Maternal Postpartum Research Articles

Well-Child Visits for Early Detection and Management of Maternal Postpartum Hypertensive Disorders

Innovative approaches are needed to address the increasing rate of postpartum morbidity and mortality associated with hypertensive disorders. To determine whether assessing maternal blood pressure (BP) and associated symptoms at time of well-child visits is associated with increased detection of postpartum preeclampsia and need for hospitalization for medical management. This is a pre-post quality improvement (QI) study. Individuals who attended the well-child visits between preimplementation (December 2017 to December 2018) were compared with individuals who enrolled after the implementation of the QI program (March 2019 to December 2019). Individuals were enrolled at an academic pediatric clinic. Eligible participants included birth mothers who delivered at the hospital and brought their newborn for well-child check at 2 days, 2 weeks, and 2 months. A total of 620 individuals were screened in the preintervention cohort and 680 individuals were screened in the QI program. Data was analyzed from March to July 2022. BP evaluation and preeclampsia symptoms screening were performed at the time of the well-child visit. A management algorithm-with criteria for routine or early postpartum visits, or prompt referral to the obstetric emergency department-was followed. Readmission due to postpartum preeclampsia. Comparisons across groups were performed using a Fisher exact test for categorical variables, and t tests or Mann-Whitney tests for continuous variables. A total of 595 individuals (mean [SD] age, 27.2 [6.1] years) were eligible for analysis in the preintervention cohort and 565 individuals (mean [SD] age, 27.0 [5.8] years) were eligible in the postintervention cohort. Baseline demographic information including age, race and ethnicity, body mass index, nulliparity, and factors associated with increased risk for preeclampsia were not significantly different in the preintervention cohort and postintervention QI program. The rate of readmission for postpartum preeclampsia differed significantly in the preintervention cohort (13 individuals [2.1%]) and the postintervention cohort (29 individuals [5.6%]) (P = .007). In the postintervention QI cohort, there was a significantly earlier time frame of readmission (median [IQR] 10.0 [10.0-11.0] days post partum for preintervention vs 7.0 [6.0-10.5] days post partum for postintervention; P = .001). In both time periods, a total of 42 patients were readmitted due to postpartum preeclampsia, of which 21 (50%) had de novo postpartum preeclampsia. This QI program allowed for increased and earlier readmission due to postpartum preeclampsia. Further studies confirming generalizability and mitigating associated adverse outcomes are needed.

Hepatitis B virus infection during pregnancy and the risk of postpartum hemorrhage: a protocol for systematic review and meta-analysis

Background: Hepatitis B virus (HBV) infection is a significant public health issue worldwide, with a hepatitis B surface antigen (HBsAg) seroprevalence of 3.5%. Maternal HBV infection during pregnancy, a common comorbidity, is associated with an increase in the risk of adverse obstetric and perinatal outcomes. However, the relationship between maternal HBV infection and postpartum hemorrhage (PPH), a leading contributor to maternal morbidity and mortality, is currently uncertain. The aim of this study is to comprehensively clarify the potential impact of maternal HBV on PPH risk. Methods and Analysis: The authors initially searched five English databases and three Chinese databases from their inception to 26th June 2023. Two reviewers will independently conduct study selection, data extraction, and quality assessment. Cohort and case–control studies investigating the effect of maternal HBV infection on PPH will be included, with study quality assessed using the Newcastle–Ottawa Scale (NOS). Meta-analyses will be performed using a fixed-effects model for I 2≤50% or a random-effects model otherwise. Several categories of subgroup analyses (e.g. sample size more than 1000 vs. less than 1000) and sensitivity analyses (e.g. omit NOS scores less than 7) will be conducted, and publication bias will be assessed through funnel plots, Begg’s and Egger’s tests using STATA 18.0. Ethics and Dissemination: This systematic review and meta-analysis do not require ethics approval and the results will be published in peer-reviewed journals. The findings of this systematic review will provide evidence on the impact of maternal HBV infection on PPH, which will contribute to better prevention and management of PPH in clinical practice and a better understanding of the disease burden of HBV infection. PROSPERO registration number: CRD42023442626

Joint effects of traffic-related air pollution and hypertensive disorders of pregnancy on maternal postpartum depressive and anxiety symptoms.

