In this editorial,we comment on a recent article by Chen et al,that addressed the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.Poo...In this editorial,we comment on a recent article by Chen et al,that addressed the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.Poor management of postcesarean pain is associated with decreased maternal care for the baby,longer hospitalization,and higher risk of developing postpartum depression.Esketamine is a more potent S-enantiomer of ketamine which has shown promising analgesic and antidepressant properties for managing post-cesarean pain and depression in clinical studies.However,due to its potential adverse effects on the neurological and hemodynamic status of patients,it is recommended that its usage in low doses should be limited to cesarean candidates experiencing unbearable pain.Before any recommendation for routine perioperative use of esketamine,more standardized clinical trials are needed to strengthen our existing knowledge of its effectiveness in reducing postpartum pain and depression.展开更多
BACKGROUND Postpartum depression(PPD)represents a significant public health concern,adversely affecting both new mothers and their infants.Despite routine early screening,PPD can persist beyond the initial postpartum ...BACKGROUND Postpartum depression(PPD)represents a significant public health concern,adversely affecting both new mothers and their infants.Despite routine early screening,PPD can persist beyond the initial postpartum months,with notably high incidence rates even one year after childbirth.Persistent PPD has been associated with poor developmental outcomes in infants,highlighting the need for continued monitoring and support during this critical period.Understanding the broader impacts of persistent PPD is essential for developing effective interventions to improve maternal and infant well-being.AIM To explore the impact of persistent PPD on infant developmental behavior and maternal self-efficacy.METHODS We recruited 60 postpartum women who experienced persistent depression after childbirth in our hospital from January 2020 to December 2024 as the research subjects.The study collected basic characteristics of both infants and mothers,analyzed the self-efficacy of the mothers and the developmental behaviors of the infants,and conducted a correlation analysis to examine the relationship between postpartum persistent depression in mothers and the developmental behaviors and self-efficacy of infants.The Bootstrap method was used to verify the significance of the mediating effect.RESULTS The basic characteristics of infants and mothers show that 53.33%are male,58.33%are born via vaginal delivery,88.33%have a normal body mass index,51.67%are aged between 25 and 29 years,70%are non-agricultural workers,51.67%have a per capita household income over 4000 yuan,96.67%are full-term births,and 58.33%of the fathers are aged between 26 and 32 years.In terms of infant development behavior,the gross motor skills score is relatively low(38.44±12.15).Regarding maternal self-efficacy,the skill score(45.68±5.49)and mental activity score(46.37±3.72)are both at a low level.Correlation analysis reveals that postpartum persistent depression is significantly negatively correlated with maternal self-efficacy and infant development behavior(β=-0.439,-0.657,P<0.001),while self-efficacy is positively correlated with infant development behavior(β=0.728,P<0.001).The path coefficient and Bootstrap method test indicate that self-efficacy acts as a mediator between postpartum persistent depression and infant development behavior,accounting for 54.80%of the effect(P<0.05),while the direct effect of postpartum persistent depression on infant development behavior is 45.20%(P<0.05).CONCLUSION Persistent PPD significantly negatively impacts infant developmental outcomes,with maternal self-efficacy serving as a partial mediator.These findings suggest that interventions targeting both depressive symptoms and selfenhancement may effectively promote infant health development.展开更多
BACKGROUND First-time mothers may encounter various problems during postpartum,which can result in negative emotions that can affect infant care.In today’s Internet era,continuous nursing services can be provided to ...BACKGROUND First-time mothers may encounter various problems during postpartum,which can result in negative emotions that can affect infant care.In today’s Internet era,continuous nursing services can be provided to mothers and their babies after delivery through Internet-based platforms.This approach can help reduce negative emotions of primiparas and promote better health for both mothers and babies.AIM To explore the effect of Internet Plus-based postpartum healthcare services on postpartum depression of primiparas and neonatal growth and development and thus provide a scientific basis for strengthening postpartum healthcare measures and better protect maternal and child health.METHODS The study retrospectively collected data of primiparas and their newborns who underwent prenatal examination and successfully delivered at the Ninth People’s Hospital of Suzhou City.The observation group included 30 primiparas and their newborns who received Internet Plus-based postpartum healthcare services between July and December 2024.According to the principle of matching(1:1)control study,the control group included 30 primiparas and their newborns who received routine postpartum healthcare services between January and June 2024.The maternal role adaptation questionnaire scores,breastfeeding rates,Edinburgh postnatal depression scale(EPDS)scores,and newborn growth and development(height,head circumference,and weight)were compared between the two groups at the time of discharge after delivery and 6-week postpartum follow-up.RESULTS Upon hospital discharge,the two groups did not demonstrate significant differences in maternal role adaptation scores,breastfeeding rates,EPDS scores,as well as newborn height,head circumference,and weight at birth(P>0.05).At the 6-week postpartum follow-up,the maternal role adaptation score and breastfeeding rate were higher in the observation group than in the control group(P<0.05).In addition,one case of postpartum depression was reported in the observation group and eight in the control group.Moreover,the control group exhibited a significant increase in EPDS scores compared with scores at hospital discharge(P<0.05),whereas the observation group showed only a marginal,nonsignificant increase in EPDS scores(P>0.05).The EPDS score of the observation group was significantly lower than that of the control group(P<0.05),indicating a lower risk of postpartum depression in the observation group.The length,head circumference,and weight of the newborns 6 weeks after birth were increased compared with those at birth,and the growth rate was higher in the observation group than in the control group(P<0.05),indicating better growth and development in the observation group.CONCLUSION Internet Plus-based postpartum healthcare services improve maternal role adaptation,increase breastfeeding rates,mitigate postpartum depression risk,and promote neonatal growth and development in primiparas.展开更多
Objective:Postpartum nutrition plays a critical role in maternal recovery and long-term health.However,the nutritional status of working mothers in the postpartum period remains understudied.This study aimed to assess...Objective:Postpartum nutrition plays a critical role in maternal recovery and long-term health.However,the nutritional status of working mothers in the postpartum period remains understudied.This study aimed to assess the dietary quality of postpartum women in urban Beijing,identify occupational-related factors influencing their diet,and explore potential interventions to improve maternal nutrition during the postpartum period.Methods:In this cross-sectional analysis,554 women one year after delivery were recruited from ten community health centers.Sociodemographic,occupational and postpartum care variables were collected via questionnaire.Dietary intake over the preceding year was assessed using a food frequency questionnaire.The modified dietary balance index for postpartum women were used for dietary quality assessment.Results:The study revealed severe dietary imbalances among postpartum women,characterized by excessive consumption of cereals,eggs,and meats,while their intake of vegetables,fruits,and dairy products was inadequate.According to dietary balance index for postpartum women,66.25%of mothers showed varying degrees of excessive intake.45.31%of mothers experienced varying levels of insufficient intake,with only 19.86%of participants having a relatively balanced diet.Occupational differences were observed,with women in the commercial employment group showing higher levels of excessive food intake.The analysis of influencing factors showed that family monthly income,maternity leave,and postpartum care significantly affected the dietary quality.Conclusions:Postpartum women in Beijing experience widespread dietary imbalances,with both excesses and deficiencies.Occupational context and related factors significantly shape diet quality.These findings highlight the need for targeted nutritional interventions tailored to the specific challenges of different occupational groups.展开更多
