Peripartum Depression

2017 ◽  
pp. 121-127
Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman
Keyword(s):  
Postpartum Period ◽  
Perinatal Period ◽  
Infertility Treatment ◽  
Adequate Treatment ◽  
Role Transitions ◽  
Treatment Of Depression ◽  
Increased Risk ◽  
The Family ◽  
Peripartum Depression ◽  
Complicated Pregnancy

IPT is based on the hypothesis that patients who experience social disruptions face an increased risk for depression. Thus, IPT is an interesting potential treatment for addressing symptoms that develop during the perinatal period. This chapter covers the use of IPT during pregnancy, miscarriage, the postpartum period, and infertility treatment. Adequate treatment of depression is important for the health not only of the mother but of the infant and other children in the family. IPT adaptations that have been proposed for use in these settings are reviewed. Research studies on the use of IPT during pregnancy and the postpartum period are summarized. The usual problem areas of the IPT framework (grief, role disputes, role transitions, and deficits) aptly apply to pregnancy, miscarriage, postpartum depression, and depression associated with infertility, with a fifth one (complicated pregnancy) added.

scholarly journals Health Promotion Among Families Having a Newborn Baby

2021 ◽  
pp. 173-184
Author(s):  
Shefaly Shorey
Keyword(s):  
Health Promotion ◽  
Maternity Care ◽  
Postpartum Period ◽  
Family Dynamics ◽  
Well Being ◽  
Perinatal Period ◽  
Newborn Baby ◽  
Care Services ◽  
The Family ◽  
The Future

AbstractPregnancy, childbirth, and the postpartum period are the stressful transition periods to parenthood. With medicalization of perinatal period, parents feel left out and less confident in their parenthood journey, which may pose serious threats to the family dynamics. Salutogenesis theory offers the potential to influence a shift away from negative health outlooks and outcomes, medicalization of childbirth, toward health promotion and positive well-being focus for maternity care services design and delivery in the future.

scholarly journals OCD in the Perinatal Period: Is Postpartum OCD (ppOCD) a Distinct Subtype? A Review of the Literature

2011 ◽  
Vol 39 (3) ◽  
pp. 285-310 ◽  
Author(s):  
Mary McGuinness ◽  
Jackie Blissett ◽  
Chris Jones
Keyword(s):  
Prospective Studies ◽  
Clinical Picture ◽  
Postpartum Period ◽  
Perinatal Period ◽  
Cochrane Library ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Increased Risk ◽  
The Impact ◽  
Distinct Subtype

Background: It has been suggested that the perinatal period is a period of increased risk for the development and/or exacerbation of OCD and that postpartum OCD (ppOCD) presents a distinct clinical picture. This raises the possibility that ppOCD might be a distinct subtype of OCD. This review examines this contention. Method: A search using Ovid (Medline, PsycINFO and Embase), EBSCO, Cochrane Library, Web of Science (ISI), Pubmed databases and Google Scholar was carried out using the key words: “obsessive compulsive disorder” (and derivatives), “perinatal”, “pregnancy”, “postnatal”, “postpartum”, “mothers” (and derivatives), “anxiety disorders” and “subtypes.” These articles and their references were reviewed. Results: The majority of studies reviewed were retrospective, which makes it impossible to infer causality. Two prospective studies found a higher incidence of OCD in the postpartum period. These were carried out in Turkey and Brazil and, as such, may be limited in their applicability to other cultural groups. Conclusion: The concept of ppOCD as a specific subtype has not been robustly demonstrated. The evidence that OCD is more prevalent in the postpartum period is mixed. The evidence that OCD in the postpartum period presents a distinctive clinical picture with specific symptomatology and course is more compelling. In view of the impact of culture and religion on the expression of OCD, collaborative, international, prospective studies that take into account the methodological and definitional issues raised in this review are necessary to provide clarification.

Obsessions and Compulsions During Pregnancy and the Postpartum Period

2014 ◽  
Author(s):  
Nichole Fairbrother ◽  
Jonathan S. Abramowitz
Keyword(s):  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Postpartum Period ◽  
Behavioral Therapy ◽  
Perinatal Period ◽  
Psychotic Symptoms ◽  
Postpartum Anxiety ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Increased Risk

