Postpartum Disorders Research Articles

Links between perceived social support, sense of parental efficacy and postpartum paternal depression

ObjectiveAlthough fathers are strongly encouraged to get involved in parenthood since pregnancy, there is still little research on the perinatal experience of fatherhood. In order to better understand and appreciate the experience of fathers during the first months after their child's birth, in this study we investigated the links between perceived social support, sense of parental efficacy and postpartum depression. Similar to studies on mothers, several risk factors may increase the fathers’ vulnerability to the development of postpartum depression symptoms. The objective of this study was to determine whether higher levels of perceived social support and sense of parental efficacy are predictive of lower levels of postpartum depression symptoms in a sample of fathers living in France. Material and methodThe study population is made up of 376 fathers aged 18 to 59 years old, living in France, and having had a child in the past 6 months. Fathers answered to measures of depression symptoms (Edinburgh Postnatal Depression Scale), perceived social support (Social Provisions Scale), and sense of parental efficacy (Parenting Expectations Survey). ResultsIn accordance with our hypotheses, fathers who reported the lowest perceptions of their parental efficacy and the lowest levels of perceived social support are those who reported the highest levels of postpartum depression symptoms. Low levels of perceived social support and of sense of parental efficacy predicted higher postpartum depression symptoms in fathers. Multiple linear regression analyses also showed that the oldest fathers in our sample (30 years and more) had the highest depression scores, as well as lower levels of perceived social support and sense of parental efficacy than younger fathers. Primiparous fathers had higher postpartum depression scores and lower parental efficacy scores than multiparous fathers. ConclusionThe considerable involvement of fathers in the study and the large size of our sample are strengths of our study that substantiate the interest of fathers in issues related to their parenthood, well-being and mental health. Our results encourage caregivers to give them more attention and well-tailored support to better respond to their specific needs during the transition to parenthood. Couple and individualized care for each parent should be proposed throughout the perinatal period in order to promote parental social support and sense of parental efficacy, particularly for first-time fathers, and to prevent postpartum disorders.

Effect of Supplementing Vitamin E, Selenium, Copper, Zinc, and Manganese during the Transition Period on Dairy Cow Reproductive Performance and Immune Function.

The transition dairy cows are challenged by various stresses such as decreased dry matter intake, liver dysfunction, increased inflammation, and oxidative stress, particularly in subtropical regions. These might increase the requirement for vitamin E and trace elements. To examine whether supplementation of vitamin E, selenium or copper, zinc, and manganese complex would help transition dairy cows to achieve greater reproduction performance by overcoming the immune function and postpartum disorders in subtropical Taiwan. A total of 24 Holstein Friesian dairy cows were enrolled in this study and divided into three groups (n = 8 cows/group): treatment 1 supplemented with organic selenium and vitamin E (SeE), treatment 2 supplemented with organic copper, zinc, and manganese complex (CZM) and control (CON). The results showed SeE supplementation improved immune function, reproductive performance, and milk yield, but not negative energy balance status. Supplementation of CZM improved milk yield and energy regulation through antioxidative capacity and immune function, but had no influence on reproductive performance.

Caesarean section and post traumatic stress disorder

IntroductionChildbirth can be a very painful experience, especially vaginally. It can have many complications. The obstetrical complications of caesarean section are well studied but its psychological complications are little mentioned. Most women recover quickly after giving birth, but others seem to have more difficulty. Researchers have attempted to identify perinatal risk factors for the development of post-traumatic stress disorder in parturients and caesarean section seems to be one of the predictors.ObjectivesThe objective of our study is to detect post traumatic stress disorder in women after vaginal delivery.MethodsThis is a cross-sectional descriptive study conducted among women from the general population who have given birth vaginally. The information was collected using a questionnaire distributed on social networks. Symptom severity was quantified using the PTSD checklist for DSM-V (PCL-5).PCL-5 is a 20-item self-assessment that measures the 20 DSM-5 symptoms of PTSD. She rates each symptom from 0 (not at all) to 4 (extremely). The score varies from 0 to 80. A threshold of 33 allows screening for post-traumatic stress disorder.Results61 women took part in this study, 81.5% of whom gave birth vaginally between the ages of 20 and 30.70.3% of the participants gave birth vaginally once, 44.4% twice and 7.3% of the women in our sample had a caesarean three times.Regarding the indication of the high way in our sample: the narrowing of the pelvis and fetal distress were in 22.2%. Exceeding term was in 18.5% of cases.In our sample, 59.3% of the women had planned their vaginal delivery and 40.7% had given birth urgently.Regarding the results of the PCL-5 scale (PTSD checklist for DSM-V), the score varies between 0 and 48 with a median score equal to 12. 3.7% of the participants had a score greater than 33.ConclusionsPost-traumatic stress disorder can accompany childbirth, especially when it is high and in an emergency. Postpartum post traumatic stress disorder affects the mother-child relationship and can be complicated by depressive disorder. Medical monitoring of pregnancy, good medical and family support for the parturient and preparation for childbirth are necessary to better start the maternity experience.Disclosure of InterestNone Declared