Ambient air pollution has been linked to postpartum depression. However, few studies have investigated the effects of traffic-related NOx on postpartum depression and whether any pregnancy-related factors might increase susceptibility. To evaluate the association between traffic-related NOx and postpartum depressive and anxiety symptoms, and effect modification by pregnancy-related hypertension. This study included 453 predominantly low-income Hispanic/Latina women in the MADRES cohort. Daily traffic-related NOx concentrations by road class were estimated using the California LINE-source dispersion model (CALINE4) at participants' residential locations and averaged across pregnancy. Postpartum depressive and anxiety symptoms were evaluated by a validated questionnaire (Postpartum Distress Measure, PDM) at 1, 3, 6 and 12 months postpartum. Multivariate linear regressions were performed to estimate the associations at each timepoint. Interaction terms were added to the linear models to assess effect modification by hypertensive disorders of pregnancy (HDPs). Repeated measurement analyses were conducted by using mixed effect models. We found prenatal traffic-related NOx was associated with increased PDM scores. Specifically, mothers exposed to an IQR (0.22 ppb) increase in NOx from major roads had 3.78% (95% CI: 0.53-7.14%) and 5.27% (95% CI: 0.33-10.45%) significantly higher 3-month and 12-month PDM scores, respectively. Similarly, in repeated measurement analyses, higher NOx from major roads was associated with 3.06% (95% CI: 0.43-5.76%) significantly higher PDM scores across the first year postpartum. Effect modification by HDPs was observed: higher freeway/highway and total NOx among mothers with HDPs were associated with significantly higher PDM scores at 12 months postpartum compared to those without HDPs. This study shows that prenatal traffic-related air pollution was associated with postpartum depressive and anxiety symptoms. The study also found novel evidence of greater susceptibility among women with HDPs, which advances the understanding of the relationships between air pollution, maternal cardiometabolic health during pregnancy and postpartum mental health. Our study has potential implications for clinical intervention to mitigate the effects of traffic-related pollution on postpartum mental health disorders. The findings can also offer valuable insights into urban planning strategies concerning the implementation of emission control measures and the creation of green spaces.

The Relationship Between Postpartum Mothers' Knowledge About Breast Care and The Incidence of Breast Milk Dam in Postpartum Mothers Days 3-6 in The Bps Area Mrs. Titik Ekawati, S.St Ds. Kintelan Kec. Puri Kab. Mojokerto

The emergence of dam milk at days 3-6 due to a lack of knowledge about the treatment of post partum mothers the right breast. The purpose of this study was conducted to know the relationship of maternal knowledge about postpartum care with the incidence of breast milk dam on postpartum days 3-6 in Region Connecticut District Puri Ny.Titik Ekawati, S.ST Village Kintelan Mojokerto regency. The design of this study using a cross sectional analytic methods. Its population is around 3-6 days post partum mothers who are in the BPS Ny.Titik Ekawati,S.ST the sample was 13 respondents residing in the territory of BPS Ny.Ekawati,S.ST, sampling is the accidental sampling technique, a variable of this study is the independent variable "knowledge of post-partum mothers about breast care "and the dependent variable" incidence of dam milk ". Data collected using questionnaires and observation Wilcoxon then tested and the results are presented in the form of a frequency distribution table. Results showed the majority (54%) of respondents whose knowledge is lacking, and almost half (46%) of respondents experienced dam milk and a small portion (8%) respondents who did not have dams milk. Wilcoxon test results obtained no knowledge of the relationship of maternal postpartum care with the incidence of breast milk dams on postpartum days 3-6 with a significance level α = 0.05 obtained significant number ρ = 0.036 which means that H1 is received.

Association of maternal postpartum depression symptoms with infant neurodevelopment and gut microbiota.

