To assess the effect of peer support on preventing or treating perinatal depression.
Eight databases (Wanfang, VIP, CNKI, CBM, Pubmed, Embase, PsycINFO, and Cochrane) were systematically searched for ...eligible randomized controlled trials from inception to July 2021. Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed extraction form.
A total of 16 studies (including 3154 participants, peer support group: 1568, control group: 1586) were included in this meta-analysis. The intervention group (peer support) had significantly better effect on preventing or treating perinatal depression than the control group SMD = −0.39, 95% CI (−0.54, −0.24), P < 0.00001, I2 = 78%. The results of subgroup analyses showed that peer support interventions provided in the perinatal period SMD = −0.51, 95% CI (−0.93, −0.09), P = 0.02 or only in the postpartum period could improve the depression of mothers SMD = −0.44, 95% CI (−0.62, −0.26), P < 0.00001. Face-to-face interventions SMD = −0.28, 95% CI (−0.40, −0.15), P < 0.0001 and telephone/internet-based interventions SMD = −0.73, 95% CI (−0.95, −0.50), P < 0.00001 were both effective for perinatal depression. As for form of intervention, the combination of individual and group sessions had the best effect on improving perinatal depression SMD = −0.63, 95% CI (−1.04, −0.23), P = 0.002. Peer support with the frequency of at least once a week had a significant effect on perinatal depression SMD = −0.88, 95% CI (−1.32, −0.44), P < 0.0001. Interventions with a length of ≤3 months SMD = −2.20, 95% CI (−3.35, −1.04), P = 0.0002 worked better than those lasting for 3–36 months SMD = −1.64, 95% CI (−2.38, −0.90), P < 0.0001 in perinatal depression management. Peer support could improve perinatal depression both in low- and middle-income countries SMD = −0.70, 95% CI (−0.95, −0.45), P < 0.00001 and high-income countries SMD = −0.15, 95% CI (−0.28, −0.02), P = 0.03.
Providing peer support during the perinatal period or only postpartum period, using Internet or telephone approaches, a combination of group and individual, at least once a week can be regarded as an effective measure to manage perinatal depression.
Mental health problems in parents have been identified as a risk factor for child maltreatment. The perinatal period (from conception to 1 year) is a critical period but it is unclear whether ...perinatal mental health problems are also associated with increased risk.
To review evidence on perinatal mental health and risk of child maltreatment.
Searches were conducted on six databases and 24 studies reported in 30 papers identified. Studies were conducted in seven countries, mainly the USA (n = 14). Sample sizes ranged from 48-14,893 and most examined mothers (n = 17). Studies were conducted in community (n = 17) or high-risk (n = 7) samples.
The majority of studies found a relationship between parental perinatal mental health problems and risk of child maltreatment, but inconsistent findings were observed between and within studies. The few studies that examined fathers (n = 6) all found a relationship between fathers’ mental health and risk of child maltreatment. Meta-analysis of 17 studies (n = 22,042) showed perinatal mental health problems increased risk of child maltreatment by OR 3.04 (95% CI 2.29–4.03). This relationship was moderated by type of sample, with larger effects for risk of child maltreatment in high-risk samples. The relationship was not moderated by type of mental illness, child maltreatment; methodological or measurement factors.
The association between perinatal mental health and risk of child maltreatment is similar to that observed at other times during childhood. Methodological heterogeneity and inconsistent findings mean conclusions are tentative and need to be considered alongside other individual, family and social/cultural risk factors.
Introduction
Determination of lithium levels in serum has become a standard of care due to its narrow therapeutic rang, thus an immediate test for determination of blood lithium may contribute to ...minimize toxicit, to avoid relapse and to ensure treatment adherence. This is particularly relevant during pregnancy and early postpartum because pharmaokinetic changes in renal physiology.
Objectives
The aim of this study is verify Medimate point-of-care method performance and systematically compare it with the routine laboratory measurement of lithium.
