregnancy increases the risk of long-term obesity and related health concerns. While many risk factors for this postpartum weight retention have been examined, the role of mode of delivery in this relationship remains controversial. We carried out a systematic review and meta-analysis to determine the effect of mode of delivery on postpartum weight retention. METHODS Ten electronic databases including PubMed, Cochrane Library, EMBASE, Web of Science, MEDLINE, CINAHL, China National Knowledge Infrastructure (CNKI), Wan-Fang database, the VIP database and China Biology Medicine Database (CBM) were searched from inception through November 2022. Review Manager 5.4 was used to pool the study data and calculate effect sizes. For dichotomous data, the odds ratio and 95 % confidence interval were used to report the results. For continuous data, the mean difference (MD) and 95 % confidence interval were used to report the results. The outcomes were the amount of postpartum weight retention and the number or proportion of women who experienced postpartum weight retention. The Newcastle- Ottawa Scale (NOS) and GRADE Guidelines were used to assess the methodological quality of the included studies. FINDINGS A total of 16 articles were included in the systematic review and 13 articles were included in the meta-analysis. The results showed that the mode of delivery had a significant effect on postpartum weight retention, women who delivered by caesarean section were more likely to experience postpartum weight retention compared to those who delivered vaginally. Sensitivity analysis showed that the results were stable and credible. CONCLUSION Due to the limitations of this study, the findings need to be treated with caution. And, to better prevent the postpartum weight retention, future practice and research need to further focus on upstream modifiable factors.
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Affiliation(s)
- Meiyu Wang
- School of Nursing, Guangzhou University of Chinese Medicine, No.232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou City, Guangdong Province 510006, China
| | - Yuting Ji
- School of Nursing, Guangzhou University of Chinese Medicine, No.232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou City, Guangdong Province 510006, China
| | - Shanxia Chen
- Health Management & Biotechnology School, Guangdong Food and Drug Vocational College, No.321, Longdong North Road, Tianhe District, Guangzhou City, Guangdong Province, China
| | - Minyi Wang
- School of Nursing, Guangzhou University of Chinese Medicine, No.232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou City, Guangdong Province 510006, China
| | - Xiaoli Lin
- School of Nursing, Guangzhou University of Chinese Medicine, No.232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou City, Guangdong Province 510006, China
| | - Ming Yang
- School of Nursing, Guangzhou University of Chinese Medicine, No.232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou City, Guangdong Province 510006, China.
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Ravi M, Singh MK, Kumar S, Singh S, Naik P. To Determine the Quality of Life in Indian Women After Peripartum Hysterectomy Using a Hindi Version of the SF-36 Questionnaire. J Obstet Gynaecol India 2024; 74:38-44. [PMID: 38434120 PMCID: PMC10902220 DOI: 10.1007/s13224-023-01812-5] [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: 02/26/2023] [Accepted: 07/07/2023] [Indexed: 03/05/2024] Open
Abstract
Objective The objective of the study was to determine the quality of life in women after peripartum hysterectomy using a Hindi version of the SF-36 questionnaire. Background There are long-term effects on quality of life in women after peripartum hysterectomy. The effects on physical, mental, and social functioning have a prolonged recovery. No studies have been done in Indian women after peripartum hysterectomy to evaluate quality of life. Methods Patients who underwent peripartum hysterectomy from January 2017 to May 2021 were contacted to participate in the study. To determine the quality of life post-surgery, a Hindi version of the 36-item Short-Form Health Survey (SF-36) was used for a face-to-face personal interview-based assessment. The participants were divided into two groups based on the duration between surgery and the interview. The aggregate scores for the eight components of SF-36 were calculated, and responses were analyzed. Results Out of the 138 post-hysterectomy women, 118 were enrolled in the study. Women who could not be contacted [14 (10.14%)] and those who died post-procedure [6 (4.35%)] were excluded. Out of the total, 43 assessed participants were within 2 years of surgery, and 75 were after 2 years of surgery. The group that was assessed after 2 years of surgery had a significantly lower quality of life in six, out of the eight aspects of SF-36 domains. Conclusion Women after peripartum hysterectomy undergo a prolonged recovery phase with effects on physical, mental, and social functioning. A multi-disciplinary long-term follow-up including physiotherapy and psychotherapy is required and that should be guided by a dedicated clinical team.
