History Of Childbirth Research Articles

Analysis of the Characteristics and Influencing Factors of Perinatal Obsessive-Compulsive Symptoms in Elderly Parturients.

Aims/Background Perinatal obsessive-compulsive symptoms are significant predictors of increased postpartum anxiety, depression, and bipolar disorder. These symptoms have persistent adverse effects on both mothers and children. Currently, there are few reports in the literature on obsessive-compulsive disorder in elderly parturient women in China. This study primarily discusses the clinical characteristics of perinatal obsessive-compulsive symptoms in elderly parturient women and analyzes their influencing factors, aiming to provide references for clinical prevention and treatment. Methods This research employed a cross-sectional design, utilizing a convenience sampling method to select elderly parturients who delivered at Panjin Central Hospital from September 2022 to August 2023. The assessment instruments included a general data questionnaire, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the self-rating anxiety scale (SAS), the edinburgh postpartum depression scale (EPDS), and the sense of coherence scale (SOC-13). The relationship between the severity of obsessive-compulsive symptoms and negative emotions and psychological burden was examined through Pearson correlation analysis. Additionally, the influencing factors of perinatal obsessive-compulsive symptoms were analyzed using multivariate logistic regression. Results In this study, a total of 124 questionnaires were distributed, and 122 valid questionnaires were recovered, yielding an effective recovery rate of 98.39%. Among the 122 elderly parturients, 37 were positive for perinatal obsessive-compulsive disorder, accounting for 30.33% (37/122). Among the 37 elderly parturients with perinatal obsessive-compulsive symptoms, 64.86% had both obsessive-compulsive thoughts and behaviors, 21.62% had obsessive-compulsive thoughts as the main symptom (8/37), and 13.51% had obsessive-compulsive behaviors (5/37). Multivariate logistic regression analysis showed that pregnancy history, pregnancy complications, fetal health, SOC-13 score, SAS score, and EPDS score were independent risk factors for positive perinatal obsessive-compulsive symptoms (p < 0.05). Conclusion The incidence of perinatal obsessive-compulsive symptoms in elderly parturient women is high. Obsessive-compulsive thoughts primarily involve fears of injury and contamination, while obsessive-compulsive behaviors mainly consist of compulsive checking and cleaning. The occurrence of perinatal obsessive-compulsive disorder is associated with factors such as pregnancy and childbirth history, pregnancy complications, fetal health, negative emotions, and stress resistance.

Childbearing Histories and Midlife Cognition: Accounting for Early Life Factors.

Childbearing histories-for example, parity and age at first birth-matter for the health outcomes of mid- and later-life women. There is growing evidence that childbearing may shape cognitive outcomes. However, previous research is not definitive due to its inability to account for selection. Selection is critical to address given that multiple factors, including socioeconomic background and cognition in adolescence, place women at risk for both specific childbearing experiences and poor cognitive functioning. We analyze the 1979 National Longitudinal Survey of Youth (NLSY79) (N=3,668), a longitudinal nationally representative dataset from the US that began collecting data during respondents' late teens and early 20s. We estimate the average treatment effects (ATEs) of childbearing histories on midlife memory and cognition using propensity-score matching techniques that incorporate an expansive set of early-life factors. In models adjusting for early life covariates, we find that any births, high parity, and early first birth are associated with worse self-reported memory, but not cognitive functioning scores. After addressing the influence of early life factors through matching techniques, the only robust differences relate to any births and early first births with self-reported memory. Selection into specific childbearing experiences partially drives the link between childbearing and cognition at mid-life, with cascading implications into later life. We suggest incorporating childbearing and early life factors into models to identify social determinants of memory and cognitive functioning.

Utilisation and associated socio-demographic factors related to the maternal continuum of care in sub-Saharan Africa: A systematic review and meta-analysis.

Maternal continuum of care (MCC) is the utilisation of maternal health care services, including 4+ antenatal care (ANC) visits, skilled birth attendants (SBAs), and postnatal care (PNC). This systematic review and meta-analysis assessed the pooled proportion of MCC utilisation among women in sub-Saharan Africa (SSA) and its association with selected sociodemographic factors. We identified keywords and MeSH terms related to the condition (MCC), the context (SSA), and population (women with history of childbirth) to search for published or unpublished observational studies. We used the Joanna Briggs Institute tool to extract data and the Newcastle Ottawa Scale for quality assessment. Meta-analysis was used to compute pooled estimates (MCC utilisation and odds ratio (OR) associates) with 95% confidence intervals (CI) using Stata 17. Of 45 402 studies identified, we included 23 involving 320 353 women. The pooled estimate of MCC utilisation across SSA was 18.72% (95% CI = 14.51, 22.93), showing a significant increase (P < 0.05) from 2015 to 2022. Southern Africa had the highest MCC utilisation (38%; 95% CI = 36.59, 39.41), while East Africa had the lowest (17.5%; 95% CI = 12.22, 22.75). Maternal continuum of care utilisation was associated with maternal age 25-34 years (pooled odds ratio (POR) = 1.27), urban residence (POR = 2.69), richer/richest wealth status (POR = 1.68), as well as higher level of education and employment (POR = 1.32). MCC utilisation in SSA remains low, with significant variation across the sub-regions and sociodemographic strata. Context-specific interventions targeting identified factors are essential to enhance MCC utilisation in SSA. PROSPERO: CRD42021272708.