Methods
This cross-sectional method comparison study was conductec in the Unit of Perinatal Mental Health in the Hospital Clinic of Barcelona. Pearson and Bland-Altman analyses were performed to assess the accuracy, precision and correlation between the capillary electrophoresis technology (Medimate MiniLab) and the ion selective electrode (ISE) potentiometry method (AVL 9180).
Results
Twenty-five women with bipolar disorder in treatment with lithium during perinatal period were enrolled, corresponding to 75 blood specimens for analyses. Correlation (r), mean difference (bias), and 95% limit of agreement (LOA) of the point-of-care method r=0.917; bias 0.0021 (95% LOA; 0.440, 0.619) mEq/L, showed that difference between ISE method and capillary electrophoresis technology was not statistically significant.
Conclusions
Considering the practicality, the microchip capillary electrophoresis technology provides a simple and highly affordable way of measuring lithium levels in a single drop of blood outside the clinical laboratory. The Medimate point-of-care system (POC) appears well adapted for the rapid and specific detection of lithium as an alternative to the current ISE procedure.
Disclosure
No significant relationships.
•Some retrieval test parameters were significantly higher in ω3-deficient mice dams.•Oxytocin levels in the paraventricular nucleus were lower in ω3-deficient females.•The maternal behavior of ...ω3-deficient dams is delayed and easily interrupted.•Omega-3 fatty acids may normalize maternal behavior.
: Perinatal women often experience mood disorders and postpartum depression due to the physical load and the rapid changes in hormone levels caused by pregnancy, childbirth, and nursing. When the mother's emotions become unstable, their parental behavior (maternal behavior) may decline, the child's attachment may weaken, and the formation of mother–child bonding can become hindered. As a result, the growth of the child may be adversely affected. The objective of this study was to investigate the effect of ω3 fatty acid deficiency in the perinatal period on maternal behavior and the oxytocin concentration and fatty acid composition in brain tissue.
: Virgin female C57BL/6 J mice fed a ω3 fatty acid-deficient (ω3-Def) or adequate (ω3-Adq) diet were mated for use in this study. To assess maternal behavior, nest shape was evaluated at a fixed time from gestational day (GD) 15 to postpartum day (PD) 13, and a retrieval test was conducted on PD 3. For neurochemical measurement, brains were removed from PD 1–6 dams and hippocampal fatty acids and hypothalamic oxytocin concentrations were assessed.
: Peripartum nest shape scores were similar to those reported previously (Harauma et al., 2016); nests in the ω3-Def group were small and of poor quality whereas those in the ω3-Adq group were large and elaborate. The inferiority of nest shape in the ω3-Def group continued from PD 0–7. In the retrieval test performed on PD 3, dams in the ω3-Def group took longer on several parameters compared with those in the ω3-Adq group, including time to make contact with pups (sniffing time), time to start retrieving the next pup (interval time), and time to retrieve the last pup to the nest (grouping time). Hypothalamic oxytocin concentrations on PD 1–6 were lower in the ω3-Def group than in the ω3-Adq group.
: Our data show that ω3 fatty acid deficiency reduces maternal behavior, a state that continued during pup rearing. This was supported by the observed decrease in hypothalamic oxytocin concentration in the ω3-Def group. These results suggest that ω3 fatty acid supplementation during the perinatal period is not only effective in delivering ω3 fatty acids to infants but is also necessary to activate high-quality parental behavior in mothers.
•Previous research has established the link between housing instability and mental health.•Very little research has examined protective factors in this association.•Social support was directly ...related to lower levels of depressed mood and posttraumatic stress.•Social support was associated with a weaker relation between housing instability and depression.
Intimate partner violence (IPV) has significant consequences for women's mental health, and it also compromises women's economic security and livelihood, including housing stability. There is a dearth of research, however, on protective factors in the link between housing instability and psychopathology in IPV-exposed women.