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Affiliation(s)
- Monisha Ravi
- Department of Reproductive Medicine, Bangalore Baptist Hospital, Bangalore, 560024 India
| | - Mukesh Kumar Singh
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, 110029 India
| | - Sandeep Kumar
- Department of Paediatrics, VMMC and Safdarjung Hospital, New Delhi, 110029 India
| | - Sarita Singh
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, 110029 India
| | - Priyanka Naik
- Department of Obstetrics and Gynaecology, AIIMS, Ansari Nagar, New Delhi, India
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3
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Lin-Lewry M, Tzeng YL, Li CC, Lee GT, Lee PH, Chen SR, Kuo SY. Trajectories of sleep quality and depressive symptoms in women from pregnancy to 3 months postpartum: a prospective cohort study. J Sleep Res 2023; 32:e13918. [PMID: 37128654 DOI: 10.1111/jsr.13918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 03/16/2023] [Accepted: 04/14/2023] [Indexed: 05/03/2023]
Abstract
Sleep quality and depression during pregnancy often affect women's adaptation to motherhood and are linked with adverse maternal and neonatal outcomes. Using a prospective cohort study comprising 190 pregnant women in central Taiwan, we investigated the trajectories of sleep quality and depressive symptoms and their associated predictors in perinatal women from pregnancy to postpartum. Sleep and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index and the Edinburgh Postnatal Depression Scale, respectively, from mid-pregnancy to 3 months postpartum. We used group-based trajectory modelling and logistic regression modelling to analyse the data collected from the structured questionnaires. Pregnant women (50.5% primipara) with a mean (standard deviation) age of 32.3 (4.1) years were included. We identified three distinctive classes of sleep quality trajectories during the perinatal period: 'stable good' (18.4%), 'increasing poor' (48.9%), and 'stable poor' (32.6%). We further detected three stable trajectories of depressive symptoms: 'stable low' (36.3%), 'stable mild' (42.1%), and 'stable high' (21.6%). A significant association between sleep quality and depression trajectories was evident (p < 0.001). High fatigue symptoms and low social support predicted the high trajectories of poor sleep and depressive symptoms. Distinctive dynamic sleep quality and stable depression trajectories were characterised. Our findings revealed that both the sleep and depression trajectories were closely associated with one another, with common predictors of fatigue symptoms and social support. The early assessment of maternal sleep and depression status is important for identifying at-risk women and initiating interventions tailored to perinatal women to improve their sleep and mental health.
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Affiliation(s)
- Marianne Lin-Lewry
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ya-Ling Tzeng
- School of Nursing, College of Health Care, China Medical University, Taichung, Taiwan
| | - Chieh-Chen Li
- School of Nursing, College of Health Care, China Medical University, Taichung, Taiwan
| | - Gabrielle T Lee
- Applied Psychology, Faculty of Education, Western University, London, Ontario, Canada
| | - Pi-Hsia Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Su-Ru Chen
- School of Nursing, School of Post-Baccalaureate Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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4
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Albzea W, Almonayea L, Aljassar M, Atmeh M, Al Sadder K, AlQattan Y, Alhajaji R, AlNadwi H, Alnami I, Alhajaji F. Efficacy and Safety of Preoperative Melatonin for Women Undergoing Cesarean Section: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1065. [PMID: 37374268 PMCID: PMC10302920 DOI: 10.3390/medicina59061065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023]
Abstract
Background: Cesarean section (CS) has been linked to a number of negative effects, such as pain, anxiety, and sleeping problems. The aim of this systematic review and meta-analysis was to investigate the safety and efficacy of preoperative melatonin on postoperative outcomes in pregnant women who were scheduled for elective CS. Methods: We systemically searched 4 electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) from inception until 10 March 2023. We included randomized controlled trials (RCTs) comparing melatonin and placebo for postoperative outcomes in CS patients. For risk of bias assessment, we used the Cochrane Risk of Bias 2 tool. Continuous variables were pooled as mean difference (MD), and categorical variables were pooled as a risk ratio (RR) with a 95% confidence interval (CI). Results: We included 7 studies with a total of 754 pregnant women scheduled for CS. The melatonin group had a lower pain score (MD = -1.23, 95% CI [-1.94, -0.51], p < 0.001) and longer time to first analgesic request (MD = 60.41 min, 95% CI [45.47, 75.36], p < 0.001) than the placebo group. No difference was found regarding hemoglobin levels, heart rate, mean arterial pressure, total blood loss, or adverse events. Conclusions: Preoperative melatonin may reduce postoperative pain in CS patients without side effects. This research offers a safe and affordable pain management method for this population, which has clinical consequences. Further research is needed to validate these findings and determine the best melatonin dosage and timing.