8100 Late Onset Sheehan Syndrome 23 Years After Post-Partum Hemorrhage: A Rare Case

Abstract Disclosure: I. Dosunmu: None. A. Alvi: None. S. Kaufman: None. A. Malik: None. Introduction: Sheehan syndrome is defined as ischemic necrosis of pituitary gland following massive postpartum hemorrhage. The majority of cases remain undiagnosed for many years after delivery. We present a unique case of late onset of Sheehan syndrome 23 years after the last childbirth which was complicated by hemorrhage. Although the syndrome can present with panhypopituitarism, most patients have partial hormone deficiency which leads to a delay in the diagnosis. Patients can remain asymptomatic for many years until the body is exposed to stressful situations. This is what we believe caused our patient to develop hyponatremia after staying symptom free for 23 years. Case Description: A 46-year-old female with no medical history presented with abdominal pain and dark colored urine. Her initial vital signs were normal. Labs showed sodium of 132 mmol/L, AST of 552 U/L, ALT of 518 U/L, ALP of 196 U/L, GGT of 166 U/L. CT scan of abdomen, liver ultrasound, and liver biopsy were unremarkable. AMA was positive with value of 1.98, consistent with diagnosis of primary biliary cholangitis. On day 2 her blood pressure decreased to 76/42 mmHg and her sodium decreased to 129mmol/L and on day 5 her blood pressure was 88/43mmHg and her sodium decreased to 122mmol/L. TSH was found to be 2.54 uIu/ml. Upon further evaluation by endocrinology, patient appeared to have sluggish speech and appeared edematous particularly in her face. A free T4 was found to be less than 0.07 ng/dl and cortisol 0.5 mcg/dl, and ACTH 22.4 pg/ml, FSH of 4.2 mIU/ml, LH 1.3 mIU/ml. On further questioning, patient confirmed history of complicated childbirth 23 years ago requiring multiple transfusions and a hysterectomy and she reported agalactorrhea after delivery. Brain MRI confirmed empty sella and she was diagnosed with Sheehan syndrome. She was started on levothyroxine and hydrocortisone and ursodiol for PBC. Discussion: Delayed onset Sheehan's syndrome stems from inadequate blood supply or ischemia to the pituitary gland during childbirth. Diagnosis can be challenging due to its gradual onset and vague presenting symptoms. In our patient, the possibility of Sheehan syndrome was suspected after evaluation for hyponatremia revealed central hypothyroidism and secondary adrenal insufficiency. &amp;#x2028;The immediate initiation of hydrocortisone followed by levothyroxine, resulted in the normalization of blood pressure and sodium and an increase in free T4 levels from &amp;lt;0.07 to 0.26 four days after hormone initiation. Early diagnosis and prompt treatment are crucial for the best outcomes. Our patient reported feeling much better and denied any symptoms 6 months after discharge. Conclusion: Delayed onset Sheehan's syndrome is a rare but important condition that can occur months or years after childbirth. Early diagnosis, proper medical management, and hormone replacement therapy are essential for improving the quality of life for affected women. Presentation: 6/2/2024

Investigating different dimensions of women’s childbirth experiences and its predictors among postnatal women: findings from a cross sectional study

Background and aimsChildbirth experience is an event in a woman’s life with short- and long-term effects on her physical and mental health. This study aimed to investigate different dimensions of women’s childbirth experiences and its predictors.MethodsThis cross-sectional study was conducted on 430 postnatal women with vaginal delivery in 2021 in Northern Iran. Data were collected using the Iranian women’s childbirth experience questionnaire (IWCEQ) and demographic and pregnancy-related characteristics questionnaire. Principal component analysis using Amos 24 and backward multiple linear regression using SPSS 22 were employed to analyze the data.ResultsThe mean score of childbirth experiences was 48.48 ± 19.09% out of 100 (95% CI: 46.68–50.28). The Principal Component Analysis revealed that the preparation (β = 0.84), positive perception (β = 0.78), and fear dimensions (β= -0.72) were the most important dimensions of women’s childbirth experiences. Moreover, education (B = -7.14, p = 0.001), spouse’s education (B = 7.40, p = 0.001), history of previous childbirth (B = 4.88, p = 0.001), obstetric problems of previous childbirth (B = − 7.73, p = 0.038), mother’s preferred type of delivery (B = 9.34, p = 0.001), the simultaneous delivery of another baby in the delivery room (B = -3.39, p = 0.017), and birth weight (B = -5.79, p = 0.005) explained 40% of the variance of the childbirth experience score.ConclusionChildbirth experience is a unique experience that influenced by positive and negative issues. More studies to identify related factors to dimensions of childbirth experience may have some insights for developing national and local- level health policies and clinical protocols.