The current study examines the protective role of social support in the association between housing instability and mental health (depression, posttraumatic stress) in a sample of pregnant, IPV-exposed women (N = 137).
Overall models for both depression and posttraumatic stress were significant (F = 6.42, p<.001; R2=16.3%; F = 15.09, p<.001; R2=31.0%, respectively). Housing instability was significantly associated with higher levels of depressed mood (β=0.20, p<.016), but not posttraumatic stress symptoms. Social support was significantly associated with lower levels of depressed mood (β=-0.17, p<.036) and posttraumatic stress (β=-0.38, p =0.001). The addition of the interaction term (housing instability*social support) resulted in a significant improvement in variance explained from the main effects model for depression (F = 4.90, p<.028, ∆R2=3.0%) and the interaction term was significant (β=-0.60, p=.029). An interaction effect of housing instability and social support on posttraumatic stress was not identified.
Although the current study is the first to examine protective factors in the relationship between housing instability and psychopathology in IPV-exposed pregnant women, data were cross-sectional and therefore directionality and temporality cannot be inferred.
Results suggest that housing instability may play a greater role in women's depressed mood than in their experience of posttraumatic stress symptoms, and the presence of social support may substantially ameliorate the effect of this adversity.
The development of an individual during fetal life and childhood is characterized by rapid growth as well as gradual maturation of organs and systems. Beyond the nutritional intake in essential ...nutrients, food contaminants can permanently influence the way organs mature and function. These processes are called “programming” and play an essential role in the occurrence of non-communicable chronic diseases throughout the lifespan. Populations as pregnant women, fetuses and young children are vulnerable and particularly sensitive to food contaminants which can induce epigenetic modifications transmissible to future generations. Among these contaminants, pesticides are found in most food matrices exposing humans to cocktails of molecules through variable concentrations and duration of exposure. The Maillard reaction products (MRPs) represent other food contaminants resulting from heat treatment of food. Modern diet, rich in fats and sugars, is also rich in neoformed pathogenic compounds, Advanced Glycation End products (AGEs), the levels of which depend on the heat treatment of foods and eating habits and whose effects on health are controversial. In this review, we have chosen to present the current knowledge on the impacts of selected pesticides and MRPs, on the risk of developing during life non-communicable chronic diseases such as IBD, metabolic disorders or allergies. A large review of literature was performed via Pubmed, and the most appropriate studies were summarised.
•Development during fetal life and infancy is characterized by rapid growth as well as maturation of organs and systems.•Diet contains numerous environmental contaminants (residues, neoformed compounds) that could contribute to the appearance of CNCD.•Food contaminants may permanently influence the way these organs mature and function, a process called “programming”.•Programming plays an important role in the occurrence of CNCD and the early life period is a window particularly sensitive to food contaminants.•Some contaminants may alter the programmed expression of some genes, resulting in effective remodeling of tissue structure and functionality.
This study aims to thoroughly explore to comprehensively examine the diverse types and subjective experiences of pain in postpartum women throughout perinatal period, aiming to deepen understanding ...and support the development of precise pain management strategies in nursing care.
A descriptive qualitative study.
Between August and November 2022, postpartum women attending outpatient clinics at a tertiary level A hospital were selected as participants. The study followed the framework of the THRIVE model and utilized a phenomenological method for qualitative research. In-depth semi-structured interviews were conducted with 21 postpartum women, and the data were analyzed using the Colaizzi 7-step analysis method.
Thematic analysis revealed that different postpartum women exhibited diverse perceptions of their own pain experiences. Three themes were identified to describe the pain encountered by postpartum women: (1) Experiencing pain is complex (including experiencing multiple kinds of pain, individual differences in pain, and pain is variable), (2) Double perceptions of pain (negative effects of pain and positive energy for perceiving pain), and (3) Fighting pain requires active support (active outside support and construct a positive self-coping style).