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Affiliation(s)
- Wardah Albzea
- Faculty of Medicine, Alexandria University, Alexandria 21544, Egypt
| | - Lolwa Almonayea
- Kuwait Institute for Medical Specializations, Kuwait City 12050, Kuwait
| | - Marah Aljassar
- Kuwait Institute for Medical Specializations, Kuwait City 12050, Kuwait
| | - Mousa Atmeh
- Department of Hemto-Oncology, Royal Medical Services, Amman 11855, Jordan
| | - Khaled Al Sadder
- Department of General Surgery, Ministry of Health, Kuwait City 12009, Kuwait
| | - Yousef AlQattan
- Kuwait Institute for Medical Specializations, Kuwait City 12050, Kuwait
| | - Raghad Alhajaji
- Department of Family Medicine, Almagrah Primary Health Care, Ministry of Health, Makkah 11176, Saudi Arabia
| | - Hiba AlNadwi
- King Abdullah Medical City, Makkah 57657, Saudi Arabia
| | - Inaam Alnami
- Senior Registerar Family Medicine, Internal Medicine Department, Security Forces Hospital Program, Makkah 14799, Saudi Arabia
| | - Fatima Alhajaji
- College of Medicine, Umm Alqura University, Makkah 57483, Saudi Arabia
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5
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Abdul Jafar NK, Tham EKH, Eng DZH, Yeo S, Rifkin-Graboi A, Gooley JJ, Loy SL, Eriksson JG, Chong YS, Tan KH, Chan JKY, Chen H, Shek LPC, Gluckman PD, Yap F, Meaney MJ, Broekman BFP, Kee MZL, Cai S. Preconception sleep quality moderates the association between preconception hair cortisol levels and mental health in pregnant women. J Affect Disord 2023; 334:187-196. [PMID: 37150222 DOI: 10.1016/j.jad.2023.04.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 03/17/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Poor sleep quality may elevate cortisol levels and affect prenatal mental health through altered HPA axis functioning. This study aims to examine whether subjective sleep quality during preconception moderates the association between preconception hair cortisol levels and mental health from preconception to pregnancy trimesters. METHODS Women from a prospective cohort study completed the Pittsburgh Sleep Quality Index (PSQI), the Edinburgh Postnatal Depression Scale (EPDS), and the State-Trait Anxiety Inventory (STAI) questionnaires during preconception (T0) and at each pregnancy trimesters (T1, T2, and T3). We analyzed 266 of these women who conceived and had fully completed measures at preconception for hair cortisol, sleep quality and either EPDS or STAI-state. Changes in EPDS and STAI-state scores were derived (i.e., T1-T0, T2-T0, T3-T0). Johnson-Neyman technique identified PSQI scores with significant moderation of cortisol on mental health. RESULTS After adjusting for potential covariates, there was a significant positive correlation between preconception hair cortisol levels and depressive symptom at the second trimester (rs (144) = 0.22, p = 0.008), but not the first and third trimesters (all ps > 0.05). The positive association between preconception hair cortisol and change in depressive symptoms between third trimester and preconception was significant only among women with poor preconception sleep quality (PSQI ≥ 7). LIMITATIONS Sleep quality and prenatal mood were derived from self-reported questionnaires, which may be more susceptible to bias. CONCLUSIONS The positive association between preconception hair cortisol and change in prenatal depressive symptoms is significant among women who reported poor sleep quality during preconception. Improving preconception sleep quality can potentially mitigate the association between preconception hair cortisol and depressive symptoms during pregnancy.