A multi-center study on the use of lidocaine thermogel for pain control in outpatient operative hysteroscopy

ObjectivesThis study aimed to explore the use of an anesthetic lidocaine thermogel in outpatient operative hysteroscopies. Specifically, it assessed the safety, tolerability, and ease of use of the gel, as well as its potential for pain reduction during the procedure. Study designThis was a multicenter observational study conducted in 9 gynecological units between March 2023 and January 2024. The study included adult women scheduled for outpatient operative hysteroscopies, excluding those with hypersensitivity to the product or recent participation in other clinical studies. The target sample size was 60 to account for potential dropouts. Data collection was electronic, and SPSS was used for analysis. The study assessed visibility conditions, procedure duration, pain scores at different stages of the procedure, and adverse event frequency. Statistical analyses utilized descriptive statistics, Student’s t-tests, Wilcoxon and Friedman tests, and Chi-Square or Fisher tests as appropriate. Binary logistic regression was applied to identify factors influencing gel volume. ResultsAll 60 participants met the inclusion criteria. The mean age was 45.5 (SD 8.8) years, with a mean BMI of 27.0 (SD 5.6) kg/m2. Medical histories were reported in 46.7% of participants, and 50% had undergone previous gynecological surgeries. Prior to the procedure, 51.8% of participants took analgesics. The average procedure duration was 13.9 (SD 15.1) minutes. Pain scores were collected at different stages of the procedure, with median VAS scores ranging from 0 to 5 out of 10. In 50% of cases, the quality of vision during the procedure was rated 9 or higher on a 10-point scale. The full recommended dose of thermogel was administered in 91.7% of cases. The mean gel volume used was 7.0 (SD 1.9) milliliters. Regression analysis showed that younger age and a history of abortions or childbirth were significantly associated with higher gel volume use. ConclusionsThe anesthetic thermogel demonstrated effectiveness in managing pain during outpatient operative hysteroscopies, with median pain scores ranging from 0 to 5 out of 10 across different stages of the procedure. The gel showed a favorable safety profile, with only 15% of participants reporting adverse effects, all of which were minor and resolved satisfactorily. The high rate of complete gel application (91.7% of cases) and positive physician feedback suggest good tolerability and ease of use. Further research is recommended to evaluate the gel’s efficacy in other gynecological procedures and to optimize application protocols based on patient-specific factors such as age and reproductive history.

Clinical and statistical analysis of the course of preterm birth based on the materials of communal enterprise «Regional Perinatal Center of the Rivne Regional Council» in 2013–2023 years

One of the priority tasks of modern medical science and practice is the preservation of reproductive health and the gene pool of the nation. It is especially difficult to perform this task during the russian war in Ukraine, which has been going on for more than ten years. According to sociologists, the outcomes of a low birth rate for the country will be catastrophic precisely because of the war.One of the reasons for the decline in the quality of health in the future is the increase in the specific weight of premature births, the frequency of which, according to the World Health Organization, has increased in Ukraine already after six months of full-scale war.The objective: to conduct an analysis of the course of premature births in the conditions of war based on the materials of the communal enterprise (CE) “Regional Perinatal Center of the Rivne Regional Council” for 2013–2023.Materials and methods. A retrospective clinical and statistical analysis of 2,742 histories of pregnancy and childbirth of women who were in labor between 22/0–36/6 weeks of gestation in obstetric departments of the communal enterprise “Regional Perinatal Center of the Rivne Regional Council” in 2013–2023 was carried out.Results. According to CE “Regional Perinatal Center of the Rivne Regional Council”, a progressive decrease in the total number of births by 41.9% was observed in the Rivne Region from 2013 to 2023. At the same time, in the general population of women giving birth, the specific rate of premature births did not have a tendency to increase.In the structure of preterm births, early and late preterm births prevailed. The specific gravity of very early preterm births, which are the most unfavorable for perinatal outcomes, did not have a sustained upward trend. At the same time, the frequency of too early premature births among residents of districts and territorial communities of the Rivne region has significantly increased (2013 – 19 (79.2%) cases, 2023 – 17 (100.0%) cases; p&lt;0.05).Every second premature birth occurred within the first day of hospitalization of a pregnant woman, while the specific rate of such too early premature births increased by 3.4 times during the analyzed period, which significantly worsens the chances of survival of newborns and is the reason for their high perinatal morbidity.The number of premature births in pregnant women with multiple pregnancies remains stable. Every third preterm birth took place on the background of early premature rupture of the fetal membranes, while a significant increase in the frequency of this complication was found in women who gave birth at 22/0–27/6 weeks of pregnancy.Traditionally, the specific rate (55.7–57.5%) of surgical delivery by caesarean section of pregnant women and mothers with premature births remains high, which contributed to a reliable reduction of the perinatal mortality rate of premature babies by 13.7% due to the reduction of antenatal losses. Indicators of early neonatal death were formed at the expense of newborns from too early and early premature births in the same ratio.Conclusions. According to thedata of CE “Regional Perinatal Center of the Rivne Regional Council”, there was a progressive decrease in the birth rate in the Rivne Region with a simultaneous stabilization of the number of premature births. The widespread use of a holistic approach during the medical care of pregnant women and the introduction of modern methods of care for premature newborns ensured a significant decrease in the rate of perinatal death of premature infants due to the reduction of antenatal losses.

