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McQueen, Anne, and Rosemary Mander. "Tiredness and fatigue in the postnatal period." Journal of Advanced Nursing 42, no. 5 (May 8, 2003): 463–69. http://dx.doi.org/10.1046/j.1365-2648.2003.02645.x.
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Sieck, G. C., M. Fournier, and C. E. Blanco. "Diaphragm muscle fatigue resistance during postnatal development." Journal of Applied Physiology 71, no. 2 (August 1, 1991): 458–64. http://dx.doi.org/10.1152/jappl.1991.71.2.458.
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postnatal development. Both twitch contraction time and half-relaxation time decreased progressively with age. Correspondingly, the force-frequency curve was shifted to the left early in development compared with adults. The ratio of peak twitch force to maximum tetanic force decreased with age. Fatigue resistance of the diaphragm was highest at birth and then progressively decreased with age. At birth, most diaphragm muscle fibers stained darkly for myofibrillar adenosinetriphosphatase after alkaline preincubation and thus would be classified histochemically as type II. During subsequent postnatal development, the proportion of type I fibers (lightly stained for adenosinetriphosphatase) increased while the number of type II fibers declined. At birth, type I fibers were larger than type II fibers. The size of both fiber types increased with age, but the increase in cross-sectional area was greater for type II fibers. On the basis of fiber type proportions and mean cross-sectional areas, type I fibers contributed 15% of total muscle mass at birth and 25% in adults. Thus postnatal changes in diaphragm contractile and fatigue properties cannot be attributed to changes in the relative contribution of histochemically classified type I and II fibers. However, the possibility that these developmental changes in diaphragm contractile and fatigue properties correlated with the varying contractile protein composition of muscle fibers was discussed.
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Riquet, S., E. Hinsinger, E. Bernard, and C. Zakarian. "Évaluation du stress en post-partum des mères lors de la consultation postnatale." Périnatalité 11, no. 3 (September 2019): 126–34. http://dx.doi.org/10.3166/rmp-2019-0058.
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Introduction : Pour l’OMS, le post-partum s’achève six à huit semaines après la naissance. Les facteurs de stress postnatal ont été appréciés chez des mères lors de la consultation postnatale. Une observation entre la perception du stress postnatal et celle du stress postaccouchement a été menée. Matériel et méthode : Une étude descriptive des mères (n = 133), puis comparative entre primipares (n = 56) et multipares (n = 77) a été réalisée à l’aide de l’échelle psychométrique Post-Natal Perceived Stress Inventory (PNPSI). Résultats : Les primipares se perçoivent significativement (p < 0,05) plus stressées sur le facteur de la relation avec leurs nourrissons, alors que les multipares sont significativement (p < 0,05) plus stressées sur la place du père auprès de l’enfant. La mort inattendue du nourrisson (MIN) est l’élément le plus stressant pour les mères, notamment les primipares (66 %). Ce stress est corrélé significativement (p < 0,05) avec celui qu’elles perçoivent sur leur fatigue, le sentiment d’être débordée et de ne pas savoir si leurs nourrissons mangent suffisamment. Le stress sur les rythmes et la santé du nourrisson est très significativement (p < 0,001) corrélé avec celui sur la MIN. À la consultation postnatale, elles sont moins stressées par la fatigue et l’allaitement contrairement au séjour en maternité, et 71 % ne sont plus du tout stressées par les soins à donner à leurs enfants. Conclusion : Développer l’entretien postnatal précoce permettrait de soutenir les parents dans leurs rôles et de renseigner les mères sur la MIN à domicile.
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Brozanski, B. S., J. F. Watchko, T. L. O'Day, and R. D. Guthrie. "Effect of undernutrition on contractile and fatigue properties of rat diaphragm during development." Journal of Applied Physiology 74, no. 5 (May 1, 1993): 2121–26. http://dx.doi.org/10.1152/jappl.1993.74.5.2121.
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The present study was designed to assess the effects of combined pre- and postnatal undernutrition on the in vitro contractile and fatigue properties of the rat diaphragm during development. In vitro direct stimulation of costal diaphragm from control (CTL) and undernourished (UN) rats was done on postnatal days 1, 4, 14, 21, 30, 40, 50, and 60. Combined pre- and postnatal undernutrition resulted in stunted animal growth but did not alter the diaphragm-to-total body weight ratio. Twitch contraction time, half-relaxation time, and force-frequency relationships were not consistently affected by undernutrition. Specific twitch force and specific tetanic force were also unchanged in the UN group. Fatigue resistance was high and comparable in UN and CTL groups at days 1 and 4. At day 14 and thereafter, fatigue resistance declined but was consistently higher in the UN than in the CTL group. We conclude that combined pre- and postnatal undernutrition results in a significant increase in fatigue resistance of the diaphragm compared with CTL, whereas diaphragm muscle contractile properties are not appreciably affected by prolonged undernutrition.
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Fratacci, MD, M. Levame, A. Rauss, and G. Atlan. "Rat diaphragm during postnatal development. II. Resistance to low- and high-frequency fatigue." Reproduction, Fertility and Development 8, no. 3 (1996): 399. http://dx.doi.org/10.1071/rd9960399.
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The effects on the rat diaphragm of fatigue induced by low- and high-frequency stimulation (at 5 Hz for 1.5 min and 75 Hz for 1 min) were examined during postnatal development. Experiments were performed on isolated costal diaphragm strips. Before stimulation, twitch contraction time and half relaxation time were longest in the neonate and decreased significantly between weeks 1 and 6. Correspondingly, the specific twitch tension (corrected for cross-sectional area) increased progressively with age. After either low- or high-frequency fatigue, the force recovery was complete in 1- and 2-week-old rats, whereas the force production progressively decreased in older rats. In addition, the neonate diaphragm further enhanced its force selectively after high-frequency fatigue. It is concluded that the rat diaphragm is comparably resistant to fatigue during the early postnatal period, whether fatigue is induced by low- or by high-frequency stimulation. This suggests that postnatal changes in diaphragm contractile and fatigue properties may be related to changes in the process of force production. The possibility is discussed that a higher total muscle oxidative potential and the mechanisms leading to force potentiation in the neonate might explain the fatigue resistance.
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Lee, Alyssa S., Rhona J. McInnes, Adrienne R. Hughes, Wendy Guthrie, and Ruth Jepson. "The Effect of the More Active MuMs in Stirling Trial on Body Composition and Psychological Well-Being among Postnatal Women." Journal of Pregnancy 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/4183648.
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Introduction.Physical activity is important for health and well-being; however, rates of postnatal physical activity can be low. This paper reports the secondary outcomes of a trial aimed at increasing physical activity among postnatal women.Methods.More Active MuMs in Stirling (MAMMiS) was a randomised controlled trial testing the effect of physical activity consultation and pram walking group intervention among inactive postnatal women. Data were collected on postnatal weight, body composition, general well-being, and fatigue. Participants were also interviewed regarding motivations and perceived benefits of participating in the trial.Results.There was no significant effect of the intervention on any weight/body composition outcome or on general well-being at three or six months of follow-up. There was a significant but inconsistent difference in fatigue between groups. Qualitative data highlighted a number of perceived benefits to weight, body composition, and particularly well-being (including improved fatigue) which were not borne out by objective data.Discussion.The MAMMiS study found no impact of the physical activity intervention on body composition and psychological well-being and indicates that further research is required to identify successful approaches to increase physical activity and improve health and well-being among postnatal women.
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Jagadhesshwari and Vaitheswari M. "Outcome of aromatherapy to reduce afterpain and fatigue among postnatal mothers." International Journal of Social Rehabilitation 7, no. 1 (June 26, 2022): 21–28. http://dx.doi.org/10.56501/intjsocrehab.v7i1.78.
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Pain is pain, but it's not all the same the international association for the study of pain. Maternal fatigue is a subjective experience of whole body, encompassing the physical, emotional and cognitive functioning in the postpartum mothers. Aromatherapy is become a frequently used non biomedical method of managing pain and it also helps in promoting, relaxation, mood stimulation, sleep promotion. The present study aims to assess the effectiveness of aromatherapy on after pain and fatigue among postnatal mothers. A quantitative quasi experimental research design was conducted among 30 postnatal mothers by using a convenience sampling technique and 15 were divided in control and experimental group. The demographic data was collected using structured interview questionnaire. The pre-test was done to assess level of after pain by visual analogue scale and level of fatigue-by-fatigue assessment scale for both the experimental and control group. The experimental group was given aromatherapy by lavender oil, the control group was given a routine care and then the post test was done. The study results show that the level of fatigue was considerably reduced in the experimental group than the control group in the post test at p<0.005. This indicates aromatherapy is effective non pharmacological method and cost-effective method to treat after pain and fatigue among postnatal mothers. The result of the study is it was concluded that aromatherapy as no side effects and it is easy and comfortable method which can be practiced to treat after pain and fatigue.
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El-Morsey, Al Shimaa. "SLEEP DISTURBANCES AND FATIGUE AMONG WOMEN IN POSTNATAL PERIOD." Port Said Scientific Journal of Nursing 6, no. 1 (June 1, 2019): 39–56. http://dx.doi.org/10.21608/pssjn.2019.33448.
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Watchko, J. F., B. S. Brozanski, T. L. O'Day, R. D. Guthrie, and G. C. Sieck. "Contractile properties of the rat external abdominal oblique and diaphragm muscles during development." Journal of Applied Physiology 72, no. 4 (April 1, 1992): 1432–36. http://dx.doi.org/10.1152/jappl.1992.72.4.1432.
