Neonates in the Intensive Care Unit: Maternal Health-Related Quality of Life and Depression After Term and Preterm Births

Background/Objective: To examine maternal physical and mental health-related quality of life (HRQoL) and depression after early and late preterm and term births in the early postpartum period.Method: In a prospective pilot study, three groups of women whose newborns had to be treated in the neonatal ward during the immediate postpartum period were established and compared with each other: 20 women with extremely to very preterm birth, 20 with moderate to late preterm birth and 20 women with term birth. All participants completed the Short Form-12 Health Survey (SF-12) to measure HRQoL, and the Edinburgh Postnatal Depression Scale (EPDS) to detect depressive symptoms combined with independently developed questions to evaluate anxiety and psychological distress.Results: Maternal psychological HRQoL was significantly worse in the very preterm birth group compared to moderate to late preterm birth (p < 0.001) and full-term birth groups (p = 0.004). There were no differences between the birth groups in depressive symptoms (p = 0.083), anxiety (p = 0.238), perceived stress (p = 0.340) and the general psychological distress values (p = 0.755). In the EPDS, the depression screening instrument 30 to 65% were beyond the cut-off-value to detect major depression.Conclusions: During the early postpartum period, an extensive medical care focussing on acute stress, HRQoL parameters and depression may be a good step to improving maternal well-being.

Assessment of Maternal Macular Pigment Optical Density (MPOD) as a Potential Marker for Dietary Carotenoid Intake during Lactation in Humans

Pregnancy and lactation can change the maternal nutrient reserve. Non-invasive, quantitative markers of maternal nutrient intake could enable personalized dietary recommendations that improve health outcomes in mothers and infants. Macular pigment optical density (MPOD) is a candidate marker, as MPOD values generally reflect carotenoid intake. We evaluated the association of MPOD with dietary and breastmilk carotenoids in postpartum women. MPOD measurements and dietary intake of five carotenoids were obtained from 80 mothers in the first three months postpartum. Breastmilk samples from a subset of mothers were analyzed to determine their nutrient composition. The association between MPOD and dietary or breastmilk carotenoids was quantitatively assessed to better understand the availability and mobilization of carotenoids. Our results showed that dietary α-carotene was positively correlated with MPOD. Of the breastmilk carotenoids, 13-cis-lutein and trans-lutein were correlated with MPOD when controlled for the total lutein in breastmilk. Other carotenoids in breastmilk were not associated with MPOD. Maternal MPOD is positively correlated with dietary intake of α-carotene in the early postpartum period, as well as with the breastmilk content of lutein. MPOD may serve as a potential marker for the intake of carotenoids, especially α-carotene, in mothers in the early postpartum period.

Thoracic aortic aneurysm in pregnancy: morphological analysis of 6 cases

Aortic dissection is rare but life-threatening complication in pregnancy, causing significant maternal and perinatal losses. Pregnancy may influence the integrity of the vessel wall and is a risk factor for dissection. There are very few data in the literature on structural changes in the aortic walls during pregnancy complicated by aortic dissection. Aim. Study of pathological features in the wall of ascending aorta (AA) during or immediately after pregnancy is presented in the article. Materials and methods. Material after surgical correction of AA in patients during pregnancy and in the early postpartum period was studied. Frozen sections were made from one part of the sample, followed by hematoxylin and eosin (H&E) staining, as well as Sudan III–IV staining to detect lipids. Paraffin sections were stained with H&E and picrofuchsin (van Gieson’s stain) for differentiation of collagen and muscle fibers, as well as fuchselin (Weigert’s elastic stain). Results. Six cases of aortic surgery during pregnancy (n = 1) and postpartum period (n = 5) were included: severe aortopathy caused by Marfan syndrome (MS) (n = 3), aortic coarctation with bicuspid aortic valve (n = 1), renal hypertension (n = 1), and pregnancy-induced hypertension (n = 1). Pathohistological studies showed that in all patients who underwent aortic surgery at the end of the third trimester in the early postpartum period changes in aortic wall collagen structure were observed. In contrast, in a pregnant woman with MS and severe aortopathy, who underwent preventive aortic surgery at 19 weeks of gestation, there were no such changes, the morphologic samples showed areas of scarring. In all 6 cases signs of lipoidosis in the AA wall were observed. All these data require further theoretical study, but clinicians are already faced with the question of the feasibility of preventive surgery in women with severe aortopathy on the preconception stage or during pregnancy. Conclusions. The specific effect of pregnancy on the AA wall leads to collagen disruption and the appearance of lipoidosis in late pregnancy, which is an important pathomorphological substrate for the occurrence of acute aortic pathology.

