Postnatal Research Articles

Study on the changes and influencing factors of depression in Chinese women with cancer: an analysis based on CHARLS panel data

BackgroundThe social problems caused by depressive disorders and psychological behaviors in women are increasingly prominent, with extreme incidents occurring from time to time. Therefore, the issue concerning “how to prevent and resolve the risk of depression in women” is gaining significant attention across various sectors. However, previous studies have largely focused on teenage girls, perimenopausal women, or women during pregnancy and the postpartum period, neglecting the adverse effects of major diseases, which is detrimental to enhancing the psychological well-being of women with cancer.ObjectiveBased on cancer impacts, this study aims to clarify the depressive state, development trends, and influencing factors in Chinese women with cancer, a group particularly susceptible to depression, to provide decision-making references for improving their psychological well-being.MethodsUsing follow-up panel data from five waves of China Health and Retirement Longitudinal Study (CHARLS), Chinese women with cancer who had complete observed values were selected as research subjects. After data cleaning, a balanced short panel dataset containing 1,030 samples was obtained. The depression characteristics and development trends in women with cancer were analyzed using the panel statistical method, and the influence of socio-demographic factors was examined using a panel stochastic trend model.ResultsThe overall depression of Chinese women with cancer has deteriorated, putting them at risk of moderate depressive disorder. The development trend shows an inverted “U” curve, with significant differences observed among various groups based on urban and rural residency, educational levels, and regional locations. Specifically, urban women with cancer show milder depressive symptoms than those in rural areas, and women in the eastern region, those with higher educational levels, and those with non-reproductive system cancers show milder depressive symptoms than those in the central and western regions, those with lower educational levels, and those with reproductive system cancers. Regression analysis indicates that socio-demographic factors significantly influence depression in women with cancer. Among these influencing factors, age, having a spouse, high educational level, good performance in the activity of daily living (ADL), frequent visits to neighbors, and regular exercise are protective factors against depression, while diabetes, dyslipidemia, frequent outpatient visits, frequent hospitalizations, smoking, and low life satisfaction are risk factors for depression.ConclusionThe depressive state among Chinese women with cancer is alarming. In view of this, there is an urgent need for introducing more supportive policies aimed at improving psychological health, developing tailored measures to address the specific needs of different groups, intensifying efforts to standardize the diagnosis and treatment of depression, particularly for those in rural areas, central and western regions, and among individuals with lower educational levels. Additionally, the role of social participation activities, such as visiting neighbors and exercising, should be given full play to alleviate depressive symptoms.

Nesfatin-1 Neurons in the Ventral Premammillary Nucleus Integrate Metabolic and Reproductive Signals in Male Rats

The ability to reproduce depends on metabolic status. In rodents, the ventral premammillary nucleus (PMv) integrates metabolic and reproductive signals. While leptin (adiposity-related) signaling in the PMv is critical for female fertility, male reproductive functions are strongly influenced by glucose homeostasis. The anorexigenic peptide nesfatin-1 is a leptin-independent central regulator of blood glucose. Therefore, its integrative role in male rats can be assumed. To investigate this, we mapped the distribution of nesfatin-1 mRNA- and protein-producing cells in the PMv during postnatal development via in situ hybridization and immunohistochemistry, respectively. Fos-nesfatin-1, double immunostaining was used to determine the combined effect of heterosexual pheromone challenge and insulin-induced hypoglycemia on neuronal activation in adults. We found that ~75% of the pheromone-activated neurons were nesfatin-1 cells. Hypoglycemia reduced pheromone-induced cell activation, particularly in nesfatin-1 neurons. Immuno-electron microscopy revealed innervation of PMv nesfatin-1 neurons by urocortin3-immunoreactive terminals, reportedly originating from the medial amygdala. Nesfatin-1 immunopositive neurons expressed GPR10 mRNA, a receptor associated with metabolic signaling, but did not respond with accumulation of phosphorylated STAT3 immunopositivity, a marker of leptin receptor signaling, in response to intracerebroventricular leptin treatment. Our results suggest that PMv nesfatin-1 neurons are primarily responsible for integrating reproductive and metabolic signaling in male rats.