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We studied the in vitro contractile and fatigue properties of the rat external abdominal oblique (EAO) and costal diaphragm (DIA) muscles during postnatal development. Isometric twitch contraction (CT) and half-relaxation (RT1/2) times were longer in both the EAO and DIA muscles during the early postnatal period and decreased with age. In the first postnatal week, the CT and RT1/2 were longer in the EAO than the DIA muscle. At 14 days of age and thereafter, the CT and RT1/2 were shorter in the EAO than in the DIA muscle. Force-frequency relationships of the EAO and DIA muscles changed during postnatal development such that the relative force (percent maximum) generated at lower frequencies (less than 15 pulses/s) decreased with age. Moreover the relative force generated by the EAO muscle at lower frequencies was greater than that of the DIA muscle during the early postnatal period but less than that of the DIA muscle in adults. The specific force of both the EAO and DIA muscles increased progressively with age. There were no differences in specific force between the EAO and DIA muscles at any age. The fatigability of the EAO and DIA muscles was comparable during the early postnatal period and increased in both muscles with postnatal development. In adults the EAO muscle was more fatigable than the DIA muscle. We conclude that the contractile and fatigue properties of the EAO and DIA muscles undergo significantly different postnatal transitions, which may reflect their functional involvement in sustaining ventilation.
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Raj K, Soumya, Reshma Rajan, and Suvi Kj. "INCIDENCE OF MINOR AILMENTS OF PUERPERIUM AND RELATED KNOWLEDGE AMONG POSTNATAL MOTHERS." Asian Journal of Pharmaceutical and Clinical Research 11, no. 1 (January 1, 2018): 261. http://dx.doi.org/10.22159/ajpcr.2017.v11i1.21022.
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Objective: The objective of the study was to identify the incidence and knowledge of minor ailments of puerperium among postnatal mothers and to develop an information leaflet on the management of minor ailments of puerperium.Methods: A quantitative approach with descriptive design and convenience sampling technique was used in this study. With these methods, the researcher selected 100 postnatal mothers attending Obstetrics and Gynecology ward, AIMS, Kochi. A semi-structured questionnaire along with a checklist was used to assess the knowledge and the incidence of minor ailments among postnatal mothers.Result: The result showed that the common incidence of minor ailments was afterpain (67%), perineal discomfort (50%), constipation (43%), and fatigue (67%). Majority of the postnatal mothers had average knowledge (65%) level, and some of them had good knowledge (21%), and some of them had poor knowledge (14%).Conclusion: The study revealed that the main four problems of minor ailments of puerperium were afterpain, perineal discomfort, constipation, and fatigue. Number of studies from different part of the world, including India, shows that a large proportion of postnatal mother experiences minor ailments of puerperium. This provides evidence for giving importance to minor ailments of puerperium. Researchers also provided a baseline information leaflet on the management of minor ailments of puerperium.
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Raj K, Soumya, Reshma Rajan, and Suvi Kj. "INCIDENCE OF MINOR AILMENTS OF PUERPERIUM AND RELATED KNOWLEDGE AMONG POSTNATAL MOTHERS." Asian Journal of Pharmaceutical and Clinical Research 11, no. 1 (January 1, 2018): 261. http://dx.doi.org/10.22159/ajpcr.2018.v11i1.21022.
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Objective: The objective of the study was to identify the incidence and knowledge of minor ailments of puerperium among postnatal mothers and to develop an information leaflet on the management of minor ailments of puerperium.Methods: A quantitative approach with descriptive design and convenience sampling technique was used in this study. With these methods, the researcher selected 100 postnatal mothers attending Obstetrics and Gynecology ward, AIMS, Kochi. A semi-structured questionnaire along with a checklist was used to assess the knowledge and the incidence of minor ailments among postnatal mothers.Result: The result showed that the common incidence of minor ailments was afterpain (67%), perineal discomfort (50%), constipation (43%), and fatigue (67%). Majority of the postnatal mothers had average knowledge (65%) level, and some of them had good knowledge (21%), and some of them had poor knowledge (14%).Conclusion: The study revealed that the main four problems of minor ailments of puerperium were afterpain, perineal discomfort, constipation, and fatigue. Number of studies from different part of the world, including India, shows that a large proportion of postnatal mother experiences minor ailments of puerperium. This provides evidence for giving importance to minor ailments of puerperium. Researchers also provided a baseline information leaflet on the management of minor ailments of puerperium.
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Kinirons, Stacy A., Mary S. Shall, J. Ross McClung, and Stephen J. Goldberg. "Effect of Artificial Rearing on the Contractile Properties and Myosin Heavy Chain Isoforms of Developing Rat Tongue Musculature." Journal of Neurophysiology 90, no. 1 (July 2003): 120–27. http://dx.doi.org/10.1152/jn.00809.2002.
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This study's purpose was to examine the influence of an altered activity level, via artificial rearing, on the contractile properties, myosin heavy chain phenotypes (MHC), and muscle fiber sizes of the developing rat tongue retractor musculature. Artificially reared rat pups were fed through a gastric cannula, eliminating nutritive suckling from postnatal day 4 to postnatal day 14. Rat pups were observed immediately following artificial rearing (postnatal day 14) and after a 1-mo resumption of function (postnatal day 42). The contractile characteristics of the tongue retractor musculature were measured in response to stimulation of the hypoglossal nerve. At postnatal day 14, artificially reared rat pups demonstrated significantly longer twitch half-decay times, lower fusion frequencies, and a marked decrease in fatigue resistance. These contractile speed and fatigue characteristics were fully recovered following a 1-mo resumption of function. MHC phenotypes of the styloglossus muscle (a tongue retractor) were determined by gel electrophoresis. At postnatal day 14, artificial rearing had not altered the MHC phenotype or muscle fiber sizes of the styloglossus muscle. However, following a 1-mo resumption of function artificially reared rat pups demonstrated a small but significant increase in MHCIIa expression and decrease in MHCIIb expression compared with dam-reared rats. These results support artificial rearing as a useful model for altering the activity level of the tongue and suggest that normal suckling behavior is necessary for the normal postnatal development of the tongue retractor musculature. This may also be the case for premature infants necessarily fed artificially.
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Zhan, Wen-Zhi, Jon F. Watchko, Y. S. Prakash, and Gary C. Sieck. "Isotonic contractile and fatigue properties of developing rat diaphragm muscle." Journal of Applied Physiology 84, no. 4 (April 1, 1998): 1260–68. http://dx.doi.org/10.1152/jappl.1998.84.4.1260.
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Postnatal transitions in myosin heavy chain (MHC) isoform expression were found to be associated with changes in both isometric and isotonic contractile properties of rat diaphragm muscle (Diam). Expression of MHCneo predominated in neonatal Diam fibers but was usually coexpressed with MHCslow or MHC2A isoforms. Expression of MHCneo disappeared by day 28. Expression of MHC2X and MHC2B emerged at day 14 and increased thereafter. Associated with these MHC transitions in the Diam, maximum isometric tetanic force (Po), maximum shortening velocity, and maximum power output progressively increased during early postnatal development. Maximum power output of the Diam occurred at ∼40% Po at days 0 and 7 and at ∼30% Po in older animals. Susceptibility to isometric and isotonic fatigue, defined as a decline in force and power output during repetitive activation, respectively, increased with maturation. Isotonic endurance time, defined as the time for maximum power output to decline to zero, progressively decreased with maturation. In contrast, isometric endurance time, defined as the time for force to decline to 30–40% Po, remained >300 s until after day 28. We speculate that with the postnatal transition to MHC2X and MHC2Bexpression energy requirements for contraction increase, especially during isotonic shortening, leading to a greater imbalance between energy supply and demand.
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Kammerer, M., A. Taylor, N. Khalife, K. O’Donnell, M. Marks, and V. Glover. "Diurnal pattern of cortisol and amylase output in postnatal depression." European Psychiatry 26, S2 (March 2011): 1099. http://dx.doi.org/10.1016/s0924-9338(11)72804-8.
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ObjectiveThis study investigated the diurnal output of saliva cortisol and saliva amylase in women with symptoms of depression postnatally.MethodTwenty one depressed and 30 non depressed women at 7.5 weeks postpartum, and 21 non perinatal controls, collected saliva at waking, 30 minutes, and three and twelve hours post waking.ResultsWomen who were not depressed postnatally showed a pattern of cortisol secretion over the day similar to non perinatal controls. There was a significant difference in diurnal pattern between postnatally depressed and postnatally non depressed women, due to a difference in the first two time points (waking and +30 mins): compared to the other two groups who each had a significant increase in cortisol levels from waking to +30 minutes, the depressed women had significantly higher cortisol levels at waking and no increase at +30 minutes. Analyses of amylase are underway and will be presented.ConclusionThe lack of a morning rise in the depressed women is similar to that reported for Post-traumatic Stress Disorder and chronic fatigue syndrome and may reflect a response, in vulnerable women, to the marked cortisol withdrawal that occurs after delivery. Alternatively it could be a trait marker for women at risk of developing postnatal depression.
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Mathur, Poonam, Rahul Mathur, and Archana Singh. "A clinical study of postpartum depression and its association with postnatal factors." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 6 (May 26, 2018): 2120. http://dx.doi.org/10.18203/2320-1770.ijrcog20181843.
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Background: The postpartum period is a time of tremendous emotional and physical change for most women as they adapt to new roles and alteration in their physiology. Postpartum depression has seen its rise lately. Multiple factors might be responsible for causation. Symptoms include depression, tearfulness, emotional liability, guilt, anorexia, sleep disorders, feeling inadequate, detachment from the baby, poor concentration, forgetfulness, fatigue, and irritability.Methods: We have conducted a study in 225 postpartum females and assessed them for depression and associated postnatal depression. The 10-question Edinburgh Postnatal Depression Scale (EPDS) was used for assessing depression.Results: Depression was evaluated as 6%. It was also found that 2% mothers with IUD babies developed postnatal depression. 1.33% cases with babies having congenital anomaly developed postnatal depression. 1.33% cases with babies having nursery admission developed postnatal depression. This has been correlated with many other studies.Conclusions: It is found that perinatal factors do affect postnatal depression as it is found in mothers who have an adverse perinatal outcome. Further research is implicated in this field.