Understanding the mechanisms underlying maternal postpartum depression (PPD) and its effects on offspring development is crucial. However, research on the association between maternal PPD, gut microbiota, and offspring neurodevelopment remains limited. This study aimed to examine the association of maternal PPD symptoms with early gut microbiome, gut metabolome, and neurodevelopment in infants at 6 months. Maternal PPD symptoms were assessed using the Edinburgh Postpartum Depression Scale (EPDS) at 42 days postpartum. Infants stool samples collected at 42 days after birth were analyzed using 16S rRNA sequencing and liquid chromatography-mass spectrometry (LC-MS) detection. Infant neurodevelopment was measured at 6 months using the Ages and Stages Questionnaire, Third Edition (ASQ-3). Correlations between gut microbiota, metabolites and neurodevelopment were identified through co-occurrence network analysis. Finally, mediation analyses were conducted to determine potential causal pathways. A total of 101 mother-infant dyads were included in the final analysis. Infants born to mothers with PPD symptoms at 42 days postpartum had lower neurodevelopmental scores at 6 months. These infants also had increased alpha diversity of gut microbiota and were abundant in Veillonella and Finegoldia, while depleted abundance of Bifidobacterium, Dialister, Cronobacter and Megasphaera. Furthermore, alterations were observed in metabolite levels linked to the Alanine, aspartate, and glutamate metabolic pathway, primarily characterized by decreases in N-Acetyl-L-aspartic acid, L-Aspartic acid, and L-Asparagine. Co-occurrence network and mediation analyses revealed that N-Acetyl-L-aspartic acid and L-Aspartic acid levels mediated the relationship between maternal PPD symptoms and the development of infant problem-solving skills. Maternal PPD symptoms are associated with alterations in the gut microbiota and neurodevelopment in infants. This study provides new insights into potential early intervention for infants whose mother experienced PPD. Further research is warranted to elucidate the biological mechanisms underlying these associations.

Assessment of Postpartum Stress Using the Maternal Postpartum Stress Scale (MPSS) in Spanish Women.

Although scales that evaluate postpartum stress exist, they lack specificity in maternal postpartum stress. The MPSS was created because there was a need to assess maternal stress during the postpartum stage. The introduction of the MPSS has enriched the evaluation tools for postpartum stress and has helped understand maternal stress at various postpartum time points and identify women at high risk for postpartum stress during this period. The aim was to translate the MPSS into Spanish and study its psychometric properties. Postpartum women (N = 167) with a mean age of 34.26 (SD = 4.71) were involved in this study. In addition to the MPSS, a battery of instruments was administered: a demographic sheet, the Birth Satisfaction Scale-Revised (BSS-R) and the Edinburgh Postnatal Depression Scale (EPDS). The MPSS data were analyzed, checking item communality first. As a result, three items showed unsatisfactory communality values (h2 < 0.40). Confirmatory Factor Analysis was conducted, comparing factor models using the full pool of MPSS items or the version without items with unacceptable communality. As a result, the original three-factor structure was endorsed on the Spanish MPSS, with better fit indices when removing items with low communality (RMSEA = 0.067, CFI = 0.99, TLI = 0.99). The reliability of this version was satisfactory (ω = 0.93). Finally, group comparisons for some perinatal variables were performed, showing no significant differences between groups of interest (p = 0.05 and above). To conclude, the MPSS will contribute to the existing literature, having a wider capacity to assess perinatal mental health difficulties in Spanish-speaking populations.

Longitudinal Exploration of Prenatal and Postnatal Intimate Partner Violence, Postpartum Depression, and Child-Mother Attachment: A Mediation Model.

This longitudinal study examines the timelines of occurrences of intimate partner violence (IPV) on child-mother attachment, as well as the mediating role of maternal postpartum depression (PPD). Using a sample in the United States (N = 2,268), findings suggest that, compared to mothers' prenatal IPV victimization, postnatal IPV more negatively influences child-mother attachment when the children were at 3 years old, and this negative impact on attachment was partially mediated through maternal PPD. As IPV screening for pregnant women in healthcare settings becomes a common practice, effective IPV and PPD screening postnatally should be broadly implemented to promote maternal mental health and child-mother attachment.

