Introduction: The perinatal period is an at-risk period for the emergence or decompensation of psychiatric disorders. Transcranial electrical stimulation (tES) is an effective and safe treatment for ...many psychiatric disorders. Given the reluctance to use pharmacological treatments during pregnancy or breastfeeding, tES may be an interesting treatment to consider. Our study aims to evaluate the efficacy and safety of tES in the perinatal period through a systematic literature review followed by three original case reports. Method: Following PRISMA guidelines, a systematic review of MEDLINE and ScienceDirect was undertaken to identify studies on tES on women during the perinatal period. The initial research was conducted until 31 December 2021 and search terms included: tDCS, transcranial direct current stimulation, tACS, transcranial alternating current stimulation, tRNS, transcranial random noise stimulation, pregnancy, perinatal, postnatal, and postpartum. Results: Seven studies reporting on 33 women during the perinatal period met the eligibility criteria. No serious adverse effects for the mother or child were reported. Data were limited to the use of tES during pregnancy in patients with schizophrenia or unipolar depression. In addition, we reported three original case reports illustrating the efficacy and safety of tDCS: in a pregnant woman with bipolar depression, in a pregnant woman with post-traumatic stress disorder (sham tDCS), and in a breastfeeding woman with postpartum depression. Conclusions: The results are encouraging, making tES a potentially safe and effective treatment in the perinatal period. Larger studies are needed to confirm these initial results, and any adverse effects on the mother or child should be reported. In addition, research perspectives on the medico-economic benefits of tES, and its realization at home, are to be investigated in the future.
This study aimed to monitor the effect of a high (HD; 140% of energy requirements) versus a low diet (LD; 80% energy requirements) on oxidative status in goats during the peripartum period. Blood ...samples were taken from all goats at −2, −1, 0 (partum), +2 and +4 weeks from delivery. Blood samples were assayed for their content of reactive oxygen metabolites (ROMs), thiol (SH) groups, total antioxidant capacity (OXY) and for glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities. The observation that ROMs levels significantly increased during the peripartum period was accompanied by a decrease of GSH-Px activity at weeks 2 and 4 postpartum, which suggested that the goats might have experienced some degree of oxidative stress and lipid peroxidation. Overall, changes to the nutritional level of the diet had very little or no effect on redox homeostasis. The lack of any correlation between the biomarkers measured indicated that each oxidative stress marker responded differently, indicating that redox homeostasis was impaired in these dairy goats during the peripartum period.
The objectives were to evaluate the effects of differential timing of supplementation of different Ca salts (CS) of fatty acids (FA) on FA profiles of cotyledonary-caruncular tissues, metabolic ...status, uterine health, pregnancy, pregnancy losses after 2 artificial inseminations (AI), and milk yield. Holstein cows (n=1,380) were assigned randomly to be fed either CS of palm oil (PO) or safflower oil (SO) from 30 d prepartum until 30 d postpartum (dpp) and further randomized to receive either CS of PO or fish oil (FO) from 30 to 160 dpp. Supplementation of CS of FA was at 1.5% of dietary dry matter. Tissues (n=23) and blood (n=32) were collected from a subsample of cows. Blood was collected daily from parturition to 10 dpp and three times weekly thereafter until 30 dpp for analyses of PGF2α metabolite, nonesterified FA, β-hydroxybutyric acid, blood urea nitrogen, and glucose. Cows were evaluated once between 8 to 10 dpp for cervical discharge type. At 43 dpp, cows received 2 injections of PGF2α 14 d apart, followed 14 d later by injections of GnRH at 7 d before and 56h after an injection of PGF2α with AI at 16h after the second GnRH injection. All cows received intravaginally a controlled internal drug-releasing device, containing 1.38g of progesterone, at 18 d after the first AI followed 7 d later by removal of the device and injection of GnRH. Nonpregnant cows at 32 d after AI were injected with PGF2α, followed 56h later with a GnRH injection and second AI 16h thereafter. Cows diagnosed pregnant after both AI were re-examined at 60 d of pregnancy to determine pregnancy losses. Milk weights were recorded monthly for all cows. Caruncular n-6:n-3 FA ratio was greater in cows fed SO. Plasma concentrations of metabolites and frequency of cervical discharge type did not differ between PO- and SO-fed cows. Plasma PGF2α metabolite was greater in SO-fed cows at 4 and 7 dpp. Pregnancy per AI at 32 and 60 d post first AI was not affected by diets, but pregnancy loss was less in FO-fed cows. At second AI, pregnancy was greater in FO-fed cows at 32 d and in SO-FO-fed cows at 60 d post AI. Pregnancy loss after second AI was not affected by diets. Overall pregnancy per AI was greater in cows fed SO followed by FO at 60 d of pregnancy and pregnancy loss was reduced in FO-fed cows. Monthly milk yield was greater (0.7 kg/d) in SO-fed cows. In conclusion, strategic feeding of CS of FA during transition and breeding periods can benefit fertility and milk production of lactating dairy cows.