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Watchko, J. F., and G. C. Sieck. "Respiratory muscle fatigue resistance relates to myosin phenotype and SDH activity during development." Journal of Applied Physiology 75, no. 3 (September 1, 1993): 1341–47. http://dx.doi.org/10.1152/jappl.1993.75.3.1341.
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We correlated the fatigue resistance (FR) of the costal diaphragm (DIA) and external abdominal oblique (EAO) of the rat during postnatal development with their respective 1) myosin heavy chain (MHC) phenotypes and 2) oxidative capacities [indexed by quantitative measurements of succinic dehydrogenase (SDH) enzyme activity]. FR was measured in vitro during isometric contractions with the use of the Burke fatigue test. FR of the DIA and EAO was high in newborns and declined during postnatal development. SDH activity was uniformly low in neonatal DIA and EAO and increased during early postnatal development before declining to adult levels. FR did not significantly correlate with SDH activity (r2 = 0.01) but did relate to the MHC phenotype as indexed by the ratio of adult MHC isoform content (slow + IIa + IIx + IIb) to developmental MHC isoform content (slow + neonatal; r2 = 0.88, P < 0.01). Stepwise regression revealed that neonatal MHC expression alone accounted for 60% of the developmental variance in FR. The correlation between FR and MHC phenotype was improved if SDH was also considered, i.e., the ratio of SDH to MHC phenotype (r2 = 0.99, P < 0.01). We conclude that FR of respiratory muscle during development relates to a balance between the energetic demands of the muscle contractile proteins as reflected by MHC isoform composition and its oxidative capacity with MHC phenotype alone exerting a strong predictive effect on FR.
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Prakash, Y. S., M. Fournier, and G. C. Sieck. "Effects of prenatal undernutrition on developing rat diaphragm." Journal of Applied Physiology 75, no. 3 (September 1, 1993): 1044–52. http://dx.doi.org/10.1152/jappl.1993.75.3.1044.
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The effects of maternal nutritional deprivation (ND) on the proportions and cross-sectional areas (CSAs) of type I and II fibers in the developing rat diaphragm (Dia) were examined. In addition, the effects of ND on in vitro contractile and fatigue properties were also studied. Compared with in the control (CTL) group (from pups of well-nourished mothers), proportions of type II fibers were significantly lower in the ND group during the first 3 postnatal wk. However, this difference did not persist into adulthood. CSAs of type I and II fibers were larger in ND Dia than in CTL Dia during early postnatal development, but in adults type I and II fiber CSAs were larger in CTL than in ND Dia. Interstitial space comprised a smaller fraction of total muscle area in ND Dia throughout postnatal development and persisted in adults. Estimated fiber density (no. of fibers/CSA muscle) was lower in ND groups at all ages. In addition, the total number of fibers was significantly lower in ND Dia at all ages. Optimal muscle fiber length for peak twitch and maximum isometric force generation was shorter in ND Dia at all ages. At postnatal days 7 and 14, specific force (maximum tetanic force in N/cm2) of ND Dia was significantly lower than that of CTL Dia. At day 21, Dia specific force was comparable between the two groups but was significantly lower in adult ND compared with adult CTL Dia. Except for days 0 and 14, ND Dia was more fatigue resistant than CTL Dia.(ABSTRACT TRUNCATED AT 250 WORDS)
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Windarti, Yunik, Yasi Anggasari, Siti Nur Hasina, and Firdaus Firdaus. "Information and Husband’s Support on Implementation Postpartum Gymnastics during COVID 19 Pandemic in Indonesia." Open Access Macedonian Journal of Medical Sciences 9, E (December 1, 2021): 1418–21. http://dx.doi.org/10.3889/oamjms.2021.7786.
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Background : The practice of postnatal gymnastics in Indonesia is still little done by postpartum mothers both before and during the covid pandemic 19. Some of the contributing factors include lack of knowledge about postnatal gymnastics, fatigue, and the mother's mindset about the importance of postnatal gymnastics for health which is still lacking. Post-delivery exercise can help mothers to get back to their normal health as they were before pregnancy.
Objective : This study aims to analyze the effect of information and husband's support on the implementation postnatal gymnastics during the covid 19 pandemic.
Methods : Non-experimental research design: cross sectional analytic, the independent variable is husband's information and support and the dependent variable is postpartum exercise. This research was conducted in April – August 2021. The population of postpartum mothers was 102, the sampling technique was incidental sampling in Wonokromo Village, Surabaya, East Java, Indonesia. Research instrument with a questionnaire. The data were analyzed using the Multiple Logistics Regression test.
Results : The results showed that partially there was a significant effect of husband's support (p = 0.013) on postnatal exercise, but for information during the pandemic there was no effect (p = 0.998) on postpartum exercise. The results of the analysis showed that the OR value of the information was 1.615E9 (95%CI: 0.000 – 0.000) and the OR of husband's support was 3.385 (95%CI: 1.289 – 8.886).
Conclusion : Husband's support during the covid 19 pandemic affects mothers in doing postnatal exercise. Obtaining information about postnatal exercise during the COVID-19 pandemic does not affect the mother in its implementation.
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Symon, A., C. M. A. Glazener, A. Macdonald, and D. Ruta. "Pilot study: Quality of life assessment of postnatal fatigue and other physical morbidity." Journal of Psychosomatic Obstetrics & Gynecology 24, no. 4 (January 2003): 215–19. http://dx.doi.org/10.3109/01674820309074685.
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Mullins, Edward, Shalini Sharma, and Alison H. McGregor. "Postnatal exercise interventions: a systematic review of adherence and effect." BMJ Open 11, no. 9 (September 2021): e044567. http://dx.doi.org/10.1136/bmjopen-2020-044567.
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ObjectiveTo evaluate adherence to and effect of postnatal physical activity (PA) interventions.DesignSystematic review of PA intervention randomised controlled trials in postnatal women. The initial search was carried out in September 2018, and updated in January 2021.Data sourcesEmbase, MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases, hand-searching references of included studies. The 25 identified studies included 1466 postnatal women in community and secondary care settings.Eligibility criteriaStudies were included if the PA interventions were commenced and assessed in the postnatal year.Data extraction and synthesisData were extracted using a prespecified extraction template and assessed independently by two reviewers using Cochrane ROB 1 tool.Results1413 records were screened for potential study inclusion, full-text review was performed on 146 articles, 25 studies were included. The primary outcome was adherence to PA intervention. The secondary outcomes were the effect of the PA interventions on the studies’ specified primary outcome. We compared effect on primary outcome for supervised and unsupervised exercise interventions. Studies were small, median n=66 (20–130). PA interventions were highly variable, targets for PA per week ranged from 60 to 275 min per week. Loss to follow-up (LTFU) was higher (14.5% vs 10%) and adherence to intervention was lower (73.6% vs 86%) for unsupervised versus supervised studies.ConclusionsStudies of PA interventions inconsistently reported adherence and LTFU. Where multiple studies evaluated PA as an outcome, they had inconsistent effects, with generally low study quality and high risk of bias. Agreement for effect between studies was evident for PA improving physical fitness and reducing fatigue. Three studies showed no adverse effect of PA on breast feeding. High-quality research reporting adherence and LTFU is needed into how and when to deliver postnatal PA interventions to benefit postnatal physical and mental health.PROSPERO registration numberCRD42019114836.
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Roberts, Sarah L., Sarah L. Roberts, John A. Bushnell, Sarah L. Roberts, John A. Bushnell, Sunny C. Collings, and Gordon L. Purdie. "Psychological Health of Men with Partners who have Post-Partum Depression." Australian & New Zealand Journal of Psychiatry 40, no. 8 (August 2006): 704–11. http://dx.doi.org/10.1080/j.1440-1614.2006.01871.x.
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Objective: To compare the psychological health of men with partners who have postpartum depression (PPD; index group) with that of men with partners without PPD (comparison group). Method: Using a cross-sectional survey, psychological symptoms and disturbances of index group men (n = 58) and comparison group men (n = 116) were compared. Validated self-report measures were used to assess five key areas of mental health: depression, anxiety, non-specific psychological impairment, aggression and alcohol use. Results: Index group men had more symptoms of depression, aggression and nonspecific psychological impairment, and had higher rates of depressive disorder, nonspecific psychological problems and problem fatigue than comparison group men. Index group men were also more likely to have three or more comorbid psychological disturbances. There was no difference between the groups on measures of anxiety and alcohol use. Conclusions: Although many men in the postnatal period experience a variety of mental health problems, those who have a partner with PPD are themselves at increased risk for experiencing psychological symptoms and disturbances. Differentiation of psychological syndromes is important; higher rates of depressive disorder, non-specific psychological problems and problem fatigue were found, but rates of anxiety disorder and hazardous alcohol use did not differ between the groups. More attention from health professionals to men's mental health in the postnatal period may be beneficial to the entire family system.
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Salian, Shivani Chowdhury, and Krisha P. Shah. "Psychosocial factors in post-partum parents in India." International Journal Of Community Medicine And Public Health 4, no. 4 (March 28, 2017): 1324. http://dx.doi.org/10.18203/2394-6040.ijcmph20171370.
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Background: Post-partum period brings along with it a lot of changes and responsibilities. Fatigue, Stress, Depression and Bonding are some of the factors which have shown to affect the parents during this period. Present study assesses the psychosocial factors in post-partum parents and differences observed amongst them. The effect of other factors like the type of delivery of the youngest child, the working status of the mother and the type of family they reside in were also assessed. Methods: 128 pair of parents (64 mothers & 64 fathers) were interviewed using a Case Report Form after procuring their informed consent. The various psychosocial domains were evaluated using Multidimensional Assessment of Fatigue (MAF) Scale, Perceived Stress Scale (PSS), Edinburgh Postnatal Depression Scale (EDPS) and the Post-Partum Bonding Questionnaire (PBQ). For each participant, the total score (factorial total score in case of PBQ) in each scale was calculated and analysed. Results: On comparing the various psychosocial factors, fatigue (p-value 0.020), stress (p-value 0.034) and depression (p-value 0.005) levels were found to be significantly higher in mother as compared to fathers. Primiparous mothers had significantly high levels of stress (p-value 0.021) and depression (p-value 0.015) in comparison to primiparous fathers. Also, mothers who underwent C-section showed a significant difference (p-value 0.023) towards their tendency of incipient abuse towards the child as compared to the other groups. Conclusions: The present study reveals that the bonding of mothers and fathers with their children is equal. However, the mothers are observed to be more fatigued, stressed and depressed as compared to fathers.