Opioid Use Disorder and Overdose in the First Year Postpartum: A Rapid Scoping Review and Implications for Future Research.

Opioid overdose is a leading cause of maternal mortality, yet limited attention has been given to the consequences of opioid use disorder (OUD) in the year following delivery when most drug-related deaths occur. This article provides an overview of the literature on OUD and overdose in the first year postpartum and provides recommendations to advance maternal opioid research. A rapid scoping review of peer-reviewed research (2010-2021) on OUD and overdose in the year following delivery was conducted in PubMed, PsycINFO, and Web of Science databases. This article discusses existing research, remaining knowledge gaps, and methodological considerations needed. Seven studies were included. Medication for OUD (MOUD) was the only identified factor associated with a reduction in overdose rates. Key literature gaps include the role of mental health disorders and co-occurring substance use, as well as interpersonal, social, and environmental contexts that may contribute to postpartum opioid problems and overdose. There remains a limited understanding of why women in the first year postpartum are particularly vulnerable to opioid overdose. Recommendations include: (1) identifying subgroups of women with OUD at highest risk for postpartum overdose, (2) assessing opioid use, overdose, and risks throughout the first year postpartum, (3) evaluating the effect of co-occurring physical and mental health conditions and substance use disorders, (4) investigating the social and contextual determinants of opioid use and overdose after delivery, (5) increasing MOUD retention and treatment engagement postpartum, and (6) utilizing rigorous and multidisciplinary research methods to understand and prevent postpartum overdose.

Prevalence and predictors for postpartum sleep disorders: a nationwide analysis

Objective To describe the prevalence and predictors of postpartum sleep disorders. Design A retrospective cohort study. Setting Postpartum. Population Commercially insured women delivering in California (USA) between 2011 and 2014. Methods Using the Optum Clinformatics Datamart Database. Main outcome measures Prevalence of a postpartum sleep disorder diagnosis with and without a depression diagnosis up to 12 months following hospital discharge for inpatient delivery. We also identified predictors of a postpartum sleep disorder diagnosis using multivariable logistic regression. Results We identified 3535 (1.9%) women with a postpartum sleep disorder diagnosis. The prevalence of sleep disorder diagnoses was insomnia (1.3%), sleep apnea (0.25%), and other sleep disorder (0.25%). The odds of a postpartum sleep disorder were highest among women with a history of drug abuse (adjusted odds ratio (aOR): 2.70, 95% confidence interval (CI): 1.79–4.09); a stillbirth delivery (aOR: 2.15, 95% CI: 1.53–3.01); and chronic hypertension (aOR: 1.82; 95% CI: 1.57–2.11). A comorbid diagnosis of a postpartum sleep disorder and depression occurred in 1182 women (0.6%). These women accounted for 33.4% of all women with a postpartum sleep disorder. The strongest predictors of a comorbid diagnosis were a history of drug abuse (aOR: 4.13; 95% CI: 2.37–7.21) and a stillbirth delivery (aOR: 2.93; 95% CI: 1.74–4.92). Conclusions Postpartum sleep disorders are underdiagnosed conditions, with only 2% of postpartum women in this cohort receiving a sleep diagnosis using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Insomnia was the most common disorder and one-third of women diagnosed with a postpartum sleep disorder had a co-morbid diagnosis of depression. Future studies are needed to improve the screening and diagnostic accuracy of postpartum sleep disorders.

