scholarly journals Factors associated with maternal postpartum fatigue: an observationalstudy

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025927 ◽  
Author(s):  
Jane Henderson ◽  
Fiona Alderdice ◽  
Maggie Redshaw
Keyword(s):  
Response Rate ◽  
Sleep Problems ◽  
Post Partum ◽  
Secondary Analysis ◽  
Well Being ◽  
Postnatal Period ◽  
Infant Attachment ◽  
Increased Risk ◽  
Experienced Fatigue ◽  
Postpartum Fatigue

ObjectivesTo assess the prevalence of postpartum fatigue at 10 days, 1 month and 3 months, and to describe the sociodemographic and clinical characteristics of women with fatigue and the associations with infant characteristics, maternal–infant attachment, and partner and midwifery support.SettingMaternity care in England. Secondary analysis of 2014 National Maternity Survey.ParticipantsParticipants were a random sample of 10 000 women selected by the Office for National Statistics using birth registration records. Women aged less than 16 years or if their baby had died were excluded. Questionnaires were sent to women at 3 months post partum and asked about well-being and care during pregnancy, labour, birth and post partum. Specifically, women were asked whether they experienced fatigue/severe tiredness at 10 days, 1 month or 3 months post partum. Responses were received from 4578 women (47% response rate).ResultsDecreasing but substantial proportions of women, 38.8%, 27.1% and 11.4%, experienced fatigue/severe tiredness at 10 days, 1 month and 3 months, respectively. These figures varied significantly by maternal age, level of deprivation, education and parity. Women reporting depression, anxiety, sleep problems and those breast feeding were at significantly increased risk (eg, OR for depression in women with fatigue at 3 months: 2.99 (95% CI 2.13 to 4.21)). Significantly more negative language was used by these women to describe their babies, and they perceived their baby as more difficult than average (eg, two or more negative adjectives used by women with fatigue at 3 months: OR 1.86 (95% CI 1.36 to 2.54)). Women with postpartum fatigue had greater partner support but were significantly less likely to report seeing the midwife as much as they wanted.ConclusionsPostpartum fatigue is not inevitable or universal, although early in the postnatal period it affects a substantial proportion of women. Predictors include age and parity, but practical help and support from partners and midwives may be protective factors.

Infant sleep and child mental health: a longitudinal investigation

2020 ◽  
Vol 105 (7) ◽  
pp. 655-660 ◽  
Author(s):  
Fallon Cook ◽  
Laura J Conway ◽  
Rebecca Giallo ◽  
Deirdre Gartland ◽  
Emma Sciberras ◽  
...  
Keyword(s):  
Mental Health ◽  
Diagnostic Criteria ◽  
Emotional Disorders ◽  
Child Mental Health ◽  
Sleep Problems ◽  
Post Partum ◽  
Well Being ◽  
Health Study ◽  
Increased Risk ◽  
Prospective Longitudinal

ObjectiveTo determine whether infants with severe persistent sleep problems are at increased risk of (1) meeting diagnostic criteria for a psychiatric disorder (age 10 years), and (2) having elevated symptoms of mental health difficulties (ages 4 and 10 years), in comparison with infants with settled sleep.Design and settingProspective longitudinal community cohort study—the Maternal Health Study. Mothers completed questionnaires/interviews at 15 weeks' gestation; 3, 6, 9 and 12 months post partum; and when their child turned 4 and 10 years old. Measures included parental report of infant night waking and sleep problems and child mental health (Strengths and Difficulties Questionnaire; Spence Children’s Anxiety Scale; Development and Well-being Assessment).Participants1460 mother-infant dyads.Results283 (19.4%) infants had persistent severe sleep problems, 817 (56.0%) had moderate/fluctuating sleep problems and 360 (24.7%) infants were settled. Infants with persistent severe sleep problems were more likely to report emotional symptoms at age 4 (adjusted odds ratio (AOR)=2.70, 95% CI 1.21 to 6.05, p=0.02), and meet diagnostic criteria for an emotional disorder at age 10 (AOR=2.37, 95% CI 1.05 to 5.36, p=0.04). Infants with persistent severe sleep problems also had elevated symptoms of separation anxiety (AOR=2.44, 95% CI 1.35 to 4.41, p<0.01), fear of physical injury (AOR=2.14, 95% CI 1.09 to 4.18, p=0.03) and overall elevated anxiety (AOR=2.20, 95% CI 1.13 to 4.29, p=0.02) at age 10.ConclusionsInfants with persistent severe sleep problems during the first postnatal year have an increased risk of anxiety problems and emotional disorders at age 10.

scholarly journals Frequency of Non-motor Symptoms in Parkinson's Patients With Motor Fluctuations