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Howard, Kathryn, Jill M. Maples, and Rachel A. Tinius. "Modifiable Maternal Factors and Their Relationship to Postpartum Depression." International Journal of Environmental Research and Public Health 19, no. 19 (September 29, 2022): 12393. http://dx.doi.org/10.3390/ijerph191912393.
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The purpose of the study was to examine how modifiable maternal factors (body mass index (BMI), household income, fatigue, sleep, breastfeeding status, diet, and physical activity) relate to postpartum depression (PPD) at 6 and 12 months postpartum. Participants (n = 26) participated in two study visits (6 and 12 months postpartum) where vitals, weight, body composition (skinfold anthropometrics), and physical activity levels (Actigraph GTX9 accelerometer) were assessed. Validated instruments (BRUMS-32, Subjective Exercise Experience Scale, Pittsburg Sleep Quality index, NIH breastfeeding survey, NIH Dietary History Questionnaire, and Edinburg Postnatal Depression Scale) assessed lifestyle and demographic factors of interest. PPD at six months was correlated to PPD at 12 months (r = 0.926, p < 0.001). At six months postpartum, PPD was positively correlated to BMI (r = 0.473, p = 0.020) and fatigue (r = 0.701, p < 0.001), and negatively correlated to household income (r = −0.442, p = 0.035). Mothers who were breastfeeding had lower PPD scores (breastfeeding 3.9 ± 3.5 vs. not breastfeeding 7.6 ± 4.8, p = 0.048). At 12 months, PPD was positively correlated to sleep scores (where a higher score indicates poorer sleep quality) (r = 0.752, p < 0.001) and fatigue (r = 0.680, p = 0.004). When analyzed collectively via regression analyses, household income and fatigue appeared to be the strongest predictors of PPD at six months postpartum.
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Henderson, Jane, Fiona Alderdice, and Maggie Redshaw. "Factors associated with maternal postpartum fatigue: an observationalstudy." BMJ Open 9, no. 7 (July 2019): e025927. http://dx.doi.org/10.1136/bmjopen-2018-025927.
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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.
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Taylor, Jan, and Maree Johnson. "The role of anxiety and other factors in predicting postnatal fatigue: From birth to 6 months." Midwifery 29, no. 5 (May 2013): 526–34. http://dx.doi.org/10.1016/j.midw.2012.04.011.
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Chen, Shu-Lan, and Chung-Hey Chen. "Effects of Lavender Tea on Fatigue, Depression, and Maternal-Infant Attachment in Sleep-Disturbed Postnatal Women." Worldviews on Evidence-Based Nursing 12, no. 6 (November 2, 2015): 370–79. http://dx.doi.org/10.1111/wvn.12122.
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Polla, B., V. Cappelli, F. Morello, M. A. Pellegrino, F. Boschi, O. Pastoris, and C. Reggiani. "Effects of the β2-agonist clenbuterol on respiratory and limb muscles of weaning rats." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 280, no. 3 (March 1, 2001): R862—R869. http://dx.doi.org/10.1152/ajpregu.2001.280.3.r862.
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The aim of this study was to analyze the effects of chronic administration of the β2-agonist clenbuterol (1.5 mg · kg−1 · day−1 for 4 wk in the drinking water) on respiratory (diaphragm and parasternal intercostal) and hindlimb (tibialis and soleus) muscles in young rats during postnatal development (21 to 49 postnatal days). The treatment resulted in very little stimulation of muscle growth. Significant slow-to-fast transitions in the expression of myosin heavy chain isoforms and significant increases in the myofibrillar ATPase activity were found in the diaphragm and soleus, whereas tibialis anterior and intercostal muscles did not show any significant fiber-type alteration. Decrease of oxidative enzyme activities and increase of glycolytic enzyme activities were also observed. It is concluded that whereas the growth stimulation is age dependent and only detectable in adult rats, the fiber-type transformation is also present in weaning rats and particularly evident in the soleus and diaphragm. The fiber-type transformation caused by clenbuterol might lead to an enhancement of contractile performance and also to a reduced resistance to fatigue.
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Zumaidar, Zumaidar, Saudah Saudah, Saida Rasnovi, and Essy Harnelly. "TUMBUHAN SEBAGAI OBAT TRADISONAL PASCA MELAHIRKAN OLEH SUKU ACEH DI KABUPATEN PIDIE." Al-Kauniyah: Jurnal Biologi 12, no. 2 (October 31, 2019): 157–63. http://dx.doi.org/10.15408/kauniyah.v12i2.9991.
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AbstrakPemanfaatan tumbuhan sebagai obat tradisional merupakan kearifan lokal yang diturunkan secara turun temurun berdasarkan resep nenek moyang, adat istiadat, kepercayaan atau kebiasaan setempat. Penelitian ini bertujuan untuk mengidentifikasi jenis tumbuhan yang digunakan dalam pengobatan pasca melahirkan oleh Suku Aceh di Kabupaten Pidie. Metode yang digunakan dalam pengumpulan data adalah teknik Participatory Rural Appraisal dan observasi. Parameter dalam penelitian ini adalah jenis tumbuhan obat, jenis ramuan obat dan cara penggunaan ramuan dalam pengobatan pasca melahirkan. Berdasarkan hasil penelitian diperoleh 25 jenis tumbuhan yang tergolong ke dalam 15 suku yang digunakan dalam pengobatan pasca melahirkan di Kabupaten Pidie. Jenis ramuan dalam pengobatan tradisional pasca melahirkan terdiri dari obat dalam dan obat luar. Obat dalam yang digunakan terdiri obat perut, bedak param, dan pilis. Penggunaan ramuan obat dalam dan obat luar selama pasca melahirkan dilakukan selama 44 hari. Manfaat dari penggunaan obat tersebut diantaranya menambah darah, meningkatkan jumlah air susu ibu, menghangatkan badan, dan menghilangkan lelah serta letih pasca melahirkan. Pemanfaatan tumbuhan obat secara tradisional sampai saat ini masih digunakan oleh masyarakat Aceh pada pengobatan ibu pasca melahirkan, selain pengobatan modern.Abstract Traditional medicine is a drug that is processed in a simple, hereditary based on ancestral recipes, customs, beliefs or local knowledge. This study aims to identify the species of plants used in post-natal care by Acehnese in Pidie District. The method used in data collection is Participatory Rural Appraisal and observation techniques. The parameters in this study are the species of medicinal plants, types of medicinal herbs and how to use the ingredients in postnatal care. The results of the study obtained 25 species plant that is grouped into 15 family used in post-natal care in Pidie District. A Traditional herbs post-natal medicine consists of internal and external medicine. The internal medicine used as stomach medicine, param powder and pilis. The use of medicinal herbs to internal and external medicine after postnatal was carried out for 44 days. The perceived benefits included adding blood, increasing the amount of breast milk, warming the body and eliminating fatigue and fatigue after childbirth. Utilization of traditional medicinal plants in this time are still used by Acehnese in the treatment of postnatal mother, besides modern treatment.
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Mohammadi, Fatemeh, Jamileh Malakooti, Jalil Babapoor, and Sakineh Mohammad‐Alizadeh‐Charandabi. "The effect of a home‐based exercise intervention on postnatal depression and fatigue: A randomized controlled trial." International Journal of Nursing Practice 21, no. 5 (March 12, 2014): 478–85. http://dx.doi.org/10.1111/ijn.12259.
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Martin-Caraballo, Miguel, Paul A. Campagnaro, Yuan Gao, and John J. Greer. "Contractile and fatigue properties of the rat diaphragm musculature during the perinatal period." Journal of Applied Physiology 88, no. 2 (February 1, 2000): 573–80. http://dx.doi.org/10.1152/jappl.2000.88.2.573.
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The following two hypotheses regarding diaphragm contractile properties in the perinatal rat were tested. First, there is a major transformation of contractile and fatigue properties during the period between the inception of inspiratory drive transmission in utero and birth. Second, the diaphragm muscle properties develop to functionally match changes occurring in phrenic motoneuron electrophysiological properties. Muscle force recordings and intracellular recordings of end-plate potentials were measured by using phrenic nerve-diaphragm muscle in vitro preparations isolated from rats on embryonic day 18 and postnatal days 0–1. The following age-dependent changes occurred: 1) twitch contraction and half relaxation times decreased approximately two- and threefold, respectively; 2) the tetanic force levels increased approximately fivefold; 3) the ratio of peak twitch force to maximum tetanic force decreased 2.3-fold; 4) the range of forces generated by the diaphragm in response to graded nerve stimulation increased approximately twofold; 5) the force-frequency curve was shifted to the right; and 6) the propensity for neuromuscular transmission failure decreased. In conclusion, the diaphragm contractile and phrenic motoneuron repetitive firing properties develop in concert so that the full range of potential diaphragm force recruitment can be utilized and problems associated with diaphragm fatigue are minimized.
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Smith, J. Chadwick, W. Allen Moore, Stephen J. Goldberg, and Mary S. Shall. "Contractile properties and myosin heavy chain composition of rat tongue retrusor musculature show changes in early adulthood after 19 days of artificial rearing." Journal of Applied Physiology 101, no. 4 (October 2006): 1053–59. http://dx.doi.org/10.1152/japplphysiol.00029.2006.