The Identification of Relationships of the Quality of Lives of Puerperal Women, Who are Registered to Certain Family Health Centers in Tokat Province of Türkiye, With Their Support Needs and The Support Received by Them in the Postpartum Period

Background: The postpartum period is of critical importance to the health of the mother and newborn. It is presumed that the social support given during this period is likely to provide numerous benefits for the health of the mother, newborn, family, and accordingly the society. Objectives: This research was conducted to evaluate puerperal women’s needs for support, the support received by them, and the quality of their lives and identify the relationships between these variables. Methods: This descriptive and correlational research included a sample of 270 puerperal women registered at nine family health centers in Tokat province of Türkiye. The research data were collected by using the Introductory Information Form, the Postpartum Support Questionnaire, and the Maternal Postpartum Quality of Life Questionnaire. In the evaluation of the data; descriptive statistics, independent samples t-test, Mann Whitney U test, one-way ANOVA, Kruskal-Wallis H test, LSD Post Hoc test and Pearson correlation analysis were used. Results: In this research, the mean scores obtained by puerperal women from the “importance of the need” scale and the “received support” scale of the Postpartum Support Questionnaire were found respectively as 122.24±49.51 and 140.54±43.57 whilst the mean of puerperal women’s Maternal Postpartum Quality of Life Questionnaire scores was 23.51±3.25. Also, in the research, it was found that puerperal women’s Maternal Postpartum Quality of Life Questionnaire scores had statistically significant negative relationships with scores obtained by them from the “importance of the need” scale of the Postpartum Support Questionnaire (r=-.30, p=.000) and its material support sub-scale (r=-.30, p=.000), emotional support sub-scale (r=-.30, p=.000), and informational support sub-scale (r=-.25, p=.000). Besides, it was identified that puerperal women’s Maternal Postpartum Quality of Life Questionnaire scores had statistically significant positive relationships with scores obtained by them from the material support sub-scale (r=.24, p=.000) and emotional support sub-scale (r=.12, p=.000) of the “received support” scale of the Postpartum Support Questionnaire. Conclusion: In this research, it was found that the need for support felt by puerperal women was not at a significant level whilst the support received by puerperal women for this need was excessive. There was a relationship between the support needs of the postpartum women in the postpartum period and the support they receive and their quality of life. In order to improve the quality of life of puerperal women, health professionals working in primary health care, especially midwives and nurses, should inform the woman and her family about the importance of postpartum social support and help plan the social support program in line with the needs of puerperal women.

Temporal changes in hospital readmissions for postpartum hypertension in the US, 2010 to 2019; a serial cross-sectional analysis

Background Hypertension is the most common primary diagnosis associated with postpartum readmissions within 42 days of delivery hospitalization. In the United States, nearly half of the cases of eclampsia, a severe form of preeclampsia, develop during the postpartum period, and the postpartum onset of hypertensive disorders of pregnancy, like antepartum hypertension poses long-term health risks to pregnant individuals, including an increased likelihood of developing overall cardiovascular disease, coronary heart disease, heart failure, and chronic hypertension. In this paper, we estimate the trends in the incidence of readmissions for postpartum hypertension within 42 days of delivery discharge in the US, disaggregated by median household income. Methods and findings Using National Readmissions Database, we calculated the readmission rates for postpartum hypertension, both overall and stratified by ZIP Code median household income for each year between 2010 and 2019. We also calculated the percentage change and average annual growth rate (AAGR) in the rate of readmissions for postpartum hypertension between 2010 and 2019 for each income group. We then used a logistic regression model to compare the temporal changes in readmission for postpartum hypertension between the lowest and the highest income quartiles. The estimated incidence of postpartum hypertension readmissions doubled for all the income groups between 2010 and 2019 (0.36% vs. 0.8%). While the incidence of postpartum hypertension cases was higher among the lowest-income quartile, the increase in postpartum hypertension readmissions between 2010 and 2019 was greater in the highest-income quartile. Moreover, the incidence of postpartum hypertension readmissions rose faster in pregnant patients without a history of hypertension compared to those with a history of hypertension (AAGR 8.3% vs. 5.1%). Conclusion The increasing postpartum hypertension readmission burden suggests rising future health risks among mothers and a growing cost burden to the U.S. healthcare system. The higher rate of increase in postpartum hypertension readmissions among people without a history of hypertension calls for blood pressure checking in the postpartum period for all patients regardless of risk status.

