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BackgroundDesignMethodsResultsConclusionMother-infant bonding refers to emotional, cognitive, neurobiological, and behavioural ties between mother and infant. It is a process that develops from pregnancy throughout infancy. Rejection sensitivity could be one of the risk factors for impaired bonding, and it is defined as a personality disposition that is characterised by an anxious expectation of rejection in social situations. It is known that rejection sensitivity is a predictor of problems in relationships, but its association with difficulties in mother-infant bonding is still unknown.This was a three-wave online longitudinal study.In this study, 1052 women participated in the second trimester of pregnancy (T1), 879 of them participated during the third trimester (T2), and 758 of them in the postpartum period (T3; 6–21 weeks). Women completed the Adult Rejection Sensitivity Questionnaire, Prenatal Attachment Inventory, Postpartum Bonding Questionnaire, and Sociodemographic and obstetric data. Mother-infant bonding had three dimensions: Impaired bonding, Anxiety about care and maternal distress, and Lack of enjoyment and affection with the baby.The path analysis was conducted where rejection sensitivity (T1) was the predictor, mother-foetal bonding (T2) mediator, and mother-infant bonding (T3) criterium while parity, education level, and place of living were covariates. Higher rejection sensitivity predicted impaired dimensions of mother-infant bonding in the postpartum directly and indirectly via lower mother-foetal bonding during pregnancy.Women with high rejection sensitivity are at risk for impaired bonding in the peripartum period. Those women should be identified during pregnancy, and special attention should be given to prevent bonding difficulties. [ABSTRACT FROM AUTHOR]

Background: The prevalence of gestational diabetes mellitus (GDM) is rapidly increasing. It is associated with adverse physical and mental health outcomes for women and their babies. Mother-infant bonding is important for maternal health and infant development, but the effect of GDM on mother-infant bonding has not been examined. Objective: To explore and describe the impact of GDM on perceived mother infant-bonding in the antenatal and postnatal period. Methods: Qualitative, individual, semi-structured interviews were conducted with 33 women from diverse backgrounds with current or previous GDM. Data were analysed using reflexive inductive thematic analysis. Results: Three main themes were generated from the analysis: 1) Concern for baby's health and its impact on bonding; 2) GDM management, the pregnancy experience, and bonding; 3) Continuity and discontinuity of the impact on bonding between the antenatal and postnatal periods. Conclusion: It was found that GDM can have both positive and negative impacts on perceived mother-infant bonding, which appear to change over the course of the perinatal period. Further observational research is needed to assist in understanding the impact of GDM on mother-infant bonding and the potential mediating effect of mental disorders, including depression. [ABSTRACT FROM AUTHOR]

AbstractWe previously developed a quantitative weight-of-evidence (QWoE) framework using prespecified scoring criteria for preclinical acetaminophen data to characterize potential developmental neurotoxicity outcomes with considerations for biological relevance of the response to adverse outcomes and the strength of methods and study design. The current analysis uses this framework to characterize potential developmental and reproductive toxicity (DART) outcomes following exposure to acetaminophen. Two-hundred forty-two QWoE entries were documented from in vivo rodent studies identified in 110 publications across five categories: DART endpoints in the context of (1) periadolescent/adulthood (nonpregnancy) exposures; (2) pregnant female exposures; and, for in utero or other developmental exposures, (3) anatomical abnormalities, (4) reproductive development, and (5) other physical development. A mean outcome score and methods score were calculated for 242 QWoE entries. Data analyzed in our framework were of moderate quality showing no consistent evidence of DART in male and female rodents following exposure to acetaminophen at therapeutic and/or non-systemically toxic doses. Similar results were found for the individual context- and outcome-related endpoint analyses and as segregated by sex. Overall, this QWoE analysis on the in vivo rodent data demonstrated no consistent evidence of adverse effects following exposure to therapeutic and/or non-systemically toxic acetaminophen on development or on the structure and function of the reproductive system. [ABSTRACT FROM AUTHOR]

AbstractAcetaminophen [paracetamol; N-acetyl-para-aminophenol (APAP)] is an antipyretic/analgesic commonly used in the treatment of fever and mild to moderate pain, headache, myalgia, and dysmenorrhea. Recent literature has questioned the safety of acetaminophen use during pregnancy, with an emphasis on whether exposure to the developing nervous system results in behavioral changes consistent with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and/or other cognitive deficits in the offspring. No previous review has used a fully detailed, quantitative weight-of-evidence (QWoE) approach to critically examine the preclinical acetaminophen data with regards to potential developmental neurotoxicity (DNT). Following regulatory guidance, a QWoE framework using prespecified scoring criteria was developed consistent with previous approaches to characterize potential adverse DNT outcomes with considerations for biological relevance of the response to adverse outcomes (outcome score) and the strength of methods and study design (methods score). Considerations for the methods score included (1) experimental design, (2) details/reliability of measurement(s), (3) data transparency, and (4) translational/methodological relevance. Considerations for the outcome score included response-related (1) statistical significance, (2) dose-response, (3) relevance/reliability/magnitude, (4) plausibility, and (5) translational relevance, including consideration of systemic toxicity/hepatotoxicity and therapeutic and/or non-systemically toxic doses and durations of use. Application of this QWoE framework to the 34 in vivo studies identified that assess the potential DNT of acetaminophen resulted in 188 QWoE entries documented across 11 DNT endpoints: social behavior, stereotypic behavior, behavioral rigidity, attention/impulsivity, hyperactivity, anxiety-like behavior, sensorimotor function, spatial learning/memory, nonspatial learning/memory, neuroanatomy, and neurotransmission. For each endpoint, the mean outcome score and methods score were calculated for total entries and for entries segregated by sex to assist in determining data quality and potential adversity. Informed by all 188 entries, the QWoE analysis demonstrated data of moderate quality showing no consistent evidence of DNT in male and female rodents following exposure to acetaminophen at therapeutic and/or nonsystemically toxic doses. Although some of the DNT endpoints (behavioral rigidity, attention/impulsivity, spatial learning/memory, neuroanatomy, and neurotransmission) generally displayed a more limited dataset and/or relatively lower data quality, similar conclusions were drawn based on results indicating a lack of biological relevance and reliability of reported adverse effects. Overall, this QWoE analysis on the preclinical in vivo data demonstrates no consistent evidence of adverse effects following developmental exposure to acetaminophen at therapeutic and/or non-systemically toxic doses on the structure and function of the nervous system, including neuroanatomical, neurotransmission, and behavioral endpoints. [ABSTRACT FROM AUTHOR]

Regarding treasures, babies emerge as divine gifts, exuding beauty that transcends words. Their delicate features and tender innocence evoke an indescribable admiration. However, understanding the physiological and biological processes that go into giving birth makes it clear that childbirth is traumatic. But why do women make childbirth and motherhood strolls in the park? Is there a fear, perhaps, that being honest diminishes the beauty of being a mother? Can the two things not be true—that it is traumatic to give birth and beautiful to bring a human being into the world? In romanticizing this process, is society not setting parameters for the shunning and shaming of women who experience problems like post-partum depression or even post-traumatic stress disorder resulting from childbirth? Is the romanticized narrative around childbirth and even motherhood, not a foundation on which shaming women who dare to say "I wanted to die rather than go through the birth" or "I want a break from my child" is built? This qualitative study investigated 64 mothers and would-be mothers in Lagos State about their pregnancy expectations. Mothers, drawn from a mix of socioeconomic ethnic and backgrounds agreed that truths and realities about pregnancy, childbirth, and motherhood are often masked or infrequently discussed in the motherhood narrative. It is also common to hear mothers speak about how great their children are, and rarely can one ever hear women talk about traumas of childbirth that are dangerous and have significant effects or impact on women's quality of life. [ABSTRACT FROM AUTHOR]