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Previously, we showed that artificial rearing using the “pup in a cup” model results in decreased tongue activity and caused some minor alterations in the tongue retrusor musculature. However, the artificial rearing time frame previously chosen was brief (11 days). The purpose of the present investigation was to extend the artificial rearing period from postnatal days 3 to 21 (P21) to determine whether significant alterations occur as a result of this reduced tongue use. Several changes in contractile properties due to the artificial rearing process were observed, which fully recovered by postnatal days 41 to 42 (P41–2). These changes included a shorter twitch contraction time, shorter twitch half-relaxation time, and decreased fatigue resistance. Styloglossus muscle exhibited more neonatal myosin heavy chain (MHC) isoform at P21 for the artificially reared (AR) group. Changes that were persistent at P41–2 were also observed. Maximum tetanic tension was lower for the AR group at P21 and P41–2 compared with their dam-reared counterparts. Twitch tension was also lower by P41–2 in the AR group. At P41–2, the AR group exhibited an increase in MHC IIa and a decrease in MHC IIb for the styloglossus muscle. In addition, the AR group exhibited a decreased MHC IIb for the long head of the biceps brachii at P41–2. Our results are similar to other models of hindlimb immobilization and suspension. By extending our artificial rearing period, this reduced tongue activity induced acute changes and alterations in the tongue retrusor musculature that persisted into early adulthood.
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Béchir, Nelly, Émilie Pecchi, Karima Relizani, Christophe Vilmen, Yann Le Fur, Monique Bernard, Helge Amthor, David Bendahan, and Benoît Giannesini. "Mitochondrial impairment induced by postnatal ActRIIB blockade does not alter function and energy status in exercising mouse glycolytic muscle in vivo." American Journal of Physiology-Endocrinology and Metabolism 310, no. 7 (April 1, 2016): E539—E549. http://dx.doi.org/10.1152/ajpendo.00370.2015.
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Because it leads to a rapid and massive muscle hypertrophy, postnatal blockade of the activin type IIB receptor (ActRIIB) is a promising therapeutic strategy for counteracting muscle wasting. However, the functional consequences remain very poorly documented in vivo. Here, we have investigated the impact of 8-wk ActRIIB blockade with soluble receptor (sActRIIB-Fc) on gastrocnemius muscle anatomy, energy metabolism, and force-generating capacity in wild-type mice, using totally noninvasive magnetic resonance imaging (MRI) and dynamic 31P-MRS. Compared with vehicle (PBS) control, sActRIIB-Fc treatment resulted in a dramatic increase in body weight (+29%) and muscle volume (+58%) calculated from hindlimb MR imaging, but did not alter fiber type distribution determined via myosin heavy chain isoform analysis. In resting muscle, sActRIIB-Fc treatment induced acidosis and PCr depletion, thereby suggesting reduced tissue oxygenation. During an in vivo fatiguing exercise (6-min repeated maximal isometric contraction electrically induced at 1.7 Hz), maximal and total absolute forces were larger in sActRIIB-Fc treated animals (+26 and +12%, respectively), whereas specific force and fatigue resistance were lower (−30 and −37%, respectively). Treatment with sActRIIB-Fc further decreased the maximal rate of oxidative ATP synthesis (−42%) and the oxidative capacity (−34%), but did not alter the bioenergetics status in contracting muscle. Our findings demonstrate in vivo that sActRIIB-Fc treatment increases absolute force-generating capacity and reduces mitochondrial function in glycolytic gastrocnemius muscle, but this reduction does not compromise energy status during sustained activity. Overall, these data support the clinical interest of postnatal ActRIIB blockade.
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Isyos Sari Sembiring, Halimatun Sakdiyah, Pristiwanti, Susanti, Arifah, and Surya Dani. "The Effect of Pregnant Women's Class on Primigravida Mother's Anxiety in Pegajahan Puskesmas, Pegajahan District, Serdang Bedagai Regency in 2022." Science Midwifery 10, no. 4 (November 1, 2022): 3448–53. http://dx.doi.org/10.35335/midwifery.v10i4.850.
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High population growth causes a population explosion These physical changes cause psychological and emotional conditions to become unstable so that it fosters constant worries until the end of her pregnancy. According to Mansur (2018), almost 80% of pregnant women experience disappointment, refusal, anxiety, anxiety, depression and moodiness and the incidence of mental disorders by 15% occurs in primigravida mothers in the first trimester. Worries and anxiety in pregnant women if not treated seriously will have a bad impact and influence. Poor health and mental health during pregnancy can have a lasting impact on the quality of life for the mother and the cognitive development of her child (Arini et al, 2018).
Emotional disturbances in pregnant women will affect the behavior of maintaining health during pregnancy, such as being lazy to eat, lazy to take a bath, sleep disturbances and fatigue (Andriana, 2017). Aprilia's research (2018) also proves that the effects of stress can increase the risk of miscarriage, preeclampsia, impaired fetal growth, premature birth and postnatal developmental delays and reduce the mother's immune response.
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Khatun, Fahima, Tae Wha Lee, Hye Jung Lee, Jeongok Park, Ju Eun Song, and Sue Kim. "Does a nurse-led postpartum self-care program for first-time mothers in Bangladesh improve postpartum fatigue, depressive mood, and maternal functioning?: a non-synchronized quasi-experimental study." Korean Journal of Women Health Nursing 27, no. 3 (September 30, 2021): 196–208. http://dx.doi.org/10.4069/kjwhn.2021.09.08.
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Purpose: This study aimed to test the efficacy of a nurse-led postpartum self-care (NL-PPSC) intervention at reducing postpartum fatigue (PPF) and depressive mood and promoting maternal functioning among first-time mothers in Bangladesh.Methods: A non-synchronized quasi-experimental design was used. First-time mothers were recruited during postpartum (PP) and assigned to the experimental or control group (34 each). The experimental group attended the NL-PPSC—a 1-day intervention that focused on increasing self-efficacy—at a hospital in person. The control group received usual care. Data on PPF, depressive mood, maternal functioning, self-care behaviors, PP self-efficacy, and self-care knowledge were collected at 2 weeks PP (attrition 23.5%) and 6 weeks PP (attrition 16.1%). Data were analyzed using descriptive statistics, bivariate statistics, and linear mixed model analysis.Results: One-third (33.3%) of new mothers experienced depressive mood (Edinburgh Postnatal Depression Scale scores of ≥13 points). The NL-PPSC intervention statistically significantly decreased PPF (β=–6.17, SE=1.81, t=–3.39, p<.01) and increased maternal functioning at 6 weeks PP in the experimental group (β=13.72, t=3.73, p<.01) as opposed to the control group. Knowledge was also statistically significant for increased maternal functioning over time (β=.37, SE=.18, t=2.03, p<.05). However, no statistically significant differences in PP depressive mood were observed over time.Conclusion: The NL-PPSC intervention was feasible and effective at improving fatigue and maternal functioning in Bangladeshi mothers at 6 weeks PP. PP care knowledge was effective at improving maternal functioning; this finding supports the implementation of the NL-PPSC intervention for new mothers after childbirth.
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Lemons, Pamela. "From Gavage to Oral Feedings: Just a Matter of Time." Neonatal Network 20, no. 3 (April 2001): 7–14. http://dx.doi.org/10.1891/0730-0832.20.3.7.
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The ability to safely and efficiently feed by mouth is based on oral-motor competence, neurobehavioral organization, and gastrointestinal maturity. Although most infants successfully make the transition to oral feedings as they approach term gestation, infants who were very immature at birth have historically had the most difficulty achieving this milestone. Postnatal complications (chronic lung disease, intraventricular hemorrhage, seizures, and so on) are also associated with delays in the onset of the first feeding, as well as with delays in achieving full enteral intake.Weaning the infant to breast is a slow and gradual process that may necessitate supplemental gavage or bottle feedings. A variety of measures—such as positioning, containment, reduced milk flow, and imposed rest breaks—may help to facilitate better oral intake, but infants probably benefit most from the passage of time. Frequently, the older the infant is at first feeding, the shorter the time required to make the transition to full oral feedings. Rather than attempting to accelerate the inherent maturational processes that form the basis for oral feeding, efforts might better be spent in providing adequate nutritional support while avoiding unnecessary stress and fatigue.
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Mariany, Mariany, Rosani Naim, and Iis Afrianty. "Hubungan Dukungan Sosial dengan Kejadian Postpartum Blues pada Ibu Nifas di Wilayah Kerja Puskesmas Pomalaa." Jurnal Surya Medika 8, no. 2 (August 31, 2022): 319–24. http://dx.doi.org/10.33084/jsm.v8i2.3916.
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Postpartum blues is a natural response to drastic hormonal changes after giving birth that affect the physical and emotional state of postpartum mothers. These drastic hormonal changes are not the main factor in the occurrence of postpartum blues, but the impact on the mother's psychological life, such as the lack of support from her husband, family, or community, postpartum fatigue, worries about economic conditions, and other social problems. This study aimed to determine the relationship between social support and the incidence of postpartum blues in postpartum mothers in the working area of the Pomalaa Health Center. This type of research is a correlation analytic with a cross-sectional design with a population of 50 postpartum mothers. Data was collected using the Postpartum Depression Predictors Inventory (PDPI) and the Edinburgh Postnatal Depression Scale (EPDS) questionnaire. 12 postpartum mothers experienced postpartum blues (24%). Four received less social support, and 8 people received good social support. There is a relationship between social support and postpartum blues in postpartum mothers in the Pomalaa Health Center working area with a p-value of 0.002. Husbands and families, as the closest people, are expected to be able to provide social support to postpartum mothers so that mothers avoid postpartum blues.
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Park, Jiyun, and Kyung-Sook Bang. "The physical and emotional health of South Korean mothers of preterm infants in the early postpartum period: a descriptive correlational study." Child Health Nursing Research 28, no. 2 (April 30, 2022): 103–11. http://dx.doi.org/10.4094/chnr.2022.28.2.103.