Although for most women the perinatal period is an exciting and joyful time, some new mothers experience the onset (or intensification) of emotional distress during this period. Whereas a great deal of attention has been paid to depression and psychotic symptoms during the postpartum period, pre- and postpartum anxiety disorders, such as obsessive-compulsive disorder (OCD), have received relatively less consideration. This is despite the fact that anxiety disorders are, as a group, the most prevalent of all psychological disorders. Anxiety disorders are more common among women compared with men, and OCD is the only anxiety disorder for which there is evidence of an increased risk of onset and exacerbation in the perinatal period; this risk is most apparent for women giving birth to their first child. In this chapter, we provide an overview and description of the clinical features of perinatal obsessive-compulsive disorder and consider the degree to which perinatal OCD is related to OCD in general. We review the data pertaining to the incidence and prevalence of perinatal OCD and discuss the relation between perinatal OCD and postpartum depression and postpartum psychosis. Theoretical perspectives on perinatal OCD are then presented before turning to treatment. Lastly, two interventions have been shown to be effective for perinatal OCD are described: cognitive-behavioral therapy (CBT) and pharmacotherapy.

Pubertal development and adult height in patients with congenital hypothyroidism detected by neonatal screening in southern Brazil

2020 ◽  
Vol 33 (11) ◽  
pp. 1449-1455
Author(s):  
Suzana Nesi-França ◽  
Rodrigo B. Silveira ◽  
Juliana Cristina R. Rojas Ramos ◽  
Adriane A. Cardoso-Demartini ◽  
Monica N. Lima Cat ◽  
...  
Keyword(s):  
Congenital Hypothyroidism ◽  
Neonatal Screening ◽  
Adult Height ◽  
Screening Program ◽  
Pubertal Development ◽  
Z Score ◽  
Normal Range ◽  
Adequate Treatment ◽  
Increased Risk ◽  
Puberty Onset

AbstractObjectivesAdequate treatment of congenital hypothyroidism (CH) is required for normal growth and sexual development. To evaluate pubertal development in patients with permanent CH detected by a statewide Neonatal Screening Program of Paraná and, secondly, to evaluate adult height (AH) in a subgroup of patients.MethodsClinical, laboratory, and auxological data obtained from medical records of 174 patients (123 girls).ResultsMedian chronological age (CA) at treatment initiation was 24 days, and mean initial levothyroxine dose was 11.7 ± 1.9 μg/kg/day; mean CA at puberty onset was 11.5 ± 1.3 years (boys) and 9.7 ± 1.2 years (girls); mean CA in girls who underwent menarche (n=81) was 12.1 ± 1.1 years. Thyroid-stimulating hormone (TSH) values above the normal range were observed in 36.4% of the boys and 32.7% of the girls on puberty onset, and in 44.6% around menarche. Among 15 boys and 66 girls who had reached the AH, the median height z-score value was significantly greater than the target height (TH) z-score value in boys (p=0.01) and in girls (p<0.001). Boys with normal TSH values at puberty onset had greater mean AH z-score compared with boys with TSH values above the normal range (p=0.04).ConclusionsIn this group, pubertal development in girls with CH was not different from that reported in healthy girls in the general Brazilian population. Boys with higher TSH at puberty onset may have an increased risk of not reaching their potential height compared with those with normal TSH during this period. In a subgroup who attained AH, the median AH z-score was greater than the median TH z-score.

scholarly journals Sperm DNA methylation mediates the association of male age on reproductive outcomes among couples undergoing infertility treatment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Oladele A. Oluwayiose ◽  
Haotian Wu ◽  
Hachem Saddiki ◽  
Brian W. Whitcomb ◽  
Laura B. Balzer ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Developed Countries ◽  
Infertility Treatment ◽  
Reproductive Outcomes ◽  
Neurodevelopmental Outcomes ◽  
Male Age ◽  
Age Related ◽  
Sperm Dna ◽  
Increased Risk ◽  
Sperm Dna Methylation

AbstractParental age at time of offspring conception is increasing in developed countries. Advanced male age is associated with decreased reproductive success and increased risk of adverse neurodevelopmental outcomes in offspring. Mechanisms for these male age effects remain unclear, but changes in sperm DNA methylation over time is one potential explanation. We assessed genome-wide methylation of sperm DNA from 47 semen samples collected from male participants of couples seeking infertility treatment. We report that higher male age was associated with lower likelihood of fertilization and live birth, and poor embryo development (p < 0.05). Furthermore, our multivariable linear models showed male age was associated with alterations in sperm methylation at 1698 CpGs and 1146 regions (q < 0.05), which were associated with > 750 genes enriched in embryonic development, behavior and neurodevelopment among others. High dimensional mediation analyses identified four genes (DEFB126, TPI1P3, PLCH2 and DLGAP2) with age-related sperm differential methylation that accounted for 64% (95% CI 0.42–0.86%; p < 0.05) of the effect of male age on lower fertilization rate. Our findings from this modest IVF population provide evidence for sperm methylation as a mechanism of age-induced poor reproductive outcomes and identifies possible candidate genes for mediating these effects.