Objective:Pelvic floor dysfunction is common among pregnant and postpartum women and significantly impacts quality of life.This study aims to translate the German Pelvic Floor Questionnaire for Pregnant and Postpartum...Objective:Pelvic floor dysfunction is common among pregnant and postpartum women and significantly impacts quality of life.This study aims to translate the German Pelvic Floor Questionnaire for Pregnant and Postpartum Women into Chinese and to evaluate its reliability and validity in the Chinese population.Methods:The questionnaire was translated using the Brislin model.A cross-sectional study was conducted among pregnant and postpartum women to assess the content validity,construct validity,Cronbach’sαcoefficient,test-retest reliability,and split-half reliability of the Chinese version.Results:A total of 72 women were included,with 6.9% being pregnant and 93.1% postpartum;the age was(32.3±3.6)years.The Chinese version of the questionnaire contains 4 dimensions and 45 items.The content validity index of individual items ranged from 0.833 to 1.000,with a scale-level content validity index of 0.977 and intraclass correlation coefficients(ICCs)exceeding 0.90.The overall Cronbach’s α coefficient was 0.891,with subscale coefficients ranging from 0.732 to 0.884(all ICCs>0.70).The testretest reliability of the total scale was 0.833,and for the 4 dimensions,bladder,bowel,prolapse,and sexual function,the values were 0.776,0.579,0.732,and 0.645,respectively.The split-half reliability was 0.74.Conclusion:The Chinese version of the questionnaire demonstrated good reliability and validity,indicating its applicability in assessing pelvic floor dysfunction and associated risk factors during pregnancy and postpartum.展开更多
BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm inf...BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm infants with low-birth-weight.However,their effects on the difference in infant growth rate and postpartum depression are still unclear.AIM To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.METHODS Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2022 and December 2024,were retrospectively collected.The infants were divided into two groups according to the different enteral feeding methods in the early stage:Control group(n=32 cases,premature infant formula feeding)and observation group(n=36 cases,micro-breastfeeding,i.e.,exclusive breastfeeding,no mixed feeding).The baseline data;feeding status;gastrointestinal adverse reactions such as vomiting,gastric retention,and abdominal distension;growth rate(body weight,body length,and head circumference);and adverse events(infection,cholestasis,hyperbilirubinemia,and necrotizing enterocolitis)were compared between the two groups.Moreover,the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale(EPDS)was compared.RESULTS No significant difference in baseline data was found between the two groups(P>0.05).The onset time of weight gain(6.49±0.53 days vs 7.09±0.61 days,P<0.001),time for complete meconium excretion(6.28±0.92 days vs 8.31±1.17 days,P<0.001),time for recovery to birth weight(8.81±1.40 days vs 10.95±1.64 days,P<0.001),and time to reach full enteral feeding(12.29±2.08 days vs 15.48±2.27 days,P<0.001)were compared between the observation and control groups.The incidence of vomiting,abdominal distension,and gastric retention was significantly lower in the observation group than in the control group,and the difference was significant(P<0.05).The rates of the weight growth(15.88±1.57 g/day vs 14.84±1.51 g/day,P=0.007),head circumference(0.63±0.08 cm/week vs 0.59±0.05 cm/week,P=0.018),and length(0.80±0.12 cm/week vs 0.73±0.14 cm/week,P=0.029)were compared between the observation and control groups.On hospital admission of preterm infants with low-birthweight,the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression(P>0.05).Preterm infants with low-birth-weight were hospitalized for 2 weeks,and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group(8.38±1.47 vs 9.49±2.35,P=0.021).CONCLUSION Compared with preterm infant formula feeding,early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications,thereby alleviating mothers’concerns about their children and reducing the risk of postpartum depression.展开更多
Objective Data on homocysteine(Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and ...Objective Data on homocysteine(Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and to explore the determinants like geographic factor.Methods This study was conducted in women at mid-pregnancy, late-pregnancy and postpartum from southern, central and northern China. Approximately 132 women were included in each stratum by the three phases and regions. Plasma Hcy concentrations were assessed using high-performance liquid chromatography(HPLC), with hyperhomocysteinemia defined as > 10.0 μmol/L. Quantile regression was to estimate medians and interquartile ranges(IQRs), and logistic regression to examine the determinants of hyperhomocysteinemia.Results For 1,190 women included, the median(IQR) Hcy concentration was 5.66(4.62, 7.37) μmol/L.The adjusted median in mid-pregnancy, late-pregnancy and postpartum women was 4.75(4.13, 5.54),5.72(4.81, 6.85) and 7.09(5.65, 8.75) μmol/L, respectively, showing an increasing trend(P < 0.001). This increasing trend persisted across the three regions. Higher Hcy concentrations were observed in women residing in northern region and those with younger age or lower economic status. A total of 106(8.9%)women had hyperhomocysteinemia, with a higher prevalence in those residing in northern region(16.0%), or in postpartum women(16.5%).Conclusion Hcy levels, varying with geographic region, maternal age and economic status, are increased from mid-pregnancy to late-pregnancy and postpartum, indicating a need to monitor Hcy levels in pregnant and postpartum women to control potential risks related to elevated Hcy levels.展开更多
BACKGROUND Postpartum pulmonary arterial hypertension(PAH)complicated with hereditary hemorrhagic telangiectasia(HHT)is a rare condition.Diagnosing and treating PAH in patients with HHT can be challenging.To the best ...BACKGROUND Postpartum pulmonary arterial hypertension(PAH)complicated with hereditary hemorrhagic telangiectasia(HHT)is a rare condition.Diagnosing and treating PAH in patients with HHT can be challenging.To the best of our knowledge,no previous reports have investigated the efficacy of pulmonary vasodilators in improving hemodynamics in postpartum patients with this disease.CASE SUMMARY In this paper,we report a postpartum case of HHT combined with PAH,pre-senting with worsening dyspnea.Genetic testing revealed that the patient carried a heterozygous variant of activin receptor-like kinase 1.The patient received various treatments,including diuretics,anticoagulants,sildenafil,macitentan,inhalation of nitric oxide,and iloprost.Changes in PaO2/FiO2,pulmonary artery systolic pressure as assessed by echocardiography,and N-terminus pro-brain natriuretic peptide levels suggested that,except for iloprost inhalation,the other treatments appeared to have limited efficacy.CONCLUSION To our knowledge,this is the first report on efficacy of pulmonary vasodilators in postpartum patients with HHT and PAH.展开更多