Characteristic differences between full-term and premature infants with intermittent exotropia

Strabismus is prevalent among preterm infants of low gestational age and birth weight in Southeast Asian countries, with intermittent exotropia (IXT) being the most common type in South Korea. In this retrospective, cross-sectional study, we investigated the differences between full-term and premature infants with IXT. IXT patients with available childbirth history were divided into two groups: preterm vs. full-term and low birth weight (LBW) vs. normal birth weight (NBW). Parameters related to exotropia including parental heredity, surgical history, and treatment options were investigated. In univariate regression for gestational age, a result of ≥ 100 s in the Titmus test was 1.352 times more frequent in preterm than in full-term infants. When birth weight was considered instead, a result of ≥ 100 s in the Titmus test was 1.412 times more frequent in the LBW compared to the NBW group. In multivariate regression for birth weight, the frequency of a result of ≥ 100 s in the Titmus test for the LBW group was 2.032 times higher than that for the NBW group. It is particularly important to examine stereopsis in preterm and LBW patients affected by IXT to ensure timely surgical planning and avoid potential recurrence after surgery.

Assessment of the frequency of cesarean section according to the criteria of M. Robson in the Regional perinatal center №1 of Turkestan region

Objective. To identify and analyze the groups of women who contribute the greatest and least to the frequency of caesarean sections in general. Conducting an assessment of the frequency of caesarean sections in the Regional Perinatal Center №1 of the Turkestan region according to the classification of M. Robson.Materials and methods. We conducted a retrospective analysis of the history of 5286 births in the Regional Perinatal Center No. 1. The history of childbirth of women who gave birth in 2022 was taken into account. According to the history of each birth to complete the table: method of delivery (delivery through the birth canal, caesarean section); parity (first time , repeated); number of fetuses (one, two, three or more); delivery period (up to 37 weeks., 37-40 weeks., 41-42 or more); type of fetal malformation (head, pelvis, transverse/ oblique); induction of labor (induction was carried out, induction was not carried out); spontaneous childbirth; the number of caesarean sections in the history (one or more) was taken into account.Results and discussion. The group contributed the most to the total CS frequency were 5 groups – with a history of one or more CSs, one fetal head arrival, ≥37 weeks – 24.1%; the group contributed the least to the total CS frequency was 9 groups – single fetal pregnancy, women with a horizontal or oblique fetal position, including women with a history of one or more CSs – 2.2%.Conclusion. The largest share of the group in the total frequency of CSwas Group 5 – 22.1% of all births, 888 (75.9%) of 1,170 women in this group underwent surgery, all pregnant women with scars on the uterus ; group 9 – 0.7% of births accounted for the smallest share of the group in the total frequency of CS, 100% of 38 women gave birth with CS.

P-419 Relevance of intravenous immunoglobulins in patients with unexplained recurrent pregnancy loss that occurred at the same gestational weeks every time

Abstract Study question Are intravenous immunoglobulins (IVIG) effective for the selected patients who experienced unexplained recurrent pregnancy loss (RPL) that occurred at the same gestational weeks every time? Summary answer IVIG before and after the gestational week-limit (GWL), where miscarriage occurred at the same gestational weeks every time, may improve pregnancy outcomes in RPL patients. What is known already There is no established treatment for patients with unexplained RPL. Some investigators have indicated that IVIG may exhibit therapeutic efficacy in women with unexplained RPL. Since it has been reported that live birth rate significantly increased in women with four or more RPL of unexplained etiology, who received a high dose IVIG at 4-5 weeks of gestation in 2022, ESHRE Guideline Group on RPL (2022) has changed the recommendation to the following: the use of repeated and high doses of IVIG very early in pregnancy may improve live birth rate in women with four or more unexplained RPL. Study design, size, duration We performed a retrospective study between September 2013 to March 2023 in two fertility centers. We included 164 patients in the study who experienced 2 or more miscarriages between 5 and 21 weeks of gestation that occurred at the same gestational weeks every time, who had all negative results for our routine RPL work up and still unsuccessful result after treating these conditions, and whose products of conceptus (POC) revealed at least one normal karyotype. Participants/materials, setting, methods IVIG (Venoglobulin IH 5%, Japan Blood Products Organization, 0.4g/kg) injection was performed twice before and after 1 week of GWL. We divided 164 patients into IVIG group and non-IVIG group by their own choice. The primary outcome was live birth rate, and the secondary outcome was modified live birth rate excluding pregnancies with abnormal fetal karyotype, maternal and neonatal complications. All participants provided written informed consent, and Institutional Review Board approval was obtained. Main results and the role of chance IVIG group (n = 116) and non-IVIG group (n = 48) showed no significant differences in the background of patients on BMI (20.3±3.7 and 21.1±2.8), age (37.4±4.2 and 36.7±3.2) and Childbirth history (20.7% and 23.0%), respectively (average±SD), except for the history of past miscarriages. Average numbers of previous miscarriages on IVIG group and non-IVIG group were 3.2±1.3 and 2.5±0.8 (p &amp;lt; 0.001), respectively. After multivariate analysis for BMI, age, Childbirth history and previous miscarriages, live birth rate of IVIG group (70.7%, 82/116) was significantly higher than that of non-IVIG group (60.4%, 29/48; Odds ratio 3.40, 95% CI: 1.49-7.74, p = 0.003). Similarly, modified live birth rate of IVIG group (73.9%, 82/111) was significantly higher than that of non-IVIG group (63.0%, 29/46; Odds ratio 3.40, 95% CI: 1.49-7.74, p = 0.003). Treatment outcomes when IVIG was used for each number of previous miscarriages, the modified birth rate was 88.3% for two times miscarriages, 77.0% for three times, and 57.1% for four or more miscarriages. Maternal complications were observed in 2 cases in IVIG group (chest tightness, obstetric critical bleeding). There were no significant differences in the birth weight, gestational weeks, preterm birth, or fetal growth restriction of newborns between two groups. Limitations, reasons for caution Since retrospective nature and we did not perform POC tests for all patients whose pregnancies had ended in miscarriage, we could not assert the effectiveness of IVIG. We need to conduct randomized controlled trial using placebo group to demonstrate the IVIG efficacy before and after the GWL using euploid blastocysts. Wider implications of the findings IVIG before and after the GWL adjusted for each patient may improve pregnancy outcomes in RPL patients. Although IVIG is expensive, the current method requires only two IVIG injections, that may be acceptable for much more patients who want to avoid miscarriages and who didn’t use IVIG for economic reasons. Trial registration number NA