Postpartum-onset obsessive-compulsive disorder: A harbinger of bipolar disorder.

Postpartum-onset obsessive-compulsive disorder: A harbinger of bipolar disorder.

Maternity Blues: A Narrative Review.

Puerperium is a period of great vulnerability for the woman, associated with intense physical and emotional changes. Maternity blues (MB), also known as baby blues, postnatal blues, or post-partum blues, include low mood and mild, transient, self-limited depressive symptoms, which can be developed in the first days after delivery. However, the correct identification of this condition is difficult because a shared definition and well-established diagnostic tools are not still available. A great heterogenicity has been reported worldwide regarding MB prevalence. Studies described an overall prevalence of 39%, ranging from 13.7% to 76%, according to the cultural and geographical contexts. MB is a well-established risk factor for shifting to more severe post-partum mood disorders, such as post-partum depression and postpartum psychosis. Several risk factors and pathophysiological mechanisms which could provide the foundation of MB have been the object of investigations, but only poor evidence and speculations are available until now. Taking into account its non-negligible prevalence after childbirth, making an early diagnosis of MB is important to provide adequate and prompt support to the mother, which may contribute to avoiding evolutions toward more serious post-partum disorders. In this paper, we aimed to offer an overview of the knowledge available of MB in terms of definitions, diagnosis tools, pathophysiological mechanisms, and all major clinical aspects. Clinicians should know MB and be aware of its potential evolutions in order to offer the most timely and effective evidence-based care.

Body mass index and persistent hypertension in patients with hypertension disorders of pregnancy one-year postpartum

Body mass index and persistent hypertension in patients with hypertension disorders of pregnancy one-year postpartum

The Prevalence, Diagnosis, Education, and Treatment of Diastasis Recti Abdominis and Pelvic Floor Dysfunction among Post-Partum Women

Pregnancy-related structural changes to the abdominal-pelvic region can cause perinatal and postpartum disorders such as diastasis recti (DRA) and pelvic floor dysfunction (PFD).This research describes the occurrence of DRA and PFD symptoms, diagnosis, use of prevention/treatment methods and sources of education among 152 women < 15 months post-partum.

Maternal morbidity and mortality associated with mode of delivery in sickle cell disease

This retrospective observational study compared pregnancy outcomes based on mode of delivery in women with homozygous sickle cell disease (HbSS) to women without (HbAA) using delivery records of 48,600 parturients between January 1992 and January 2020. Fisher’s exact tests and Mann–Whitney’s test were used to analyse variables based on sickle cell status. Vaginal delivery and HbSS were more associated with labour induction/augmentation (AOR = 2.4, (0.7–7.8)), intrapartum complications (AOR = 2.6, (0.5–14)), postpartum haemorrhage (AOR = 2.8 (0.5–15.2)) and postpartum infections (AOR = 9.6 (1.7–54.4)). Caesarean delivery resulted in more postpartum infections in the HbSS group (AOR = 23.6 (0.9–638.4)). Vaginal delivery in HbSS resulted in more intrapartum complications and postpartum haemorrhage but caesarean delivery greatly increased the risk of postpartum infections and hypertensive disorders. Sickle cell disease (SCD) did not confer increased risk of adverse perinatal outcomes regardless of mode of delivery. Impact Statement What is already known on this subject? Women with homozygous sickle cell disease (SCD) are at an increased risk of postpartum infections, undergoing caesarean delivery, admission to the neonatal intensive care unit and overall perinatal mortality when compared to women with normal haemoglobin genotype. Comparisons have been made between homozygous SS disease and haemoglobin SC disease revealing higher rates of maternal and foetal morbidity in both groups. What do the results of this study add? Studies comparing maternal and foetal morbidity based on mode of delivery are lacking. To our knowledge, this study is the first examine maternal and perinatal outcomes in women with SCD undergoing vaginal and abdominal delivery compared to women with normal haemoglobin. We found that vaginal delivery in SCD is associated with more postpartum haemorrhage and caesarean delivery was linked to more hypertensive disorders and postpartum infections then compared to women with normal haemoglobin. Converse to other reports, there was no difference in perinatal outcomes based on mode of delivery. What are the implications of these findings for clinical practice and/or further research? Caesarean delivery and SCD greatly increased the risk of postpartum infections and hypertensive disorders but did not confer a higher risk of postpartum haemorrhage. There were more maternal deaths in SCD women who underwent caesarean vs. vaginal delivery and this requires further study to determine the pregestational predictors of adverse outcomes. Women with SCD who achieve a successful primary vaginal delivery may have reduced risk of complications in subsequent pregnancies, possibly comparable to women without the disease.