The high incidence of postpartum hypogalactia hinders the healthy development of postpartum women and the next generation.Lacquer seed oil(LSO),extracted from the seeds of the lacquer tree,has been traditionally used ...The high incidence of postpartum hypogalactia hinders the healthy development of postpartum women and the next generation.Lacquer seed oil(LSO),extracted from the seeds of the lacquer tree,has been traditionally used as a dietary supplement for promoting postpartum lactation and recovery in some districts of China.However,its physiological effects have not been verified,and the mechanism and active components of LSO have not been analyzed.Thus,we applied LSO to bromocriptine-induced postpartum hypogalactia rats.The results showed that LSO supplement effectively improves bromocriptine-induced postpartum hypogalactia.LSO also increased prolactin levels reduced by bromocriptine,promoted JAK2/STAT5 and PI3K/AKT pathways and several gene expression levels of milk synthesis in mammary gland.Moreover,metabolomic and network pharmacological analysis further revealed that JAK2/STAT5,PI3K/AKT,and estrogen signaling pathway are the potential main regulatory sites for the beneficial effects of LSO on postpartum hypogalactia,and that quercetin,kaempferol,arachidonic acid,epicatechin,and β-sitosterol are the top 5 main active ingredients of LSO.Our results suggested that LSO has great potential in the application of the improvement of postpartum hypogalactia.展开更多
BACKGROUND Postpartum women are at an increased risk of generalized anxiety disorder(GAD),which can negatively affect both mental health and physical recovery.Pelvic floor dysfunction,common in this population,can exa...BACKGROUND Postpartum women are at an increased risk of generalized anxiety disorder(GAD),which can negatively affect both mental health and physical recovery.Pelvic floor dysfunction,common in this population,can exacerbate psychological distress.Although pelvic floor rehabilitation is effective in physical recovery,its potential to improve psychological outcomes,especially in women with GAD,remains underexplored.AIM To evaluate the effectiveness of an individualized pelvic floor rehabilitation program in improving anxiety,pelvic floor function,and quality of life in postpartum women with GAD.METHODS A retrospective study was performed to analyze 80 postpartum women with GAD who completed a 12-week individualized pelvic floor rehabilitation program(January 2020-December 2024),combining supervised pelvic floor muscle training and psychological support.Primary outcomes were changes in GAD-7 and Hamilton anxiety rating scale(HAM-A)scores and pelvic floor function measured by surface electromyography(sEMG).Secondary outcomes included World Health Organization quality of life-BREF,pelvic floor symptom severity,and impact on daily activities(pelvic floor impact questionnaire).Assessments were conducted at baseline and 6 and 12 weeks during the intervention period.RESULTS Significant improvements were observed in anxiety measures,with mean GAD-7 scores decreasing from 14.8±3.2 at baseline to 8.2±2.9 at week 12(P<0.001)and HAM-A scores decreasing from 22.6±4.5 to 12.4±3.8(P<0.001).Pelvic floor function showed substantial enhancement,with sEMG amplitude increasing from 22.4±5.6μV to 35.9±6.8μV(P<0.001).Quality of life improved across all domains,with the most significant improvements in psychological(28.5%increase)and physical health(25.8%increase).Program adherence was 91.5%for the supervised sessions,and no serious adverse events were reported.CONCLUSION Individualized pelvic floor rehabilitation training effectively improves both psychological and functional outcomes in postpartum women with GAD.The high adherence and significant outcomes make this integrated approach feasible and effective.展开更多
This study evaluated the effectiveness of Chinese herbal foot bath therapy in improving sleep quality among postpartum women of advanced maternal age.A quasi-experimental design was used,involving 60 participants with...This study evaluated the effectiveness of Chinese herbal foot bath therapy in improving sleep quality among postpartum women of advanced maternal age.A quasi-experimental design was used,involving 60 participants with sleep disturbances recruited from Zouping County Traditional Chinese Medicine Hospital.Participants were divided into control and experimental groups,and sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI)before and after the intervention.The experimental group received Chinese herbal foot bath therapy,while the control group did not.Post-intervention results showed a significant improvement in sleep quality for the experimental group,with a mean PSQI score of 7.79(SD=2.90),compared to 13.45(SD=2.57)in the control group,indicating continued poor sleep.Statistical analysis confirmed that the therapy led to significant improvements across overall and component PSQI scores.The study concludes that Chinese herbal foot bath therapy is a safe,non-invasive,and cost-effective method to enhance sleep quality among postpartum women,especially those of advanced maternal age.It holds promise as a complementary treatment option and could be integrated into standard postpartum care practices to address sleep disturbances without relying on pharmacological interventions.展开更多
BACKGROUND Postpartum stress urinary incontinence(SUI)symptoms affect a patient’s daily activities and quality of life and increase the negative emotions that they experience.At present,there is no research on the ef...BACKGROUND Postpartum stress urinary incontinence(SUI)symptoms affect a patient’s daily activities and quality of life and increase the negative emotions that they experience.At present,there is no research on the effect of fractional CO_(2)laser treatment combined with Kegel exercise on postpartum SUI and postpartum depression and anxiety.AIM To investigate the effect of lattice CO_(2)laser treatment combined with Kegel exercise on mild to moderate postpartum SUI and its influence on postpartum depression and anxiety.METHODS Using a retrospective study,data from 82 cases of mild to moderate postpartum SUI in Huzhou Maternal&Child Health Care Hospital from January to April 2024 were retrospectively collected.The cases were divided into groups according to the different treatment methods,namely Group S(41 cases,only receiving lattice CO_(2)laser treatment)and Group L(41 cases,receiving lattice CO_(2)laser combined with Kegel exercise treatment).The baseline data of the two groups were compared.In addition,we analyzed and compared the scores of the international commission on urinary incontinence questionnaire short form(ICI-Q-SF),incontinence quality of life questionnaire(I-QOL),Edinburgh postnatal depression scale(EPDS),and postpartum specific anxiety scale(PSAS)before treatment,at the end of treatment,and 3 months after the end of treatment between the two groups.Furthermore,the clinical efficacy and adverse reactions of the two groups were analyzed and compared at the end of treatment and 3 months after the end of treatment.RESULTS There was no significant difference in the baseline data and the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between the two groups before treatment.However,at the end of treatment,the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between Groups L and S were significantly different.The overall effective rate of treatment in Group L was significantly higher than that in Group S.During the 3-month follow-up after treatment,it was found that the ICIQ-SF,EPDS,and PSAS scores of Group L were still lower than those of Group S.In comparison,the I-QOL score and total effective rate of treatment were still higher in Group L than those in Group S,and this difference was significant.There was no significant difference in the adverse reactions between Group L and Group S.CONCLUSION The combination of dot lattice CO_(2)laser and Kegel exercise has a significant therapeutic effect on mild to moderate postpartum SUI.It can prolong the duration of therapeutic effects,improve a patient’s quality of life,and alleviate postpartum depression and anxiety.展开更多
BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant dispa...BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant disparities remain in screening,diagnosis,and treatment,particularly in low-resource and culturally diverse settings.The complex interplay of biological and psychosocial determinants complicates conventional intervention models.Integrating epidemiological patterns,pathophysiological mechanisms,and sociocultural factors will inform more effective and equitable strategies for PPD screening,prevention,and treatment.METHODS A narrative review was conducted following PRISMA 2020 guidelines.Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed,Web of Science,EMBASE,and PsycINFO.Inclusion criteria comprised studies addressing PPD epidemiology,risk stratification,biological mechanisms,and intervention strategies.After screening and full-text review,84 studies were included.Study designs primarily involved cohort studies,randomized controlled trials,and meta-analyses.Extracted data were categorized thematically and assessed for methodological quality and generalizability.RESULTS PPD arises from multifactorial interactions involving hormonal dysregulation,neurochemical changes,psychosocial stressors,and cultural influences.Primary risk factors include personal or family history of depression,antenatal anxiety,low maternal self-efficacy,and inadequate social support.Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening,cognitive behavioral therapy,interpersonal psychotherapy,psychoeducation,and pharmacological treatments such as brexanolone and zuranolone.Culturally adapted,community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability,particularly in underserved populations.Emerging evidence highlights inflammatory biomarkers(e.g.,interleukin-6 and C-reactive protein),AI-assisted screening tools,and family-inclusive strategies as promising for enhanced detection and outcomes.CONCLUSION Effective PPD management requires integrative,culturally sensitive approaches,prioritizing scalable,personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.展开更多
Postpartum depression(PPD)is a severe mental health disorder affecting 10%to 15%of postpartum women worldwide.Pre-eclampsia is a hypertensive disorder of pregnancy that has been identified as a significant factor for ...Postpartum depression(PPD)is a severe mental health disorder affecting 10%to 15%of postpartum women worldwide.Pre-eclampsia is a hypertensive disorder of pregnancy that has been identified as a significant factor for PPD due to its vascular dysfunction,systemic inflammation and neurobiological alterations.The neuroinflammatory mechanisms common to both pre-eclampsia and PPD,that contribute to depressive symptoms include elevated proinflammatory cytokines(interleukin-6,tumor necrosis factor-alpha),activation of the kynurenine pathway,and oxidative stress.To critically evaluate Wu et al's study,which investigates blood pressure variability(BPV)and gestational body mass index(BMI)as independent predictors of PPD.To integrate recent findings on the metabolic and cardiovascular links between depression,pre-eclampsia,and postpartum mental health outcomes.Pre-pregnancy BMI is found to be a stronger predictor of PPD than gestational weight gain.A vascular-neuropsychiatric connection has been indicated in pre-eclamptic women,indicating a significant correlation between BPV and depressive postpartum symptoms.There is increased susceptibility to depression due to neuroinflammation contributed by blood pressure fluctuations and metabolic dysregulation.The incidence of PPD could be reduced by early identification and intervention for BP fluctuations.Early detection and intervention in high-risk pregnancies should be conducted through public health strategies that prioritize awareness,education,and accessibility to mental health care.展开更多
AIM： To review the safety （infection, perforation） and efficacy （expulsion, continuation rates, pregnancy） of intrauterine device （IUD） insertion in the postpartum period. METHODS： MEDLINE, PubMed and Google S...AIM： To review the safety （infection, perforation） and efficacy （expulsion, continuation rates, pregnancy） of intrauterine device （IUD） insertion in the postpartum period. METHODS： MEDLINE, PubMed and Google Scholar were searched for randomized controlled trials and prospective cohort studies of IUD insertions at different times during the postpartum period. Time of insertion during the postpartum period was documented speci-fically, immediate post placenta period （within 10 min）, early post placenta period （10 min to 72 h）, and de-layed/interval period （greater than 6 wk）. Other study variables included mode of delivery, vaginal vs cesarean, manual vs use of ring forceps to insert the IUD. RESULTS： IUD insertion in the immediate postpartum （within 10 min of placental delivery）, early postpartum （10 min up to 72 h） and Interval/Delayed （6 wk onward） were found to be safe and effcacious. Expulsion rates were found to be highest in the immediate postpartum groups ranging from 14% to 27%. Immediate post placental insertion found to have expulsion rates that ranged from 3.6% to 16.2%. Expulsion rate was significantly higher after insertion following vaginal vs cesarean delivery. The rates of infection, perforation and unplanned pregnancy following postpartum IUD insertion are low. Method of insertion such as with ring forceps, by hand, or another placement method unique to the type of IUD did not show any signifcant difference in expulsion rates. Uterine perforations are highest in the delayed/interval IUD insertion groups.Breastfeeding duration and infant development are not affected by delayed/interval insertion of the non-hormonal （copper） IUD or the Levonorgestrel IUD. Timing of the Levonorgestrel IUD insertion may affect breastfeeding. CONCLUSION： IUD insertion is safe and efficacious during the immediate postpartum, early postpartum and delayed postpartum periods. Expulsion rates are highest after vaginal delivery and when inserted during the immediate postpartum period. IUD associated infection rates were not increased by insertion during the postpartum period over interval insertion rates. There is no evidence that breastfeeding is negatively affected by postpartum insertion of copper or hormone-secreting IUD. Although perforation rates were higher when inserted after lactation was initiated. Randomized controlled trials are needed to further elucidate the consequence of lactation on postpartum insertion. Despite the concerns regarding expulsion, perforation and breastfeeding, current evidence indicates that a favorable risk beneft ratio in support of postpartum IUD insertion. This may be particularly relevant for women for whom barriers exist in achieving desired pregnancy spacing.展开更多
Objective To evaluate the clinical efficacy of acupuncture in treatment of postpartum depression. Methods Pubmed database and Embase database were retrieved online in English, and China National Knowledge Internet （C...Objective To evaluate the clinical efficacy of acupuncture in treatment of postpartum depression. Methods Pubmed database and Embase database were retrieved online in English, and China National Knowledge Internet （CNKI）, China Biology Medicine disc （CBM）, VIP database and Wanfang Data were retrieved in Chinese. Literature in recent 10 years relating to clinical randomized controlled trials of acupuncture in treatment of postpartum depression were collected, and Meta analysis was performed by adopting RevMan5.3. Results Fourteen articles were included in the study in total; it was shown from HAMD result that after combination, WMD=-2.27, 95%CI （-2.55, 0.01）; according to Z-test, Z=2.95, P=0.05, and the difference in efficacy between treatment group and control group was statistically significant. It was shown from EPDS result that after combination, WMD=-0.53, 95%CI （-0.92, -0.03）; according to Z-test, Z=2.08, P〈0.05, and the difference in efficacy between treatment group and control group was statistically significant. During the analysis taking estradiol as standard, it was shown from the result that after combination, WMD=63.99, 95%CI （13.39, 114.60）; according to Z-test, Z=2.48, P〈0.05, and the difference in efficacy between treatment group and control group had remarkably statistical significance. During the analysis taking effective rate as standard, it was shown from the result that after combination, OR=3.15, 95%CI （2.19, 4.55）; according to Z-test, Z=6.14, P〈0.05, and the difference in efficacy between treatment group and control group had remarkably statistical significance. Conclusion Acupuncture treatment for postpartum depression is effective, but more clinical randomized controlled trials with high quality and large sample size are still needed to verify the result.展开更多