Hypertension : what's new in 2024

The major clinical studies in 2024 reviewed in this manuscript will focus on blood pressure measurement, the effect of coffee on the latter, its follow-up in the postpartum period, blood pressure targets for patients at high cardiovascular risk, particularly those with diabetes, and the late onset of primary aldosteronism after a negative initial confirmation test.

Temporal expression and specific localization of tenomodulin with reference to vascular endothelial growth factor A and calcitonin gene-related peptide in developing diaphragm in mice.

Tenomodulin (TNMD) is related to chondromodulin-1, a cartilage-derived growth regulator. It is specifically expressed in hypovascular connective tissues, including tendons and ligaments. Vascular endothelial growth factor A (VEGF-A) and calcitonin gene-related peptide (CGRP) correlate with angiogenesis and neurogenesis, respectively, during development. Because of that the morphological profiles of TNMD, VEGF-A, and CGRP distributions in developing diaphragm are still unclear, we aimed to determine the expression of mRNA and proteins of these 3 markers during the development of the central tendon of the diaphragm (CTD) and the surrounding diaphragm tissue in mice. Male mice from the embryonic and postnatal periods [embryonic day 14.5 (E14.5), E17.5, postnatal day 1 (P1), and P5] were used and their mRNA and protein expressions were assessed using in situ hybridization, immunohistochemistry and quantitative real-time polymerase chain reaction. The results showed that TNMD was preferentially detected in muscle-tendon junction of the CTD at E17.5 and P1, in contrast to scattered distribution of CGRP and VEGF-A throughout the diaphragm from E14.5 to P5. These findings may provide fundamental information concerning the role of the TNMD in the CTD development.

Hindlimb muscles of the Emperor Penguin Aptenodytes forsteri (Aves, Sphenisciformes) at different postnatal ontogenetic stages

AbstractThe Emperor Penguin Aptenodytes forsteri is the largest living species of penguin, found exclusively in Antarctica, and is unique in breeding during the winter. Consequently, fewer anatomical studies have been conducted on this species over time compared to others. This study aims to provide an updated and comprehensive description of the hindlimb musculature of Aptenodytes forsteri. The muscles of the thigh, shank and foot were compared along postnatal development. The results were compared with the muscles of swimming and diving birds and also with ground‐dwelling taxa. By dissecting seven specimens, the origin and insertion were described in newborns, chicks and juveniles. Of the 37 muscles recognized, 19 correspond to the thigh, 14 to the shank, and four to the foot. Notably, the hindlimb muscles appear relatively developed compared to the overall body size in the newborns, showing considerable development in independent chicks, and reached full growth in the juvenile. The m. flexor hallucis brevis, m. extensor hallucis longus and m. lumbricalis were absent in all specimens, whereas the m. femorotibialis lateralis was found in only one specimen. Additionally, a branch of the m. flexor cruris medialis, originating in the abdominal area and merging with the pelvic portion before insertion, was observed in the newborn chicks. Aptenodytes forsteri showed similarities with Numida meleagris in the insertion of m. iliofibularis, and m. flexor cruris lateralis p. pelvica. These findings, along with other comparative results, constitute the first comprehensive descriptive study of the hindlimb musculature of Aptenodytes forsteri, including different ontogenetic stages.