Emergency Department Utilization for Substance Use DisorderDuring Pregnancy and Postpartum in the United States (2006-2016).

We aimed to better understand emergency department (ED) use, admission patterns, and demographics for substance use disorder in pregnancy and postpartum (SUDPP). In this longitudinal study, the United States Nationwide Emergency Department Sample was queried for all ED visits by 15- to 50-year-old women with a primary diagnosis defined by International Classification of Diseases, 9th or 10th edition Clinical Modification, codes of SUDPP between 2006 and 2016. Patterns of ED visit counts, rates, admissions, and ED charges were analyzed. Annual national estimated ED visits for SUDPP increased from 2,919 to 9,497 between 2006 and 2016 (a 12.4% annual average percentage change), whereas admission rates decreased (from 41.9% to 32.0%). ED visits were more frequent among women who were 20-29years old, using Medicaid insurance, in the lowest income quartile, living in the South, and in metropolitan areas. Compared with the proportion of ED visits, 15- to 19-year-olds had significantly lower admission rates, whereas women with Medicaid and in the lowest income quartile had higher admission rates (p<.001). Opioid use, tobacco use, and mental health disorders were most commonly associated with SUDPP. The ED average inflation-adjusted charges for SUDPP increased from $1,486 to $3,085 between 2006 and 2016 (7.1% annual average percentage change; p<.001), yielding total annual charges of $4.02 million and $28.53 million. Despite the decrease in admissions, the number and charges for ED visits for SUDPP increased substantially between 2006 and 2016. These increasing numbers suggest a continuous need to implement preventive public health measures and provide adequate outpatient care for this condition in this population specifically.

Predictors of postpartum glucose metabolism disorders in women with gestational diabetes mellitus

Background and aimsPostpartum glucose metabolism disorders are a common problem in women with gestational diabetes mellitus (GDM). They are often underdiagnosed since many patients do not attend the postpartum screening. This study aims to assess predictors of postpartum glucose metabolism disorders and type 2 diabetes mellitus (T2DM) after GDM. Material and methodsRetrospective study in women with GMD who underwent postpartum screening for glucose metabolism disorders (n = 2688). Logistic regression was used in the statistical analysis. Results24.6% of women had postpartum glucose metabolism disorder. In multivariate analysis, pre-pregnancy body mass index (BMI) 25–30 kg/m2 (OR 1.46, 95%CI 1.05 to 2.02) or BMI ≥30 kg/m2 (OR 2.62, 95%CI 1.72 to 3.96), diagnosis of GDM before 20 weeks of pregnancy (OR 2.33, 95%CI 1.57 to 3.46), fasting plasma glucose after diagnosis of GDM ≥90 mg/dl (OR 2.12, 95%CI 1.50 to 2.98), postprandial glucose ≥100 mg/dl (OR 1.47, 95%CI 1.09 to 2.99), and HbA1c in the third trimester of pregnancy ≥5.3% (2.04, 95%CI, 1.52 to 2.75) were independent predictors for any postpartum glucose metabolism disorder. Conclusionpostpartum screening for T2DM should be performed in all women with GDM, and it is especially important not to lose follow-up in those with one or more predictive factors.