Objective To explore the efficacy of Tuina for postpartum lactation and work out an optimal protocol involved. Methods With a randomized, controlled and clinical method, Eighty-four full-term primiparas were divided i...Objective To explore the efficacy of Tuina for postpartum lactation and work out an optimal protocol involved. Methods With a randomized, controlled and clinical method, Eighty-four full-term primiparas were divided into a Tuina group （58 cases） and a control group （26 cases）. While the patients in the control group received rooming in conventional nursing, those in the Tuina group were additionally treated with Tuina, including local manipulations at the breasts combined with acupoint manipulations. The colostrum time, lactation volume and serum prolactin were observed to make the comparisons between the two groups. Results The scores of lactation quantity after the 1st, 2nd, 3rd of the treatment were 1.660±0.785, 2.530±1.030, 2.880±1.171 in the Tuina group and 1.270±0.533, 1.460±0.811, 1.500±0.583 in the control group respectively, where there were significant differences in each time stage between the two groups （all P0.001）. The time of colostrum was （21.6±10.5） h in the Tuina group and （22.5±9.7） h in the control group, in which the difference was not statistically significant （P0.05）. The levels of prolactin were （314.35±110.37） ng/mL and （321.56±109.61） ng/mL in the Tuina group, （385.78±85.19） ng/mL and （340.12±103.10） ng/mL in the control group before and after treatment respectively, suggested that there were no significant difference （both P0.05）. Conclusion Postpartum Tuina at the breasts could increase the quantity of lactation and delay the decreasing of the levels of prolactin, which contributes primiparas to lactate more and sooner.展开更多
BACKGROUND Rectus abdominis separation(DRA)affects pelvic stability and body image.No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression.AIM To analyze the curative e...BACKGROUND Rectus abdominis separation(DRA)affects pelvic stability and body image.No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression.AIM To analyze the curative effect of massage on early postpartum DRA and its impact on postpartum depression and thus its ability promote the overall psychosomatic rehabilitation of postpartum women.METHODS Data were retrospectively collected on 70 primiparous women with postpartum DRA who underwent rehabilitation at the Postpartum Rehabilitation Center of Huzhou Maternal and Child Health Hospital from October 2022 to September 2023.The patients were divided into the Group S(35 cases,biomimetic electrical stimulation treatment)and Group L(35 cases,biomimetic electrical stimulation combined with manual massage treatment).Baseline data,the edinburgh postpartum depression scale(EPDS)score,and the visual analog scale(VAS)scores for rectus abdominis distance,waist circumference,and lower back pain before and after treatment were compared.RESULTS No significant differences were found in the baseline data,rectus abdominis distance,waist circumference,and VAS and EPDS scores between the two groups before treatment(P>0.05).After treatment,the distance between rectus abdominis and waist circumference in Group L were significantly smaller than those in Group S(P<0.05).Furthermore,lower back pain(VAS score)and the EPDS score in Group L were significantly lower than those in Group S(P<0.05).CONCLUSION Manual massage can significantly reduce early postpartum DRA,waist circumference,and back pain and improve the patient’s mental state and postpartum depression.展开更多
BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved effic...BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.AIM To investigate the correlations among mindfulness,marital quality,anxiety,and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.METHODS A cross-sectional study was conducted.The self-administered questionnaire was submitted online through smartphones.The levels of mindfulness,anxiety,depression,and marital quality were respectively investigated by the mindful attention awareness scale(MAAS),the self-rating anxiety scale(SAS),the selfrating depression scale(SDS),and the marriage perception scale(MPS)in these enrolled Han and Tujia primiparas.RESULTS No statistical significance was observed in the prevalence of postpartum anxiety and depression,nor scores of MAAS and MPS-Total in different regions or ethnicities(P>0.05).However,MPSMarital interaction(P<0.05),MPS-Family relationship(MPS-FR)(P<0.01),and MPS-Marital conflict(MPS-MC)(P<0.01)scores of urban primiparas were higher than those of rural primiparas.The MPS-MC score of Han primiparas was higher than that of Tujia primiparas(P<0.05).Negative correlations were observed between MAAS and SAS(r=-0.457,P<0.01),and MAAS and SDS(r=-0.439,P<0.01).SAS has revealed a highly positive correlation with SDS(r=0.720,P<0.01)and a weak negative correlation with MPS(r=-0.200,P<0.05).Besides,a weak negative correlation was observed between MAAS and MPS-MC(r=-0.184,P<0.05),and a weak positive correlation was noticed between SAS and MPS-MC(r=-0.225,P<0.01).Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety(P<0.05,95%CI:-0.384 to 0.033),MPS-MC and postpartum anxiety(P<0.01,95%CI:0.027-0.193),MPS-FR and postpartum depression(P<0.05,95%CI:-0.365 to 0.031),and MPS-MC and postpartum depression(P<0.01,95%CI:0.022-0.206).CONCLUSION Mindfulness demonstrates negative correlations with marital conflict,postpartum anxiety and depression,and it may have cross-ethnic and trans-regional characteristics.Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study,it demonstrates a full mediation effect on the relationships between family relationships,marital conflict,and postpartum anxiety and depression.展开更多
Postpartum depression (PPD) is a term applied to describe depressive symptoms occurring during the first year of the postpartum period and is characterized by low mood, loss of enjoyment, reduced energy, and activity,...Postpartum depression (PPD) is a term applied to describe depressive symptoms occurring during the first year of the postpartum period and is characterized by low mood, loss of enjoyment, reduced energy, and activity, marked functional impairment, reduced self-esteem, ideas or acts of self-harm or suicide. The women’s change into motherhood is a difficult period that involves significant changes in the psychological, social and physiological aspects, and is considered to increase vulnerability for the development of mental illness. In Somalia, 1 in 20 women aged 15 - 49 die due to pregnancy- or birth-related complications every year. This makes being pregnant in Somalia a risk that has its own stress and anxiety. Objective: To evaluate postpartum depression and associated factors among mothers who gave birth in the last 12 months in Mogadishu, Somalia. Methodology: The study is analytic cross sectional study design in which postpartum depression and its associated factors are measured. We used Cochran’s formula (Z<sup>2</sup>p(1 – p)/d<sup>2</sup>). Results: One fifth of the study population was found to have postpartum depression and the factors relating to it included marital status, substance abuse, mode and place of delivery. Conclusion: This shows that neglected mental health of the mothers in Somalia has its burden on the society. Recommendation: Mental health care component should be integrated with maternal care programs available in the country to work on prevention and control of motherhood related stress and depression among mothers who are giving birth under the very difficult circumstances in the country.展开更多
文摘In this editorial,we comment on a recent article by Chen et al,that addressed the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.Poor management of postcesarean pain is associated with decreased maternal care for the baby,longer hospitalization,and higher risk of developing postpartum depression.Esketamine is a more potent S-enantiomer of ketamine which has shown promising analgesic and antidepressant properties for managing post-cesarean pain and depression in clinical studies.However,due to its potential adverse effects on the neurological and hemodynamic status of patients,it is recommended that its usage in low doses should be limited to cesarean candidates experiencing unbearable pain.Before any recommendation for routine perioperative use of esketamine,more standardized clinical trials are needed to strengthen our existing knowledge of its effectiveness in reducing postpartum pain and depression.