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Affiliation(s)
- Nur K Abdul Jafar
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Maternal Fetal Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore
| | - Elaine K H Tham
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Derric Z H Eng
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Sherwynn Yeo
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Anne Rifkin-Graboi
- Centre for Research in Child Development, Office of Educational Research, National Institute of Education, Nanyang Technological University, Singapore
| | - Joshua J Gooley
- Program in Neuroscience and Behavioural Disorders, Duke-NUS Medical School, Singapore
| | - See Ling Loy
- Department of Reproductive Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Johan G Eriksson
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yap-Seng Chong
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kok Hian Tan
- Department of Reproductive Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore; Paediatrics Academic Clinical Programme, Duke-NUS Medicine School, Singapore
| | - Jerry Kok Yen Chan
- Department of Reproductive Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Helen Chen
- Department of Psychological Medicine, Kandang Kerbau Women's and Children's Hospital, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter D Gluckman
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael J Meaney
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Canada
| | - Birit F P Broekman
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Psychiatry, OLVG and Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program Amsterdam, the Netherlands
| | - Michelle Z L Kee
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Shirong Cai
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Ryali S, Kumar MS, Ryali V, Paspulati S. Is cesarean section a clinical marker for psychiatric and sleep disorder in young mothers? A cross-sectional study from rural South India. Ind Psychiatry J 2023; 32:158-163. [PMID: 37274594 PMCID: PMC10236682 DOI: 10.4103/ipj.ipj_51_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/02/2022] [Accepted: 06/14/2022] [Indexed: 06/06/2023] Open
Abstract
Background Gestation and postnatal period are important stages in a woman's life. The type of delivery, vaginal delivery (VD) or cesarean Section (CS), is determined by maternal and fetal factors and their mutual fit. The type of delivery has consequences on the health and well-being of the mother and the newborn. Postpartum psychiatric disorders have been found to be both positively and negatively associated with the mode of delivery and demographic and clinical variables of the postpartum mothers. In view of the foregoing, a comprehensive investigation of the demographic and clinical variables and a range of psychiatric disorders among postpartum women delivered both vaginally and by CS in a rural tertiary care hospital in South India was proposed. Materials and Methods All consecutive women delivered vaginally and by CS attending Maternal and Child Clinic within 42 days of delivery were approached. Following informed consent and application of inclusion and exclusion criteria, 121 women delivered vaginally and 124 women delivered by CS were assessed using Mini International Neuropsychiatric Interview (MINI) and Pittsburgh Sleep Quality Index (PSQI). The data obtained were entered into MS Excel 2010 version and further analyzed using STATA v13. Results Both groups were matched on most demographic and clinical variables except age and whether pregnancy was planned or not. Postpartum depression was the most frequent diagnosis in both groups, with significantly more cases following CS compared to VD. Other psychiatric disorders were also found to be more following CS. The quality of sleep (QOS) was significantly poor following CS. QOS was significantly poor in the presence of a coexisting psychiatric disorder. Conclusion This study has limitations in terms of being cross-sectional and disability being defined by cutoff scores on MINI and PSQI.
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Affiliation(s)
- Sumalatha Ryali
- Department of Obstetrics and Gynaecology, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
| | - Mulinti S. Kumar
- Civil Assistant Surgeon Specialist (Psychiatry), Area Hospital, Pulivendla, YSR Kadapa District, Andhra Pradesh, India
| | - V.S.S.R. Ryali
- Department of Psychiatry, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
| | - Sreelatha Paspulati
- Department of Psychiatry, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
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7
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Ciechanowicz S, Pandal P, Carvalho B, Blake L, Van Damme S, Taylor J, Sultan P. Assessment of fatigue in postpartum women using patient-reported outcome measures: a systematic review utilising Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. FATIGUE: BIOMEDICINE, HEALTH & BEHAVIOR 2022. [DOI: 10.1080/21641846.2022.2142030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. Ciechanowicz
- Department of Anaesthesia and Perioperative Medicine, University College London Hospital, London, UK
| | - P. Pandal
- Clinical Research Associate, Stanford University School of Medicine, Stanford, CA, USA
| | - B. Carvalho
- Stanford University School of Medicine, Stanford, CA, USA
| | - L. Blake
- UAMS Library, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S. Van Damme
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - J. Taylor
- Faculty of Health, University of Canberra, Canberra, Australia
| | - P. Sultan
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
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8
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Hao X, Lu J, Yan S, Tao F, Huang K. Maternal Pre-Pregnancy Body Mass Index, Gestational Weight Gain and Children’s Cognitive Development: A Birth Cohort Study. Nutrients 2022; 14:nu14214613. [PMID: 36364875 PMCID: PMC9654549 DOI: 10.3390/nu14214613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
To investigate the joint effect of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on children’s cognitive development. We recruited 1685 mother–child pairs from the Ma’anshan Birth Cohort in China. Pre-pregnancy BMI and GWG were calculated based on the height and weights measured at multiple antenatal checkups. Children’s cognition was assessed by Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition. Poisson regression model was used to analyze the association between maternal pre-pregnancy BMI and children’s cognitive dimensions under different GWG categories. Women with overweight or obese before pregnancy were more likely to obtain excessive GWG. When women had excessive GWG, pre-pregnancy overweight was associated with low children’s PSI (OR = 1.69, 95%CI: 1.02–2.81) and pre-pregnancy obesity was related to poor VCI in children (OR = 3.71, 95%CI: 1.49–9.22), after adjusting for potential confounders. In pre-pregnancy underweight mothers, adequate GWG reduced the risk of below-average VSI in children (OR = 0.22, 95%CI: 0.05–0.92), but excessive GWG was related to low FSIQ in children (OR = 2.53, 95%CI: 1.34–4.76). In women with excessive GWG, maternal pre-pregnancy BMI displays an inverted U-shape association with children’s cognition. Moreover, adequate GWG in women with pre-pregnancy underweight was beneficial for children’s cognition.