The correlation between postpartum stress disorder and maternal anxiety in different types of delivery (vaginal and cesarean section)

Aim: Post-traumatic stress disorder refers to a person&#8217;s experience of a traumatic event. Traumatic experiences during childbirth can cause postpartum stress in some women. The present study aimed to investigate the correlation between postpartum stress disorder in different types of delivery (normal vaginal delivery and cesarean section) and maternal anxiety. Design: This was a cross-sectional study. Methods: This cross-sectional study was performed on 714 pregnant mothers selected via cluster sampling six-eight weeks after their delivery in selected health centers. The data were collected using Post-Traumatic Stress Disorder Symptom Scale I and the Spielberger State-Trait Anxiety Inventory. The data were then entered into the SPSS 20 software and were analyzed using a chi-square test. The significance level was set as p &lt; 0.05. Results: The results showed that most of the participants in the two groups had medium to low anxiety levels, and the two groups were homogeneous in this regard. However, the mean scores of obvious anxiety (p &lt; 0.0001) and hidden anxiety (p &lt; 0.0001) were significantly higher in the normal vaginal delivery group compared to the cesarean section group. Moreover, post-traumatic stress score was significantly correlated to both obvious anxiety and hidden anxiety in the two study groups. Conclusion: Postpartum stress disorder had a positive relationship with obvious anxiety and hidden anxiety in both study groups. Counseling may be effective in reducing post-traumatic stress disorder in women.

Assessment of Blood Metabolites during Early Postpartum Period as an Indicator of Reproductive Performance in Mehsana Buffaloes

Background: The postpartum period being a crucial on future performance and fertility, it should be monitored critically and evaluated. Therefore, the study was designed to investigate associations between the metabolic indicators during early postpartum period with uterine diseases and the subsequent effect on reproductive performance. Methods: The blood metabolites including non-esterified fatty acid (NEFA), beta hydroxy butyrate (BHBA), cholesterol, total protein, blood glucose and calcium are studied at 1st and 2nd week postpartum (PP) in 50 Mehsana buffaloes. The difference and their association were seen in relation to postpartum diseases and reproductive performance. Result: The glucose concentration significantly (P less than 0.05) decreased in 2nd week compared to 1st week postpartum in Mehsana buffaloes with anoestrous ( greater than 75 days PP), longer service period ( greater than 125 days) and postpartum disorders (Within 125 days). The BHBA and NEFA did not differ significantly between the time points or between the buffaloes suffering from postpartum disorders or not. The early postpartum glucose level can be used as a predictive indicator for buffaloes suffering from anoestrus, longer service period and postpartum disorders.

Association among postpartum posttraumatic stress disorder, family coping, neurodevelopment, and language development in high-risk infants: a retrospective study.

BackgroundA high-risk infant (HRI) is a child whose fetal, neonatal, and infant development is impacted by adverse factors that may cause cognitive, sensory, behavioral, or language defects. The complex situation in the treatment process is a continuous challenge and stressor for parents. If parents fail to take appropriate coping styles, it will have an adverse impact on the health of parents and the growth and development of children. The purpose of this study was to explore the impact of clinical characteristics, postpartum posttraumatic stress disorder (PTSD), and family coping on the neurodevelopment and language development of HRIs as a reference for targeted intervention.MethodsThis study retrospectively recruited 211 children who were hospitalized in the neonatal intensive care unit (NICU) of Suzhou Kowloon Hospital from January 2018 to December 2021. HRI and their mother were interviewed by telephone with general information questionnaire, Perinatal Post-traumatic Stress Disorder Questionnaire, medical coping modes questionnaire, Bayley Scales of Infant Development the Early Language Milestone Scale to investigate HRI and their mothers; Logistic regression was used to analyze the relationship between HRI mothers’ emotions and family coping with neurodevelopment and language development.ResultsThe neurodevelopmental scores of HRIs differed according to gestational week of delivery, birth weight, and disease diagnosis. The language development scores of HRIs differed according to gestational week of delivery, birth weight, disease diagnosis, and maternal education. Multiple stepwise regression analysis showed that the neurodevelopmental scores were affected by gestational week of delivery, postpartum PTSD score, and family coping. Logistic regression analysis showed that the language development scores were affected by maternal education and neurodevelopmental level. The correlation analysis showed that the postpartum PTSD scores were negatively correlated with family coping, neurodevelopment, and language development, and that family coping was positively correlated with the neurodevelopment and language development scores (P<0.05).ConclusionsThe neurodevelopment and language development of HRIs were affected by the gestational week of delivery, maternal education, the child’s birth weight, and disease diagnosis. NICU wards can promote the healthy development of HRIs by providing mothers with targeted health education concerning the child’s condition, postpartum PTSD, and family coping strategies.