A Cross-sectional Study to Identify Risk Factors for Hepatitis C in Punjab, India.

Hepatitis C virus (HCV) antibody prevalence in Punjab, India (0.56%) is higher than the national average (0.32%), but primary drivers of local transmission are unclear. The objective of this study was to identify behavioral and demographic predictors of screening positive for HCV in Punjab. Interviews assessing exposure to potential HCV risk factors were administered cross-sectionally to persons screening for HCV across 10 treatment facilities. Risk ratios (RRs) were calculated using generalized estimating equation models accounting for clustering by health facility. One thousand seven hundred and sixty-three patients tested anti-HCV positive; 595 were negative. 57.7% of respondents were male; the median age was 40 years. 13.8% reported injecting drugs. Males were more likely to test positive than females (RR: 1.14, 95% confidence interval [CI]: 1.07-1.21). Unmarried men were at higher risk of anti-HCV positivity compared with married men (RR: 1.16, 95% CI: 1.08-1.24), but unmarried women were at lower risk (RR: 0.65, 95% CI: 0.43-0.98). The strongest risk factors were history of injecting drugs (RR: 1.37, 95% CI: 1.24-1.51), incarceration (RR: 1.22, 95% CI: 1.12-1.33), acupuncture use (RR: 1.20, 95% CI: 1.09-1.33), having household member(s) with a history of incarceration (RR: 1.17, 95% CI: 1.08-1.26), and tattoos (RR: 1.16, 95% CI: 1.09-1.24). Additional risk factors among men included receiving injections in a public hospital or from unregistered medical practitioners and among women included a history of childbirth. Injecting drugs was most strongly associated with anti-HCV positivity in this population. Greater attention to HCV prevention is needed, with a focus on people-centered harm reduction programs, behavioral change interventions, and increasing safety in potential transmission settings.

Pregnancy and Childbirth Fear of Women from Poland, Greece, Turkey, Belarus, and Russia.

Background/Objectives: Pregnancy and childbirth in many women cause various situations, from physical to emotional. The analysis of selected factors affecting pregnancy and childbirth in a group of women from Poland, Greece, Turkey, Belarus, and Russia and self-assessment of their impact on fear of pregnancy and childbirth. Material and Methods: A total of 2017 women were surveyed, including 584 pregnant women, 528 postpartum women, and 906 non-pregnant and never-pregnant women. The study used an original questionnaire, including questions on socio-demographics and the history of pregnancy and childbirth. The material status of the respondents was assessed using the Family Affluence Scale. Results: The age range of respondents was 19-50. The surveyed women most often reported (p < 0.001) fear (n = 928) and excitement (n = 901). A positive correlation was found between anemia, infections, and fear in women from Belarus. No correlation was found between low, average, or high material status and the perception of pregnancy in women from the studied countries. Significantly (p < 0.001), women from Turkey had more children (p < 0.001) than women from other countries. With the exception of Russia, statistical correlations were shown between the feeling of fear of pregnancy and childbirth and the way the previous/current pregnancy was delivered and the experience of an artificial/natural miscarriage in the past. In general, 630 women had given birth vaginally, and 283 women had given birth by cesarean section. In the group of currently pregnant women, 22 women had had natural miscarriages in Belarus, 37 in Poland, 27 in Greece, 29 in Turkey, and 9 in Russia. Conclusions: When thinking about pregnancy, respondents in all groups most often felt joy and excitement, as well as fear and excitement, about childbirth. Natural miscarriage was experienced most frequently by women in Poland and Greece and induced in Belarus. The largest number of women who had cesarean section were from Poland and Belarus.

Are physical fitness, a history of childbirth and injury history related to knee valgus in female Canadian Armed Forces members during a bodyweight overhead squat movement?

ObjectivesA history of childbirth is associated with musculoskeletal injury (MSKi) in female members of the Canadian Armed Forces (CAF). While previous injury and pregnancy impact knee kinematics, it is unclear...