The perinatal period is a vulnerable time for the development of psychopathology, particularly mood and anxiety disorders. In the study of maternal anxiety, important questions remain regarding the ...association between maternal anxiety symptoms and subsequent child outcomes. This study examined the association between depressive and anxiety symptoms, namely social anxiety, panic, and agoraphobia disorder symptoms during the perinatal period and maternal perception of child behavior, specifically different facets of development and temperament. Participants (N = 104) were recruited during pregnancy from a community sample. Participants completed clinician-administered and self-report measures of depressive and anxiety symptoms during the third trimester of pregnancy and at 16 months postpartum; child behavior and temperament outcomes were assessed at 16 months postpartum. Child development areas included gross and fine motor skills, language and problem-solving abilities, and personal/social skills. Child temperament domains included surgency, negative affectivity, and effortful control. Hierarchical multiple regression analyses demonstrated that elevated prenatal social anxiety symptoms significantly predicted more negative maternal report of child behavior across most measured domains. Elevated prenatal social anxiety and panic symptoms predicted more negative maternal report of child effortful control. Depressive and agoraphobia symptoms were not significant predictors of child outcomes. Elevated anxiety symptoms appear to have a distinct association with maternal report of child development and temperament. Considering the relative influence of anxiety symptoms, particularly social anxiety, on maternal report of child behavior and temperament can help to identify potential difficulties early on in mother-child interactions as well as inform interventions for women and their families.
Leaders in nursing education embrace innovative, real‐world learning environments that transform today's generation of nursing students into critical thinkers. Scheduling exclusive child‐bearing ...practicums are challenging due to staffing, time, and maternal client presentation. Utilizing transformative learning theory a perinatal continuum of care clinical learning experience evolved. This paper will discuss the qualitative, descriptive study of Bachelor of Science in Nursing students in rural, Midwestern United States who completed maternal/infant didactic, high‐fidelity simulation, and real‐world experiences relative to women during the perinatal period. Participants (n = 50) consisted of third‐semester baccalaureate nursing students enrolled in the maternal/infant course. Data were collected from students' reflective journal blogs at the end of the semester. The aim of this study was to identify the outcomes of students learning through this perinatal experience. Three themes emerged from this study: self‐analysis, critical thinking, and self‐efficacy. Students' reflection indicated that through this comprehensive clinical experience, they developed a new self‐awareness. Students noted that the experience was unique to any they had encountered. The perinatal assignment provided an opportunity for professional growth in this specialty area due to the interface of theory, simulation, and clinical applications expounded in the reflective clinical blog throughout the experience.
In the article, the recommendations of the Polish Psychiatric Association regarding pharmacological treatment of women with bipolar disorder during pregnancy and postpartum period were presented. The ...issue pertains to every twentieth woman wanting to get pregnant. Before planned pregnancy, it is advisable to obtain a several-month stabilization of psychiatric state, to establish treatment with one mood-stabilizing drug (except for valproate and carbamazepine) or gradual discontinuation of drugs in case of mild course of illness and lack of recurrences in recent two years. In the first trimester of pregnancy, the dose of the mood-stabilizing drug should be reduced (lithium carbonate to 500 mg/day). Depression during pregnancy can be treated with quetiapine or lamotrigine or with antidepressant drug added to a mood-stabilizing drug. Atypical antipsychotics drugs with mood-stabilizing properties can be used in case of (hypo) manic or mixed states. Following the delivery, it is advisable to introduce a moodstabilizing drug as soon as possible to prevent postpartum psychiatric disturbances. In the treatment of postpartum depression, quetiapine can be used or an antidepressant drug added to a mood-stabilizer. Considering breastfeeding, it should be remembered that the infant/maternal ratio of serum drug concentration is low for valproate, olanzapine, quetiapine, sertraline and paroxetine, and high for lithium and lamotrigine. In the case of postpartum psychosis, a hospitalization and antipsychotic treatment are needed.