Prediction of Hospitalization During Infancy: Scoring the Risk of Admission

PEDIATRICS ◽  
1974 ◽  
Vol 53 (5) ◽  
pp. 716-720
Author(s):  
S. T. Winter ◽  
Pearl Lilos
Keyword(s):  
Hospital Admissions ◽  
Newborn Infants ◽  
Health Resources ◽  
Risk Coefficient ◽  
Special Services ◽  
Total Cohort ◽  
Increased Risk ◽  
The Family ◽  
Male Sex ◽  
Predicted Risk

A cohort of 5,243 live newborn infants in Haifa was followed to determine hospital admissions during the first two years of life. Parameters of the family and the neonate, routinely available at birth, were collected and studied in order to select those which would identify co-host infants with an increased risk of hospitalization during infancy. A total of 767 cohort children (14.6%) were admitted to hospital. Multivariate analysis showed that many group factors are interrelated and therefore inconsistent. Six single independent factors predisposing to hospital admission could be defined (in order of decreasing significance): increasing birth order, male sex, poor education (up to four years of schooling), birth weight less than 2,250 gm, Jewish mothers born in Asia or Africa, and maternal age up to 24 years. Numerical risk coefficients allocated to each of the above six single (multivariate) factors enabled the calculation of a predicted risk coefficient scoring the risk of admission to hospital. The use of a score predicted 43.3% of the total initial hospitalizations affecting 23.3% of the total cohort. The allocation of health resources might be improved by the use of such a method of scoring to select families in need of special services.

Factors associated with congenital syphilis: A retrospective study in Jiangxi Province, China

2021 ◽  
pp. 095646242110521
Author(s):  
Zhihua Wan ◽  
Yuling Tao ◽  
Huan Zhang ◽  
Yang Hu ◽  
Kuanyong Shu
Keyword(s):  
Regression Analysis ◽  
Retrospective Study ◽  
Pregnant Women ◽  
Congenital Syphilis ◽  
Jiangxi Province ◽  
Multivariable Logistic Regression Analysis ◽  
Syphilis Infection ◽  
Adequate Treatment ◽  
Maternal Characteristics ◽  
Increased Risk

Background There are a lack of studies about factors influencing congenital syphilis (CS) in economically underdeveloped areas, such as Jiangxi Province, China. Methods A retrospective study was conducted based on the information system of prevention of mother-to-child transmission of syphilis management in Jiangxi Province, China. Pregnant women with syphilis infection who delivered ≥28 gestational weeks and registered in this system from 1 January 2013 to 2030 June 2018 were enrolled. Maternal characteristics and treatment regimens associated with CS were evaluated using multivariable regression analysis. Results 1196 syphilis infected mothers and their 1207 infants were included in the analyses, and 116 infants were diagnosed with CS, providing an overall incidence of 9.61% (116/1207). Multivariable logistic regression analysis showed that increasing maternal age was barely associated with the risk of CS (adjusted odds ratio (aOR) = 0.97, 95% CI, 0.93–1.00, p = .047). Women with a high nontreponemal serum test titer (≥1:8) had a 126% increased risk of delivering an infant with CS than those with a low titer (<1:8) (aOR = 2.26, 95% CI, 1.51–3.39, p < .001). The risk for CS decreased significantly in infants born to mothers receiving adequate treatment than those receiving no treatment (aOR = 0.36, 95% CI, 0.21–0.61, p < .001). Conclusions Adequate treatment is critical for the prevention of CS. Further strategies focusing on early diagnosis and adequate treatment among syphilis infected pregnant women, particularly among those with younger age and high nontreponemal titer, should be strengthened to prevent CS.