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Affiliation(s)
- Xuemei Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People’s Republic of China, Anhui Medical University, Hefei 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Jingru Lu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People’s Republic of China, Anhui Medical University, Hefei 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Shuangqin Yan
- Ma’anshan Maternal and Child Health Center, Ma’anshan 243011, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People’s Republic of China, Anhui Medical University, Hefei 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People’s Republic of China, Anhui Medical University, Hefei 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, China
- Correspondence: ; Tel.: +86-13856967937
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9
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Bao C, Jin D, Sun S, Xu L, Wang C, Tang W, Zhang W, Bao Y, Xu D, Zhou S, Yu X, Zhao K. Trajectories and Depressive Symptoms During the Perinatal Period: A Longitudinal Population-Based Study in China. Front Psychiatry 2022; 13:762719. [PMID: 35432035 PMCID: PMC9009256 DOI: 10.3389/fpsyt.2022.762719] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 02/02/2022] [Indexed: 11/27/2022] Open
Abstract
Most women in the perinatal period face sleep issues, which can affect their mental health. Only a few studies have focused on sleep trajectories and depressive symptoms of women during the perinatal period in China. This study aims to explore the development trajectory of sleep quality by classifying pregnant women according to the changes in their sleep quality during pregnancy and postpartum and investigate the correlation between different sleep quality trajectory groups and depressive symptoms. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality, and the Edinburgh Postnatal Depression Scale (EPDS) was used to assess the symptoms of depression. Participants (n = 412) completed the assessment of sleep quality, depressive symptoms, and some sociodemographic and obstetric data at 36 weeks of gestation, 1 week after delivery, and 6 weeks after delivery. The group-based trajectory model (GBTM) was used to complete the trajectory classification, and logistic regression was used to analyze the predictive factors of postpartum depressive symptoms. Four different sleep quality trajectories were determined: "stable-good," "worsening," "improving," and "stable-poor" groups. The results demonstrate that poor sleep trajectories, social support and parenting experience during the perinatal period are related to postpartum depression. Screening for prenatal sleep problems is crucial for identifying the onset of perinatal depressive symptoms.
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Affiliation(s)
- Ciqing Bao
- Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Dongzhen Jin
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Ling Xu
- Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Chaoyue Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Weina Tang
- Shaoxing 7th People's Hospital, Shaoxing, China
| | - Wenmiao Zhang
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yin Bao
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongwu Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Siyao Zhou
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xin Yu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
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Ladyman C, Signal TL, Sweeney B, Jefferies M, Gander P, Paine SJ, Huthwaite M. Multiple dimensions of sleep are consistently associated with chronically elevated depressive symptoms from late pregnancy to 3 years postnatal in Indigenous and non-Indigenous New Zealand women. Aust N Z J Psychiatry 2021; 55:687-698. [PMID: 33176439 DOI: 10.1177/0004867420972762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Poor sleep and depressive symptoms are common throughout the perinatal period, but little is known about the extended time course of depression and the sleep dimensions associated with these trajectories. OBJECTIVE This study investigated different depression trajectories in New Zealand Māori and non-Māori women from late pregnancy to 3 years postnatal. Relationships between multiple dimensions of sleep and these depression trajectories were also investigated. METHODS Data from 856 women (30.6% Māori and 69.4% non-Māori) from the longitudinal Moe Kura cohort study were used. Depressive symptoms and multiple dimensions of sleep (quality, duration, latency, continuity and daytime sleepiness) were collected at 36 weeks' gestation, 12 weeks postnatal and 3 years postnatal. Trajectory analysis was completed using latent class analysis. RESULTS Latent class analysis revealed two distinct groups of depressive symptom trajectories: 'chronic high' and 'stable mild' for both Māori and non-Māori women. Māori women in both trajectories were more likely than non-Māori women to have clinically significant depressive symptoms at every time point. Poorer sleep quality, latency, continuity and greater daytime sleepiness were consistently associated with the chronic high depressive symptom trajectory at all three time points, after controlling for sociodemographic factors. CONCLUSION A significant proportion of Māori and non-Māori women experience chronically high depressive symptoms during the perinatal period and the following years. Across this extended time frame, Māori women have a higher probability of experiencing clinically significant depressive symptoms compared to non-Māori women. These persistent patterns of depressive symptoms occur concurrently with multiple dimensions of poor sleep. Given the well-described impact of maternal depression on the mother, child, family and community, this highlights the importance of healthcare professionals asking about mothers' sleep quality, continuity, latency and daytime sleepiness as potential indicators of long-term mood outcomes.