基金Supported by the Key Medical Research Project of Hebei Province in 2020,No.20201360.
文摘BACKGROUND Postpartum depression(PPD)represents a significant public health concern,adversely affecting both new mothers and their infants.Despite routine early screening,PPD can persist beyond the initial postpartum months,with notably high incidence rates even one year after childbirth.Persistent PPD has been associated with poor developmental outcomes in infants,highlighting the need for continued monitoring and support during this critical period.Understanding the broader impacts of persistent PPD is essential for developing effective interventions to improve maternal and infant well-being.AIM To explore the impact of persistent PPD on infant developmental behavior and maternal self-efficacy.METHODS We recruited 60 postpartum women who experienced persistent depression after childbirth in our hospital from January 2020 to December 2024 as the research subjects.The study collected basic characteristics of both infants and mothers,analyzed the self-efficacy of the mothers and the developmental behaviors of the infants,and conducted a correlation analysis to examine the relationship between postpartum persistent depression in mothers and the developmental behaviors and self-efficacy of infants.The Bootstrap method was used to verify the significance of the mediating effect.RESULTS The basic characteristics of infants and mothers show that 53.33%are male,58.33%are born via vaginal delivery,88.33%have a normal body mass index,51.67%are aged between 25 and 29 years,70%are non-agricultural workers,51.67%have a per capita household income over 4000 yuan,96.67%are full-term births,and 58.33%of the fathers are aged between 26 and 32 years.In terms of infant development behavior,the gross motor skills score is relatively low(38.44±12.15).Regarding maternal self-efficacy,the skill score(45.68±5.49)and mental activity score(46.37±3.72)are both at a low level.Correlation analysis reveals that postpartum persistent depression is significantly negatively correlated with maternal self-efficacy and infant development behavior(β=-0.439,-0.657,P<0.001),while self-efficacy is positively correlated with infant development behavior(β=0.728,P<0.001).The path coefficient and Bootstrap method test indicate that self-efficacy acts as a mediator between postpartum persistent depression and infant development behavior,accounting for 54.80%of the effect(P<0.05),while the direct effect of postpartum persistent depression on infant development behavior is 45.20%(P<0.05).CONCLUSION Persistent PPD significantly negatively impacts infant developmental outcomes,with maternal self-efficacy serving as a partial mediator.These findings suggest that interventions targeting both depressive symptoms and selfenhancement may effectively promote infant health development.
基金Supported by 2024 Academy Level Research Start up Fund,No.YK202434.
文摘BACKGROUND First-time mothers may encounter various problems during postpartum,which can result in negative emotions that can affect infant care.In today’s Internet era,continuous nursing services can be provided to mothers and their babies after delivery through Internet-based platforms.This approach can help reduce negative emotions of primiparas and promote better health for both mothers and babies.AIM To explore the effect of Internet Plus-based postpartum healthcare services on postpartum depression of primiparas and neonatal growth and development and thus provide a scientific basis for strengthening postpartum healthcare measures and better protect maternal and child health.METHODS The study retrospectively collected data of primiparas and their newborns who underwent prenatal examination and successfully delivered at the Ninth People’s Hospital of Suzhou City.The observation group included 30 primiparas and their newborns who received Internet Plus-based postpartum healthcare services between July and December 2024.According to the principle of matching(1:1)control study,the control group included 30 primiparas and their newborns who received routine postpartum healthcare services between January and June 2024.The maternal role adaptation questionnaire scores,breastfeeding rates,Edinburgh postnatal depression scale(EPDS)scores,and newborn growth and development(height,head circumference,and weight)were compared between the two groups at the time of discharge after delivery and 6-week postpartum follow-up.RESULTS Upon hospital discharge,the two groups did not demonstrate significant differences in maternal role adaptation scores,breastfeeding rates,EPDS scores,as well as newborn height,head circumference,and weight at birth(P>0.05).At the 6-week postpartum follow-up,the maternal role adaptation score and breastfeeding rate were higher in the observation group than in the control group(P<0.05).In addition,one case of postpartum depression was reported in the observation group and eight in the control group.Moreover,the control group exhibited a significant increase in EPDS scores compared with scores at hospital discharge(P<0.05),whereas the observation group showed only a marginal,nonsignificant increase in EPDS scores(P>0.05).The EPDS score of the observation group was significantly lower than that of the control group(P<0.05),indicating a lower risk of postpartum depression in the observation group.The length,head circumference,and weight of the newborns 6 weeks after birth were increased compared with those at birth,and the growth rate was higher in the observation group than in the control group(P<0.05),indicating better growth and development in the observation group.CONCLUSION Internet Plus-based postpartum healthcare services improve maternal role adaptation,increase breastfeeding rates,mitigate postpartum depression risk,and promote neonatal growth and development in primiparas.
基金supported by an Innovation Fund for Medical Sciences of the Chinese Academy of Medical Sciences (Grant No.2019-I2M-2-007).
文摘Objective:Postpartum nutrition plays a critical role in maternal recovery and long-term health.However,the nutritional status of working mothers in the postpartum period remains understudied.This study aimed to assess the dietary quality of postpartum women in urban Beijing,identify occupational-related factors influencing their diet,and explore potential interventions to improve maternal nutrition during the postpartum period.Methods:In this cross-sectional analysis,554 women one year after delivery were recruited from ten community health centers.Sociodemographic,occupational and postpartum care variables were collected via questionnaire.Dietary intake over the preceding year was assessed using a food frequency questionnaire.The modified dietary balance index for postpartum women were used for dietary quality assessment.Results:The study revealed severe dietary imbalances among postpartum women,characterized by excessive consumption of cereals,eggs,and meats,while their intake of vegetables,fruits,and dairy products was inadequate.According to dietary balance index for postpartum women,66.25%of mothers showed varying degrees of excessive intake.45.31%of mothers experienced varying levels of insufficient intake,with only 19.86%of participants having a relatively balanced diet.Occupational differences were observed,with women in the commercial employment group showing higher levels of excessive food intake.The analysis of influencing factors showed that family monthly income,maternity leave,and postpartum care significantly affected the dietary quality.Conclusions:Postpartum women in Beijing experience widespread dietary imbalances,with both excesses and deficiencies.Occupational context and related factors significantly shape diet quality.These findings highlight the need for targeted nutritional interventions tailored to the specific challenges of different occupational groups.
基金supported by the Natural Science Foundation of Hunan Province(2024JJ6626)the Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control(HPKL202320),China.