In Oman, the risk of maternal depression is not routinely screened for during pregnancy or after childbirth. This study aimed therefore to explore the prevalence of and the association between the risk of antenatal and postnatal depression among Omani mothers, as well as the sociodemographic characteristics of women with increased risk of antenatal depression. A longitudinal study was conducted among 263 Omani pregnant women who were screened for risk of antenatal and postnatal depression, using the Edinburg Postnatal Depression Scale (EPDS). A considerable rate of women had an increased risk of antenatal depression (22.4%), which slightly increased after childbirth. The majority of mothers who had increased risk of depression were housewives (61.0%), had low monthly income (62.7%), had higher education (54.2%), were living in simple family construction (55.9%), were physically inactive (86.4%), and were not using contraception before the current pregnancy (55.9%). Increased risk of antenatal depression was significantly and positively associated with risk of postnatal depression (P < 0.001). The findings of this study highlight the urgent need for standardization of depression screening of all pregnant women in the Sultanate. It also calls for a population-based study to investigate the prevalence of depression in pregnant women and the first year following childbirth. [ABSTRACT FROM AUTHOR]

Little is known about how grandparents influence childcare and mothering practices in developing countries. This is against the backdrop of literature that has documented that when young women become mothers, they receive extensive support and guidance on how to parent their babies from grandparents. This study explored how grandmothers in Lusaka, Zambia, shaped the mothering practices of first-time mothers.The study used an exploratory qualitative descriptive research design. Thirty grandmothers were interviewed independently using a semi-structured interview guide. Results highlighted a wide variation of teachings in the pre-and post-natal phase. At prenatal, Teachings before childbirth was the main theme, with the sub-themes preparing for labor and preserving pregnancy. While at postnatal, teachings after child's birth emerged as the primary theme with sub-themes, caring for the newborn and keeping the baby safe. Grandmother teachings were essential for keeping mother and baby healthy during prenatal and postnatal. Grandmother teachings in both prenatal and postnatal phases were found significant in ensuring the mother and the baby are healthy. These findings underscore the need to involve grandmothers in health programming and interventions to improve maternal and infant health in Zambia. Abbreviations: HIV: Human Immunodeficiency Virus; WHO: World Health Organization. [ABSTRACT FROM AUTHOR]

Background: Myelomeningocele or spina bifida is an open neural tube defect that is characterized by protrusion of the meninges and the spinal cord through a deformity in the vertebral arch and spinous process. Myelomeningocele of post-natal tissue is well described; however, pre-natal tissue of this defect has no known previous histologic characterization. We compared the histology of different forms of pre-natal myelomeningocele and post-natal myelomeningocele tissue obtained via prenatal intrauterine and postnatal surgical repairs. Methods: Pre-and post-natal tissues from spina bifida repair surgeries were obtained from lipomyelomeningocele, myeloschisis, and myelomeningocele spina bifida defects. Tissue samples were processed for H&E and immunohistochemical staining (KRT14 and p63) to assess epidermal and dermal development. Results: Prenatal skin near the defect site develops with normal epidermal, dermal, and adnexal structures. Within the grossly cystic specimens, histology shows highly dense fibrous connective tissue with complete absence of a normal epidermal development with a lack of p63 and KRT14 expression. Conclusion: Tissues harvested from prenatal and postnatal spina bifida repair surgeries appear as normal skin near the defect site. However, cystic tissues consist of highly dense fibrous connective tissue with complete absence of normal epidermal development. [ABSTRACT FROM AUTHOR]

AimsMethodsResultsConclusionTo evaluate the effects of a 5-day residential psychoeducational program on maternal anxiety and fatigue symptoms among women admitted with their unsettled infants and determine the psychological, social and demographic characteristics which are associated with the effect sizes.This is a secondary analysis of routinely collected data from mothers with children aged up to 24 months who were admitted to and completed the residential early parenting psychoeducational program at Masada Private Hospital Early Parenting Centre in Melbourne. Maternal anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale Three-item Anxiety subscale and maternal fatigue symptoms were the Modified Fatigue Assessment Scale at preadmission, predischarge and follow-up 6-weeks post discharge.Overall, 1220 admissions were included in analyses. Cohen’s d for reductions in the anxiety symptoms during the program was 0.64 (95% CI 0.59 to 0.70) and from pre-discharge to post-discharge was 0.14 (95% CI 0.09 to 01.9), and for fatigue was 1.21 (95% CI 1.11 to 1.32). Higher borderline personality disorder symptoms and experiencing more stressful life events were associated with lower mean reductions in anxiety and fatigue symptoms. Women with a history of mental health problems had lower anxiety symptom reductions. Women who were older or had younger babies had lower fatigue score reductions.This study confirms the effectiveness of a 5-day residential early parenting psychoeducational program provided by a private sector facility in reducing postnatal anxiety and fatigue rapidly, with effects maintained to at least 6-weeks post-discharge. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Women in the postpartum period come under multi-level pressure to return to pre-pregnancy body shape and size. This pressure can lead to reduced body image satisfaction, self-esteem, and mood. In this systematic review we explored the influences and outcomes of body dissatisfaction during the postpartum period.Four databases were searched using keywords: postpart* OR postnatal OR peripart* OR ‘new mother’ OR ‘breast feed*’ AND ‘body image’ OR ‘body dissatisf*’ OR ‘body satisf*’ OR ‘body attitude’ OR ‘body shape’.The influences and outcomes of body image dis/satisfaction in the postpartum period from 55 international studies were found to align within four of the five factors of the socioecological model. Intrapersonal factors: weight and body shape concerns, mental health and stressors, attitudes and behaviours, and protective coping skills and interventions. Interpersonal factors: social support (partner, family, and friends) and sexual functioning. Institutional factors: experiences with the healthcare system and returning to work. Societal factors: culture and ethnicity, media influences and social norms such as the thin ideal.A focus on intrapersonal factors alone is insufficient to understand women’s experiences of body dis/satisfaction during the postpartum period. This suggests a need for better education and policy practices in pre-natal and postpartum care directed at body image and education to dispel societal norms such as the thin ideal. Doing so shifts the focus to include interpersonal, institutional, and societal influences alongside intrapersonal experiences. Research is needed to explore the utility and efficacy of broader approaches for women during this vulnerable life period. [ABSTRACT FROM AUTHOR]

This study explores the effects of prenatal and postnatal (until weaning period) arsenic exposure given via pregnant females on Wistar rat neonates. Pregnant female rats were divided in four groups – control, low dose, moderate dose and high dose groups of sodium arsenite exposure during gestation and weaning period. Half of the neonates were sacrificed at day 1 of birth and other half at day 21 of birth. Cell cycle analysis in epidermal keratinocytes using flowcytometer revealed that there was a consistent increase in number of cells in G2/M phase from 0.04% in control group to 0.88%, 1.59% and 2.77% in low, moderate and high dose groups respectively for neonates sacrificed at day-1. Whereas, the increase in number of cells with increasing doses in G2/M phase of neonates sacrificed at day-21 was from 3.44% to 5.1%, 6.82%, and 9.17%. At postnatal day 21, mRNA expression of Cyclin A and B1, p53, Caspases 3, 7 and 9, and Bax were found to be up-regulated. Whereas that of Cyclin E, CDK 1 and 2 and Bcl2 were down regulated consistently in skin tissues of arsenic exposed groups. [ABSTRACT FROM AUTHOR]

Abstract Postnatal women’s physically active leisure experiences can sometimes be inhibited by gendered expectations of motherhood. As a result, participation in leisure, such as community team sport, may be a context for resisting ideologies such as gender and intensive mothering. In this paper, we critically examine postnatal women’s return to community team sport and gendered expectations of motherhood. Using narrative methods, eighteen interviews were conducted with six postnatal women participating in three interviews over a three-month duration. Six creative nonfiction stories were constructed to represent the mothers’ unique, yet shared experiences and their return to community team sport. Emphasis is placed on the complicated relationship between resistance, reproduction, and empowerment as postnatal women encounter the gendered expectations of motherhood. We additionally explored the potential of stories, community, and support as central to the process of resisting gendered expectations. [ABSTRACT FROM AUTHOR]