Factors affecting reproductive outcomes in lactating dairy cows that undergo presynchronization-Ovsynch and successive resynchronization programs

This study was designed to identify the factors affecting reproductive outcomes in lactating dairy cows undergoing Presynchronization-Ovsynch and successive resynchronization programs. Data were collected from 1,458 cows on 11 dairy farms, regarding nutrition, health, reproduction, and specifically reproductive programs used for the first timed artificial insemination (TAI; Modified Presynch-Ovsynch or Modified Double-Ovsynch) and for re-inseminations (Ovsynch or PreGnRH-Ovsynch); as well as the weather. Body condition score (BCS) and timing of TAI affected (P < 0.01) the probability of pregnancy per AI after first TAI. Cows with a BCS ≥3.25 were more likely (P < 0.01) to be pregnant at 31 (odds ratio [OR]: 1.85) and 49 (OR: 1.93) days after the first TAI than cows with BCS ≤2.75. Cows inseminated during months of heat stress (June to September) were less likely (P < 0.01) to be pregnant at 31 (OR: 0.74) and 49 (OR: 0.68) days after first TAI than those inseminated during months of no heat stress (October to May). Cows that had a pre- or postpartum disorder were more likely to lose their pregnancy (OR: 2.17, P < 0.01) than those that did not. Cows inseminated ≥76 days after calving (OR: 1.67, P < 0.1) or during the months of heat stress (OR: 2.02, P < 0.05) were also more likely to lose pregnancy than cows inseminated ≤75 days after calving or during the months of no heat stress. Following successive resynchronizations, cows with a third (OR: 1.32, P < 0.1) or fourth (OR: 1.68, P < 0.05) TAI were more likely to be pregnant than those with a second TAI. Cows with BCS ≥3.25 at the beginning of resynchronization were more likely (OR: 1.49, P < 0.05) to be pregnant than cows with BCS ≤2.75. Finally, the likelihood of being pregnant by 210 days postpartum was positively associated with a favorable BCS, but negatively associated with the presence of a pre- or postpartum disorder and a larger number of days to first TAI following calving (≥76 vs. ≤75 days). In conclusion, high BCS has beneficial effects during the entire reproductive period, whereas TAI during heat stress, the presence of a pre- or postpartum disorder, a larger number of days to first TAI following calving, and TAI number (second or ≥ fifth) adversely affects the outcomes associated with pregnancy during the early or later breeding periods in lactating dairy cows undergoing Presynchronization-Ovsynch and successive resynchronization programs.

HOW TO COPE WITH BABY BLUES: A CASE REPORT

During parturition phase, usually mother cannot get through psychological adaptations well, it can cause something that you might not accept-postpartum mental disorders called baby blues. There are 30-75% of women after childbirth who experience the baby blues. Many factors affect baby blues. The symptoms that begin within a few days of delivery include mood lability, irritability, tearfulness, generalized anxiety, sleep, and appetite disturbance. The author reported a case of women with baby blues. The instrument uses Edinburgh Postnatal Depression Scale (EPDS) for screening. EPDS test on the patient showed a score of 13. The patient gets treatment with classical music therapy, a support system, and continued breastfeeding. After treatment, the patient can control her emotions, sleep well, and already breastfeed the baby. The husband also takes a role in caring for their baby. EPDS test on the patient showed a score of 8. Early detection and appropriate treatment from a midwife can decrease baby blues symptoms. Keywords: post-partum mental disorder, baby blues, EPDS.

The Effectiveness of Dialectical Behavioral Therapy on the Success of Breast Feeding in Traumatic Childbirth: A Randomized Controlled Trial.