Efficacy of Fat Supplements with Different Unsaturated/Saturated FA Ratios Undergoing First Postpartum Ovulation in Lactating Anovulatory Goats

We investigated whether microalgae or linseed supply during the early postpartum period affects ovarian restimulation and supports the first postpartum ovulation in lactating anovulatory goats. Thirty-eight An-glo-Nubian-crossbred adult goats were allocated into three groups, one with a control diet (n = 12), fed a total mixed ration (TMR) comprising chopped elephant grass and concentrate; an algal diet (n = 13), fed TMR + green microalgae (1% dry matter); and a linseed diet (n = 13), TMR + linseed (12% dry matter). Supplements were furnished from the second to fifth week (time of weaning). Goats were estrus synchronized on day 40 by insertion of an intravaginal CIDR device for 5 days, after which 0.075 mg PGF2α was applied to induce ovulation, and estrus was monitored for 72 h. From the 5th–15th day of ovulation induction, the corpus luteum (CL) area and progesterone rate were monitored. The algal and linseed groups showed lower feed intake (p < 0.001) and higher (p < 0.001) triglyceride levels/follicle numbers, respectively. After estrus induction, no differences were observed in estrus response; however, the linseed group showed more and larger growing follicles (p = 0.016 and p < 0.01), a higher ovulation rate (p < 0.05), a larger CL area (p < 0.05), and higher progesterone levels (p < 0.001). Linseed after delivery stimulates follicular growth before and after ovulation induction, favoring better CL quality during the first ovulation.

Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios

Mid-trimester preterm premature rupture of membranes is a rare complication of pregnancy associated with significant maternal and fetal risks. The ensuing prolonged oligohydramnios can lead to fetal pulmonary hypoplasia. In addition, there is an increased risk of miscarriage, preterm birth, and chorioamnionitis, contributing to septic morbidity in the mother–baby dyad. This case report describes the management and outcomes of an infant born at 32 weeks following the rupture of membranes at 16 weeks of gestation, resulting in severe oligohydramnios. Soon after birth, the infant had respiratory compromise, requiring high-frequency oscillatory ventilation and nitric oxide. Despite the initial poor prognosis, the infant remained stable with various ventilation modalities managed by a multidisciplinary team. He was discharged home after 108 days in the hospital and remained on non-invasive ventilatory support until 8 months of age while the home care and hospital specialty teams monitored him. The favorable respiratory outcome of this case is a rarity for cases with similar clinical circumstances, in which the managing team counsels parents about poor fetal outcomes and many proceed to terminate the pregnancies. In this reported case, we highlight the importance of multidisciplinary and interprofessional team management from antepartum monitoring and planning delivery time to subsequent short- and long-term postnatal care involving maternal-fetal medicine specialists, neonatologists, pediatric cardiology and respiratory specialists, and home care teams.

Type 1 Diabetes Mellitus and Thromboembolism in Pregnancy.

Objective The impact of type 1 DM (T1DM) on thromboembolism in pregnancy is uncertain. We hypothesized that T1DM is associated with higher rates of thrombotic events during pregnancy and the postpartum period. Study Design This is a retrospective cohort study utilizing the National Inpatient Sample database from HCUP/AHRQ for 2017-2019. Pregnant and postpartum patients with a history of T1DM were compared to those without. The primary outcome was a composite diagnosis of any thrombotic disease (pulmonary embolism (PE), deep vein thrombosis (DVT), cerebral vascular thrombosis (CVT), or other thromboses). Secondary outcomes were the diagnosis of each individual type of thrombo-embolic event. Groups were compared via Student's test, chi-squared, and logistic regression analyses, controlling for confounders including age, race, obesity, tobacco use, cHTN, asthma, anemia, and cesarean section. Results A total of 2,361,711 subjects met criteria. Patients with T1DM encompassed 0.4% of subjects (N=9,983). T1DM subjects were more likely to be younger, non-Hispanic white, obese, tobacco users, chronic hypertensive, asthmatic, and have a history of cesarean (all p<0.001). They were less likely to be in the top income quartile. Thrombo-embolic events occurred more frequently in those with T1DM (0.45% vs 0.20%, p<0.001). DVT was the most common event (0.25%). After controlling for confounders, T1DM remained independently associated with any thromboembolic event in pregnancy (aOR 2.19, 95%CI 1.49-3.23), PE (aOR 3.59, 95%CI 1.65-7.82), and DVT (aOR 2.43, 95%CI 1.43-4.14). Conclusion T1DM is associated with an increased risk of thrombo-embolic events in pregnancy. Key Words Type 1 Diabetes Mellitus, VTE, thromboembolism, pregnancy.