Preventing postpartum insomnia: findings from a three-arm randomized-controlled trial of cognitive behavioral therapy for insomnia, a responsive bassinet, and sleep hygiene.

Insomnia symptoms are common during the perinatal period and are linked to adverse outcomes. This single-blind three-arm randomized-controlled trial examined whether two interventions targeting different mechanisms prevent postpartum insomnia. Participants were nulliparous females 26-32 weeks gestation with Insomnia Severity Index (ISI) scores ≥ 8, recruited in Australia and randomized 1:1:1 to: (1) a responsive bassinet (RB) designed to support infant sleep and reduce maternal sleep disruption until 6 months postpartum, (2) therapist-assisted cognitive behavioral therapy for insomnia (CBT-I) delivered during pregnancy and postpartum, or (3) a sleep hygiene booklet (control; CTRL). Outcomes were assessed at baseline (T1), 35-36 weeks gestation (T2), and 2, 6, and 12 months postpartum (T3-T5). The primary outcome was ISI scores averaged T3-T5. Primary analyses were regressions controlling for baseline outcomes. One hundred and twenty-seven participants (age M ± SD = 32.62 ± 3.49) were randomized (RB = 44, CBT-I = 42, CTRL = 41). Both interventions were feasible and well-accepted, with few related adverse events reported. Compared to CTRL, the average ISI across T3-T5 was lower for CBT-I (p = .014, effect size [ES] = 0.56, medium) but not RB (p = .270, ES = 0.25, small). Exploratory findings on maternal insomnia diagnosis, sleep disturbance, sleep-related impairment, beliefs and attitudes about sleep, depression, anxiety, as well as infant sleep outcomes were also presented. CBT-I but not RB reduced prenatal insomnia (very large effect) and prevented postpartum insomnia (medium effect). Further research is needed to examine the effects of both CBT-I and RB on other outcomes such as sleep-related well-being, postpartum depression, and maternal postpartum sleep duration. The Study for Mother-Infant Sleep (The SMILE Project): reducing postpartum insomnia using an infant sleep intervention and a maternal sleep intervention in first-time mothers. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377927, Australian New Zealand Clinical Trials Registry: ACTRN12619001166167.

Association Between Maternal Age and Postpartum Assessment of High-Grade Cervical Dysplasia Diagnosed in Pregnancy [ID 2683560

INTRODUCTION: The incidence of cervical dysplasia in pregnancy is expected to rise as patients delay childbearing. Historical studies have quoted high rates of postpartum regression of lesions diagnosed in pregnancy. We sought to evaluate the relationship between maternal age and postpartum progression, regression, and persistence of high-grade lesions. METHODS: This is a retrospective cohort study of patients with biopsy-proven high-grade dysplasia diagnosed during pregnancy from January 2013 to December 2022. Institutional review board approval was obtained. Only immunocompetent patients with postpartum pathology obtained within 1 year of delivery were included. Definitions based on postpartum pathology were as follows: regression as low-grade or resolved dysplasia, persistence as high-grade dysplasia, and progression as invasive cervical cancer. Results were stratified by maternal age (≤24, 25–29, 30–34, 35+) and data were analyzed using the Cochran–Armitage test. RESULTS: Among our cohort (N=286), 101 (35%) were diagnosed with CIN2, 181 (63%) with CIN3/CIS, and 4 (1%) with HSIL (not otherwise specified) on antepartum cervical biopsy. Average age was 28 (±4.2) years. Postpartum regression rate was 44% for patients aged 24 years or younger, 37% in ages 25–29, 33% in ages 30–34, and 33% in ages 35 or older (P=.174). Persistence was common (55%, 63%, 67%, and 64%, respectively) and apparent progression to cancer was rare, occurring in 1% of patients aged 24 years or younger and in 2.8% of patients 35 or older (P=.68). CONCLUSION: Persistence occurred in over half of patients, regardless of age. Our findings emphasize the importance of postpartum follow-up, and possible cervical excision, in patients with antepartum high-grade dysplasia.

