Possible contribution of better maternal psychological well-being to the acquisition of sleeping through the night in infants during the early postpartum period

The objective of this study was to elucidate whether better maternal psychological well-being contributes to the acquisition of "sleeping through the night" (STN) in infants during the early postpartum period. Fifty-two primiparous mothers completed the General Health Questionnaire-28 (GHQ-28) in the third trimester (prenatal) and when the conceptional ages of their babies reached 8-9 weeks (hereafter, 2 months), 12-13 weeks (3 months), and 16-17 weeks (4 months). They also recorded babies' nocturnal sleep patterns in a timetable for 5 consecutive days each month postpartum. "Regular STN" was defined when the mean of longest nocturnal sleep duration for 5 consecutive days was > 8 h or between 6 and 8 h with < 1.0 nocturnal awakenings. According to these criteria, a total of 14 infants (27 %) acquired regular STN at 4 months (referred to as "STN infants"), with STN infants showing a marked increase in longest nocturnal sleep duration and a decrease in nocturnal awakenings from 2 to 3 months of age. The mothers of STN infants demonstrated steady reductions in postnatal GHQ-28 scores and had significantly lower prenatal GHQ-28 scores compared with the mothers of non-STN infants (3.7 ± 3.0 vs. 6.4 ± 4.1, p = 0.027). In random forest models for binomial classification, both prenatal and postnatal (at 4 months) GHQ-28 scores were identified as significant covariates for distinguishing STN infants, and other important covariates, including weeks of delivery, stepfamily, birth weight of the infant, and maternal co-sleeping at bedtime, were selected. Among these covariates, maternal co-sleeping at bedtime had relatively stronger correlations with both STN infants (r = - 0.440) and prenatal maternal GHQ-28 scores (r = 0.377). In conclusion, because prenatal maternal psychological well-being was thought to predict the acquisition of STN in infants, infants born from mothers with better psychological well-being appear to have some advantages in acquiring STN. These cross-lagged correlations suggest that the pathway from mothers to infants may be mediated by certain parenting behaviors, such as maternal co-sleeping at bedtime.

The Efficacy of Text-Based Mentoring for Postpartum Mothers: A Pilot Study

OBJECTIVES

Technology-based outreach offers promise for providing support to a broad population of postpartum mothers while keeping costs low. However, research on the efficacy of this approach is scarce. We conducted a pre-registered randomized pilot trial of the effects of a novel technology-based approach for supporting postpartum mothers - via text-based mentoring - from infant's birth through 18 months.

METHODS

Mothers (n = 201) were recruited at West Penn Hospital in Pittsburgh, PA in the days immediately following delivery. Treatment mothers were matched with volunteer mentors who communicated with them entirely via text messages. Control mothers received monthly one-way texts on basic safety topics. Measures were collected via hospital records and mother surveys. We estimated treatment effects on mothers' parenting stress, mental health, knowledge of child development, engagement in language and literacy activities, and child milestones at 4- and 18-months postpartum. We used a systematic coding approach and simple descriptive statistics to analyze the treatment mother-mentor texting transcripts.

RESULTS

We found no statistically significant impacts on targeted outcomes. However, impacts for some outcomes were meaningfully large (> 0.2 SDs). Analyses of texting transcripts showed that most mothers stayed engaged for the full 18-month study period and that mother-mentor pairs primarily discussed maternal wellbeing and child-focused topics.

CONCLUSIONS FOR PRACTICE

Postpartum mothers will engage with mentors in a text-based mentoring program around important maternal and child health topics. More research and development on technology-based supports for parents in the early childhood years is needed.

Association between exclusive breastfeeding and postpartum post-traumatic stress disorder

BACKGROUND

Research on the association between breastfeeding and postpartum post-traumatic stress disorder (PTSD) is sparse. This study aimed to examine the association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD.

METHODS

An epidemiologic study was conducted in a tertiary hospital in China between October 2019 and October 2020. Eligible mothers were recruited at 3 days after childbirth and assessed using the Post-Traumatic Stress Disorder Checklist - Civilian version (PCL-C) for PTSD at 42 days postpartum. The independent association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD was estimated using log-binomial regression models, after adjusting for potential confounders.