Objective: Traumatic childbirth may expose mothers to physical and psychological postpartum disorders. The reduced rate of exclusive breast feeding is an essential consequence of this problem. The goal of this study was to see if dialectical behavioral therapy could help with the onset and duration of exclusive breast feeding after a traumatic delivery. Method : This clinical trial study included, 210 primiparous women with traumatic vaginal births were admitted to Bahar hospital in Shahroud. A standard protocol was designed and administered. The group allocation imbalance happened by chance and was averted by utilizing block randomization with a size of four and sequentially numbering the intervention or control groups with a sealed concealed envelope Participants in the intervention group had one individual session and four group counseling sessions by the researcher, while the control group participants obtained a routine care. Breast feeding self-efficacy was measured using a related questionnaire before the intervention, six and 12 weeks postpartum. Exclusive breast feeding was determined using a related form at the end of each month until the fourth month. Results: The outcome of repeated measure ANOVA Before the intervention, based on the greenhouse geisser test indicated no statistically significant difference in breast feeding self-efficacy (P = 0.07) or infant weight between the two groups. (P = 0.98). Nevertheless, a statistically significant difference between the mean score of breast feeding self-efficacy and infant's weight was discovered by a post hoc test utilizing the Bonferroni correction, (P = 0.001) between the two groups after the intervention. Therefore, in the intervention group, the level of exclusive breast feeding was higher than in the control group, and four months after birth, more infants in the intervention group were exclusively breastfed (58% vs 32%) (P < 0.001). The analysis of data using the GEE model showed that the odds of adherence to exclusive breast feeding in the intervention group were 3.4 (0.95 CI: 2.04-5.7). Conclusion: Dialectical behavior therapy is a powerful tool for minimizing the negative features of traumatic childbirth and increase the success of breast feeding mothers. Therefore, it can be used as a supportive method for mothers.

Factors affecting calving to conception interval (days open) in dairy cows located at Dessie and Kombolcha towns, Ethiopia.

This study was aimed at determining the median days of calving to conception interval (days open) and identifying the major risk factors determining the days open in dairy cows. Both retrospective and longitudinal studies were conducted on dairy cows located in the Dessie and Kombolcha towns of South Wollo Zone, northeast Ethiopia from August 2019 to August 2020. The Kaplan-Meier model of survival analysis was used to determine the median days open and compare the survival distribution of each level of explanatory variables likely to influence the days open of dairy cows. Accordingly, the overall conception rate of dairy cows was 44.7%. The median days open in the study was 154 days. There is a 16% probability of surviving (i.e, the probability that the conception event has not yet occurred) at the end of 210 days postpartum period. The Cox proportional hazard model was used to quantify the effect of each of the explanatory variables on the days open in the first 210 days postpartum. Factors that had a significant effect (p<0.05) on the calving to conception interval were the season of insemination, breeding system, calving to insemination interval, and herd milk yield level. However, the peripartum, postpartum disorders, and the town of the farm are not significant (p>0.05). Accordingly, cows inseminated in the autumn season (HR = 4.45), cows less than or equal to 85 days calving to insemination interval (HR = 2.41), artificially inseminated cows (HR = 1.45), and high herd milk yield cow had a higher probability of becoming pregnant. In conclusion, the management practices and breeding decisions seem to be important determinants to improve the conception rate or decrease the days open in dairy cows.

Effects of replacement of corn silage and distillers' grain diets with hay during prepartum on the health and production performance of dairy heifers postpartum.

In this study, we aimed to comprehensively evaluate the effects of prepartum replacement of corn silage and distillers' grain diets with hay on the postpartum health and production performance in dairy heifers. Pregnant Holstein dairy heifers were randomly assigned to two groups and fed different diets with the same net energy and protein concentrations. The low corn silage plus hay (CH) group diet mainly contained oat hay (28.5%), corn silage (25%) and folium ginkgo (23%). The high corn silage plus distillers' grains (CD) group diet contained corn silage (53.5%), distillers' grains (5%) and folium ginkgo (18%). Dairy heifers were fed from the beginning of pregnancy to the end of the transition period. Calf birthweight, postpartum morbidity, milk production and reproductive performance were determined. Compared with the cows in the CH group, those in the CD group presented increased calf birthweight and a high risk of some postpartum disorders (p<0.05), particularly ketosis (37.63% vs. 24.54%) and retained placenta (9.41% vs. 3.92%). However, there was no difference between the groups in reproductive performance, including first timed artificial insemination (TAI) rate, date of TAI and conception rate of TAI. The lactation curves showed no difference in milk yield during the peak lactation period of primiparous cows between the CH and CD groups; the total milk production was 33.39kg and 33.19kg respectively. Notably, the time to peak milk production was delayed in the CD group. It can be concluded that replacing corn silage and distillers' grains with hay can reduce postpartum morbidity in dairy heifers and shorten the time to peak milk production.