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Affiliation(s)
- Clare Ladyman
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - T Leigh Signal
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Bronwyn Sweeney
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Mona Jefferies
- Health Services Research Centre, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Philippa Gander
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
| | - Sarah-Jane Paine
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Mark Huthwaite
- Department of Psychological Medicine (Wellington), University of Otago, Wellington, New Zealand
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Change patterns of sleep problems predict mental health problems among adolescents: a 10-year cohort study of Chinese Wenchuan earthquake. J Affect Disord 2021; 287:138-144. [PMID: 33780829 DOI: 10.1016/j.jad.2021.02.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/02/2021] [Accepted: 02/28/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The predictive effects of change patterns of sleep problems on mental health after a long-term disaster remain poorly known. We examined the change patterns of sleep problems after the Wenchuan earthquake, and tested whether specific sleep-related change patterns could predict mental health problems (posttraumatic stress disorder [PTSD], anxiety, and depression) in the 10 years after Wenchuan earthquake. METHODS 1357 adolescents exposed to the Wenchuan earthquake were surveyed on potential sleep problems at 18 months (T18m) and 30 months (T30m) post-earthquake. Among them, 799 participants completed the followed-up survey online 10 years after the earthquake (T10y). Since some participants did not provide sleep problems data at both T18m and T30m, 707 samples were included in final analyses. Linear regression analysis was performed. RESULTS Four different patterns of sleep problems were identified: stable-low pattern (61.1%), stable-high pattern (15.3%), decreasing pattern (13.2%), and increasing pattern (10.5%). Additionally, we found that individuals in stable-high and increasing patterns were more likely to experience PTSD, anxiety, and depression at T10y in the crude model. After controlling for confounders (e.g., earthquake exposure), these patterns were strongly predictive of depression at T10y. LIMITATIONS Only two waves of sleep problems were collected and subjective sleep outcomes methods were used to collect data instead of objective methods. CONCLUSIONS Sleep problems had heterogeneity after a deadly earthquake. Individuals in stable-high and increasing patterns should be given more attention. Timely assessment and targeted interventions on specific sleep problems are necessary for preventing an escalation of adverse mental health outcomes.
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Duthie EA. In-Hospital Newborn Falls Associated With a Sleeping Parent: The Case for a New Paradigm. Hosp Pediatr 2020; 10:1031-1037. [PMID: 33229336 DOI: 10.1542/hpeds.2020-0112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A newborn fall to the floor from a sleeping parent's arms in the immediate postpartum period may result in a skull fracture, head bleed, and transfer to the NICU for observation. These harmful consequences galvanized frontline clinicians to prevent these tragic accidents, but, a decade later, they continue at a stubbornly low, persistent level. In this article, I suggest that a misunderstanding of sleep science may be a barrier to effective interventions. The science of sleep is presented to inform a new paradigm that would have greater potential of eliminating dangerous newborn falls.