Maternity Care Deserts and Postpartum Outcomes: Bridging the Gap in Maternal Health Care in Florida [ID 2683485

INTRODUCTION: Over 2.2 million women of reproductive age live in areas, referred to as maternity care deserts (MCD), with inadequate access to postpartum care services. Furthermore, deaths occurring during the postpartum period account for over half of all pregnancy related deaths. This analysis serves to provide an overview of the intricate relationship between health care access and postpartum health while exploring the increased risk of delayed detection of postpartum complications and the association to increasing maternal mortality rates. METHODS: Data provided by the Area Health Resource File were used to identify counties in Florida that met the criteria of a designated MCD. Data collected on all pregnancy-related deaths verified by the Florida Department of Health (2020–2021) and geographic codes for MCD were used to identify significant associations. RESULTS: This study collected data from a total of 1,938 pregnancy related deaths. A significant increase in the number of postpartum related deaths was during that time (75%). More than a quarter were in MCD (26%). An association of postpartum related deaths with MCD showed an increase (22%). 1 in 10 women living in MCD reported to not receive a postpartum care visit, these counties were also noted to be more likely to have limited telehealth access (30%). CONCLUSION: Maternity care desert limitations to postpartum care reduce prevention efforts, increase risk for delayed complications to go undetected, and contribute to the maternal mortality rates. Potential solutions include policy revisions to expand telehealth access and efforts to increase the awareness of the importance of postpartum care.

Beyond Maternal Health: Examining the Effect of Birth Complications on Unmarried Fathers' Postpartum Well-Being [ID 2683609

INTRODUCTION: Birth complications (BCs) are known risk factors for maternal postpartum depression, but their effect on paternal postpartum depression (PPD), especially among unmarried fathers, remains understudied. METHODS: In this cross-sectional study, we analyzed data from The Future of Families and Child Wellbeing longitudinal birth cohort, focusing on unmarried fathers who were present at their child’s birth (n=1,484). Paternal PPD was assessed using a 12-item CES-D scale, dichotomized into depression present versus absent. Maternal medical records identified seven conditions constituting BC, including excessive bleeding, placental abruption, placenta previa, emergency c-section, seizure during delivery, cord prolapse, or fetal distress. Logistic regression models were estimated, adjusting for parents' demographics, self-reported health status, cohabitation, poverty, substance use, relationship quality, and prior fatherhood experience. RESULTS: Postpartum depression affected 132 fathers (9%), while BC occurred in 602 mothers (41%). In the unadjusted model, BC was associated with 42% increased odds of paternal PPD compared to uncomplicated births (95% CI, 1.00–2.04). In multivariable analysis, BC was significantly linked to paternal PPD (aOR 1.46; 95% CI, 1.00–2.12). Fathers in great/very good health had 37% lower paternal PPD odds than those in good/fair/poor health (95% CI, 0.43–0.96), while interparental conflict was linked to higher paternal PPD odds (aOR 2.38; 95% CI, 1.61–3.52). CONCLUSION: Our study found birth complications to be associated with increased odds of paternal postpartum depression. Further research is needed to explore how maternal birth experiences affect paternal well-being, particularly among unmarried fathers, and identify novel ways to incorporate fathers into perinatal support systems and interventions.

Maternal Postpartum Work Resumption Stress: Questionnaire Development and Validation.

Transitioning back to work after maternity leave is increasingly common. While differences exist, for many mothers this transition represents a stressor. This study aimed to define the construct of maternal postpartum work resumption stress and develop and validate a self-report measure in a low-risk sample of Dutch mothers. First, the item pool (N = 71) and face and content validity of the questionnaire were established. Next, two independent samples of mothers returning to work (N = 298, N = 291) were recruited to identify factor structure, reduce the number of items, and assess the dimensionality, reliability, convergent and discriminant validity of the questionnaire. Based on exploratory and confirmatory factor analyses, the reliable and valid REturn to Work INventory (REWINd) with 30 items across three factors was established. While further validation is needed, REWINd can be used to further study the nature and consequences of maternal postpartum work resumption stress.