RESULTS

Ninety-two of 759 (12.1%) mothers developed postpartum PTSD within 42 days after childbirth. Compared with partially breastfeeding mothers, exclusively breastfeeding mothers had lower risks of postpartum PTSD (relative risk [RR] 0.28; 95% confidence interval [CI] 0.13, 0.59), re-experience (RR 0.48; 95% CI 0.30, 0.76), avoidance (RR 0.55; 95% CI 0.32, 0.97), and hyperarousal (RR 0.52; 95% CI 0.34, 0.78). After adjustment for family support, parity, mode of delivery, perceived birth trauma, early contact / suckling, and rooming-in, associations between exclusive breastfeeding and postpartum PTSD remained significant: the overall PTSD adjusted relative risk [aRR] was 0.31; (95% CI 0.15, 0.66), with a re-experience aRR of 0.48; (95% CI 0.30, 0.77) and hyperarousal aRR of 0.56; (95% CI 0.37, 0.85).

CONCLUSION

Exclusive breastfeeding up to 42 days after childbirth was associated with reduced risk of postpartum PTSD. While the potential for reverse causation cannot be ruled out, strategies to improve rates of exclusive breastfeeding through teaching, counselling, and support may benefit mothers and their infants by reducing the risk of postpartum PTSD.

Magnitude and associated factors of suicidal behavior among postpartum mothers attending public health centers of Addis Ababa, Ethiopia

BACKGROUND

In low-income nations, suicidal conduct increases within the first year following delivery, ranging from 4 to 17.6%, with a three-fold cause of maternal death. Suicidal behavior was also reported to be 14% among postpartum women in Ethiopia.

OBJECTIVE

To assess the magnitude and associated factors of suicidal behavior among postpartum mothers attending public health centers in Addis Ababa, Ethiopia, 2021.

METHODS

A cross-sectional study was conducted in ten public health facilities of Addis Ababa, Ethiopia with a total sample size of 615 women. The data were entered into Epi data 4.6 and exported to SPSS version 25 for statistical analysis. A logistic regression model with adjusted odds ratio (AOR), 95% confidence interval (CI) and p-value of ≤0.05 was used to identify predictors of the outcome variable.

RESULTS

The magnitude of suicidal behavior among postnatal mothers attending public health centers in Addis Ababa was 41.46% with 95%CI (35.2-44.5%). Being mother's literate (adjusted odds ratio (AOR) = 0.64, 95% CI: 0.42-0.97), verbal abuses (AOR = 2.18, 95% CI: 1.38-3.44), history of rape (AOR = 3.03, 95% CI 1.14 -8.05), history of depression (AOR = 4.12, 95% CI 1.21-14.03), women's having sexually unfaithful husband (AOR = 1.42, 95% CI 1.14-6.23) and khat chewing (AOR = 8.48, 95% CI 2.52-28.50) were significantly associated with suicidal behavior.

CONCLUSION

The magnitude of suicidal behavior among postnatal mothers attending public health centers in Addis Ababa was 41.46% and it was found to be associated with being literate, rape, verbal abuse, having a history of depression, having a sexually unfaithful husband and chewing khat. As a result, women should be screened for suicidal behavior during antenatal and postnatal services for early detection and management.

Mothers' knowledge and attitudes about newborn screening in Jordan

Newborn screening is an important public health program that helps save the lives of many infants worldwide. The aim of this cross-sectional descriptive study was to examine the knowledge and attitudes of mothers regarding the newborn screening test in Jordan. A convenient sample of 301 mothers of newborns was interviewed to collect data, using structured questionnaires about their knowledge and attitudes regarding the newborn screening. Most mothers exhibited positive attitudes toward the newborn screening. However, their knowledge about it was only moderate; their knowledge levels contributed positively to their attitudes to the test. The mothers’ source of information about the test was a significant predictor for both their level of knowledge and attitudes toward the newborn screening. The healthcare providers, particularly nurses, were identified as the main source of mothers’ information in Jordan. The educative role of the health professionals is key and should be better activated to optimize the outcomes of early newborn screening. Changes in current practices regarding mothers’ education about NS is recommended to increase the knowledge and enhance attitude about NS among the mothers.

Psychological Processes of Postpartum Mothers with Newborns Admitted to the Intensive Care Unit

PURPOSE

This research aims to explore the psychological processes of postpartum mothers during the admission of their newborns to the intensive care unit. It is hoped that the findings from this study will serve as a reference for clinical medical staff in providing individual and holistic patient care.

METHODS

Using grounded theory methodology, we collected data through semi-structured, one-to-one in-depth interviews. When data saturation occurred, 12 participants were involved through the constant comparative analysis process.