2021 ◽  
Vol 12 ◽  
Author(s):  
Mariana Fernandes ◽  
Mariangela Pierantozzi ◽  
Alessandro Stefani ◽  
Carlo Cattaneo ◽  
Erminio A. Bonizzoni ◽  
...  
Keyword(s):  
Sleep Problems ◽  
Psychiatric Symptoms ◽  
Secondary Analysis ◽  
Real Life ◽  
Well Being ◽  
Motor Fluctuations ◽  
Motor Symptoms ◽  
High Prevalence ◽  
Non Motor Symptoms ◽  
Real Life Condition

Background: Non-motor symptoms (NMS), including neuropsychiatric, sleep, autonomic, and sensory domains, are an integral aspect of the clinical presentation of Parkinson disease (PD) and affect neurocognitive functioning as well as patients' and caregivers' well-being.Objective: To describe the occurrence of NMS in PD patients with motor fluctuations in real-life condition.Methods: The present study is a secondary analysis of a previous multinational, multicenter, retrospective-prospective cohort observational study (SYNAPSES). Patients with PD diagnosis and motor fluctuations aged ≥18 years were included. Data collected at the baseline visit were used for this study, and descriptive analyzes were conducted to describe the distribution of NMS in motor-fluctuating PD patients distributed according to different clinical characteristics.Results: Of the 1,610 patients enrolled, 1,589 were included for the analysis (978 males and 611 females), with a mean age of 68.4 (SD = 9.6). Most patients had at least one NMS (88.5%). Sleep problems and psychiatric symptoms were the most prevalent NMS in motor fluctuating PD patients in all H and Y stages. Psychiatric disorders were more frequent in older patients and in patients with a larger number of years of PD diagnosis, while sleep problems were more preeminent in younger patients and with inferior disease duration.Conclusions: The present findings further support the high prevalence of NMS in PD patients with motor fluctuations, thus reinforcing the need for assessing them for diagnostic accuracy and for delivering holistic care.

Flexible Pay but Fixed Expenses: Personal Financial Strain among On-Call Employees

2005 ◽  
Vol 35 (3) ◽  
pp. 499-528 ◽  
Author(s):  
Gunnar Aronsson ◽  
Margareta Dallner ◽  
Tomas Lindh ◽  
Sara Göransson
Keyword(s):  
Sleep Disturbances ◽  
Response Rate ◽  
Well Being ◽  
Financial Strain ◽  
Study Group ◽  
Temporary Employees ◽  
Financial Pressure ◽  
Personal Finances ◽  
Increased Risk ◽  
Poverty And Health

The aim of the study was to investigate the financial circumstances of a group of temporary employees and whether personal financial strain is related to an increased risk of ill-health. The study group consisted of 778 on-call employees. The response rate to a mailed questionnaire was 56 percent. Twenty percent of respondents stated that they had experienced economic difficulties of some kind. More than 50 percent regarded their form of employment as an impediment to obtaining a loan, and approximately 40 percent regarded it as a barrier to acquiring a housing contract. The study group is strongly polarized with regard to personal financial matters. There is a clear connection between poverty and health. Individuals who were both worried about their personal finances and objectively poor had far lower levels of psychological well-being (as measured by GHQ-12), more stomach, back, and neck complaints, more headaches, and greater tiredness and listlessness. Sleep disturbances acted as a mediating variable between financial pressure and stomach problems.

scholarly journals Recovery from work: testing the effects of chronic internal and external workload on health and well-being

2020 ◽  
pp. jech-2019-213367
Author(s):  
Mark Cropley ◽  
Leif W Rydstedt ◽  
David Andersen
Keyword(s):  
Sleep Problems ◽  
Occupational Status ◽  
Well Being ◽  
Physical Fatigue ◽  
Work Related ◽  
Increased Risk ◽  
Gender Education ◽  
High Workload ◽  
Recovery From Work ◽  
Anxiety Depression

BackgroundThe aim of this study was to examine the effects of reduced recovery opportunities on health, associated with chronic internal workload (ie, during work) and external workload (ie, following work).MethodsData from two consecutive surveys (2013 and 2016) from the Norwegian Living Conditions Survey on Work Environment were used. To assess a dose–response association between workload and health, self-reported ratings of internal workload (ie, having too much to do and skipping lunch breaks during work) and external workload (ie, using mobile technology for work-related issues during leisure time) over the two time periods were divided into tertile groups representing low, medium and high workload. Anxiety, depression, physiological and psychological fatigue and sleep were assessed as outcome symptoms.ResultsChronic medium levels of internal workload were associated with psychological fatigue (OR=2.84, 95% CI 1.75 to 4.62) and physical fatigue (OR=1.85, 95% CI 1.31 to 2.63), and high internal workload was associated with psychological fatigue (OR=7.24, 95% CI 4.59 to 11.40), physical fatigue (OR=4.23, 95% CI 3.06 to 5.83) and sleep problems (OR=1.81, 95% CI 1.07 to 3.05). Chronic external high workload was only associated with psychological fatigue (OR=1.67, 95% CI 1.26 to 2.22) and with physical fatigue problems (OR=1.47, 95% CI,1.09–1.98) when the data were adjusted for age, gender, education level, job autonomy and occupational status.ConclusionsThis study emphasises that individuals who chronically experience high workload are at an increased risk for reporting psychological and physical fatigue, and sleep problems.