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Purpose: This study investigated the physical and emotional health of South Korean mothers of preterm infants in the early postpartum period.Methods: In this descriptive correlational study, the participants included 91 mothers of preterm infants who were admitted to the neonatal intensive care unit of a tertiary hospital in South Korea. Physical health status was measured using a self-reported questionnaire, postpartum depression using the Edinburgh Postnatal Depression Scale, anxiety using the State-Trait Anxiety Inventory, and guilt using a 4-item scale.Results: Fatigue had the highest score among mothers' physical health problems, followed by shoulder pain, nipple pain, neck pain. The average postpartum depression score was 11.02 points, and 44% of women had postpartum depression with a score of 12 or above. Postpartum depression significantly was correlated with physical health (r=.35, p=.001), anxiety (r=.84, p<.001), and guilt (r=.75, p<.001) and was significantly higher for women with multiple births, and preterm infants who required ventilator and antibiotic treatment. Anxiety also showed a significant difference according to preterm infants’ condition.Conclusion: The significant correlations between postpartum depression and physical health, anxiety, and guilt indicate a need for nursing interventions that provide integrated management of mothers’ physical and emotional health.
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Anggraeni, Ni Putu Dian Ayu, Lucky Herawati, Melyana Nurul Widyawati, and I. Komang Leo Triandana Arizona. "The Effect of Exercise on Postpartum Women’s Quality of Life: A Systematic Review." Jurnal Ners 14, no. 3 (January 3, 2020): 146. http://dx.doi.org/10.20473/jn.v14i3.16950.
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Postpartum mothers are vulnerable to several problems during the puerperium, such as fatigue, sleep disorders, anxiety, depression, sexual problems, physical functioning and dissatisfaction with partner support that can affect their quality of life. The aim of this systematic review is to explore the effect of exercise on postpartum women’s quality of life. Comprehensive searches including experimental studies (including RCTs and non-randomized trials) from several databases, namely Scopus, PubMed, and Science-Direct, were used to search for scientific contributions published between 2009 and 2019. The articles are identified using the relevant keywords. This systematic review is guided by PRISMA. Fourteen of the 636 articles met both the inclusion and exclusion criteria. The postpartum exercises found in this study were Yoga, Pelvic Floor Muscle Training (PFMT), Pilates, Postnatal Exercise, Aerobic Exercise and Progressive Muscle Relaxation (PMR). This review cannot provide definitive conclusions about the best form of exercise, the suggested duration or the timing needed to improve the quality of life for postpartum women. However, Yoga and Pilates are proven to effectively improve maternal well-being because this exercise focuses on increasing the physical, psychological and social support during the postpartum period. Further research is needed to provide evidence and to strengthen the results of this systematic review.
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Ahn, Jin, Dong-Hwan Kim, Hee-Bok Park, Sang-Hyun Han, Seongsoo Hwang, In-Cheol Cho, and Jeong-Woong Lee. "Ectopic Overexpression of Porcine Myh1 Increased in Slow Muscle Fibers and Enhanced Endurance Exercise in Transgenic Mice." International Journal of Molecular Sciences 19, no. 10 (September 28, 2018): 2959. http://dx.doi.org/10.3390/ijms19102959.
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Myosin heavy chain (MyHC) isoforms consist of Myh7, Myh2, Myh1, and Myh4, which are expressed in skeletal muscle tissues during postnatal development. These genes influence the contraction–relaxation activity in skeletal muscles and are involved in determining muscle composition such as the proportion of fast-to-slow and/or slow-to-fast fiber types. Among them, Myh1 is associated with skeletal muscle contraction and is involved in both slow-to-fast and fast-to-slow transition. However, the muscle transition mechanism is not well understood. For this study, we first produced porcine Myh1 transgenic (TG) mice to study whether the ectopic expressed porcine Myh1 gene had any effects on muscle composition, especially on slow-type muscle components. Our results showed that the factors associated with slow muscles, such as Myh7, Myoglobin, Troponin (slow-type units), and cytochrome C, were highly expressed in the quadriceps muscles of Myh1 transgenic mice. Furthermore, the ectopic porcine MYH1 protein was located only in the slow-type muscle fibers of the quadriceps muscles in Myh1 transgenic mice. In physical endurance tests, Myh1 transgenic mice ran longer and further on a treadmill than wild-type (WT) mice. These data fully supported our hypothesis that Myh1 is associated with slow muscle composition, with overexpression of Myh1 in muscle tissues possibly being a new key in modulating muscle fiber types. Our study provides a better understanding of muscle composition metabolism, physical mobility, and genetic factors in muscle fatigue.
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Fine, Michael L., Noelle M. Burns, and Thomas M. Harris. "Ontogeny and sexual dimorphism of sonic muscle in the oyster toadfish." Canadian Journal of Zoology 68, no. 7 (July 1, 1990): 1374–81. http://dx.doi.org/10.1139/z90-205.
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Previous work has shown that neurons in the sonic motor nucleus of the oyster toadfish, Opsanus tau, grow larger in males than in females and increase in size and number for 7–8 years. In order to correlate postnatal motoneuron development with growth of target muscle fibers, we examined the ontogeny of sonic muscle growth. Both the swim bladder and attached sonic muscles increased in size for life and were, respectively, 20 and 44% larger in males than in females. The muscle and swim bladder grew at an equivalent rate in males, whereas in females, muscle growth did not keep up with bladder growth. The number of muscle fibers increased about 16-fold (31 000 to 488 000), and mean minimum fiber diameter increased almost 3-fold (11.5 to 28.6 μm) as fish grew. Fibers were 15.3% larger in females than in males (adjusted means of 21.9 and 19.0 μm, respectively), but males had 47% more fibers per muscle (adjusted means of 307 000 and 209 000). Muscle fibers also exhibited morphological changes. Most of the fibers in two juveniles had yet to differentiate the core of sarcoplasm characteristic of sonic muscle, whereas the largest cells in mature males and females tended to have multiple pockets of sarcoplasm and a contractile cylinder split into fragments. Multiple pockets in large fibers and the presence of smaller fibers in males than females are interpreted as adaptations for increased speed and fatigue resistance.
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Okun, Michele, Leilani Feliciano, Harvey Karp, and Keston Lindsay. "759 Sleep and Mental Health in New Mothers with a History of Depression: Preliminary Data from Late Pregnancy to 1-month Postpartum." Sleep 44, Supplement_2 (May 1, 2021): A296. http://dx.doi.org/10.1093/sleep/zsab072.756.
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Abstract Introduction Perinatal women report more sleep disruptions than non-pregnant women. This phenomenon is exaggerated among women with a history of depression, as sleep complaints are one of the most frequent symptoms of depression. Understanding the change in sleep and mental health from late pregnancy to postpartum may provide insights into prevention and intervention. Presented here are preliminary data from new mothers regarding sleep and mental health. Methods Preliminary examination of sleep and psychological data from 22 women enrolled in a study to assess the efficacy of the SNOO on infant and maternal sleep during the first 6 months of life. Participants were eligible if they had a history of, but no active depression as assessed by the Edinburgh Postnatal Depression Scale (EPDS). Data are from late pregnancy and at 1-month postpartum. Questionnaires included the Pittsburgh Sleep Quality Index (PSQI), Insomnia Symptom Questionnaire (ISQ), Epworth Sleepiness Scale (ESS), Flinders Fatigue Scale (FFS), and the Generalized Anxiety Disorder scale (GAD). Paired t-tests or chi-square tests were used to assess change over the first month postpartum. Linear regressions were done to determine whether sleep in late pregnancy was associated with depression and anxiety scores. Results Participants were 30 ± 2.2 years of age and 72.7% were White. In the first month postpartum, sleep was negatively impacted. Clinical insomnia increased (4 (18.2%) vs 5 (22.7%); X2 = 7.61, p = .006), sleep quality (PSQI) worsened (6.13 ± 3.54 vs 8.89 ± 3.54; t = -3.03, p =n .006), daytime sleepiness was higher (4.77 ± 2.51 vs 6.64 ±3.44; t = -3.31, p = .003), and fatigue was greater (9.55 ± 4.73 vs 13.36 ± 5.86; t = -3.21, p = .004). Likewise, depression and generalized anxiety increased (p’s < .01). Insomnia in late pregnancy was associated with more depression (β = .542, p = .009) and more anxiety (β = .510, p = .015). Conclusion Pregnant women with a history of depression are at risk for more sleep disturbances, and therefore more likely to be at significant risk for a recurrent depressive episode. Improving sleep in the perinatal period could have a positive impact. Support (if any) Happiest Baby Inc.
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Khursheed, Gazala. "A QUASI-EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF GARLIC SCENTED MUSTARD OIL FOOT MASSAGE ON FATIGUE AFTER CHILDBIRTH AMONG POSTNATAL MOTHERS IN SELECTED HOSPITALS OF DISTRICT MOHALI, PUNJAB." GFNPSS GLOBAL NURSING JOURNAL OF INDIA 3, no. III (December 31, 2020): 269. http://dx.doi.org/10.46376/gnji/3.iii.2020.269-272.
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Rogozina, N. V., V. V. Vasil’ev, N. S. Bezverhaja, R. A. Ivanova, G. M. Ushakova, and E. S. Romanova. "Cytomegalovirus infection in immunocompetent pregnant women: clinical manifestations and management tactics." Journal Infectology 14, no. 2 (July 13, 2022): 80–86. http://dx.doi.org/10.22625/2072-6732-2022-14-2-80-86.