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Affiliation(s)
- Elizabeth A Duthie
- Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
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McEvoy KM, Rayapati D, Washington Cole KO, Erdly C, Payne JL, Osborne LM. Poor Postpartum Sleep Quality Predicts Subsequent Postpartum Depressive Symptoms in a High-Risk Sample. J Clin Sleep Med 2019; 15:1303-1310. [PMID: 31538601 PMCID: PMC6760397 DOI: 10.5664/jcsm.7924] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/10/2019] [Accepted: 05/10/2019] [Indexed: 12/26/2022]
Abstract
STUDY OBJECTIVES Postpartum depression (PPD) occurs in 15% to 20% of mothers worldwide and is associated with adverse outcomes for mother and child. Prior research has established a relationship between concurrent sleep quality and PPD. We conducted a secondary analysis in 45 women with mood disorders to study overall sleep quality (and individual components of sleep), measured in the early postpartum period, as a predictor of subsequent PPD. METHODS We measured sleep quality using the Pittsburgh Sleep Quality Index (PSQI; subscale and total scores) at 1 month postpartum (and during the third trimester). We measured depressive symptoms using the Inventory of Depressive Symptoms, Self-Report (IDS-SR) at 3 months postpartum. We used bivariate and multivariate linear regression models to study the association between PSQI and IDS scores. RESULTS We found that higher global PSQI scores as well as higher component scores for self-reported sleep quality, sleep latency, sleep efficiency, sleep medication usage, and daytime dysfunction, measured 1 month postpartum, were associated with increased IDS scores (at 3 months postpartum (P = .01, .01, .01, .003, < .001, respectively). We did not find an association between poor sleep quality in the third trimester and PPD. CONCLUSIONS Poor sleep quality in the early postpartum period independently predicts development of later PPD. This is clinically significant and highlights the importance of sleep interventions as an immediate postpartum therapeutic tool. CITATION McEvoy KM, Rayapati D, Washington Cole KO, Erdly C, Payne JL, Osborne LM. Poor postpartum sleep quality predicts subsequent postpartum depressive symptoms in a high-risk sample. J Clin Sleep Med. 2019;15(9):1303-1310.
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Zhou X, Zhen R, Wu X. Trajectories of sleep problems among adolescents after the Wenchuan earthquake: the role of posttraumatic stress disorder symptoms. Psychol Health 2019; 34:811-827. [DOI: 10.1080/08870446.2019.1574348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Rui Zhen
- Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
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Wang G, Deng Y, Jiang Y, Lin Q, Dong S, Song Y, Zhu L, Zhu Q, Sun W, Zhang Y, Jiang F. Trajectories of sleep quality from late pregnancy to 36 months postpartum and association with maternal mood disturbances: a longitudinal and prospective cohort study. Sleep 2018; 41:5238931. [DOI: 10.1093/sleep/zsy179] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Indexed: 12/21/2022] Open
Affiliation(s)
- Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Yujiao Deng
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Qingmin Lin
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Shumei Dong
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Yuanjin Song
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Lixia Zhu
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Wanqi Sun
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong SAR
| | - Yunting Zhang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
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Okun ML, O'Brien LM. Concurrent insomnia and habitual snoring are associated with adverse pregnancy outcomes. Sleep Med 2018; 46:12-19. [DOI: 10.1016/j.sleep.2018.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/01/2018] [Accepted: 03/06/2018] [Indexed: 11/25/2022]
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The Relationship between Constitution of Traditional Chinese Medicine in the First Trimester and Pregnancy Symptoms: A Longitudinal Observational Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3901485. [PMID: 27087821 PMCID: PMC4818819 DOI: 10.1155/2016/3901485] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/03/2016] [Indexed: 11/17/2022]
Abstract
Objective. We report on the distribution of traditional Chinese medicine (TCM) constitution in the first trimester and on the association between TCM constitution and maternal symptoms related to pregnancy. Methods. Participants were followed up until delivery to observe primary measures (gestational hypertension and gestational diabetes mellitus) and secondary measures (signs of miscarriage, miscarriage, nausea and vomiting, and sleepiness and defecation during pregnancy). Descriptive analysis, t-tests, chi-square tests, and logistic regression analysis were used in this study. Results. 61.8% of the participants had unbalanced constitutions. We did not find a significant association between the TCM constitution and gestational hypertension, gestational diabetes, miscarriage, signs of miscarriage, and defecation during pregnancy. And we found that women with unbalanced constitutions in early pregnancy had a greater likelihood of severe nausea and vomiting and poor sleep during pregnancy in the logistic regression analysis. Conclusions. These results have implications for female health care providers and policy makers. Identification of TCM constitution may be helpful for understanding nausea and vomiting and poor sleepiness during pregnancy, especially in the condition that can not be explained by modern medical science, and be helpful for making program to improve these uncomfortable symptoms.
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