文摘Objective:Pelvic floor dysfunction is common among pregnant and postpartum women and significantly impacts quality of life.This study aims to translate the German Pelvic Floor Questionnaire for Pregnant and Postpartum Women into Chinese and to evaluate its reliability and validity in the Chinese population.Methods:The questionnaire was translated using the Brislin model.A cross-sectional study was conducted among pregnant and postpartum women to assess the content validity,construct validity,Cronbach’sαcoefficient,test-retest reliability,and split-half reliability of the Chinese version.Results:A total of 72 women were included,with 6.9% being pregnant and 93.1% postpartum;the age was(32.3±3.6)years.The Chinese version of the questionnaire contains 4 dimensions and 45 items.The content validity index of individual items ranged from 0.833 to 1.000,with a scale-level content validity index of 0.977 and intraclass correlation coefficients(ICCs)exceeding 0.90.The overall Cronbach’s α coefficient was 0.891,with subscale coefficients ranging from 0.732 to 0.884(all ICCs>0.70).The testretest reliability of the total scale was 0.833,and for the 4 dimensions,bladder,bowel,prolapse,and sexual function,the values were 0.776,0.579,0.732,and 0.645,respectively.The split-half reliability was 0.74.Conclusion:The Chinese version of the questionnaire demonstrated good reliability and validity,indicating its applicability in assessing pelvic floor dysfunction and associated risk factors during pregnancy and postpartum.
文摘BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm infants with low-birth-weight.However,their effects on the difference in infant growth rate and postpartum depression are still unclear.AIM To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.METHODS Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2022 and December 2024,were retrospectively collected.The infants were divided into two groups according to the different enteral feeding methods in the early stage:Control group(n=32 cases,premature infant formula feeding)and observation group(n=36 cases,micro-breastfeeding,i.e.,exclusive breastfeeding,no mixed feeding).The baseline data;feeding status;gastrointestinal adverse reactions such as vomiting,gastric retention,and abdominal distension;growth rate(body weight,body length,and head circumference);and adverse events(infection,cholestasis,hyperbilirubinemia,and necrotizing enterocolitis)were compared between the two groups.Moreover,the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale(EPDS)was compared.RESULTS No significant difference in baseline data was found between the two groups(P>0.05).The onset time of weight gain(6.49±0.53 days vs 7.09±0.61 days,P<0.001),time for complete meconium excretion(6.28±0.92 days vs 8.31±1.17 days,P<0.001),time for recovery to birth weight(8.81±1.40 days vs 10.95±1.64 days,P<0.001),and time to reach full enteral feeding(12.29±2.08 days vs 15.48±2.27 days,P<0.001)were compared between the observation and control groups.The incidence of vomiting,abdominal distension,and gastric retention was significantly lower in the observation group than in the control group,and the difference was significant(P<0.05).The rates of the weight growth(15.88±1.57 g/day vs 14.84±1.51 g/day,P=0.007),head circumference(0.63±0.08 cm/week vs 0.59±0.05 cm/week,P=0.018),and length(0.80±0.12 cm/week vs 0.73±0.14 cm/week,P=0.029)were compared between the observation and control groups.On hospital admission of preterm infants with low-birthweight,the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression(P>0.05).Preterm infants with low-birth-weight were hospitalized for 2 weeks,and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group(8.38±1.47 vs 9.49±2.35,P=0.021).CONCLUSION Compared with preterm infant formula feeding,early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications,thereby alleviating mothers’concerns about their children and reducing the risk of postpartum depression.
文摘Objective Data on homocysteine(Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and to explore the determinants like geographic factor.Methods This study was conducted in women at mid-pregnancy, late-pregnancy and postpartum from southern, central and northern China. Approximately 132 women were included in each stratum by the three phases and regions. Plasma Hcy concentrations were assessed using high-performance liquid chromatography(HPLC), with hyperhomocysteinemia defined as > 10.0 μmol/L. Quantile regression was to estimate medians and interquartile ranges(IQRs), and logistic regression to examine the determinants of hyperhomocysteinemia.Results For 1,190 women included, the median(IQR) Hcy concentration was 5.66(4.62, 7.37) μmol/L.The adjusted median in mid-pregnancy, late-pregnancy and postpartum women was 4.75(4.13, 5.54),5.72(4.81, 6.85) and 7.09(5.65, 8.75) μmol/L, respectively, showing an increasing trend(P < 0.001). This increasing trend persisted across the three regions. Higher Hcy concentrations were observed in women residing in northern region and those with younger age or lower economic status. A total of 106(8.9%)women had hyperhomocysteinemia, with a higher prevalence in those residing in northern region(16.0%), or in postpartum women(16.5%).Conclusion Hcy levels, varying with geographic region, maternal age and economic status, are increased from mid-pregnancy to late-pregnancy and postpartum, indicating a need to monitor Hcy levels in pregnant and postpartum women to control potential risks related to elevated Hcy levels.
基金Supported by the Shanghai Sailing Program,No.21YF1440300 and No.22YF1407700and the National Natural Science Foundation of China,No.82200061.
文摘BACKGROUND Postpartum pulmonary arterial hypertension(PAH)complicated with hereditary hemorrhagic telangiectasia(HHT)is a rare condition.Diagnosing and treating PAH in patients with HHT can be challenging.To the best of our knowledge,no previous reports have investigated the efficacy of pulmonary vasodilators in improving hemodynamics in postpartum patients with this disease.CASE SUMMARY In this paper,we report a postpartum case of HHT combined with PAH,pre-senting with worsening dyspnea.Genetic testing revealed that the patient carried a heterozygous variant of activin receptor-like kinase 1.The patient received various treatments,including diuretics,anticoagulants,sildenafil,macitentan,inhalation of nitric oxide,and iloprost.Changes in PaO2/FiO2,pulmonary artery systolic pressure as assessed by echocardiography,and N-terminus pro-brain natriuretic peptide levels suggested that,except for iloprost inhalation,the other treatments appeared to have limited efficacy.CONCLUSION To our knowledge,this is the first report on efficacy of pulmonary vasodilators in postpartum patients with HHT and PAH.
基金financially supported by the Science and Technology Research of Shaanxi Province(2020QFY08-03)Forestry Science and Technology Programs of Shaanxi Province(SXLK2020-0213)supported by the Fundamental Research Funds for the Central Universities(GK202103098)。
文摘The high incidence of postpartum hypogalactia hinders the healthy development of postpartum women and the next generation.Lacquer seed oil(LSO),extracted from the seeds of the lacquer tree,has been traditionally used as a dietary supplement for promoting postpartum lactation and recovery in some districts of China.However,its physiological effects have not been verified,and the mechanism and active components of LSO have not been analyzed.Thus,we applied LSO to bromocriptine-induced postpartum hypogalactia rats.The results showed that LSO supplement effectively improves bromocriptine-induced postpartum hypogalactia.LSO also increased prolactin levels reduced by bromocriptine,promoted JAK2/STAT5 and PI3K/AKT pathways and several gene expression levels of milk synthesis in mammary gland.Moreover,metabolomic and network pharmacological analysis further revealed that JAK2/STAT5,PI3K/AKT,and estrogen signaling pathway are the potential main regulatory sites for the beneficial effects of LSO on postpartum hypogalactia,and that quercetin,kaempferol,arachidonic acid,epicatechin,and β-sitosterol are the top 5 main active ingredients of LSO.Our results suggested that LSO has great potential in the application of the improvement of postpartum hypogalactia.