PROXIMATE COMPOSITION, MINERALS CONTENT, TOTAL PHENOLICS AND ANTIOXIDANT ACTIVITY OF TRADITIONALLY CONSUMED POSTPARTUM SUPPLEMENTAL FOODS

The postpartum period is critical for maternal and newborn health, marked by significant physiological and emotional changes. Cultural and traditional dietary practices often play a vital role in restoring maternal health and promoting lactation. This study investigates the proximate composition, mineral content, total phenolic content, and antioxidant activity of traditionally consumed postpartum supplemental foods in eight districts of Khyber Pakhtunkhwa, Pakistan. Data were collected from postpartum women through interviews, and commonly consumed foods were selected for chemical analysis. The findings reveal that these foods are nutrient-dense, with significant amounts of macronutrients, minerals, and bioactive compounds. The study highlights the role of traditional dietary practices in maternal nutrition while emphasizing the need for a balanced approach combining cultural practices and medical guidelines. These insights can aid healthcare professionals in optimizing dietary plans for lactating mothers, ensuring improved maternal and neonatal health outcomes.

Implications of mechanical circulatory support devices in a pregnant woman with cardiogenic shock

Data on the use of mechanical circulatory support devices in pregnant women are limited. A 27-year-old woman at 27 weeks and 6 days of gestation was supported by three different mechanical circulatory support devices due to cardiogenic shock. She came into spontaneous labor, which was complicated by major hemorrhage at the cannulation site, fetal distress, and transverse position, requiring emergency cesarean section. The postpartum period was complicated by intra-abdominal bleeding and arterial occlusion of lower extremity. When using mechanical circulatory support devices in pregnant women, a multidisciplinary approach is recommended.

THE RELATIONSHIP OF EARLY BREASTFEEDING INITIATION (IMD) TO POST PARTUM UTERINE INVOLUTION IN THE INDEPENDENT PRACTICE OF MIDWIVES (PMB) MARIYAH ULFAH EAST JAKARTA

Early breastfeeding initiation (IMD) is one of the factors that influence uterine involution. IMD can stimulate and release hormones, including the hormone oxytocin, which functions in addition to stimulating contraction of breast smooth muscles, also causes contraction and retraction of uterine muscles. This will compress the blood vessels resulting in reduced blood supply to the uterus. In women who choose to breastfeed their babies, the baby's suction will stimulate the release of oxytocin and help the uterus return to its normal shape. This study aims to determine the relationship of Early Breastfeeding Initiation (IMD) to uterine involution in post partum at PMB Mariyah Ulfah East Jakarta which was conducted in May-August 2024. The type of research used in this study is quantitative research. This study used a Cross Sectional approach. The sample technique used in this study was total sampling of 30 people. The research instruments used were metline and observation sheet. The results of this study identified that there was a difference in TFU reduction in mothers who did , Early initiation of breastfeeding (IMD) and those who did not do IMD, so there was a relationship between Early Breastfeeding Initiation (IMD) to Uterine Involution during the nifaas period at PMB Mariyah Ulfah East Jakarta, where the p-value = 0.006 (0.006 &lt;0.05)

CD9/SOX2-positive cells in the intermediate lobe of the rat pituitary gland exhibit mesenchymal stem cell characteristics.