Stroke in Pregnancy and Puerperium: Validated Incidence Trends With Risk Factor Analysis in Finland 1987–2016

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011990
Author(s):  
Liisa Karjalainen ◽  
Minna Tikkanen ◽  
Kirsi Rantanen ◽  
Karoliina Aarnio ◽  
Aino Korhonen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Postpartum Period ◽  
First Trimester ◽  
Class Iii ◽  
Hypertensive Disorders Of Pregnancy ◽  
Risk Factor Management ◽  
Incidence Trends ◽  
Hypertensive Disorders ◽  
Increased Risk

Objective:To investigate whether previously reported increasing incidence of pregnancy-associated stroke (PAS) is observed in chart-validated register data in Finland. In an exploratory analysis, we studied risk factors for PAS.Methods:We performed a retrospective population-based cohort study and nested case-control study in Finland 1987-2016. The Medical Birth Register (MBR) was linked with the Hospital Discharge Register to identify women with incident stroke (ischemic stroke, cerebral venous thrombosis, intracerebral or subarachnoid hemorrhage) during pregnancy or puerperium. Cases were verified from patient records. Incidence of PAS over the study period, in 5-year age groups and pregnancy/postpartum period were calculated per number of deliveries. Three matched controls were selected for each case from MBR to compare risk factors.Results:After chart review, 29.6% (257/868) of cases were PAS. The incidence of PAS was 14.5 (95%CI: 12.8-16.3) per 100,000 deliveries. Incidence increased from 11.1 to 25.2 per 100,000 deliveries from 1987-1991 to 2012-2016 (p<0.0001). Incidence increased by age from 9.8 to 29.9 per 100,000 deliveries from ages 20-24 to ages >40 (p<0.0001). During early postpartum period, incidence was 5-fold greater compared to the first trimester. Maternal mortality was 6.6%. In the multivariable adjusted model, smoking beyond 12 gestational weeks (odds ratio [OR] 1.8, 95%CI: 1.2-2.7), migraine (OR 16.3, 95%CI: 5.3-49.8), and hypertensive disorders of pregnancy (OR 4.0, 95%CI: 2.5-6.3) were the most important risk factors for PAS.Conclusion:PAS incidence is increasing stressing the importance of careful pregnancy surveillance and risk factor management, particularly in older expectant mothers and extending to puerperium.Classification of Evidence:This study provides Class III evidence that smoking beyond 12 gestational weeks, migraine and hypertensive disorders of pregnancy are associated with an increased risk of PAS.

scholarly journals TO THE QUESTION ON UTERINE FIBROIDS DURING PREGNANCY

2021 ◽  
pp. 54-59
Author(s):  
T. F. TATARCHUK ◽  
N. V. KOSEY ◽  
S. I. REGEDA ◽  
O. V. ZANKO ◽  
K. D. PLAKSIIEVA
Keyword(s):  
Statistical Analysis ◽  
Cesarean Section ◽  
Live Birth ◽  
Uterine Fibroid ◽  
Postpartum Period ◽  
Uterine Fibroids ◽  
Premature Delivery ◽  
Pelvic Ultrasound ◽  
Natural Childbirth ◽  
Increased Risk

Uterine fibroids is an extremely common tumor of the female reproductive system, among whose manifestations are infertility, spontaneous abortions, incorrect fetal position, placenta previa, premature delivery, bleeding during and after delivery, and an increased risk of cesarean section. According to the literature, myomas are changing in size during pregnancy and in the postpartum period. Aim of the study. To assess the dynamics of uterine fibroid size change during pregnancy and the effect of an existing uterine fibroid on the course of pregnancy and labor. Materials and methods. Outpatient records of patients aged 24 to 45 years (mean age 33.36 ± 4.63 years) who were diagnosed with Pregnancy and uterine fibroids from 2016 to 2021 at Verum Medical Center were evaluated (n = 57). The size of the fibroids (volume and diameter) before, during (I or II prenatal screening) and after pregnancy (first pelvic ultrasound after delivery) was used for statistical analysis. Forty-one of the 57 patients had pelvic ultrasound before, during, and after pregnancy and were included in the statistical analysis of changes in uterine myoma size. Results. Among the patients included in the statistical analysis, uterine fibroids increased in volume by 194.38% ± 86.9 (40.98% ± 18.4 in diameter) during pregnancy, and decreased by 53.98% ± 14.93 in diameter and by 54.28% ± 29.62 of baseline in the postpartum period. A significant number of fibroids (39.47%) did undergo involutionary changes and were not visualized in the first postpartum ultrasound. The live birth rate was high at 90% (64% of deliveries were through natural childbirth and 26% through cesarean section). Conclusions. There was no effect of intramural, intramural-subserosal, and subserosal uterine fibroids with an average diameter of £20 mm on pregnancy and live birth in women. A great amount of uterine fibroids nearly triple in size during pregnancy, but after delivery they return to their original size and even halve in size. This can be regarded as a confirmation of the absence of a negative effect of pregnancy, or, possibly, a positive effect on uterine fibroid size, which requires further investigation.

Sign in / Sign up

Export Citation Format

Share Document