This study provides a comprehensive overview of perinatal pain management in postpartum women, offering recommendations for accurate pain understanding and management. Healthcare professionals should be vigilant about maternal pain changes and individual experiences, implement targeted measures and support, aid in alleviating psychological burdens, boost maternal confidence in childbirth, and enhance postpartum quality of life.
In this study, interviews were conducted in the hospital outpatient department, and the participants included in this study participated in the interviews to provide support for the implementation of this subject.
•Paternal and maternal depression increases offspring ADHD and ASD risks.•Parental depression in pre-pregnancy, perinatal and postnatal periods were associated with increased offspring ADHD and ASD ...risks.•The chronicity and additive effect of paternal and maternal depression increased offspring ADHD and ASD risks.
Studies have indicated that parental depression was slightly related to the increased risk of offspring attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). However, the association between exposure to parental depression at different neurodevelopmental stages (i.e., perinatal or postnatal period) and subsequent ADHD and ASD development remained uncertain.
708,515 children born between 2001 and 2008 were screened for ADHD and ASD based on ICD-9-CM codes of 314 and 299 given by psychiatrists from their birth to the end of 2011. Paternal and maternal depression was separately assessed during five periods, namely those before pregnancy (pre-pregnancy), during pregnancy (perinatal), and <1, 1–3, and >3 years after childbirth (postnatal). Cox regression analyses were performed.
Both paternal and maternal depression occurring in the pre-pregnancy, perinatal and postnatal periods were significantly associated with subsequent ADHD and ASD in the offspring, with hazard ratios between 1.42 (95% confidence interval CI: 1.35–1.49) and 2.25 (2.09–2.41). The chronicity and additive effect of paternal and maternal depression were related to increased risks of offspring ADHD and ASD. The effects of maternal depression were stronger than the effects of paternal depression for offspring ADHD (HR: 1.35, 95% CI: 1.27–1.45) and ASD (HR: 1.23, 95% CI: 1.05–1.46) risks.
Both paternal depression and maternal depression in the pre-pregnancy, perinatal and postnatal periods increases offspring ADHD and ASD risks, and these risks increase further with increases in the duration of parental depression and with the additive effect of parental and maternal depression.
Intimate partner violence (IPV) affects individuals and families from all backgrounds, regardless of their ethnicity, socio-economic status, sexual orientation, or religion. Pregnancy and childbirth ...could be a time of vulnerability to violence because of changes in physical, emotional, social, and economic demands and needs. Prevalence of IPV against women during the perinatal period is increasingly researched and documented. However, evidence on IPV prevalence among intimate partners as well as on the course of IPV over the perinatal period is scarce. The purpose of this review was to provide a narrative synthesis of the existing literature regarding the prevalence estimates of IPV among intimate partners over the perinatal period. Through this review, we also gained better insight into associated factors, as well as the various forms of IPV. Of the 766 studies assessing prevalence estimates identified, 86 were included, where 80 studies focused on unidirectional IPV (i.e., perpetrated by men against women) and six studies investigated bidirectional IPV (i.e., IPV perpetrated by both partners). Most of the included studies reported lower overall prevalence rates for unidirectional IPV postpartum (range: 2-58%) compared to pregnancy (range: 1.5-66.9%). Psychological violence was found to be the most prevalent form of violence during the entire perinatal period. Studies on bidirectional IPV mostly reported women's perpetration to be almost as high as that of their partner or even higher, yet their findings need to be interpreted with caution. In addition, our results also highlighted the associated factors of IPV among partners, in which they were assimilated into a multi-level ecological model and were analyzed through an intersectional framework. Based on our findings, IPV is found to be highly prevalent during the entire perinatal period and in populations suffering from social inequalities. Further research exploring not only the occurrence, but also the motivations and the context of the bidirectionality of IPV during the perinatal period may facilitate better understanding of the detrimental consequences on partners and their families, as well as the development of effective intervention strategies. Public health prevention approaches intervening at optimal times during the perinatal period are also needed.
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