Adult tissue stem cells of the anterior pituitary gland, CD9/SOX2-positive cells, are believed to exist in the marginal cell layer (MCL) bordering the residual lumen of the Rathke's pouch. These cells migrate from the intermediate lobe side of the MCL (IL-MCL) to the anterior lobe side of the MCL and may be involved in supplying hormone-producing cells. Previous studies reported that some SOX2-positive cells of the anterior lobe differentiate into skeletal muscle cells. These findings suggest that CD9/SOX2-positive cells in the anterior pituitary have mesenchymal stem cell (MSC) properties. To substantiate this hypothesis, we examined whether CD9-positive cells isolated from IL-MCL of adult male rats differentiate into mesenchymal cells, such as endothelial cells, adipocytes, chondrocytes, and osteocytes. Immunohistochemical analysis revealed that the CD9-positive cells were positive for the MSC markers, CD349, CD105, CD271, and CD273 and were detected in the early postnatal period at the boundary between the posterior and intermediate lobes but not in the embryonic period. In addition, some adult tissue stem cells derived from neural crest cells and bone marrow haematopoietic stem cells were positive for both CD9 and MSC markers, indicating that several CD9/SOX2-positive cells in the IL-MCL of the pituitary gland are MSCs that invaded from external tissues during pituitary development in the early postnatal period and exist in the adult tissue stem cells as suppliers of hormone-producing and endothelial cells in the anterior lobe. These findings should have implications for the application of CD9/SOX2-positive cells in regenerative therapy of the pituitary.

What makes a city breastfeeding friendly? A qualitative analysis of interviews with breastfeeding women from Europe and Asia.

The warm chain of support is the continuous enabling environment from the mother's first contact with healthcare professionals during early pregnancy, birth and immediate post-partum period, her transition from healthcare facility to home, through to work and the community at large. A breastfeeding-friendly city should be able to support a breastfeeding journey across the warm chain. To determine breastfeeding women's perspective of an ideal breastfeeding-friendly city. Between September 2021 and January 2022, twenty-two women who were breastfeeding or had ever breastfed in the last 5 years from Ireland and Malaysia were interviewed. A set of selection criteria was applied to ensure representation of a range of the characteristics known to be associated with breastfeeding success: diverse age groups, birth and breastfeeding experiences, culture and socioeconomical background. One-on-one semi-structured online interviews were conducted by the first author. Data were analysed using Braun and Clarke's Thematic Analysis framework. One overarching theme of breastfeeding at the front and centre of the city, and three major themes were developed: 1. mothers feel supported when breastfeeding is prioritised; 2. when breastfeeding is visible in the environment, it becomes normalized; 3. there is a need to have seamless breastfeeding support across the continuum of the warm chain, and at all levels of society. The findings demonstrated the importance of prioritized, and continuous support throughout the breastfeeding journey. The hopes and aspirations of a breastfeeding-friendly city expressed here would be useful for cities to consider when developing or implementing breastfeeding support programmes as well as guide development of indicators of a breastfeeding-friendly city.

The relationship between anxiety, depression, and COVID-19 diagnosis in term pregnancy: a hospital-based Romanian study

Background and aim. There are few published data on the mental health problems of women with pregnancy complicated by SARS-CoV-2 infection. Our study aimed to evaluate anxiety and depression related to a COVID-19 diagnosis in women who gave birth in a Romanian tertiary maternity. Methods. A hospital-based cross-sectional study was conducted between September 2020 and October 2021 on 105 women admitted for term delivery; 51 women were diagnosed with SARS-CoV-2 infection just before delivery, and 54 without infection. Participants were assessed during the first 72 hours postpartum (T1) and the following two weeks postpartum (T2). Hospital Anxiety and Depression Scale (HADS) was used for anxiety and depression assessment at T1. The COVID-19 Pandemic Mental Health Questionnaire (CoPaQ) was applied at T2 only in the COVID-positive cases identified at T1. Results. Postnatal anxiety levels were higher in COVID-positive women compared to COVID-negative women (p = .004), but there were no differences in the postnatal depression level between the groups. Psychological manifestations related to the pandemic, such as contamination anxiety, posttraumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) symptoms, were positively related to HADS anxiety scores, while maintaining social relationships were negatively associated with the scale. The COVID-19 diagnosis was found to be a significant predictor for adverse pregnancy outcomes (APOs), with COVID-positive women having a 4.72-fold higher risk of developing them than those who tested COVID-negative (OR=4.72, 95% CI [2.05; 10.86]). The multivariate analysis using anxiety and depression as dependent variables indicated a significant effect for COVID-19 diagnosis, Wilks’ Lambda = 0.940, p = 0.048. Conclusion. Increased levels of anxiety, PTSD, and obsessive-compulsive symptoms were associated with the postpartum period in pregnant women with COVID-19 infection during delivery. Maintaining social interaction proved to be a protective factor against the increased anxiety reported by COVID-19-infected women.