A survey of breastfeeding among women with previous surgery for benign breast disease: a descriptive exploratory study

BackgroundSurgery is the primary treatment for benign breast disease and causes some disruption to the normal physiology of the breast, even when this disruption is localised, it remains unclear whether it affects women’s ability to breastfeed. There are only a few studies describing the experience of breastfeeding in women who have undergone benign breast disease (BBD) surgery.MethodsWe retrospectively analysed data from patients aged 20–40 years in Guangdong, China, who underwent breast lumpectomy for BBD in our department between 01 January 2013 and 30 June 2019, with a follow-up date of 01 February 2022. Patients were included who had a history of childbirth between the time of surgery and the follow-up date. By collecting general information about this group of patients and information about breastfeeding after surgery, we described the breastfeeding outcomes of women of a fertile age who had previously undergone surgery for benign breast disease.ResultsWith a median follow-up of 5.9 years, a total of 333 patients met the inclusion criteria. From the breastfeeding data of the first child born postoperatively, the mean duration of ‘exclusive breastfeeding’ was 5.1 months, and the mean duration of ‘any breastfeeding’ was 8.8 months. The rate of ‘ever breastfeeding’ is 91.0%, which is lower than the national average of 93.7%, while the exclusive breastfeeding rate at six months was 40.8%, was higher than the 29.2% national average. The any breastfeeding rate at 12 months was 30.0%, which was well below the 66.5% national average. The common reason for early breastfeeding cessation was insufficient breast milk. A total of 29.0% of patients who had ever breastfed after surgery voluntarily reduced the frequency and duration of breastfeeding on the operated breast because of the surgery.ConclusionsThere are some impacts of BBD surgery on breastfeeding and some may be psychological. Institutions should provide more facilities for mothers who have undergone breast surgery to help them breastfeed, such as conducting community education on breastfeeding after breast surgery, training professional postoperative lactation consultants in hospitals, and extending maternity leave. Families should encourage mothers to breastfeed with both breasts instead of only the non-operated breast.

Factors associated with toddler development

Introduction: Children are the nation's next generation; therefore, they need quality children to achieve a good future for the nation. Growth and development experience a rapid increase at an early age, namely from 0-5 years. Objective: This study knows the factors related to toddler development. Method: The research design uses correlational with a cross-sectional approach. The population of this study was all toddlers, as many as 250 toddlers. The sample of 71 toddlers used the sampling technique of proportionate random sampling. Test data analysis using the chi-square test, continue correction, and alternative Fisher’s exact test. Results: This study showed a significant association between nutritional status (p = 0.04), history of chronic disease (p = 0.01), education (p = 0.04), history of childbirth (p = 0.03), stimulation (p = 0.04) with toddler development and there was no significant relationship between socioeconomic (p = 0.71) and toddler development. Conclusion: there is a relationship between nutritional status, history of chronic disease, education, history of childbirth, and stimulation with toddler development. Health workers should be advised to detect child growth and development early by looking at the history of chronic diseases suffered and stimulating toddlers for optimal development.

Comparison of Different Ultrasonic Screening Methods and Analysis of High Risk Factors for Fetal Cardiac Malformation in Second Trimester of Pregnancy.

Current study aims to compare the application of two-dimensional (2D) color doppler ultrasound (CDU) and four-dimensional (4D) ultrasound spatiotemporal image correlation (STIC) in fetal congenital heart disease in the second trimester of pregnancy and to analyze the high risk factors of the disease. From August 2019 to July 2021, 135 second-trimester patients with highly suspected congenital heart malformations were selected who underwent prenatal screening at South Taihu Hospital Affiliated to Huzhou University. 2D-CDU, 4D STIC, and postnatal examination were completed in all patients. 2D-CDU, 4D STIC and 2D-CDU combined with 4D STIC were used to detect fetal cardiac malformations and classify cardiac malformations. The sensitivity, specificity, positive predictive value, negative predictive value and coincidence rate of 2D-CDU, 4D STIC and 2D-CDU combined with 4D STIC were compared. The results of 2D-CDU, 4D STIC and 2D-CDU combined with 4D STIC screening were analyzed for consistency using the results of postpartum diagnosis as the gold standard. Moreover, effects of maternal gestational factors on fetal cardiac malformations by univariate and multivariate analysis. 2D-CDU combined with 4D STIC showed significantly higher section display number than 2D-CDU or 4D STIC in the view of ductal arch, aortic arch, and aortic short-axis. A total of 45 cases of fetal congenital heart malformation were detected in 135 patients in the second trimester, 40, 38 or 42 cases were detected by 2D-CDU, 4D STIC or 2D-CDU combined with 4D STIC, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and coincidence rate of 2D-CDU combined with 4D ultrasound in congenital heart malformation screening were higher than those of 2D-CDU or 4D STIC. Kappa agreement analysis showed that the diagnostic results of 4D STIC and 2D-CDU combined with 4D ultrasound in fetuses with suspected congenital heart malformation were in excellent agreement (κ > 0.75), while 2D-CDU was in good agreement with postpartum diagnosis (κ < 0.75). Univariate and multivariate regression analysis revealed that maternal age ≥ 35, drinking during pregnancy, and history of adverse pregnancy and childbirth were all independent risk factors for fetal cardiac malformations, while folic acid supplementation was an independent protective factor for fetal cardiac malformations. 2D-CDU combined with 4D echocardiography may be superior to single 2D-CDU or 4D STIC in the screening of fetal congenital heart malformation in the second trimester. In order to reduce the incidence of fetal heart anomalies, we should strengthen the screening of pregnancy anomalies in high-risk pregnant women and control the risk factors.