Despite the well-established role of repetitive negative thinking (RNT) in the prediction and maintenance of depression and anxiety, only minimal research to date has investigated RNT in the context of postnatal psychological adjustment. We examined the relationships between RNT, associated maladaptive cognitive processes, infant responsiveness and psychopathology in a sample of first-time mothers (N = 235) with babies under 12 months. Participants completed an online battery of measures that indexed RNT, dampening of positive affect, metacognitive beliefs about RNT, infant responsiveness, depression and anxiety symptoms. As predicted, RNT was correlated with depression. Controlling for depression, RNT was associated with anxiety, dampening positive affect and positive beliefs about RNT. RNT was inversely related to maternal responsiveness, but this relationship was accounted for by depression. Consistent with findings in the broader literature, RNT was associated with depression, anxiety and other unhelpful cognitive processes in the postnatal period, as well as with poor infant responsiveness. Whilst cross-sectional and preliminary, these data suggest there may be potential clinical utility in targeting RNT in first-time mothers. [ABSTRACT FROM AUTHOR]

Due to a wide range of stressors during the first postpartum year, this study aimed to develop and validate a self-report measure of stress intensity specific for postpartum. Postpartum women (N= 603) completed the Maternal Postpartum Stress Scale in a cross-sectional online study. They also filled out questionnaires on general stress, depression, and anxiety. Factor analysis, reliability, and validity were examined. Exploratory factor analyses revealed a three-factor structure: Personal needs and fatigue , Infant nurturing , and Body changes and sexuality. The reliability of the total scale and all subscales was good. Significant positive correlation with general stress indicated good convergent validity, and with depression and anxiety good divergent validity. Primiparous mothers had a higher score on the Infant nurturing subscale, and the mothers of infants with health problems had a higher score on the total scale, Personal needs and fatigue, and Infant nurturing. Maternal Postpartum Stress Scale is a new, valid, and reliable 22-items scale that measures stress during the first postpartum year. The total scale and tree subscales can be calculated separately to provide detailed information about stressors that mothers struggle with. The scale can be used for research and practical purposes. [ABSTRACT FROM AUTHOR]

New pathways for the management of postpartum voiding dysfunction and postpartum urinary retention should be considered to shorten hospital stays and promote early discharge during the COVID-19 pandemic. This rapid systematic review aimed to identify relevant national and international guidelines, and summarise available recommendations on postpartum bladder care that are relevant to women's care and management at the time of the pandemic. We searched Medline, Embase and Cochrane from inception till September 2021. Hand-searching of national and international specialist societies' websites was performed. We identified one international technical consultation, one international society's report of recommendations and two national guidelines. Guidelines stated that postnatal women should not be left more than 6 hours without voiding and assessed for postpartum urinary retention. As the cut-off of 150 ml for the diagnosis of significant postvoid residual volume is commonly used with no reported adverse outcomes, it could be beneficial to adopt this instead of 100 ml as further unnecessary interventions can be avoided. Such changes can reduce the number of women staying in the hospital. Clean intermittent self-catheterisation for the management of postpartum urinary retention could be considered as an option during the COVID-19 pandemic aiming to shorten hospital stays and avoid further attendances. Optimised bladder care has become more relevant during the coronavirus pandemic by striving towards self-care, community-based and remote care. We propose consideration of intermittent self-catheterisation in cases of postpartum urinary retention enabling self-care and avoidance of hospital visits. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the early neonatal outcomes of cases with foetal ventriculomegaly (VM) and to investigate the aetiological and prognostic factors according to the degree of VM in a single tertiary referring centre. The medical records of 87 foetuses diagnosed with VM (≥10 mm) within 6 years were evaluated. Postnatal evaluation and early neonatal prognosis were determined in 39 cases divided into two groups as mild (10–15 mm, 30 cases) and severe (>15 mm, 9 cases) according to the ventricular size. The mean gestational age at which foetal VM was detected was 22 + 3 weeks. In terms of severity, severe cases of VM were more frequent in terminated pregnancies. There was no difference in gestational age, birth weight, fifth minute Apgar scores, or cord blood gases between mild and severe cases at delivery. Isolated VM was detected in 63% of mild and 22% of severe cases. In severe cases, the need for intensive care and surgery was higher than in mild cases. Antenatal VM regressed in 50% of mild cases and 22% of severe cases. Increasing knowledge about neonatal prognosis, the factors involved in aetiology, and the degree of VM will guide the management of foetal VM. What is already known in this subject? Some cases of foetal VM resolve spontaneously, and postnatal ultrasonography can detect normal ventricle sizes. While 74.6% of isolated VM cases show spontaneous regression, this rate is 52.1% in nonisolated cases. The gestational week at the time of diagnosis, the degree and cause of VM, intrauterine progression and the presence of any genetic, infectious, cerebral, or extracerebral disorders all influence the prognosis. What do the results of this study add? Antenatal VM regressed in 50% of mild cases and 22% of severe cases. In severe cases, the need for intensive care and surgery was higher than in mild cases. The higher frequency of accompanying cerebral findings in severe cases was striking. What are the implications of these findings for clinical practice and/or further research? The current study revealed that isolated VM with ventricular diameter less than 15 mm, after excluding out chromosomal abnormalities and prenatal infections, and no prior history of VM, has a favourable neonatal prognosis in terms of mortality and morbidity. In cases of foetal VM, increased knowledge of neonatal prognosis will guide pregnancy care and postnatal follow-up planning. Prospective multicentre studies on the neonatal period are required to bridge the gap between foetal VM and long-term consequences [ABSTRACT FROM AUTHOR]

To gain an in-depth understanding of the lived experience of women with postnatal depression (PND). Although there is a small body of existing research which explores subjective experience of this phenomenon, relatively little research has been carried out and is prior to the publication of the NICE guidelines for PND in 2007. Semi-structured interviews were carried out with six mothers (aged 23–40 years), who had taken part in a PND support group. Verbatim transcripts were analysed using Interpretative Phenomenological Analysis (IPA). One broad superordinate theme of 'the conflicted mother' emerged from the data, with four corresponding sub-themes (own mother as absent and judgemental; internalised mother; pregnancy on the road to motherhood as an unpleasant stranger; the ideal mother). It is argued that a broad umbrella construct of 'the conflicted mother' exists in PND experience. This study highlights the importance of the mother's own maternal relationship in living with depression. The authors discuss limitations of the study, make service recommendations to improve current clinical practice for women with PND, and provide future research directions. [ABSTRACT FROM AUTHOR]

The transition to parenthood following childbirth can be socially and emotionally significant, impacting on postnatal sexual functioning. This study aimed to conduct a systematic review of the literature on mothers' experiences of sex and sexual intimacy in the first postnatal year, since an early meta-analysis was conducted in 1996. Systematic review strategies of nine databases were conducted to identify relevant literature. Electronic databases were searched for English language, peer-reviewed literature using search terms relating to 'sex', 'intimacy', 'postnatal', 'experience', and 'twelve months' and their quality was systematically assessed. Thirteen studies meeting the criteria were included. Women typically resumed sexual intercourse during the early postnatal weeks when the prevalence of sexual health problems was high. Women experienced significantly more sexual problems, such as pain and dyspareunia following perineal trauma, yet sexual functioning changes or problems were rarely explored by healthcare professionals. Consistent with earlier reviews, this review demonstrated the lack of focus on all aspects of sexual intimacy post-natally. The prevalence of postnatal sexual problems following perineal trauma highlights the need for interventions aimed at supporting these women, including healthcare professionals providing information, and having discussions with women regarding postnatal sexual changes and possible problems. [ABSTRACT FROM AUTHOR]