scholarly journals Acceptability and adherence to a Mediterranean diet in the postnatal period to prevent type 2 diabetes in women with gestational diabetes in the UK: a protocol for a single-arm feasibility study (MERIT)

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050099
Author(s):  
Angeliki Bolou ◽  
Doris Lanz ◽  
Zoe Drymoussi ◽  
Francisco Jose Gonzalez Carreras ◽  
Frances Austin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Mediterranean Diet ◽  
Feasibility Study ◽  
Post Partum ◽  
Action Plan ◽  
Postnatal Period ◽  
South Central ◽  
Increased Risk

IntroductionWomen with gestational diabetes are at increased risk of developing type 2 diabetes later in life. In at-risk general populations, Mediterranean-style diet helps prevent type 2 diabetes. But its effect on postnatal women with a history of gestational diabetes is not known. Prior to a full-scale trial on Mediterranean-style diet in the postnatal period to prevent type 2 diabetes, a feasibility study is required to assess the acceptability of the diet and evaluate the trial processes.Methods and analysisMEditerranean diet for pReventIon of type 2 diabeTes is a single-arm feasibility study (65 women) with qualitative evaluation of women who have recently given birth and had gestational diabetes. The intervention is a Mediterranean-style diet supplemented with nuts and olive oil, with dietary advice and an action plan. A dedicated Health Coach will interact with participants through an interactive lifestyle App. Women will follow the intervention from 6 to 13 weeks post partum until 1 year post partum. The primary outcomes are rates of recruitment, follow-up, adherence and attrition. The secondary outcomes are maternal dysglycaemia, cost and quality of life outcomes, and acceptability of the intervention to participants, and to healthcare professionals delivering the intervention. Feasibility outcomes will be reported using descriptive statistics.Ethics and disseminationEthical approval was obtained through the South Central—Berkshire Research Ethics Committee (19/SC/0064). Study findings will be disseminated via publication in peer-reviewed journals, as well as via newsletters made available to participants and members of Katie’s Team (a women’s health patient and public advisory group).Trial registration numberISRCTN40582975.

scholarly journals An Integrated Mechanistic Model of Mindfulness-Oriented Recovery Enhancement for Opioid-Exposed Mother–Infant Dyads

2021 ◽  
Vol 12 ◽  
Author(s):  
Sarah E. Reese ◽  
Elisabeth Conradt ◽  
Michael R. Riquino ◽  
Eric L. Garland
Keyword(s):  
Behavioral Interventions ◽  
Mechanistic Model ◽  
Well Being ◽  
The United States ◽  
Psychological Research ◽  
Parenting Behavior ◽  
Stress Sensitivity ◽  
Opioid Use ◽  
Infant Attachment ◽  
Increased Risk

A growing body of neurobiological and psychological research sheds light on the mechanisms underlying the development and maintenance of opioid use disorder and its relation to parenting behavior. Perinatal opioid use is associated with risks for women and children, including increased risk of child maltreatment. Drawing from extant data, here we provide an integrated mechanistic model of perinatal opioid use, parenting behavior, infant attachment, and child well-being to inform the development and adaptation of behavioral interventions for opioid-exposed mother–infant dyads. The model posits that recurrent perinatal opioid use may lead to increased stress sensitivity and reward dysregulation for some mothers, resulting in decreased perceived salience of infant cues, disengaged parenting behavior, disrupted infant attachment, and decreased child well-being. We conclude with a discussion of Mindfulness-Oriented Recovery Enhancement as a means of addressing mechanisms undergirding perinatal opioid use, parenting, and attachment, presenting evidence on the efficacy and therapeutic mechanisms of mindfulness. As perinatal opioid use increases in the United States, empirically informed models can be used to guide treatment development research and address this growing concern.