Medication and procedural abortions before 13 weeks gestation and risk of psychiatric disorders

BackgroundThe proportion of abortions provided by medication in the US and worldwide has increased greatly since FDA-approval of mifepristone in 2000. While existing research has shown that abortion does not increase risk of mental health problems, no population-based study has examined specifically whether a procedural or medication abortion increases risk of mental health disorders. ObjectiveThis study examined whether mental health disorders increased in the shorter and longer-term after a medication or procedural abortion. Study DesignUsing Danish population registers’ data, we conducted a prospective cohort study in which we included 72,424 females born in Denmark between 1980-2006, who were ages 12-38 during the study period and had a first first-trimester abortion before 13 weeks gestation in 2000-2018. Females with no previous psychiatric diagnoses were followed from one year before their abortion until their first psychiatric diagnosis, December 31, 2018, emigration from Demark, or death, whichever came first. Risk of any first psychiatric disorder was defined as a recorded psychiatric diagnosis at an in- or out-patient facility from the one year after to more than 5 years after a medication or procedural abortion relative to the year beforehand. Results were adjusted for calendar year, age, gestational age, partner status, prior mental and physical health, childbirth history, childhood environment, and parental mental health history. ResultsFemales having medication (n = 37,155) and procedural abortions (n = 35,269) had the same risk of any first psychiatric diagnosis in the year after their abortion relative to the year before their abortion (medication abortion adjusted incidence rate ratio [MaIRR] = 1.02, 95% CI: 0.93-1.12; procedural abortion adjusted incidence rate ratio [PaIRR] = 0.94, 95% CI: 0.86-1.02). Moreover, as more time from the abortion passed, the risk of a psychiatric diagnoses decreased relative to the year before their abortion for each abortion method (MaIRR 1-2 years after = 0.89, 95% CI: 0.80-0.98; PaIRR 1-2 years after = 0.81, 95% CI: 0.88-1.05; MaIRR 2-5 years after = 0.77, 95% CI: 0.71-0.84; PaIRR 2-5 years after = 0.72, 95% CI: 0.67-0.78; MaIRR 5+ years after = 0.58, 95% CI: 0.53-0.63; PaIRR 5+ years after = 0.54, 95% CI: 0.50-=0.58). ConclusionsBecause the risk of psychiatric diagnoses was the same in the year after relative to the year before a medication and procedural abortion and the risk did not increase as more time after the abortion increased, neither abortion method increased risk of mental health disorders in the shorter or longer-term.

Prenatal ultrasound diagnostics and sociopsychological support as rehabilitation measures in patients with congenital cleft palate complicated by anomalies of other organs and systems

BACKGROUND: Prenatal ultrasound diagnostics and sociopsychological support in the early rehabilitation of children with congenital cleft palate combined with malformations of other organs and systems complement the unified algorithm of dynamic monitoring and rehabilitation treatment of these patients. Thus, predicting the choice of techniques and the system of rehabilitation prescriptions became possible. AIM: To present the experience of prenatal ultrasound diagnostics and sociopsychological support during pregnancy for the early rehabilitation of a patient with cleft palate combined with malformations of other organs and systems. MATERIALS AND METHODS: The study was conducted in the Multiprofile Clinical Medical Center “Bonum” in Yekaterinburg. For 24 years, from the analysis of medical records of the organizational and rehabilitation process of 2,475 patients with congenital cleft lip and/or palate receiving comprehensive care (1998–2022), 823 (33.25%) patients who had with cleft palate and malformations of other organs and systems were enrolled in this study. The discharge epicrises of the pregnancy and the timing of intrauterine ultrasound diagnostics of the fetus were studied, and the history of childbirth and anamnesis of newborns and timing of their routing and registration in the specialized “Bonum” Center were analyzed. At the time of the initial outpatient appointment at the center, parents’ responses to a survey on the nature of emotional and psychological experiences during the prenatal ultrasound examination of the fetus, period of “bearing” pregnancy, and birth of a baby with a complex anatomical and physiological pathology were analyzed. RESULTS: Ultrasound examination of the fetus during uterine development registered 292 (35.48%) of 823 cases of a combination of congenital cleft palate and anomalies of other organs and systems. The main forms of malformations in the fetus were established in the second (n=99, 33.90%) and third (n=185, 63.36%) trimester pregnancy screening. Mothers who were told about the results of ultrasound diagnostics of the fetus showed anxiety and emotional lability. The use of psychocorrectional and socially significant measures during the diagnosis of fetal pathologies and at the time deciding whether to continue pregnancy, as well as the newborn period, which relieved the psycho-emotional tension of parents, was proposed. CONCLUSION: Early rehabilitation of patients with congenital cleft palate combined with malformations of other organs and systems should be provided as an integral part of the complex rehabilitation therapy. Sociopsychological support of the family from the period of prenatal diagnosis of the fetus who had multiple malformations is necessary at all stages of pregnancy and rehabilitation treatment of the child.