RESULTS

The psychological processes consisted of a core category and three main categories. The core category was "worrying about the baby and striving to fulfill maternal responsibilities." The three main categories:" impact on the maternal role", "recognition of the maternal identity", and "exhibition of maternal role". The entire process may be affected by intrinsic and extrinsic factors, such as breast milk supply, skin-to-skin contact opportunities for mother and baby, seriousness of the newborn's health conditions, the support system, and the style of postpartum confinement care.

CONCLUSIONS

It is recommended that the neonatal intensive care unit should adopt family-centered care, taking an initiative to empathize and care for the mother, assisting skin-to-skin contact for the mother and baby as soon as possible, maintaining established breastfeeding, providing the correct concept of postpartum care, and encouraging participation in support groups. These activities can reduce the impact of the situation on the maternal role and improve maternal identity recognition.

Prevalence and associated factors of postpartum depression among postpartum mothers in central region, Eritrea: a health facility based survey

BACKGROUND

Postpartum depression (PPD) is a mood disorder that occurs within the first 12 months after delivery. It affects 20 to 40% of women living in the low-income countries. In resource limited countries discovering the predictors of PPD is important as it allows close follow-up and targeted screening of at risk mothers. The objective of this study was to assess the magnitude and predictors of PPD among recently delivered mothers in Central Region of Eritrea.

METHODS

This study used analytical cross-sectional study design to evaluate the magnitude of and factors associated with postpartum depression among 380 randomly selected mothers. The study was conducted in four primary health care facilities of Zoba Maekel (Central Region), Eritrea. A structured closed-ended questionnaire was used to capture the socio-demographic and maternity related information of the study participants. The standard Diagnostic and Statistical Manual of Mental Disorders Fifth Edition was used to assess depression. The dependent variable for this study was status of the mother with regard to PPD. The socio-demographic and maternity related variables of the mothers, presumed to influence the likelihood of developing postpartum depression, were the independent variables.

RESULTS

In this study the prevalence of PPD was found to be 7.4%. Mother's who are housewives were less likely to develop PPD (AOR = 0.24, 95% CI: 0.06-0.97; p = 0.046), whereas, mothers with perceived low economic status (AOR = 13.33, 95% CI: 2.66-66.78; p = 0.002), lack of partner support (AOR = 5.8, 95% CI: 1.33-25.29; p = 0.019), unplanned pregnancy (AOR = 3.39, 95% CI: 1.24-9.28; p = 0.017), maternal illness after delivery (AOR = 7.42, 95% CI: 1.44-34.2; p = 0.016), and reside in Southwest-Asmara (AOR = 6.35, 95% CI: 1.73-23.23; p = 0.05) had statistically significant higher odds of postpartum depression.

CONCLUSIONS

In the current study setting, factors that associated with PPD are grouped in to two domains; the woman's potential to bear the forthcoming responsibility and the social support they get after delivery. The findings of this study imply the need to introduce an active screening program for PPD the health facilities as part of the postpartum care.

Complementary alternative medicine use among postpartum mothers in a primary care setting: a cross-sectional study in Malaysia

Background

Complementary alternative medicine (CAM) is widely used among postpartum mothers to maintain their well-being. This study aims to determine the prevalence and factors associated with CAM use among postpartum mothers in a primary-care clinic in Malaysia.

Methods

This is a cross-sectional study of 725 postpartum mothers, aged 18 and above, attending a primary-care clinic. The systematic sampling method was used to recruit patients through a structured, self-administered questionnaire. Data analysis was conducted using SPSS version 23. Multiple logistic regression was used to identify the predictors of CAM use among postpartum mothers.

Results

The prevalence of CAM use among postpartum mothers was 85.5%. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping were the most widely used methods of CAM (84.1%) among postpartum mothers, followed by biological-based therapies (33.1%). More than half of the respondents (52.1%) opted to use CAM, as they had observed good results from other CAM users. However, our study showed that 57.1% of mothers who consumed herbal medicine reported neonatal jaundice in their newborn. The median of the expenditure on CAM usage was 250 Malaysian Ringgits, or USD 61.3 per month. According to multiple logistic regression analyses, being Muslim (OR = 5.258, 95% CI: 2.952–9.368), being Malay (OR = 4.414, 95% CI: 1.18–16.56), having a higher educational level (OR = 2.561, 95% CI: 1.587–4.133) and having delivered via spontaneous vaginal delivery (OR: 5.660, 95% CI: 3.454–9.276) had a significantly positive association with CAM use among postpartum mothers.