The Role of Sleep Duration and Sleep Problems During Childhood in the Development of ADHD in Adolescence: Findings From a Population-Based Birth Cohort

2019 ◽  
Vol 24 (4) ◽  
pp. 590-600 ◽  
Author(s):  
Marina Xavier Carpena ◽  
Tiago N. Munhoz ◽  
Mariana Otero Xavier ◽  
Luis Augusto Rohde ◽  
Iná S. Santos ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Birth Cohort ◽  
Sleep Duration ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Secondary Analysis ◽  
Well Being ◽  
Population Based ◽  
Early Markers

Objective: We aimed to investigate the association between sleep in early life and ADHD in adolescence. As a secondary analysis, we tested whether the associations may be specific to ADHD. Method: Data from 3,467 participants of the 2004 Pelotas Birth Cohort were used. Information on their sleep duration and problems was collected at 12, 24, and 48 months of age. ADHD diagnosis and hyperactivity/inattention problems were assessed with the Development and Well-Being Assessment (DAWBA) and the Strengths and Difficulties Questionnaire (SDQ) among participants at 11 years of age. Results: Difficulty going to sleep at 24 months, nightmares at 24 months and at 48 months, and restless sleep at 48 months were consistently associated with ADHD as well as with other mental disorders. Conclusion: The results suggest that sleep disturbances may be more important ADHD predictors than sleep duration or sleep duration trajectories. However, it may also be considered early markers of other mental disorders.

scholarly journals Pre-natal Attachment and Parent-To-Infant Attachment: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Tommaso Trombetta ◽  
Maura Giordano ◽  
Fabrizio Santoniccolo ◽  
Laura Vismara ◽  
Anna Maria Della Vedova ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Partum ◽  
Well Being ◽  
Perinatal Period ◽  
Self Report ◽  
Infant Attachment ◽  
Attachment Relationship ◽  
Observational Measures ◽  
Projective Measures ◽  
Different Populations

During the perinatal period, the establishment of the attachment relationship with the fetus and subsequently with the real child is crucial for the parents' and the child's well-being. Coherently with the assumption that the attachment relationship starts to develop during pregnancy, this systematic review aims to analyze and systematize studies focused on the association between pre-natal attachment and parent-to-infant attachment, in order to clarify the emerging results and provide useful information for clinical purposes. Nineteen studies were included. Sixteen researches identified a positive relationship between pre-natal attachment and parent-to-infant attachment, and three articles highlighted a negative association between antenatal attachment and post-partum bonding disorders. These results were found both in women and men, in normative and at-risk pregnancies, adopting different assessment approaches (i.e., self-report measures, observations, and projective measures). However, only small or moderate associations were found. Future studies are needed to further confirm these findings across different populations (e.g., male samples, non-normative samples or samples in disadvantaged conditions) and with different methodological approaches (e.g., observational measures). Moreover, studies would be needed in order to clarify mechanisms through which pre-natal attachment influences parent-to-infant attachment, as well as protective and risk factors which intervene between these two variables.

scholarly journals Paternal and maternal long-term psychological outcomes after uterine artery embolization for severe post-partum hemorrhage

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maude Bernasconi ◽  
Béatrice Eggel-Hort ◽  
Antje Horsch ◽  
Yvan Vial ◽  
Alban Denys ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Uterine Artery Embolization ◽  
Stress Disorder ◽  
Post Partum ◽  
Post Traumatic Stress ◽  
Artery Embolization ◽  
Increased Risk ◽  
Post Traumatic

AbstractThis study intend to compare the long-term psychological impact (depression, post-traumatic stress disorder) on both partners between patients that underwent uterine artery embolization (UAE) for post-partum hemorrhage (PPH) and uneventful deliveries. Women who experienced severe PPH treated by UAE in our institution between 2003 and 2013 were identified in our obstetrical database. These cases were matched to controls with uneventful deliveries. Matching criteria were maternal age, parity, ethnicity, year of delivery, birthweight, gestational age and mode of delivery. Patients and their partners completed validated questionnaires measuring post-traumatic stress (TSQ), as well as depression symptoms (MINI). A total of 63 cases of PPH and 189 matched controls (1:3) participated in a study exploring gynecological and obstetrical outcomes. With a mean of 8 years post-index delivery, patients after PPH showed increased risk of depression (p = 0.015) and post-traumatic stress disorder (22.2% versus 4.8%, p < 0.005) compared to controls. PPH remains strongly associated with post-traumatic stress disorder, even after adjustment for depression (adjusted odds ratio 5.1; 95% confidence intervals 1.5–17.5). Similarly, partners of patients with PPH showed a propensity to depression (p = 0.029) and post-traumatic stress disorder (11.5% versus 1.5%, p = 0.019). In conclusion, both women and their partners are at increased risk of long-term psychological adverse outcomes after PPH. Couples may benefit from psychological support.

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