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Objective: to analyze clinical manifestations, diagnostic and therapeutic approaches to management of pregnant women with cytomegalovirus infection for optimization of clinical and laboratory diagnostics and reduction of risks of congenital cytomegalovirus infection in the postnatal period.Materials and methods: in the article describe results a retrospective study the pregnancy course of 92 women who had 94 children with a confirmed congenital manifest form of cytomegalovirus infection. The inclusion criteria in main group were women aged 18-40 years and presence the results of examination for TORCH-syndrome in the first trimester of pregnancy, negative results for HIV. Markers of cytomegalovirus infection were determined by PCR (blood, vaginal secretions) and serologically (IgM, IgG to CMV-infection).Findings: the study showed that acute cytomegalovirus infection was documented during pregnancy in 18.4% of cases, and recrudescence of CMV-infection only in 33.6% of cases. Acute cytomegalovirus infection was asymptomatic in 35.3% of patients, the rest had nonspecific symptoms in the form of fatigue and headache, cholestasis was registered in 35.2% of cases, whereas with recrudescence of cytomegalovirus infection, catarrhal symptoms in the form of rhinitis and pharyngitis prevailed 42,8% cases, p<0,05. 15 people received therapy during pregnancy: 2 of them – antiviral (valgancyclovir), 11 – immunocorrective (interferon2alfa) and 2 – pathogenetic therapy (blood transfusion to the fetus for anemia). Based on the literature data and obtained by analyzing management tactics of the observed pregnant women, an algorithm for the management of pregnant women with cytomegalovirus infection was created.Conclusion: the study made it possible to substantiate algorithm of diagnosis and tactics management of cytomegalovirus infection in immunocompetent pregnant women and gave recommendations for obstetricians and gynecologists about alertness regarding cytomegalovirus infection.
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Karisnan, Kanakeswary, Tanzila Mahzabin, Anthony J. Bakker, Yong Song, Peter B. Noble, J. Jane Pillow, and Gavin J. Pinniger. "Gestational age at time of in utero lipopolysaccharide exposure influences the severity of inflammation-induced diaphragm weakness in lambs." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 314, no. 4 (April 1, 2018): R523—R532. http://dx.doi.org/10.1152/ajpregu.00150.2017.
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The preterm diaphragm is functionally immature compared with its term counterpart. In utero inflammation further exacerbates preterm diaphragm dysfunction. We hypothesized that preterm lambs are more vulnerable to in utero inflammation-induced diaphragm dysfunction compared with term lambs. Pregnant ewes received intra-amniotic (IA) injections of saline or 10 mg lipopolysaccharide (LPS) 2 or 7 days before delivery at 121 days (preterm) or ∼145 days (term) of gestation. Diaphragm contractile function was assessed in vitro. Plasma cytokines, diaphragm myosin heavy chain (MHC) isoforms, and oxidative stress were evaluated. Maximum diaphragm force in preterm control lambs was significantly lower (22%) than in term control lambs ( P < 0.001). Despite similar inflammatory cytokine responses to in utero LPS exposure, diaphragm function in preterm and term lambs was affected differentially. In term lambs, maximum force after a 2-day LPS exposure was significantly lower than in controls (by ~20%, P < 0.05). In preterm lambs, maximum forces after 2-day and 7-day LPS exposures were significantly lower than in controls (by ~30%, P < 0.05). Peak twitch force after LPS exposure was significantly lower in preterm than in controls, but not in term lambs. In term lambs, LPS exposure increased the proportion of MHC-I fibers, increased twitch contraction times, and increased fatigue resistance relative to controls. In preterm diaphragm, the cross-sectional area of embryonic MHC fibers was significantly lower after 7-day versus 2-day LPS exposures. We conclude that preterm lambs are more vulnerable to IA LPS-induced diaphragm dysfunction than term lambs. In utero inflammation exacerbates diaphragm dysfunction and may increase susceptibility to postnatal respiratory failure.
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Jandrić-Kočić, Marijana. "Postpartal depression and thyroid disorders." Praxis medica 49, no. 1-2 (2020): 53–57. http://dx.doi.org/10.5937/pramed2002053j.
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Introduction: Postpartum depression negatively affects a woman's quality of life and the development of a relationship with her child, which can have far-reaching consequences on the cognitive, behavioral and emotional development of the child. Etiology includes genetic predisposition, sudden hormonal changes, and sociodemographic factors. Case report: A 28-year-old patient, married, mother of a one-month-old boy. She graduated from the High school of economics, unemployed. She appears in the family medicine clinic due to chronic fatigue and bad mood, at the insistence of her husband, who thinks that she needs professional help. She grew up in a harmonious family. He gets along well with his wife, there are no existential problems. It denies previous illnesses. Neat appearance, inconspicuous posture and behavior, psychomotor diskette slowed down, more sparse spontaneous verbalization, slightly compromised volitional instinctual dynamisms, lowered basic mood. In the laboratory findings, hypothyroidism with elevated thyroid peroxidase antibody and antithyreoglobulin antibodies is detected. The thyroid ultrasound verifies the right lobe of 46x14x15mm, the left lobe of 48x13x12mm, inhomogeneous and easily hypoechoic structure. The Edinburgh Postnatal Depression Scale indicates the presence of depression (total score 18). The patient is referred for a consultative examination by a psychiatrist and a nuclear medicine specialist. Psychiatrist indicates the introduction of Sertralin 50 mg tablets (1x1/2 for the first seven days, then 1x1) and Bromasepam tablets 1,5 mg (2x1/2), nuclear specialist Levotiroskin sodium tablets 50 mcg (1x1/2 for 5 days and 1x1 for 2 days). After six months, withdrawal of the symptoms of the disease and exclusion of therapy by a psychiatrist. Conclusion: Autoimmune thyroid disease is a significant and often unrecognized cause of postpartum depression. Early detection and timely therapeutic intervention of these have a significant role in the prevention and successful treatment of postpartum depression.
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Hickie, Ian B., Elizabeth M. Scott, and Tracey A. Davenport. "Are Antidepressants All the Same? Surveying the Opinions of Australian Psychiatrists." Australian & New Zealand Journal of Psychiatry 33, no. 5 (October 1999): 642–49. http://dx.doi.org/10.1080/j.1440-1614.1999.00632.x.
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Objective: Controlled trials do not suggest differences in efficacy between antidepressant compounds. Psychiatrists, however, frequently express the view that real differences do exist and are relevant to clinical practice. Since multiple comparative trials are not feasible, an alternative method for expanding the evidence base is to survey regularly the opinions of practising psychiatrists. Method: Two surveys of psychiatrists' opinions were conducted. Participants in the first survey were drawn from contact with ‘SPHERE: A National Depression Project’, while those in the second survey responded to a brief questionnaire distributed with Australasian Psychiatry. Results: Reported volumes of scripts written, ratings of efficacy and tolerability, and preferences in specific clinical situations indicate that clinical psychiatrists now strongly prefer the newer antidepressant agents. They rate serotonin and noradren-alin re-uptake inhibitors (SNRIs) and selective serotonin re-uptake inhibitors (SSRIs) highest for antidepressant efficacy, serotonin receptor subtype 2 (5HT2) antagonists and some SSRIs highest for anti-anxiety efficacy, and some SSRIs and reversible inhibitors of monoamine oxidase inhibitor-A (RIMAs) lowest for side-effect burden. Further, SSRIs were their first preferences for most clinical situations. Serotonin and noradrenalin re-uptake inhibitors were the preferred choice for treatment-resistant depression and patients who had failed to respond to one SSRI. Serotonin receptor subtype 2 antagonists were the second choice to SSRIs for mixed anxiety and depression, and major depression with sleep disturbance. Reversible inhibitors of monoamine oxidase inhibitor-A were the second choice to SSRIs for adolescents with major depression, patients aged over 65 years, patients with serious medical illnesses and patients with chronic fatigue. Tricyclic antidepressants (TCAs) were the preferred choice for patients with chronic pain, and second choice to SSRIs for patients with major depression with panic disorder, postnatal disorders and patients with psychotic depression. Conclusion: Psychiatrists believe that important differences do exist between available antidepressant compounds. Such opinions are divergent from limited controlled data but may be influenced by a wide range of factors other than direct clinical experience. The role of such surveys in ongoing evaluation of clinical practice is emphasised.
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Sun, Yaoyao, Yanyan Li, Juan Wang, Qingyi Chen, Alessandra N. Bazzano, and Fenglin Cao. "Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial." Journal of Medical Internet Research 23, no. 1 (January 27, 2021): e23410. http://dx.doi.org/10.2196/23410.
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Background Despite potential for benefit, mindfulness remains an emergent area in perinatal mental health care, and evidence of smartphone-based mindfulness training for perinatal depression is especially limited. Objective The objective of this study was to evaluate the effectiveness of a smartphone-based mindfulness training intervention during pregnancy on perinatal depression and other mental health problems with a randomized controlled design. Methods Pregnant adult women who were potentially at risk of perinatal depression were recruited from an obstetrics clinic and randomized to a self-guided 8-week smartphone-based mindfulness training during pregnancy group or attention control group. Mental health indicators were surveyed over five time points through the postpartum period by online self-assessment. The assessor who collected the follow-up data was blind to the assignment. The primary outcome was depression as measured by symptoms, and secondary outcomes were anxiety, stress, affect, sleep, fatigue, memory, and fear. Results A total of 168 participants were randomly allocated to the mindfulness training (n=84) or attention control (n=84) group. The overall dropout rate was 34.5%, and 52.4% of the participants completed the intervention. Mindfulness training participants reported significant improvement of depression (group × time interaction χ24=16.2, P=.003) and secondary outcomes (χ24=13.1, P=.01 for anxiety; χ24=8.4, P=.04 for positive affect) compared to attention control group participants. Medium between-group effect sizes were found on depression and positive affect at postintervention, and on anxiety in late pregnancy (Cohen d=0.47, –0.49, and 0.46, respectively). Mindfulness training participants reported a decreased risk of positive depressive symptom (Edinburgh Postnatal Depression Scale [EPDS] score>9) compared to attention control participants postintervention (odds ratio [OR] 0.391, 95% CI 0.164-0.930) and significantly higher depression symptom remission with different EPDS reduction scores from preintervention to postintervention (OR 3.471-27.986). Parity did not show a significant moderating effect; however, for nulliparous women, mindfulness training participants had significantly improved depression symptoms compared to nulliparous attention control group participants (group × time interaction χ24=18.1, P=.001). Conclusions Smartphone-based mindfulness training is an effective intervention in improving maternal perinatal depression for those who are potentially at risk of perinatal depression in early pregnancy. Nulliparous women are a promising subgroup who may benefit more from mindfulness training. Trial Registration Chinese Clinical Trial Registry ChiCTR1900028521; http://www.chictr.org.cn/showproj.aspx?proj=33474
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Kusbandiyah, Jiarti, and Yuniar Angelia Puspadewi. "Pengaruh Postnatal Massage terhadap Proses Involusi dan Laktasi Masa Nifas di Malang." Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) 7, no. 1 (April 5, 2020): 065–72. http://dx.doi.org/10.26699/jnk.v7i1.art.p065-072.