Influencing Factors in Urinary Retention in Parturients With Epidural Anesthesia Following Term Vaginal Birth.

Background: Epidural analgesia is a widely employed method in obstetric care for labor pain management. Postpartum urinary retention is a common complication that can arise during the postnatal period. This study aimed to evaluate the current status and influencing factors of postpartum urinary retention in parturients who received epidural anesthesia. Methods: We retrospectively included parturients who underwent vaginal delivery at our institution from June 2022 to October 2024. The characteristics of parturients with and without postpartum urinary retention were analyzed and compared. Logistic regression analyses were conducted to evaluate the influencing factors of postpartum urinary retention. Results: This study enrolled a cohort consisting of 520 parturients who underwent epidural anesthesia, resulting in a total of 520 instances of childbirth. Among this population, 56 parturients were identified as experiencing postpartum urinary retention. The incidence of postpartum urinary retention in parturients with epidural anesthesia was 10.77%. Correlation analysis results showed that the parity (r = 0.582), duration of analgesia (r = 0.554), degree of perineal laceration (r = 0.656) and use of oxytocin (r = 0.580) were correlated with the occurrence of postpartum urinary retention among parturients with epidural anesthesia (all p < .05). Logistic regression analysis indicated that parity (OR = 2.587, 95% CI: 1.890∼3.225), duration of analgesia (OR = 2.778, 95% CI: 2.104∼3.467), degree of perineal laceration (OR = 3.265, 95% CI: 2.620∼3.815) and use of oxytocin (OR = 2.436, 95% CI: 1.909∼3.875) were the independent influencing factors of postpartum urinary retention (all p < .05). Conclusion: It is imperative that clinical healthcare providers implement targeted preventative and management strategies to reduce postpartum urinary retention.

Postnatal development of vasoactive intestinal polypeptide-expressing GABAergic interneurons in mouse somatosensory cortex.

Despite dysfunctional vasoactive intestinal polypeptide-positive interneurons (VIP-INs) being linked to the emergence of neurodevelopmental disorders, the temporal profile of VIP-IN functional maturation and cortical network integration remains unclear. Postnatal VIP-IN development was traced with patch clamp experiments in the somatosensory cortex of Vip-IRES-cre x tdTomato mice. Age groups were chosen during barrel field formation, before and after activation of main sensory inputs, and in adult animals (postnatal days (P) P3-4, P8-10, P14-16, and P30-36). Changes in passive and active membrane properties show a maturation towards accelerated signal integrations. Excitatory and inhibitory postsynaptic currents (EPSCs and IPSCs) showed progressive VIP-IN integration into cortical networks, likely via synaptogenesis: mEPSC frequency increased before P8-10, while mIPSC frequency increased at P14-16. Only mIPSC kinetics became accelerated, and the E/I ratio of synaptic inputs, defined as a ratio of mEPSC to mIPSC charge transfer, remained constant throughout the investigated developmental stages. Evoked (e)EPSCs and (e)IPSCs showed increased amplitudes, while only eIPSCs demonstrated faster kinetics. eEPSCs and eIPSCs revealed a paired-pulse facilitation by P14-16, indicating probably a decrease in the presynaptic release probability (pr) and a paired-pulse depression in adulthood. eIPSCs also showed the latter, suggesting a decrease in pr for both signal transmission pathways at this time point. VIP-INs mature towards faster signal integration and pursue different strategies to avoid overexcitation. Excitatory and inhibitory synaptic transmission become stronger and shorter via different pre- and postsynaptic alterations, likely promoting the execution of active whisking.