Objective: The aim of this qualitative research study was to explore how new/recent mothers experience intrusive, infant-related harm thoughts (IRHTs). Background: New/recent mothers' experiences of IRHTs remain a taboo topic, yet several studies indicate such thoughts are common. Understanding the normal experience of such thoughts is needed to improve the postpartum experiences of mothers, and clinical practice. The aim was to elicit a fuller, critical understanding of the experience of harm thoughts in a mixed, non-clinical sample, exploring how they are understood, managed and shared by women. Methods: Semi-structured interviews were conducted with eight new/recent mothers who had experienced IRHTs related to their youngest child, born within the last two years. Data were analysed with Thematic Analysis. Findings: The results yielded three core themes: Heightened emotions; Constructions of motherhood and maternal identity; Costs and benefits of sharing. Conclusion: Findings corroborate previous literature showing that IRHTs commonly occur among non-clinical postpartum mothers, highlighting their intense emotional impact, and barriers to women reporting them due to stigma. Results also highlighted ways in which the pervasive ideology of motherhood informed mothers' meaning-making of IRHTs. Recommendations include discussing the ideology of motherhood with pregnant women and partners and facilitating open, normalising discussion of IRHTs. [ABSTRACT FROM AUTHOR]

Experimental studies indicate that perinatal light may imprint the circadian timing system, subsequently affect later life physiology, and possibly disease risk. We combined individual time-of-year of birth and corresponding latitude to determine perinatal photoperiod characteristics for UK Biobank participants (n = 460,761) and tested for associations with diabetes mellitus (DM, the pathophysiology of which is often linked with circadian disruption) and chronotype (a trait co-governed by the circadian timing system) prevalence in a cross-sectional investigation. The UK Biobank is a population-based cohort with a 5.5% participation rate (~9.2 million individuals were invited into the study between 2006 and 2010). We defined three groups based on photoperiods experienced in the 3rd trimester of pregnancy and first 3 months post-birth time windows: (1) those who exclusively experienced non-extreme photoperiods (NEP, 8–16 hours), (2) those who experienced at least one extreme short photoperiod (ESP, <8 hours), and those who experienced at least one extreme long photoperiod (ELP, >16 hours). For individuals in each group and time window, mean daily photoperiod and relative photoperiod range (relative = relative to the mean) were calculated. Inclusion of relative photoperiod range adds dispersion information (relative change of photoperiods) to statistical models. Multivariable and multinomial logistic regression analyses were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Increased 3rd trimester relative range was associated with decreased odds of DM (OR 0.63 95%CI 0.49–0.81) in the NEP group, but increased odds of DM were detected for the ESP (OR 1.34, 95%CI 0.96–1.86) and ELP groups (OR 1.32, 95%CI 0.78–2.22). Increased 3rd trimester relative range was associated with increased odds of being a "Morning" (OR 1.20, 95%CI 1.02–1.41) or "Evening" (OR 1.43, 95%CI 1.21–1.69) chronotype in the NEP group, but this was not observed in other groups. Additionally, different effect sizes and directions of association with DM were observed in different strata of ethnicity and chronotype and statistically significant odds ratio modifications were detected. In conclusion, perinatal photoperiod associations with DM and chronotype prevalence are detected in the UK Biobank. NEP, ESP, and ELP differences are speculated to be caused by a non-linear dose-response to photoperiods from 0–24 hours or by confounding due to artificial light playing a dominant role in ESP individuals and seeking darkness in ELP individuals. Ethnicity and chronotype may be important effect modifiers of perinatal photoperiod associations with DM. Potential for selection biases due to low UK Biobank participation rate disallows stating conclusions too strongly. Overall, further studies are needed to confirm different perinatal photoperiod associations with DM and chronotype. Further investigations into the hypothesized imprinting mechanism are also warranted. [ABSTRACT FROM AUTHOR]

Objective: The aim of this prospective observational study was to establish a suitable model for the postnatal follow-up and management of prenatal renal and urinary tract anomalies in Shanghai, China.Methods: Minhang and Changning maternal child health care hospitals were selected to establish the integrated management model. Newborns with prenatal renal and urinary tract anomalies in these two centers were eligible to participate in the study from 2015 to 2017. All newborns were classified into three groups based on prenatal findings: (1) severe/complex urinary tract dilatation (UTD) with ureterectasia, (2) other renal and urinary tract abnormalities, and (3) isolated mild to moderate UTD. The newborns underwent their first postnatal ultrasound and follow-up according to the presumed management strategy. Demographic and clinical data were collected from all institutes.Results: A total of 129 newborns fulfilled the study criteria, and 121 completed the postnatal evaluation. Ten newborns in group 1 (n = 13) were diagnosed with obstructive uropathy, including 9 with ureteropelvic junction obstruction (UPJO) and one with megaureter. All 13 newborns in group 2 had consistent postnatal results and were followed under previously established procedures. Sixty-seven cases in group 3 (n = 95) had a UTD at their first scan at 42 postnatal days, and two were diagnosed with UPJO. A total of 2 infants with UPJO underwent surgery, and 71 (65.7%, 71/108) of the UTD cases were resolved.Conclusions: The majority of the patients had a favorable outcome. Close multidisciplinary collaboration among obstetricians, neonatologists, pediatricians, and pediatric nephrologists and urologists is mandatory. [ABSTRACT FROM AUTHOR]

To evaluate the association of environmental tobacco smoke (ETS) exposure with hypertension and blood pressure (BP) in children, a sample of 9,354 children, aged 5–17 years, was studied from seven northeastern cities of China in 2012–2013. The results showesd that significant associations were observed for hypertension with ETS exposure in utero [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.18–1.57], with current major ETS exposure from fathers (1.38, 1.21–1.57) or anyone (1.26, 1.12–1.42), and with intensity of ETS exposure greater than 1 cigarette per day (ORs ranged from 1.20 to 1.35). For SBP, significant associations were only observed in children with major ETS exposure from father and with cigarettes smoking >10/day. When stratified by sex, more significant associations were found in girls than in boys. In conclusion, prenatal and postnatal ETS exposure was significantly associated with increased odds of hypertension in children, especially in girls. [ABSTRACT FROM AUTHOR]

Objective: To identify factors associated with parental pre- and postnatal attachment to a child. Background: Establishing a relationship with a child is one of the most important parental tasks during pregnancy. Studies examining the determinants of parental attachment have focused mostly on mothers and prenatal period. Methods: Couples awaiting their first child were recruited for a prospective study, with the first stage (3rd trimester of pregnancy) and the second (after delivery). Mothers and fathers completed questionnaires: MAAS/PAAS, MPAS/PPAS by Condon; KPR-Roc M/O by Plopa; EPDS by Cox et al. and the PRAM by Vreeswijk et al. Results: The most important factors for prenatal maternal attachment included depressiveness, an accepting mother's attitude and the partner's relationship; whereas postpartum depressiveness and prenatal maternal attachment were important for postnatal maternal attachment. For men, partner's depressiveness, an inconsistent and over-protecting mother's attitude and a declaration of attendance at birth predicted their relationship with the child during pregnancy, and prenatal paternal attachment for the period after childbirth. Conclusions: The determinants of parental attachment to a child differ for men and women. The most important prenatally are depressiveness, attitudes of their own parents recorded from childhood, while prenatal attachment to a child is most significant postnatally. [ABSTRACT FROM AUTHOR]

Objectives: To establish which Social Cognitive Theory constructs mediated effects of the MobileMums (MMP) program on increased duration and frequency of moderate-vigorous physical activity (MVPA) in women with young children (<5 years). Methods: This secondary data analysis is from a community-based randomised controlled trial. Over 12 weeks, intervention participants received a minimum of 52 individually tailored text messages, one face-to-face and one telephone-delivered session with a trained behavioural counsellor. Participants identified a support person who also received 12 weeks of individually tailored text messages. Control participants received minimal intervention contact. Data were collected pre- and post-program. Five potential mediators were assessed: barrier self-efficacy, goal setting skills, outcome expectancies, perceived environmental opportunity for physical activity and social support for physical activity. Results: Improvements in MVPA frequency were mediated by improvements in barrier self-efficacy, goal setting skills, outcome expectancies and perceived social support. Improvements in MVPA duration resulting from the MMP were mediated by improvements in women's barrier self-efficacy and goal setting skills. Conclusions: MMP improved targeted theoretical constructs and this led to changes in women's MVPA. These findings are valuable for refinement and translation of the MMP and for further research to create theory- and evidence-based physical activity behaviour change programs for women with young children. [ABSTRACT FROM AUTHOR]