Breastfeeding self-efficacy and related factors during early postpartum period

BACKGROUNDBreastfeeding self-efficacy (BSE) could be an indicator of the performance of mothers in breastfeeding during the immediate postpartum time period. The factor most affecting the duration and success of breastfeeding is the self-efficacy perception of the mothers. This study was carried out to determine the BSE and the factors related to it in the early postpartum period. METHODSA cross-sectional study was performed involving 264 mothers. Data were collected by using a questionnaire and the BSE scale (BSES). The questionnaire consisted of questions regarding descriptive characteristics (age, educational status, family type, income level, etc.) and obstetric characteristics regarding pregnancy, delivery and breastfeeding status (number of pregnancies, number of births, type of delivery, planned and desired pregnancy, birth weight, first breast-feeding time after birth, etc.). Simple and multiple linear regression were performed to examine factors related to BSE. RESULTSThe mean BSE score of the mothers participating in the study was 65.20 ± 9.3. Simple and multiple linear regression models indicated that significant determinants of BSE score include having nuclear family type, having social security, a greater number of pregnancies, a greater number of births, the status of antenatal visits in pregnancy, the status of getting information about breastfeeding, and short first breastfeeding time. Getting information about breastfeeding was the most influential factor of BSE (Beta=3.432; 95% CI : 32.771-51.626; p=0.000). CONCLUSIONSIn this study, getting information about breastfeeding was the most influential factor of BSE in the early postpartum period. A woman's level of breastfeeding self-efficacy should be determined during the early postpartum period.

The effect of kangaroo mother care applied to the healthy newborns in the early postpartum period on breastfeeding: a randomized controlled trial

Objective: This study aims to determine the effect of kangaroo mother care applied to the healthy newborns in the early postpartum period on breastfeeding. Methods: Our research was conducted over the period June 1 - August 25, 2016 at the obstetrics and maternity units in Istanbul. A of 112 healthy newborns and their mothers (56 in the study group and 56 in the control group) were recruited into a randomized controlled experimental study. The newborns in the study group were administered kangaroo mother care for 3 hours after birth while the control group of newborns was cared for using the unit’s standard postpartum procedures. The time the newborns in the study and control groups first started to breastfeed, the number of breastfeeding within the first 24 hours, the duration of their breastfeeding and suckling skills were evaluated. Results: It was found that newborns subjected to kangaroo mother care provided immediately after delivery started suckling at the breast sooner (P = .001), for a longer period (P = .001) and more frequently (P = .001) than the newborns provided with standard post-delivery care. While there was no difference between the groups in terms of initial suckling skills (P = .862), the newborns in the kangaroo mother care group were better at suckling in the 24th hour (P = .001). Continuous...

The value of vaginal lactobacilli in the restoration of vaginal microbiocenosis in women in the early postpartum period, depending on the method of delivery

BACKGROUND: Despite numerous studies of the vaginal microbiota, there is still a lack of knowledge regarding its restoring dynamics in the early postpartum period. The condition of the vaginal microflora during pregnancy plays a key role in maintaining the physiological microbiocenosis of the birth canal and creating conditions for the normal course of pregnancy, the establishment of an infants intestinal microbiota, and the further development of the child. AIM: The aim of this study was to estimate the role of certain types of lactobacilli in restoring the vaginal microbiota in women in the early postpartum period, depending on the method of delivery. MATERIALS AND METHODS: We examined 150 women at 38-41 weeks of gestation. The clinical material for the study was vaginal discharge before and after delivery. To determine the species of lactobacilli and other microorganisms in the clinical material, we used quantitative real-time PCR. RESULTS: Before delivery, lactobacilli were found in vaginal discharge in 144 out of 150 women (96.0%), their number in the majority being more than 106 GE. In the postpartum period, lactobacilli were found in 66/128 (51.5%) cases, while prevailing in women after vaginal delivery in 50/65 (76.9%) cases (4.61.6, p = 0.000000). Among the dominant species of lactobacilli was L. crispatus, found in vaginal discharge before delivery, which most often affects the recovery of the vaginal microbiota in the postpartum period (29 out of 61 women, 47.5%). L. iners detected in the lochia predisposes to the violation of uterine involution in the early postpartum period (p = 0.03). CONCLUSIONS: Normal vaginal microbiota in the postpartum period is restored more quickly in women after vaginal delivery. Our study confirms that L. crispatus and L. iners play a major role in restoring the vaginal microbiota in the postpartum period.