The effect of intrapartum labor induction with oxytocin on maternal depression scoring in early postpartum period: a retrospective cohort study

Aims: Studies showing that synthetic oxytocin (SO) used for induction during labor increases the risk of postpartum maternal depression are increasing day by day in literature. Objective was to investigate the effect of SO administered for induction during labor on the tendency to maternal depression in early postpartum period. Methods: The study encompassed nulliparous women, all of whom delivered at gestational weeks 37 to 41 between 2020 and 2022 and underwent standard postpartum assessments on the 10th day following delivery. Exclusion criteria comprised pregnant individuals with predisposing factors for depression before conception, during gestation, or in the postpartum period. Pregnants who were admitted to delivery room due to labor and gave birth without any induction method were classified as group C (n=137), and who were induced with SO were classified as group O (n=122). Edinburgh Postnatal Depression Scale (EPDS) scores on 0th day and 10th day postpartum of two groups were compared. Additionally, relationship between duration of induction and EPDS scores was analyzed. Results: No statistically significant difference was detected between two groups in terms of age, gestational week, or educational status (p&gt;0.05). No statistically significant difference was detected between the groups in EPDS scores on 0th or 10th day postpartum (p&gt;0.05). There was no significant difference between induction time and EPDS scores on 0th or 10th day postpartum (p&gt;0.05). Conclusion: SO used for labor induction may not primary affect the tendency to postpartum depression in the early period. Further studies in populations without risk factors for depression are needed.

Ethnic and racial discrimination in maternal health care in Mexico: a neglected challenge in the search for universal health coverage

BackgroundEthnic and racial discrimination in maternal health care has been overlooked in academic literature and yet it is critical for achieving universal health coverage (UHC). There is a lack of empirical evidence on its impact on the effective coverage of maternal health interventions (ECMH) for Indigenous women in Mexico. Documenting progress in reducing maternal health inequities, particularly given the disproportionate impact of the Covid-19 pandemic on ethnic minorities, is essential to improving equity in health systems.MethodsWe conducted a population-based, pooled cross-sectional, and retrospective analysis for 2009–2023, using data from the last three waves (2014, 2018, and 2023) of a nationally representative demographic survey (ENADID). Our study included n = 72,873 (N = 23,245,468) Mexican women aged 12–54 with recent live births. We defined ECMH as adequate antenatal care (ANC), skilled and/or institutional delivery care, timely postpartum care, and complication-free postpartum/puerperium. After describing sociodemographic characteristics and maternal health coverage by Indigenous status, we estimated a pooled fixed-effects multivariable regression model to adjust ECMH for relevant covariates. We used the Blinder-Oaxaca decomposition for nonlinear regression models to quantify inequities in ECMH due to ethnic-racial discrimination, defined as differences in outcomes attributable to differential treatment.FindingsIndigenous women had lower education, labor market participation, and socioeconomic position, higher parity, and more rural, poorer state residence than non-Indigenous women. They faced significant health coverage loss due to the dismantling of Seguro Popular, a public health insurance mechanism in place until the end of 2019, right before the start of the Covid pandemic. Adjusted ECMH was 25.3% for non-Indigenous women and 18.3% for Indigenous women, peaking at 28.8% and 21.2% in 2013–2018, declining to 25.7% and 18.7% pre-Covid (January 2019 to March 2020), and further declining to 24.0% and 17.4% during Covid, with an increase to 26.6% for non-Indigenous women post-Covid, while remaining similar for Indigenous women. Decomposition analyses revealed that during the analyzed period, 30.8% of the gap in ECMH was due to individual characteristics, 51.7% to ethnic-racial discrimination, and 17.5% to their interaction. From 2009 to 2012, 42.2% of the gap stemmed from observable differences, while 40.4% was due to discrimination. In the pre-Covid-19 phase, less than 1% was from observable characteristics, with 75.3% attributed to discrimination, which remained in the post-Covid-19 stage (78.7%).ConclusionsDespite modest health policy successes, the ethnic gap in ECMH remains unchanged, indicating insufficient action against inequity-producing structures. Ethnic and racial discrimination persists, exacerbated during the pandemic and coinciding with the government’s cancellation of targeted social programs and public health insurance focused on the poorest populations, including Indigenous peoples. Thus, prioritizing maternal and child health underscores the need for comprehensive policies, including specific anti-racist interventions. Addressing these inequities requires the recognition of both observable and unobservable factors driven by discriminatory ideologies and the implementation of targeted measures to confront the complex interactions driving discrimination in maternal health care services for Indigenous women.