Our study evaluated factors associated with ill-health in a population-based longitudinal study of women who delivered a singleton live-born baby in a 3-month period across Jamaica. Socio-demographics, perception of health, chronic illnesses, frequency and reasons for hospital admission were assessed. Relationships between ill-health and maternal characteristics were estimated using log-normal regression analysis. Of 9,742 women interviewed at birth, 1,311 were assessed at four stages, 27.7% of whom reported ill-health at least once. Hospitalization rates were 20.9% during pregnancy, 6.1% up to 12 months and 0.5% up to 22 months after childbirth. Ill-health, reported by 11% of women, was less likely with better education (RR=0.62, 95%; 0.42-0.84). Hospital admission was associated with higher socio-economic status (RR=1.33, 95% 1.04-1.70) and Caesarean section [CS] (RR=1.57, 95%; 1.21-2.04). One in three (33.7%) women reported chronic illnesses, and the likelihood increased with age, parity and delivery by elective CS (RR=1.44, 95%; 1.20-1.73). In multivariable analyses, ill-health was more likely with chronic illness (RR=2.06, 95%; CI: 1.71-2.48) and hospital admission from 12 to 22 months after childbirth (RR=1.54, 95% CI: 1.12-2.12). Ill-health during pregnancy and after childbirth represent a significant burden of disease and requires a standardised comprehensive approach to measuring and addressing this disease burden. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether evaluations of antenatal umbilical coiling index (aUCI) could predict postnatal umbilical coiling index (UCI) (pUCI) in people with gestational diabetes mellitus (GDM) compared with normal pregnancy independent of maternal demographic and reproductive characteristics.Method: In this prospective study, 105 women with normal pregnancy, and 117 women with pregnancy complicated by GDM were recruited. Ultrasound scan of umbilical cord was performed at 18-23 and 37-41 weeks of gestation (WG). Evaluation of pUCI, as the reference standard, was performed within 24 hours after delivery.Findings: There was no significant relationship between aUCI and maternal demographic and reproductive characteristics. The mean for pUCI was 0.21 ± 0.12 in the GDM group, and 0.21 ± 0.09 in the normal pregnancy (p = .61). In the GDM group, a significant association was found between aUCI and pUCI categories (p = .004). The area under curve (AUC) was less than 0.5 for hypocoiling in both groups. For hypercoiling it was 0.84 ± 0.04 in the GDM group and 0.75 ± 0.06 in the normal pregnancy group (18-23 WG). In the GDM group the cutoff points that predict hypercoiling were 0.28 (18-23WG), and 0.21 (37-41WG). These were 0.35 (18-23WG), and 0.33 (37-41WG) in the normal pregnancy group. Diagnostic accuracy analysis revealed that in the GDM group, the sensitivity and specificity of hypercoiling for prediction of pUCI were 0.94 and 0.70 respectively at 18-23 WG.Conclusions: Antenatal hypercoiling at the second trimester of pregnancy strongly predict postnatal hypercoiling in pregnancies complicated by GDM. [ABSTRACT FROM AUTHOR]

Breastfeeding rates in the UK remain persistently low, with a rapid fall off during the first 6–8 weeks. The work of healthcare and public health practitioners impacts on mothers' experiences of infant feeding. Support, promotion and protection of breastfeeding are a national priority. Semi-structured qualitative interviews were undertaken with mothers who had experience of breastfeeding. Participants were engaged with a local Children's Centre (indicating engagement with public health provision) and their babies were up to 6-month old (to increase recall of early experiences). Twenty-four participants were recruited and interviews thematically analysed. Mothers identified matters significant in relation to public health provision for breastfeeding, including three stages of time of significance for breastfeeding impact. These interlinked critical stages impact on a mother's experiences. Joined up public health practice providing breastfeeding support and information before birth, around the time of the birth, and once home is significant in mother's accounts. Breastfeeding support, in both healthcare and public health contexts, needs to be highly attuned to different stages in the experiences of mothers. Breastfeeding continuation is influenced by support experienced antenatally, perinatally, and in early weeks. To enhance the initiation and retention of breastfeeding, public health practice must pay attention to these stages. Breastfeeding support needs to begin prior to birth and be given throughout the postnatal period and beyond. [ABSTRACT FROM AUTHOR]

Depression is the most common perinatal psychiatric disorder, but little is known about how it may impact offspring neurodevelopment, as well as the mechanisms by which it may confer transgenerational psychiatric risk. This review presents imaging studies conducted to evaluate the relationship between perinatal depression (PND) and infant and child neurodevelopment. Altered structural and functional connectivity is implicated in children exposed to PND and anxiety. Overall, there are changes in connectivity between amygdala and the prefrontal cortex. Studies suggest decreased hippocampal growth in the first 6 months after birth, decreased cortical thickness in children, and increased amygdala volumes, that are more pronounced in female offspring. Future research is needed to understand the impact of PND on development so that early interventions which promote mother–infant bonding and cognitive development may improve developmental outcomes in children exposed to PND, reducing later risk of psychopathology. [ABSTRACT FROM AUTHOR]

The possible intake of folate in excess of the recommended upper levels is a matter of critical importance. This study was conducted to investigate the effects of prenatal and postnatal high folic acid supplementation (FAS) on glucose tolerance, insulin sensitivity, lipid metabolism, and expression of adiponectin in rats. The study included 20 female rats divided into two groups: control group and FAS group (receiving high folic acid supplemented diet). Both groups of female rats were mated and pregnancy confirmed. At parturition, the diet of 5 dams that were fed with control diet during gestation and their litters was changed to FAS diet and continued throughout lactation. Similarly, half of the dams that were previously fed with FAS diet during gestation and their litters were also changed to control diet. The remaining 5 dams in each group continued on their respective diets throughout lactation with their litters. Other dams remained on their respective diets throughout lactation. Food and water intake, body weight, lipid concentrations, insulin, and the expression of adiponectin were determined. Glucose tolerance and insulin sensitivity were also measured to evaluate glucose homeostasis. FAS significantly increased the postweaning food, water intake, triglyceride, and insulin levels but diminished insulin sensitivity in adult offspring. The expression of adiponectin in insulin-sensitive tissues was also significantly decreased and these were consistent with insulin resistance of FAS offspring. High-dose FAS may promote insulin resistance and dyslipidemia and disrupt glucose metabolism possibly by depressing adiponectin expression. Although this is an animal model and the effects of the diets cannot be directly transposed to humans, this study provides indications of the possible adverse effects of FAS maternal diet on glucose metabolism in the offspring. [ABSTRACT FROM AUTHOR]

Purpose: Photoreceptors in the mouse retina express much of the molecular machinery necessary for phototransduction and glutamatergic transmission prior to eye opening at postnatal day 13 (P13). Light responses have been observed collectively from rod and cone photoreceptors via electroretinogram recordings as early as P13 in mouse, and the responses are known to become more robust with maturation, reaching a mature state by P30. Photocurrents from single rod outer segments have been recorded at P12, but no earlier, and similar studies on cone photoreceptors have been done, but only in the adult mouse retina. In this study, we wanted to document the earliest time point in which outer retinal photoreceptors in the mouse retina begin to respond to mid-wavelength light. Methods: Ex-vivo electroretinogram recordings were made from isolated mouse retinae at P7, P8, P9, P10, and P30 at seven different flash energies (561 nm). The a-wave was pharmacologically isolated and measured at each developmental time point across all flash energies. Results: Outer-retinal photoreceptors generated a detectable response to mid-wavelength light as early as P8, but only at photopic flash energies. a-wave intensity response curves and kinetic response properties are similar to the mature retina as early as P10. Conclusion: These data represent the earliest recorded outer retinal light responses in the rodent. Photoreceptors are electrically functional and photoresponsive prior to eye opening, and much earlier than previously thought. Prior to eye opening, critical developmental processes occur that have been thought to be independent of outer retinal photic modulation. However, these data suggest light acting through outer-retinal photoreceptors has the potential to shape these critical developmental processes. [ABSTRACT FROM AUTHOR]