Disparities in Maternal Health Visits Between Rural and Urban Communities in the United States, 2016-2018.

The objective was to estimate the rural-urban differences in the receipt of prepregnancy, prenatal, and postpartum services. The authors conducted a cross-sectional data analysis using data from the Pregnancy Risk Assessment and Monitoring System from 2016 to 2018 to analyze rural-urban differences in the receipt of medical visits and care content delivery during the prepregnancy year, as well as the prenatal and postpartum periods among birthing people in the US, using survey-weighted multivariable logistic regression models. Rural-dwelling birthing people were significantly less likely to attend a medical visit in the prepregnancy year or postpartum period, even when controlled for sociodemographic and clinical characteristics. Compared to their urban counterparts, they were also less likely to receive comprehensive screening and counseling in the prepregnancy and postpartum maternity phases. Efforts to ameliorate rural-urban differences in maternal care access and quality should explicitly adopt multilevel, systemic approaches to policy and program implementation and evaluation. Policymakers and practitioners should consider telehealth as a potential complementary tool to minimize gaps in quality of care which disproportionately impact rural-dwelling birthing people.

Prevalence of Cognitive Impairments In Postpartum Period Among Young Adult Female's

This study aims to determine the prevalence of cognitive impairments in postpartum period among young adult female’s. Pregnancy and postpartum period are the most crucial phases of women’s life. During and after pregnancy, a women’s body undergoes numerous changes such as physical, physiological, emotional, social, hormonal and psychological, this changes may contribute to some negative impacts on women’s neuro-psychologocal state, due to which they may experience a range of emotions, from joy and fulfilment to anxiety, forgetfulness, sadness, often referred to as the “Mommy Brain” phenomenon. A cross-sectional study was carried out. The study sample included 50 females’ in early post-partum phase and 50 females’ in late post-partum phase, they were selected based on the inclusion and exclusion criteria. Convenient sampling was done. Ethical approval was taken prior to the study. Memory and cognitive functions was assessed using Everyday Memory Questionnaire-Revised (EMQ-R), and Mini-Mental Status Examination Scale (MMSE), we also assessed post-partum quality of life using Maternal Postpartum Quality of Life-Instrument (MPQOL). Appropriate statistical tests were used to analyse the data. Mean, SD, coefficient of correlation and percentage distribution of cognitive impairment were tested. Results of the study showed significant difference between two groups. On MMSE, subjects in the late postpartum phase performed better as compared to the subjects in early postpartum phase, on EMQ-R subjects in the early postpartum phase experienced higher levels of memory impairments. On MPQOL, the late postpartum group had a higher mean score on the MPQOL (Maternal Postpartum Quality of Life) compared to the early postpartum group. This implies that women in the late postpartum phase reported a better quality of life related to maternal aspects compared to those in the early postpartum phase. Accordingly, it was determined that a significant portion of postpartum women’s experience some level of cognitive impairment, though the severity varies.

AI and narrative embeddings detect PTSD following childbirth via birth stories

Free-text analysis using machine learning (ML)-based natural language processing (NLP) shows promise for diagnosing psychiatric conditions. Chat Generative Pre-trained Transformer (ChatGPT) has demonstrated preliminary initial feasibility for this purpose; however, whether it can accurately assess mental illness remains to be determined. This study evaluates the effectiveness of ChatGPT and the text-embedding-ada-002 (ADA) model in detecting post-traumatic stress disorder following childbirth (CB-PTSD), a maternal postpartum mental illness affecting millions of women annually, with no standard screening protocol. Using a sample of 1295 women who gave birth in the last six months and were 18+ years old, recruited through hospital announcements, social media, and professional organizations, we explore ChatGPT’s and ADA’s potential to screen for CB-PTSD by analyzing maternal childbirth narratives. The PTSD Checklist for DSM-5 (PCL-5; cutoff 31) was used to assess CB-PTSD. By developing an ML model that utilizes numerical vector representation of the ADA model, we identify CB-PTSD via narrative classification. Our model outperformed (F1 score: 0.81) ChatGPT and six previously published large text-embedding models trained on mental health or clinical domains data, suggesting that the ADA model can be harnessed to identify CB-PTSD. Our modeling approach could be generalized to assess other mental health disorders.