Abstract PO1-17-11: Trends in post-mastectomy reconstruction by age in Korea and among Asian-Americans

Abstract Background: Post-mastectomy immediate breast reconstruction (PMIBR) has been underutilized in the elderly. This study examines the trends of PMIBR by age in a large Korean medical center and compares them to the Asian-American population in the National Cancer Database (NCDB). Methods: We analyzed 5,601 patients who underwent PMIBR out of 13,654 total mastectomy patients between 2001 and 2021 in a Korean Center. Patient characteristics associated with higher likelihood of receiving reconstruction were assessed and compared between patients under 60 years of age and those aged 60 years and older. Complications were investigated in 1,669 patients between 2010 and 2020. In addition, we compared this to 966,354 female patients in the NCDB from 2004-2020 with stage 0-3 breast cancer who underwent mastectomy. Results: The number of PMIBR at the Korean center increased almost ten-fold, but there was a discrepancy in the increase between younger and older women. In the younger group, the proportion of PMIBR rose from 13% (53/398) to 77% (508/664), while in the older group, it increased from 0% (0/60) to 26% (49/186). In the NCDB, Asian-Americans had the lowest rate of breast reconstruction (29%) compared to white (35.4%), black (30.1%), and Hispanic Americans (33.5%). As seen in the table, the rates increased in both age groups but plateaued around 2014 and remained stable until 2020. In 2020, the PMIBR rates were 37% for young Asian-Americans, 48% for young non-Asians, 14% for older Asian-Americans, and 24% for older non-Asians. At the Korean center, patients living in a metropolitan area (42.6% vs.39.8% p=0.001), having higher education (44.7% vs. 10.5% p&amp;lt; 0.001), being unmarried (63.1% vs. 39.3% p&amp;lt; 0.001), having no history of childbirth (53.7% vs 39.9% p&amp;lt; 0.001), having lower stage and hormone receptor-positive HER2-negative breast cancer were more likely to undergo reconstruction. These factors were all more common in the younger age group. In the NCDB, patients receiving PMIBR were more likely to be white or non-Asian, have higher income and education, reside in a metropolitan area and in the Northeast, have less comorbidities, be treated in an academic center, and have a luminal subtype, lower stage, and private health insurance. At the Korean center, autologous reconstruction was more common than implant reconstruction, (68.4% vs. 31.6% for younger women, and 63.3% vs. 36.9% for older women) and the complication rate was similar for both age groups. In contrast, in the NCDB, implant reconstruction was more common in both age groups, tissue-based (29% vs 31%), implant-based (40.7% vs 40%), combined (11% vs 10.8%) and other (18% vs 17.6%) for older and younger women respectively. Conclusion: Both the Korean and American data illustrate remarkably lower utilization of immediate breast reconstruction in older patients. There are notable demographic and clinical differences between age groups but negligible difference in complication rates. Further research and interventions to address barriers in older women are needed. The higher rates of PMIBR in South Korea mirrors that of white women in the northeast USA, suggesting a potential disparity for Asian-Americans. Percentage of PMIBR over total mastectomy (with or without reconstruction) by age and race PMIBR= post-mastecomy immediate breast reconstruction; NCDB= national cancer database Citation Format: Soo-Young Lee, Madhav KC, Hyun Ho Han, Leah Kim, Mehra Golshan, Eric Schneider, Rachel Greenup, Donald Lannin, Hyung Bae Kim, Byung Ho Son, Jong Won Lee, Sae Byul Lee, Hee Jeong Kim, Tristen Park. Trends in post-mastectomy reconstruction by age in Korea and among Asian-Americans [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-17-11.

Musculoskeletal Injuries, Exercise Behaviors, and Reproductive Health Are Related to Physical Fitness of Female First-Responders and Health Care Providers.

Musculoskeletal injuries (MSKi) are the most common injury type experienced by first-responders and health care providers (HCPs), making them a significant threat to physical and mental well-being. Female reproductive health and injury history has been related to physical fitness in female members of the Canadian Armed Forces. This relationship has not been explored in Canadian protective services personnel (first-responders) or HCPs. Fifty-seven females employed as firefighters, paramedics, law enforcements, or HCPs completed a physical fitness protocol to assess the following: (1) muscular power (standing long jump and medicine ball throw), (2) muscular strength (4 repetition maximum (4RM) back squats and bench press), (3) muscular endurance (Biering-Sorenson test, single-leg wall sit, and push-ups), (4) flexibility (sit-and-reach), and (5) aerobic capacity (graded treadmill VO2max test). Spearman rho correlation analyses were applied to descriptive analysis, independent-samples t-test, one-way ANCOVA (adjusted by age), and chi-square test. Spearman rho correlation analyses were used to compare physical fitness results for female reproductive health history (e.g., parity status), previous MSKi, and physical activity behaviors (e.g., sports participation). A p value of <0.05 is considered significant. History of childbirth, body composition, and exercise behaviors were related to physical fitness (i.e., standing long jump, Biering-Sorenson test, bench press, and back squat) in law enforcement, firefighting, paramedicine, and health care personnel. Physical training programs aimed at supporting parous first-responders or HCPs should emphasize lower body power, lower body strength, and upper body strength.