This study examined multilevel factors related to postnatal checkups for mothers in selected West African countries. The study analyzed data from Demographic and Health Surveys (DHS) for five West African countries: Sierra Leone (2013), Cote d’Ivoire (2012), Guinea (2012), Niger (2012), and Liberia (2013). The weighted sample sizes were 2125 (Cote d’Ivoire), 2908 (Guinea), 1905 (Liberia), 5660 (Niger), and 3754 (Sierra Leone). The outcome variable was maternal postnatal checkups. The explanatory variables were community and individual/household characteristics. With the use of Stata 12, the chi-square statistic and multilevel mixed-effects logistic regression were applied. More than two-thirds of respondents in Guinea and Niger did not receive a postnatal checkup after their last birth, while in Cote d’Ivoire, Liberia, and Sierra Leone, more than half of respondents received a postnatal checkup after their last childbirth. Community characteristics accounted for the following variations in postnatal checkups: 33.9% (Cote d’Ivoire), 37.2% (Guinea), 27.0% (Liberia), 33.5% (Niger), and 37.2% (Sierra Leone). Community factors thus had important relations to use of postnatal care in West Africa. Interventions targeting more community variables, particularly community education and poverty, may further improve postnatal care in West Africa. [ABSTRACT FROM PUBLISHER]

Background: Postpartum contraception is especially important for women who use alcohol and other substances, given the risk of possible rapid repeat pregnancy and prenatal substance exposure. However, little is known about postpartum contraceptive use among women with substance use histories. Objective: To characterize postpartum contraceptive initiation, 24-month continuation, and rapid repeat pregnancy among women who used substances during pregnancy. Methods: This is a secondary analysis of 161 pregnant women who enrolled in a randomized clinical trial to treat substance use in pregnancy and completed at least one follow-up assessment. Women were eligible if they were less than 28 weeks gestation and reported alcohol or illicit drug use within the past 30 days. Participants were recruited from two hospital-based OB/GYN clinics between 2006 and 2010, and completed assessments at delivery and 3-, 12-, and 24-months postpartum. Results: Past 30-day use of any substance (not including tobacco) was 52.4%, 58.3%, and 59.8% at 3-, 12-, and 24-month follow-up, respectively. Marijuana was the most commonly reported illicit substance (as high as 48.1%). Rates of any contraceptive use were 71.3%, 66.7% and 65.3% at 3-, 12-, and 24-month follow-up, respectively; DepoProvera and condoms were the most common methods. Rapid repeat pregnancy occurred in 28% of participants by 24-month follow-up. Conclusions/Importance: Postpartum contraceptive use among substance using women was at or near 70%, which is comparable to other samples of postpartum women. Innovative efforts are needed to promote effective contraceptive use among postpartum women in general and among those who use substances in particular. [ABSTRACT FROM AUTHOR]

HIV-related conditions are one of the indirect causes of maternal deaths in Zimbabwe and the prevalence rate was estimated to be 13.63% in 2009. The study utilised a descriptive correlational design on 80 pregnant women who were HIV positive at Mbuya Nehanda maternity hospital in Harare, Zimbabwe. Participants comprised a random sample of 80 postnatal mothers. Permission to carry out the study was obtained from the respective review boards. Participants signed an informed consent. Data were collected using a structured questionnaire and record review from 1 to 20 March 2012. Interviews were done in a private room and code numbers were used to identify the participants. Completed questionnaires were kept in a lockable cupboard and the researcher had sole access to them. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 12. Descriptive statistics were used to analyse data on demographics, maternal health outcomes and self-care practices. Inferential statistics (Pearson’s correlation and regression analysis) were used to analyse the relationship between self-care practices and maternal health outcomes. Self-care practices were good with a mean score of 8 out of 16. Majority (71.3%) fell within the good category. Maternal outcomes were poor with a mean score of 28 out of 62 and 67.5% falling in the poor category. Pearson’s correlation indicated a weak significant positive relationship (r = .317, p = <.01). Regression analysis (R2) was .10 implying that self-care practices explained 10% of the variance observed in maternal health outcomes. More research needs to be carried out to identify other variables affecting maternal outcomes in HIV-positive pregnant women. [ABSTRACT FROM AUTHOR]

This article suggests that transactional analysis can be an effective treatment approach for women suffering from mental health conditions and the emotional and life disturbances that may occur during the perinatal period. It offers a brief introduction to perinatal psychological distress followed by a description of the use of transactional analysis psychotherapy for this condition. The article outlines a new model for a research project that aims to ascertain women's views on the helpfulness of the treatment and to gain a better understanding of the stigma often associated with perinatal mental health issues. The author argues for the necessity of qualitative research to assess the efficacy of transactional-analysis-based treatment and to increase our knowledge about the change process in transactional analysis psychotherapy with this client population as well as to inform future transactional analysis treatment protocols. [ABSTRACT FROM AUTHOR]

Introduction: Adequate antenatal counseling combined with postnatal lactation support is likely to improve exclusive breastfeeding rates.Objective: To assess the impact of a postnatal video based health education program in promoting exclusive breastfeeding among primiparous mothers.Methods: This interventional study was done in a tertiary care teaching hospital, south India. Primiparous mothers in one postnatal ward (group A) received routine lactation counseling. A similar group of primiparous mothers in another postnatal ward (group B) were administered a video based health education program on exclusive breastfeeding in the local language Tamil in addition to the routine lactation counseling. The exclusive breastfeeding rates of these two groups of mothers were compared. Their knowledge and perceptions after intervention were also compared using a pretested questionnaire.Results: Among 878 primiparous mothers, 94% fed colostrum and 43% initiated breastfeeding within one hour of delivery. Correct attachment was noted with 96% and 13% had lactation issues. Group B had marginally better exclusive breastfeeding rate at six months but not statistically significant. Mothers in group B had a statistically significant better knowledge score post-intervention compared to those in Group A. Use of gripe water was more in group A compared to group B.Conclusion: The video based health education program when combined with routine lactation counseling improved the knowledge regarding exclusive breastfeeding among postnatal primiparous mothers better than with routine lactation counseling alone. However, both interventions had similar effect on exclusive breastfeeding rate at six months. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to explore the accuracy and performance of a new transcutaneous bilirubinometer (TCB) for the screening of jaundice in late preterm and term infants.Methods: A cross-sectional study was conducted. TCB measurements were performed using the BiliCare(TM) bilirubinometer. Paired TCB and serum bilirubin (SB) measurements were analysed.Results: One hundred and fourteen paired samples were collected from 93 healthy late preterm and term infants. Bilirubin measurements were done at median (interquartile range) of 50.5 (34, 72) hours. The mean (SD) difference between the TCB and SB was 1.87 (1.98) mg/dL. A TCB cut-off level at 8.0 mg/dL provides a sensitivity of 97.3% with a negative predictive value (NPV) of 87.5% to detect a SB level of at least 8.0 mg/dL. For SB levels of at least 10.0 mg/dL, a TCB cut-off at 9.0 mg/dL shows a sensitivity of 97.5%; NPV 95.4%. For a SB level of at least 13.0 mg/dL, a TCB cut-off at 12 or 13 mg/dL had a sensitivity of 92.9% and NPV of 98.7%.Conclusion: The BiliCare(TM) demonstrated good performance with positive bias for the screening of jaundice in healthy late preterm or term infants. However, if adopted, proper cut-off levels should be chosen because of sub-optimal device precision. [ABSTRACT FROM AUTHOR]