COMPARATIVE ANALYSIS OF NUTRITIONAL STRATEGIES FOR ENHANCING LACTATION IN NIGERIA AND THE USA

This paper seeks to undertake a comparative analysis of the nutritional strategies utilized in Nigeria and the United States to enhance lactation, with a specific focus on dietary approaches and supplements. Through an exploration encompassing cultural relevance, regulatory approval, effectiveness, and safety of these strategies in both nations, this study endeavors to shed light on the multifaceted landscape of lactation support. In Nigeria, where cultural traditions intertwine with dietary practices, conventional approaches to lactation enhancement often revolve around the consumption of specific foods believed to stimulate milk production. Fenugreek seeds, moringa leaves, and papaya are commonly incorporated into maternal diets, reflecting longstanding cultural beliefs aimed at bolstering lactation. Additionally, traditional soups and stews rich in nutrients derived from fish, meats, and green leafy vegetables play a pivotal role in replenishing maternal health postpartum. In contrast, the United States exhibits a diverse array of dietary approaches and supplements utilized to support lactation, influenced by cultural diversity and healthcare practices. While there is no prescribed "lactation diet," breastfeeding mothers are encouraged to maintain a well-balanced diet comprising fruits, vegetables, whole grains, lean proteins, and healthy fats. Conversely, in the United States, a myriad of lactation supplements, including herbal formulations and galactagogues, are subject to regulatory oversight by agencies such as the Food and Drug Administration (FDA), ensuring safety and efficacy. By examining the cultural relevance, regulatory frameworks, effectiveness, and safety of nutritional strategies in Nigeria and the United States, this paper aims to elucidate the nuanced nuances and commonalities underlying lactation support practices. Understanding these disparities and similarities holds immense potential in informing global initiatives aimed at enhancing lactation support systems and addressing the diverse needs of mothers and infants worldwide.&#x0D; Keywords: Lactation, Nutrition, Dietary Approaches, Supplements, Cultural Relevance, Safety.

Factors related to a positive childbirth experience – a cross-sectional study

ABSTRACT Background/aims Giving birth is a life-changing experience for women. Most previous studies have focused on risk factors for a negative childbirth experience. The primary aim of this study was to assess childbirth experience in a sample of postnatal Swedish women. The secondary aim was to analyse demographic and clinical determinants associated with a positive birth experience. Design/Methods A digital survey including the instrument Childbirth Experience Questionnaire 2 (CEQ2) was answered by 619 women six to 16 weeks postpartum. Regression analyses were made assessing the impact that different factors had on the overall childbirth experience and the four subscales of CEQ2: Own Capacity, Perceived Safety, Professional Support and Participation. Results Overall, women were satisified with their birthing experience. Several factors contributed to a positive childbirth experience. Having a vaginal mode of birth (without vacuum extraction) together with not having ongoing mental health problems were the factors with the most influence on the total childbirth experience. Not having maternal complications postpartum and receiving much support from a trusted birth companion were two other important factors. Conclusion Although Swedish women tend to express satisfaction with their childbirth experiences, there is a necessity to advocate for a childbirth approach that optimises the chance of giving birth vaginally rather than with vacuum extraction or acute caesarean section, and reduces the risk for complications whenever possible. During pregnancy, mental health problems should be appropriately addressed. Healthcare professionals could also more actively involve the birth companion in the birthing process and equip them with the necessary tools to effectively support birthing women.

Association Between Pandemic-Related Maternal Perinatal Anxiety and Early Postpartum Breastfeeding Success.