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Masa Nifas merupakan masa kritis bagi ibu pasca melahirkan. Ketidaksiapan secara fisik, psikis, mental dan spiritual dalam menghadapi masa ini akan membuat masa nifas berjalan tidak normal. Parameter kesuksesan masa nifas adalah proses involusi dan laktasi. Permasalahn involusi dilihat dari banyaknya perdarahan postpartum yang disebabkan oleh atonia uteri di Kabupaten Malang sebanyak 34%, sedangkan permasalahan laktasi dikaitkan dengan pemberian ASI Eksklusif di Kota Malang masih rendah sekitar 60%. Salah satu upaya yang bisa dilakukan adalah tindakan postnatal massage. Tindakan tersebut dapat merelaksasikan ketegangan dan mengatasi keletihan pasca melahirkan yang dapat memicu subinvolusi dan kegagalan laktasi. Penelitian ini bertujuan untuk mengetahui pengaruh postnatal massage terhadap proses involusi dan laktasi pada masa nifas. Penelitian dilaksanakan di beberapa Bidan Praktik Mandiri (PMB) di kota dan kabupaten Malang menggunakan desain quasi experimental. Populasi adalah ibu postpartum 2 jam sampai dengan 6 hari. Sampel diambil menggunakan purposive sampling sebanyak masing-masing 21 ibu postpartum kelompok perlakuan dan kelompok kontrol. Data penelitian menggunakan data primer dan dianalisis secara deskriptif dan analitik. Analisis data menggunakan uji Mann-Whitney menunjukkan hasil p-value 0,093 untuk involusi dan 0,369 untuk laktasi. Kesimpulannya adalah tidak ada pengaruh signifikan antara postnatal massage dengan involusi dan laktasi pada masa nifas. Postnatal massage lebih berkaitan dengan efek jangka pendek dalam memberikan efek relasasi dan mengurangi keletihan pasca melahirkan. Dukungan dan motivasi dalam bentuk dukungan psikologis dan peran dalam merawat bayi sangat diperlukan oleh ibu postpartum dalam menjaga proses involusi dan laktasi tetap lancar. Puerperium is a critical period for mother after giving birth. Physical, psychological, mental and spiritual unpreparedness in dealing with this period will make the puerperium run abnormally. The parameters of the success of the puerperium are ivolution and lactation. The problem of involution can be seen from the amount of postpartum hemorrhage caused by uterine atony in Malang as much as 34%, while the lactation problem associated with exclusive breastfeeding in malang is still around 60% low. One effort that can be done is postnatal massage. These action can relax tension and overcome postpartum fatique wich can trigger subinvolution and lactation failure. This study aims to know the effect of postnatal massage on involution and lactation during the puerperium. The study was conducted in several independent midwifery practice in the city and district of Malang using a quasi experimental design. The population is postpartum mothers 2 hours to 6 days. Samples were taken using purposive sampling as amany as 21 postpartum mothers in the treatment group dan control group. Data analysis using the Mann-Whitney test showed p-values 0,093 for involution and 0,369 for lactation. The conclution is that there no significant effect between postnatal massage with involution and lactation in the puerperium. Postnatal massage has more to do with short-term effects in providing a relationship effect and reducing postpartum fatique. Support and motivation in the form of psychological supports and the role in caring for infants is needed by postpartum mothers in maintaining the process of involution and lactation remain smooth.
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Fenta, Esete Habtemariam, Bilal Shikur Endris, Yalemwork Getenet Mengistu, Fekadu Elias Sadamo, Endashaw Hailu Gelan, Tsegaye Gebrezgher Beyene, and Seifu Hagos Gebreyesus. "Landscape analysis of nutrition services at Primary Health Care Units (PHCUs) in four districts of Ethiopia." PLOS ONE 15, no. 12 (December 3, 2020): e0243240. http://dx.doi.org/10.1371/journal.pone.0243240.
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Background Good nutrition and healthy growth during the first 1000days have lasting benefit throughout life. For this, equally important is the structural readiness of health facilities. However, structural readiness and nutrition services provision during the first 1000 days in Ethiopia is not well understood. The present study was part of a broader implementation research aimed at developing model nutrition districts by implementing evidence based, high impact and cost-effective package of nutrition interventions through the continuum of care. This study was aimed at assessing structural readiness of health facilities and the extent of nutrition service provision in the implementation districts. Methods This assessment was conducted in four districts of Ethiopia. We used mixed method; a quantitative study followed by qualitative exploration. The quantitative part of the study addressed two-dimensions, structural readiness and process of nutrition service delivery. The first dimension assessed attributes of context in which care is delivered by observing availability of essential logistics. The second dimension assessed the service provision through direct observation of care at different units of health facilities. For these dimensions, we conducted a total of 380 observations in 23 health centers and 33 health posts. The observations were conducted at the Integrated Management of Neonatal and Childhood Illnesses unit, immunization unit, Antenatal care unit and Postnatal care unit. The qualitative part included a total of 60 key informant interviews with key stakeholders and service providers. Result We assessed structural readiness of 56 health facilities. Both quantitative and qualitative findings revealed poor structural readiness and gap in nutrition services provision. Health facilities lack essential logistics which was found to be more prominent at health posts compared to health centers. The process evaluation showed a critical missed opportunity for anthropometric assessment and preventive nutrition counselling at different contact points. This was particularly prominent at immunization unit (where only 16.4% of children had their weight measured and only 16.2% of mothers with children under six month of age were counselled about exclusive breastfeeding). Although 90.4% of pregnant women who came for antenatal care were prescribed iron and folic acid supplementation, only 57.7% were counselled about the benefit and 42.4% were counselled about the side effect. The qualitative findings showed major service provision bottlenecks including non-functionality of the existing district nutrition coordination body and technical committees, training gaps, staff shortage, high staff turnover resulting in work related burden, fatigue and poor motivation among service providers. Conclusion We found a considerable poor structural readiness and gaps in delivering integrated nutrition services with a significant missed opportunity in nutrition screening and counselling. Ensuring availability of logistics and improving access to training might improve delivery of nutrition services. In addition, ensuring adequate human resource might reduce missed opportunity and enable providers to provide a thorough preventive counselling service.
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Zisovska, Elizabeta, Lidija Madzovska, and Marija Dimitrovska Ivanova. "TRANSIENT TACHYPNEA OF THE NEWBORN." Knowledge International Journal 34, no. 4 (October 4, 2019): 925–29. http://dx.doi.org/10.35120/kij3404925z.
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Transient tachypnea of the newborn is a mild breathing problem. It affects babies during the first hours of life. Tachypnea means fast breathing rate, and usually affects term newborns, more likely those delivered by C-section. The problem usually goes away without treatment in 3 days or less. Only a small number of all newborn babies get this breathing problem. Your baby's healthcare provider may use a chest X-ray to help diagnose the problem. On X-ray, the lungs look streaked and overinflated. The symptoms of this breathing problem may be similar to other more serious respiratory problems. These include lung infection (pneumonia) or premature lungs (respiratory distress syndrome). Often transient tachypnea of the newborn is diagnosed when symptoms go away in the first few hours to days of life. The Aim of this study was to evaluate and describe the frequency and course of perinatal and postnatal factors in neonates experiencing transient tachypnea during the first hours of life and to determine risk factors for complications of this condition.Methods: This was prospective opservational study during the period of six months in 2019, at the University Clinic for Gynecology and Obstetrics in Skopje. In the evaluation process were included newborn children born later than 34 gestational weeks, admitted to the Neonatal Department. The correlation between gestational age and need of oxygen support was determined, and the overall outcome of those newborns presented. If necessary, X-ray of lungs was performed.Results: In this study 2268 newborns were evaluated, born as late preterm (35th and 36th gestational age) and term newborns. None of the evaluated newborns was admitted to the Intensive Neonatal Care Unit. The C-section rate in the facility during this period for the evaluated newborns was 38,5%. Transient tachypnea was detected in 178 newborn babies, 65/178 were late preterm and 113/178 were term newborns. The proportion of preterm/term newborns was 246/2022. The accurate diagnosis has to be confirmed with X-ray in 30% of all of them presenting unclear signs of respiratory problems. The condition was resolved by its own in 83%, and the other have developed symptoms of more severe respiratory diseases, as respiratory distress syndrome in premature infants, congenital pneumonia, or respiratory condition of extra-pulmonary origin. Discussion: Transient tachypnea of the newborn occurs in approximately 1 in 100 preterm infants and 3.6-5.7 per 1000 term infants. It is most common in infants born by Cesarian section without a trial of labor after 35 weeks' gestation. It is self-limiting condition and the symptoms are resolved spontaneously, excluding some cases which could be complicated. The likelihood of complications is 1-2%.Conclusion: Transient tachypnea is very common cause of respiratory condition in neonates. Fortunately, the prognosis is very good, but when managing transient tachypnea of the newborn, it is imminent to observe for development of respiratory fatigue and signs of clinical deterioration that may suggest some other diagnoses.