Objective:The project aimed to test of the quality and acceptability of researcher-developed Short Message Service (SMS) messages designed to support fathers of infants aged 12 months or less.Background:The findings of previous studies suggest antenatal and postnatal depression among fathers’ impacts negatively on the health of family members.Method:Draft messages were first modified based on expert review. In a second phase, parents (mothersn = 56; fathersn = 46; unknownn = 4) were recruited through two early childhood parenting services to rate the clarity, usefulness and relevance of the 70 SMS messages using a paper-based survey. In a third phase, 15 fathers were recruited to receive texts at different times over three weeks.Results:Findings suggest that SMS items were easily understood by the majority of parents, with only 3% of responses indicating an item was ‘not easily understood’. Feedback from parents indicated that negatively rated SMS messages were considered as either poorly phrased, lacking enough information or as not offering sufficient support. The majority (88%) of the SMS items were also rated as ‘useful’ by the parents.Conclusion:Fathers’ responses indicated that receiving the texts at different times was acceptable and that message content was relevant to their fathering. The study has produced a set of brief text messages suitable and acceptable to new fathers and their partners. [ABSTRACT FROM PUBLISHER]

Objective(s): To describe the complications, and their incidence, associated with the management and delivery of a distinct second-trimester miscarriage cohort.Methods: A retrospective cohort study was undertaken in a large, tertiary-referral university hospital (8500 deliveries per annum). All cases of pregnancy loss occurring between 14(+0) and 23(+6) were identified from July 2009 to June 2013 (n = 181). Medical notes were reviewed and the number of complications among this cohort was identified. Logistic regression was conducted to assess associations with clinical presentation and management.Results: The mean gestation of loss was 18(+2) weeks (SD: 2(+2)). 64.6% (n = 117) of the total losses were of intrauterine fetal demise (IUFD) with 17.7% (n = 32) following preterm premature rupture of membranes (PPROM) and 17.7% (n = 32) following preterm labour (PTL). All women required inpatient admission with 59.1% (n = 107) undergoing medical induction of labour. PPROM cases, compared with cases of IUFD, had increased odds of requiring antibiotic therapy (OR 13.75, 95% CI: 4.88-38.72) and readmission (OR OR 4.15, 95% CI 1.12-15.36).Conclusion: These women represent a small proportion of the obstetric population but remain a distinct cohort whose management is complicated by high rates of morbidity requiring medical intervention. An awareness of these risks should inform future clinical practice. [ABSTRACT FROM AUTHOR]

Aim: Preterm infants are often significantly underweight at the time of hospital discharge. Growth impairment during early infancy can have permanent detrimental effects. We aimed to evaluate the incidence and risk factors of postnatal growth restriction (PNGR) in preterm infants. Methods: This prospective study included 124 preterm infants in neonatal intensive care unit between January 2015 and June 2016. Results: Of 140 preterm infants screened, postnatal growth retardation was detected in 46 babies (37%). Low gestational age was independent risk factors for PNGR. Conclusion: Clinicians should be aware of the presence of this morbidity when caring for preterm infants and to provide optimal enteral nutrition. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate postnatal outcomes in fetuses with gastroschisis.Methods: This is a retrospective study (2009-2013) of patients with gastroschisis at the Hospital São Paulo (Federal University of São Paulo, Brazil).Results: A total of 44 infants with gastroschisis were examined. The mean maternal age was 21.1 years and mean gestational age at delivery was 36.1 weeks. Delivery occurred before 34 weeks in 13.6%, between 34 and 36 weeks and 6 d in 40.9%, and after 37 weeks in 45.5%. The mean birth weight was 2349 g, with 37.2% small-for-gestational age infants. The mean umbilical cord blood pH was 7.32. Bowel resection and delayed fascial closure was performed in 14.6% and 19.5%, respectively. The mean hospitalization time in the neonatal intensive care unit was 52.7 d. Neonatal infection was detected in 52.4%, with a positive blood culture; 77.3% of those cases were coagulase negative staphylococci. The overall rate of mortality was 25%; 18.2% before birth, 45.4% during the neonatal period, and 36.4% in infants. The main cause of postnatal death was septicemia (55.5%).Conclusions: Despite advances in perinatal care and surgical techniques, infants with gastroschisis still present high rates of complications and death. [ABSTRACT FROM AUTHOR]

Prescription of postnatal thromboprophylaxis has increased with the Royal College of Obstetricians and Gynaecologists and the National Institute for Health and Care Excellence guidance. Our study of postnatal women meeting the criteria for thromboprophylaxis aimed to ascertain compliance with low-molecular-weight heparin and barriers to completion of a full course. Women were recruited from the antenatal clinic or postnatal wards. Those who agreed were contacted by telephone 14 days after delivery and asked about their compliance with and experience of thromboprophylaxis. 111 women were followed up. We found reported compliance with postnatal thromboprophylaxis to be high (83% taking the full course); most women self-injected (54%) but a significant number relied on family members (39%). Most would be prepared to take the course in a future pregnancy (94%); however, some felt that they needed more information. Reported compliance with postnatal thromboprophylaxis is high. This may be down to the motivation of the new mother, appropriate information giving and access to health care professionals for advice. [ABSTRACT FROM AUTHOR]

Objectives: To determine the magnitude and type of naturally occuring physical activity changes in women around the time of pregnancy. Background: This systematic review synthesises the results of studies examining naturally occurring physical activity in women before they become pregnant and the magnitude and type of changes during pregnancy and the postnatal period. Methods: Electronic databases were searched for relevant articles and PRISMA guidelines for selection of articles were used. Only studies examining naturally occurring, non-intervention changes in regular activity levels were included. The quality assessment was based on protocols of the Cochrane Database of Systematic Reviews. Of the initial 720 titles, 24 studies met the inclusion criteria and were included in the final review. Results: Compared to pre-pregnancy, the magnitude of physical activity decreased over the course of pregnancy and postnatally and the types of activities tended to be of lesser intensity than pre-pregnancy. The quality of the research was varied; methodological limitations included using subjective methods of assessment of physical activity (9/24), failing to report reliabilities or validity of measures used (8/24), no information on parity (13/24) or level of fitness prior to pregnancy (11/24). Conclusion: The evidence suggests a marked decrease in the amount and type of moderate to strenuous physical activity during the transition to motherhood, which does not always increase again postpartum. Patient education targeting specific physical activities at regular intervals during and after pregnancy to improve long-term maternal health is necessary. [ABSTRACT FROM AUTHOR]

Objectives Developmental iron deficiency (ID) has been shown to put children at risk for compromised learning and memory capacity, and it has also been shown to impair hippocampus-dependent forms of memory as well as hippocampal synaptic transmission. Catecholamines are known to play a pivotal role in memory consolidation, and studies have demonstrated that perinatal ID alters dopaminergic systems in various brain areas. It is not known, however, whether perinatal ID impairs dopaminergic synaptic plasticity in learning and memory structures such as the hippocampus. The objective of the present study was to examine dopaminergic-mediated synaptic efficacy in the hippocampus of mice subjected to an ID or control (CN) diet. Methods The present study used electrophysiological brain slice methods to examine dopaminergic-mediated synaptic efficacy in the hippocampus of mice subjected to an ID or CN diet from postnatal day (P) P0 through P20. Hippocampal brain slices were prepared in young (P26–30) and adult animals (P60–64). Synaptic efficacy was measured in CA1 neurons by examining population spike amplitude. Slices were treated with the dopaminergic agonist SKF-38393. Results Slices obtained from young and adult CN mice exhibited a long-lasting increase in synaptic efficacy as the result of SKF-38393 perfusion while the young and adult ID slices showed little or no increase. Discussion The present study demonstrates that postnatal ID produces long-lasting impairments in dopaminergic-dependent synaptic plasticity in the hippocampus. These impairments may play a role in the learning and memory deficits known to result from ID. [ABSTRACT FROM AUTHOR]