Prior studies have shown conflicting results on the impact of maternal anxiety on breastfeeding initiation and success. Furthermore, a substantial increase in maternal anxiety levels was shown in response to the COVID-19 pandemic. In this study, we aimed to investigate the relationship between maternal perinatal anxiety induced by the COVID-19 pandemic and early breastfeeding outcomes. This cross-sectional study was conducted in two regional maternity hospitals, involving 220 first-time pregnant patients with a gestational age of ≥37 weeks. All patients had no current diagnosis of COVID-19 and no cases of COVID-19 in their close environment at the time of admission. At 24-48 hours postpartum or at the time of discharge, threefollowing scoring systems were employed: the Coronavirus Anxiety Scale (CAS), the State-Trait Anxiety Inventory (STAI), and the LATCH (short for latch, audible swallowing, type of nipple, comfort, and hold) score. A LATCH score of ≥8 was chosen as the cutoff point for defining successful breastfeeding performance. Spearman's rank correlation was used to evaluate relationships between the CAS, STAI scores, maternal and infant factors, and LATCH scores. There were no differences in baseline characteristics between groups categorized as successful and unsuccessful in breastfeeding initiation. The mean total STAI score was 86.3±13.2, the CAS score was 1.07±1.91, and the LATCH score was 8.42±1.7. Although there was an increase in State-Trait Anxiety Inventory-State Anxiety (STAI-S) scores compared to State-Trait Anxiety Inventory-Trait Anxiety (STAI-T) scores, and the STAI-S score and CAS score were higher in the unsuccessful group, these differences did not reach statistical significance (p = 0.22 and 0.16, respectively). When we evaluated the correlation of the LATCH score with STAI total, STAI-S and STAI-T scores, CAS score, and maternal and infant factors, only the type of delivery showed a significant correlation with the LATCH score (p = 0.008). Early postpartum breastfeeding efficiency, as measured by the LATCH score, was only correlated with the type of delivery. No significant correlation was found between pandemic-related maternal perinatal anxiety and early postpartum breastfeeding success.

Association of Pregnant Women's Perinatal Depression with Sociodemographic, Anthropometric and Lifestyle Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study.

Background: In recent decades, the incidence of depression has gradually increased in the general population globally. Depression is also common during gestation and could result in detrimental gestational complications for both the mother and the fetus. The survey presented aimed to evaluate whether pregnant women's perinatal depression could be associated with socio-demographic, anthropometry and lifestyle factors, and perinatal and postnatal outcomes. Methods: This is a cross-sectional survey conducted on 5314 pregnant women. Socio-demographic and lifestyle factors were recorded by relevant questionnaires via face-to-face interviews. Anthropometric parameters were measured by qualified personnel. Perinatal depressive symptomatology status was evaluated by Beck's Depression Inventory (BDI-II) questionnaire. Results: Depressive symptoms throughout gestation were found in 35.1% of the enrolled women. Perinatal depression was significantly associated with lower educational and economic level, pre-pregnancy regular smoking and reduced levels of Mediterranean diet adherence levels, a higher prevalence of gestational diabetes and preterm birth, as well as a higher incidence of delivering by caesarean section and abnormal childbirth weight. Perinatal depression was also significantly associated with a higher prevalence of maternal postpartum depression and lower prevalence of exclusive breastfeeding practices, as well as with a higher incidence of childhood asthma. Conclusions: Pregnant women's perinatal depression appears to be associated with various socio-demographic, anthropometry, and lifestyle characteristics and with a higher frequency of several adverse pregnancy complications. The present findings emphasize the importance of pregnant women's perinatal mental health, highlighting the need to develop and apply public strategies and policies for psychological counseling and support of future mothers to minimize probable risk factors that may trigger perinatal depression. Novel well-organized, follow-up surveys of enhanced validity are highly recommended to establish more definitive conclusions.

Investigating the Effect of Infant Massage by the Mother on Maternal Postpartum Depression

Investigating the Effect of Infant Massage by the Mother on Maternal Postpartum Depression