Conclusions

The prevalence of CAM use was high (8 out of 10) among postpartum mothers. Postpartum mothers who are Malay, Muslim, have a higher educational level and who have had spontaneous vaginal delivery tended to use CAM more. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping, were the most widely used forms of CAM, followed by biological-based therapies. More than half of the mothers who consumed herbal medicine reported neonatal jaundice in their newborn. Thus, education to increase awareness regarding the consumption of herbs is urgently required in this country.

Knowledge on postnatal care among postpartum mothers during discharge in maternity hospitals in Asmara: a cross-sectional study

BACKGROUND

The early postnatal period is a dangerous time for both mother and baby where morbidity and mortality are highly prevalent if proper care is not done. Post natal care (PNC) knowledge has significant role in reducing such complications. In this study, the knowledge of postpartum mothers on PNC and its determinants were determined.

METHODS

A cross-sectional quantitative study was conducted in postpartum mothers (PpM) who attended all maternal delivery services in Asmara. Data was collected by a structured questionnaire. All (n = 250) PpM who gave birth in December, 2017 were included in the study. Independent samples t-test and one way ANOVA were used to compare the scores in knowledge across categories of background characteristics using SPSS. Bonferroni post-hoc test was performed for variables that were found to be significant while using ANOVA tool. P-values less than 0.05 were considered as significant.

RESULTS

The percentage of PpM who cited vaginal bleeding, as a maternal danger sign, and fever, as a baby danger sign, were 83.2 and 58.8%, respectively. The majority (96%) of PpM responded the correct answer on where to go if they note any danger signs. In addition, more than nine tenth of PpM correctly identified injectable contraceptives (92.7%) and oral contraceptive (91.5%). The percentages of knowledge in recognizing the necessary nutrients ranged from 87.6% for carbohydrates to 46% for minerals. The percentages of correct knowledge regarding first baby bath, frequency of breast feeding, umbilical care, duration of exclusive breast feeding, need and purpose of vaccine were 40.1, 81.9, 77.4, 94.8, and 99.2% respectively. The mean PNC knowledge score was 24.89/60. The score of knowledge on postnatal care was found to significantly differ across the categories of residence (p < 0.001) and ethnicity (p = 0.015). An increasing trend of knowledge score was observed with increase in age group (p < 0.001), educational level (p = 0.021), gravida (p < 0.001) and para (p < 0.001).

CONCLUSION

Considerable gaps in knowledge regarding postnatal care among postpartum mothers were evident. Special attention should be laid on rural residents, single/living together, junior/below in educational level, primigravida/para, non-Tigrigna ethnicity, and 17 to 25 years old mothers.

Early postnatal care use by postpartum mothers in Mundri East County, South Sudan

BACKGROUND

Globally, most maternal and newborn deaths are within the first week of delivery. Early postnatal-care (EPNC) visits between 2 and 7 days detects early morbidity and averts deaths. However, there is scarcity of information on use of EPNC in Mundri East County, South Sudan. This study investigated factors associated with EPNC use among postpartum mothers in Mundri East County, South Sudan.

METHODS

This was an analytical cross-sectional study of 385 postpartum mothers from 13 health facilities. Data was collected by structured questionnaires, entered in EpiData and analyzed with STATA at 5% significance level. Chi-squared, Fisher's exact and Student's t-tests were used for bivariate analysis and logistic regression for multivariable analysis.

RESULTS

The mean age of respondents was 27.9-years (standard deviation: 6.7), 276 (71.7%) were below 30-years, 163 (42.3%) were Muru ethnicity, 340 (88.3%) were single and 331 (86.1%) were unemployed. 44 (11.4%; 95% CI: 8.4-15.0) used EPNC. Poor health services access at government health facilities (Adjusted odds ratio (AOR) = 0.18; 95% CI: 0.05-0.61; P = 0.006), more than 1-h access to health facility (AOR = 0.27; 95% CI: 0.09-0.78; P = 0.015), at least secondary maternal education (AOR = 5.73; 95% CI: 1.14-28.74; P = 0.034) and receipt of PNC health education post-delivery (AOR = 3.47; 95% CI: 1.06-11.33; P = 0.004) were associated with EPNC use.

CONCLUSIONS

Use of EPNC in Mundri East County, South Sudan was low. It was significantly reduced at government and inaccessible health facilities. However, it increased with receipt of PNC health education after delivery and at least secondary level of education.