Objective:To develop a grounded theory model of first-time mothers’ experiences of postnatal posttraumatic stress, with the aim of aiding understanding, formulation and treatment of new mothers.Background:Research into postnatal posttraumatic stress is growing, yet evidence-based treatment models have yet to be fully developed. It is unknown whether existing models of posttraumatic stress are directly applicable to postnatal posttraumatic stress, or whether other factors are particularly relevant for symptoms occurring in this context.Methods:A qualitative design explored first-time mothers’ experiences of pregnancy, labour, birth and the postpartum, following a subjectively identified traumatic labour and/ or childbirth. Eleven mothers were interviewed individually, either reporting full symptoms of posttraumatic stress (n= 6), or partial symptoms (n= 5). Grounded theory methodology was used to code the data and develop a theoretical model of maternal postnatal posttraumatic stress based on these accounts.Results:Factors emerged specific to postnatal experiences, including: antenatal expectations and anxieties, constructions of the experience, perceptions of other people’s views, social support (from specific sources) and adaptive and maladaptive coping strategies.Limitations:The study was based on a small sample of first-time mothers’ accounts, and therefore may not be applicable to mothers with previous children, or a wider maternal population.Conclusions:The new model highlights important areas for development in clinical practice at various stages of maternal healthcare provision: in the antenatal period, during labour and birth, and into the postpartum. The model can inform formulation and treatment of mothers experiencing postnatal trauma symptoms, providing specific areas of focus for intervention. [ABSTRACT FROM PUBLISHER]

This article contributes to, and extends, feminist and visual sociological scholarship by examining how a sample of pregnant women in Australia documented their postpartum experiences through digital photographs. It is argued that photography is powerful in helping women to articulate the ways in which subjectivities and bodily boundaries are reframed in the postpartum period. Dressing is used as a key example to demonstrate this. A further aim of this paper is to identify whether women's photographs can be used to contest dominant cultural ideologies and how we may read these using feminist perspectives. Throughout this article, women's individual embodied experiences of post-pregnancy are reflected in the production and viewing of their own photographic images. [ABSTRACT FROM AUTHOR]

Background: Nearly all newborn deaths occur in low- or middle-income countries. Many of these deaths could be prevented through promotion and provision of newborn care practices such as thermal care, early and exclusive breastfeeding, and hygienic cord care. Home visit programmes promoting these practices were piloted in Malawi, Nepal, Bangladesh, and Uganda. Objective: This study assessed changes in selected newborn care practices over time in pilot programme areas in four countries and evaluated whether women who received home visits during pregnancy were more likely to report use of three key practices. Design: Using data from cross-sectional surveys of women with live births at baseline and endline, the Pearson chi-squared test was used to assess changes over time. Generalised linear models were used to assess the relationship between the main independent variable - home visit from a community health worker (CHW) during pregnancy (0, 1-2, 3+) - and use of selected practices while controlling for antenatal care, place of delivery, and maternal age and education. Results: There were statistically significant improvements in practices, except applying nothing to the cord in Malawi and early initiation of breastfeeding in Bangladesh. In Malawi, Nepal, and Bangladesh, women who were visited by a CHW three or more times during pregnancy were more likely to report use of selected practices. Women who delivered in a facility were also more likely to report use of selected practices in Malawi, Nepal, and Uganda; association with place of birth was not examined in Bangladesh because only women who delivered outside a facility were asked about these practices. Conclusion: Home visits can play a role in improving practices in different settings. Multiple interactions are needed, so programmes need to investigate the most appropriate and efficient ways to reach families and promote newborn care practices. Meanwhile, programmes must take advantage of increasing facility delivery rates to ensure that all babies benefit from these practices. [ABSTRACT FROM AUTHOR]

Purpose: The estimation of plutonium fetal transfer and the calculation of individual in utero and postnatal doses for the Mayak Production Association (PA) offspring cohort. Materials and methods: The model developed by the International Commission on Radiological Protection (ICRP) for the transfer of plutonium to the fetus following maternal intakes before and during pregnancy has been adjusted for application to analysis of the fetal transfer of 239Pu for Mayak workers. Improved estimates of fetal to maternal concentration ratios (CF:CM) have been obtained based on a correlation observed between adult offsprings' measured daily urine 239Pu activity and estimates of their mothers' systemic activity at conception. Data on 239Pu activity in daily urine samples were collected from 13 selected adults whose mothers worked at the Mayak PA facility during the period from 1948-1953, before and/or during pregnancy. Results: A comparison of measured and modeled excretion data enabled a mean value of 0.18 ± 0.02 ( n = 21) to be inferred for the Pu CF: CM ratio, with a coefficient of variation of 60%. Conclusions: Point estimates of the individual in utero and postnatal absorbed doses for the red bone marrow and liver were in the range 2...13 mGy in 95% of the cases for the cohort of 1936 offspring. [ABSTRACT FROM AUTHOR]

Objective:This study explores fathers’ paternal roles and relationships when their partner and baby were admitted to a Perinatal Mental Health Unit. It contributes to an understudied and important area of perinatal mental health.Background:The importance of establishing a secure attachment in the first months of life is widely accepted to be critical to the development of good infant mental health. Parental mental ill-health and parent–infant separation can negatively impact parental and infant attachment. Additionally, maternal postnatal mental health is known to affect the father’s well-being and this can impact on his parenting.Methods:Grounded theory methodology was used. Eight fathers were recruited from two Perinatal Mental Health Units. Transcripts were analysed and compared by researchers.Results:Fathers described a difficult experience of trying to create and maintain family bonds. Long admissions with infrequent visits were most difficult. Fathers wanted to bond and had concerns about bonding, but prioritised the mother–baby bond. Couple relationships were strained and fathers relied on external family supports. Fathers experienced anxiety about their partner’s illness and felt relief when their partner was admitted. Fathers were uncertain about treatment and prognosis and desired improved communication with professionals.Conclusion:Severe maternal postnatal mental illness and inpatient admission affected fathers. They were aware of not being consistently available to their baby and were concerned about the impact of this on bonding, attachment, and the infant’s well-being. Fathers would benefit from increased staff awareness of their needs, increased involvement in their partner’s care planning, and additional support to promote infant-father attachment. [ABSTRACT FROM PUBLISHER]

Objective:This study explored women’s experience of puerperal psychosis (PP) and their perceptions of its cause, in order to contribute to an increased understanding of PP and promote consideration of new management perspectives.Background:Out of every 1000 live births, approximately one to two women will develop PP. The numbers are relatively small, yet the consequences can be devastating. Key theoretical explanations for the aetiology of PP are genetic, biochemical and endocrine. A small and relatively tenuous evidence base considers PP from a psychological perspective, despite acknowledgement of the need for broader understanding. A stress–vulnerability model has offered a contemporary explanation of psychotic symptoms in other contexts and non-clinical populations and may offer useful insight in relation to a psychobiological model of PP.Methods:In a qualitative study, seven women who had been diagnosed with PP previously were interviewed and the data subjected to an inductive thematic analysis. Trustworthiness and rigour of the study was assured by careful monitoring of the research process and data checking.Results:Four themes were identified – The path to PP; Unspeakable thoughts and unacceptable self; ‘Snap out of it’; and Perceived causes. While women attributed their PP to the physiological changes associated with childbirth, their accounts of PP began before and during pregnancy. Women highlighted stressful pregnancies characterised by significant challenges and emotions, difficult births and unsupportive family relationships postnatally. The experience of PP was extremely distressing.Conclusion:Findings add to the debate about a more multifaceted explanation of PP and potentially offer a psychobiological model of understanding. [ABSTRACT FROM PUBLISHER]