Objective: to explore the wide-ranging sources of support that the maternal-infant dyad need or expect throughout the perinatal period in urban India. Design: qualitative interviews and ethnographic ...approach. Setting homes and community settings in greater metropolitan Bangalore, South India. Participants: using in-depth interviews of 36 mothers from different socio-cultural and socio-economic backgrounds who had given birth within the past two years in a tertiary hospital, we explored the nature of support, advice and emotional sustenance through pregnancy, childbirth and the early child rearing period available to these women. Findings: the overwhelming importance of women's own mothers in practical and emotional terms, the connectedness to 'native' place or 'ooru', the role of the diverse, extensive female network and the more contingent role of the husband emerged as major themes. The family was a major source of support as well as distress. While the support from their own mother was a constant, women used various forms of support throughout the perinatal continuum. Conclusions and implications for practice we call for a more nuanced understanding of what women in urban India expect and need in terms of support throughout the perinatal period. Clinicians and policy makers need to understand the various players, their different roles at critical times through the perinatal continuum and be able to identify those who are vulnerable and in need of enhanced support. Although the health sector is not a strong player in the socio-cultural milieu in the perinatal period, their role as facilitators of this support is crucial. Copyright Elsevier Ltd.
Maternal grandmothers play a key role in allomaternal care, directly caring for and provisioning their grandchildren as well as helping their daughters with household chores and productive labor. ...Previous studies have investigated these contributions across a broad time period, from infancy through toddlerhood. Here, we extend and refine the grandmothering literature to investigate the perinatal period as a critical window for grandmaternal contributions. We propose that mother-daughter co-residence during this period affords targeted grandmaternal effort during a period of heightened vulnerability and appreciable impact. We conducted two focus groups and 37 semi-structured interviews with Himba women. Interviews focused on experiences from their first and, if applicable, their most recent birth and included information on social support, domains of teaching and learning, and infant feeding practices. Our qualitative findings reveal three domains in which grandmothers contribute: learning to mother, breastfeeding support, and postnatal health and well-being. We show that informational, emotional, and instrumental support provided to new mothers and their neonates during the perinatal period can aid in the establishment of the mother-infant bond, buffer maternal energy balance, and improve nutritional outcomes for infants. These findings demonstrate that the role of grandmother can be crucial, even when alloparenting is common and breastfeeding is frequent and highly visible. Situated within the broader anthropological and clinical literature, these findings substantiate the claim that humans have evolved in an adaptive sociocultural perinatal complex in which grandmothers provide significant contributions to the health and well-being of their reproductive-age daughters and grandchildren.
Oxytocin (OT) is a neuropeptide involved in human social behaviors and reproduction. Non-invasive OT levels in saliva have recently roused interest as it does not require a specialized medical ...setting. Here, we observed one woman’s basal serum and saliva OT from pregnancy to 1 year postpartum to track OT concentration changes over this period. We examined the changes in salivary OT levels over time in response to maternal physiological and behavioral responses. The fluctuation of saliva OT levels is well correlated with serum OT during pregnancy and breastfeeding. However, while salivary OT increased rapidly during direct interaction (social interaction tests) with the infant and/or when the mother was watching her own infant’s video (video tests), no increase was observed in serum. We used social interaction and video tests on a group of mothers (nine mothers for social interaction and six for the video test) to clarify these single-subject results. In both tests, the mothers had increased OT in their saliva but not serum. Our study may suggest that salivary samples reflect not only the physical but also the emotional state and that saliva samples may be useful for monitoring women’s OT levels during pre- and postpartum periods. Further studies with larger sample numbers are necessary to confirm the rapid changes in salivary OT levels in response to maternal physiological and behavioral responses.
To investigate the milk fatty acid composition of female Steller sea lions (Eumetopias jubatus (Schreber, 1776)) between and within maternal states (i.e., perinatal or foraging), milk samples were ...collected in 2010 and 2011 via gastric intubation from Steller sea lion pups on a small rookery in the central Gulf of Alaska. Maternal states of lactating females were determined upon reuniting with their sampled pups via remotely operated video cameras on the rookery. Milk fatty acid composition between Steller sea lion maternal states was significantly different, and thus can be utilized to distinguish between perinatal and foraging Steller sea lions of the same geographic region in the absence of direct observation. However, milk fatty acid composition remained relatively constant within perinatal Steller sea lions, suggesting steady mobilization of fatty acids from blubber to milk, and within foraging Steller sea lions, implying females forage on similar prey species within several days after their perinatal period. Differences in milk fatty acid composition between maternal states, including differences in the relative percentages of polyunsaturated fatty acids, may have important implications for growth and development of offspring.
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