基金2022 Annual Medical Science Research Project Plan of Hebei Province,No.20221111.
文摘BACKGROUND Postpartum women are at an increased risk of generalized anxiety disorder(GAD),which can negatively affect both mental health and physical recovery.Pelvic floor dysfunction,common in this population,can exacerbate psychological distress.Although pelvic floor rehabilitation is effective in physical recovery,its potential to improve psychological outcomes,especially in women with GAD,remains underexplored.AIM To evaluate the effectiveness of an individualized pelvic floor rehabilitation program in improving anxiety,pelvic floor function,and quality of life in postpartum women with GAD.METHODS A retrospective study was performed to analyze 80 postpartum women with GAD who completed a 12-week individualized pelvic floor rehabilitation program(January 2020-December 2024),combining supervised pelvic floor muscle training and psychological support.Primary outcomes were changes in GAD-7 and Hamilton anxiety rating scale(HAM-A)scores and pelvic floor function measured by surface electromyography(sEMG).Secondary outcomes included World Health Organization quality of life-BREF,pelvic floor symptom severity,and impact on daily activities(pelvic floor impact questionnaire).Assessments were conducted at baseline and 6 and 12 weeks during the intervention period.RESULTS Significant improvements were observed in anxiety measures,with mean GAD-7 scores decreasing from 14.8±3.2 at baseline to 8.2±2.9 at week 12(P<0.001)and HAM-A scores decreasing from 22.6±4.5 to 12.4±3.8(P<0.001).Pelvic floor function showed substantial enhancement,with sEMG amplitude increasing from 22.4±5.6μV to 35.9±6.8μV(P<0.001).Quality of life improved across all domains,with the most significant improvements in psychological(28.5%increase)and physical health(25.8%increase).Program adherence was 91.5%for the supervised sessions,and no serious adverse events were reported.CONCLUSION Individualized pelvic floor rehabilitation training effectively improves both psychological and functional outcomes in postpartum women with GAD.The high adherence and significant outcomes make this integrated approach feasible and effective.
文摘This study evaluated the effectiveness of Chinese herbal foot bath therapy in improving sleep quality among postpartum women of advanced maternal age.A quasi-experimental design was used,involving 60 participants with sleep disturbances recruited from Zouping County Traditional Chinese Medicine Hospital.Participants were divided into control and experimental groups,and sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI)before and after the intervention.The experimental group received Chinese herbal foot bath therapy,while the control group did not.Post-intervention results showed a significant improvement in sleep quality for the experimental group,with a mean PSQI score of 7.79(SD=2.90),compared to 13.45(SD=2.57)in the control group,indicating continued poor sleep.Statistical analysis confirmed that the therapy led to significant improvements across overall and component PSQI scores.The study concludes that Chinese herbal foot bath therapy is a safe,non-invasive,and cost-effective method to enhance sleep quality among postpartum women,especially those of advanced maternal age.It holds promise as a complementary treatment option and could be integrated into standard postpartum care practices to address sleep disturbances without relying on pharmacological interventions.
基金Supported by Huzhou Science and Technology Bureau,No.2023GYB16.
文摘BACKGROUND Postpartum stress urinary incontinence(SUI)symptoms affect a patient’s daily activities and quality of life and increase the negative emotions that they experience.At present,there is no research on the effect of fractional CO_(2)laser treatment combined with Kegel exercise on postpartum SUI and postpartum depression and anxiety.AIM To investigate the effect of lattice CO_(2)laser treatment combined with Kegel exercise on mild to moderate postpartum SUI and its influence on postpartum depression and anxiety.METHODS Using a retrospective study,data from 82 cases of mild to moderate postpartum SUI in Huzhou Maternal&Child Health Care Hospital from January to April 2024 were retrospectively collected.The cases were divided into groups according to the different treatment methods,namely Group S(41 cases,only receiving lattice CO_(2)laser treatment)and Group L(41 cases,receiving lattice CO_(2)laser combined with Kegel exercise treatment).The baseline data of the two groups were compared.In addition,we analyzed and compared the scores of the international commission on urinary incontinence questionnaire short form(ICI-Q-SF),incontinence quality of life questionnaire(I-QOL),Edinburgh postnatal depression scale(EPDS),and postpartum specific anxiety scale(PSAS)before treatment,at the end of treatment,and 3 months after the end of treatment between the two groups.Furthermore,the clinical efficacy and adverse reactions of the two groups were analyzed and compared at the end of treatment and 3 months after the end of treatment.RESULTS There was no significant difference in the baseline data and the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between the two groups before treatment.However,at the end of treatment,the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between Groups L and S were significantly different.The overall effective rate of treatment in Group L was significantly higher than that in Group S.During the 3-month follow-up after treatment,it was found that the ICIQ-SF,EPDS,and PSAS scores of Group L were still lower than those of Group S.In comparison,the I-QOL score and total effective rate of treatment were still higher in Group L than those in Group S,and this difference was significant.There was no significant difference in the adverse reactions between Group L and Group S.CONCLUSION The combination of dot lattice CO_(2)laser and Kegel exercise has a significant therapeutic effect on mild to moderate postpartum SUI.It can prolong the duration of therapeutic effects,improve a patient’s quality of life,and alleviate postpartum depression and anxiety.
文摘BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant disparities remain in screening,diagnosis,and treatment,particularly in low-resource and culturally diverse settings.The complex interplay of biological and psychosocial determinants complicates conventional intervention models.Integrating epidemiological patterns,pathophysiological mechanisms,and sociocultural factors will inform more effective and equitable strategies for PPD screening,prevention,and treatment.METHODS A narrative review was conducted following PRISMA 2020 guidelines.Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed,Web of Science,EMBASE,and PsycINFO.Inclusion criteria comprised studies addressing PPD epidemiology,risk stratification,biological mechanisms,and intervention strategies.After screening and full-text review,84 studies were included.Study designs primarily involved cohort studies,randomized controlled trials,and meta-analyses.Extracted data were categorized thematically and assessed for methodological quality and generalizability.RESULTS PPD arises from multifactorial interactions involving hormonal dysregulation,neurochemical changes,psychosocial stressors,and cultural influences.Primary risk factors include personal or family history of depression,antenatal anxiety,low maternal self-efficacy,and inadequate social support.Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening,cognitive behavioral therapy,interpersonal psychotherapy,psychoeducation,and pharmacological treatments such as brexanolone and zuranolone.Culturally adapted,community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability,particularly in underserved populations.Emerging evidence highlights inflammatory biomarkers(e.g.,interleukin-6 and C-reactive protein),AI-assisted screening tools,and family-inclusive strategies as promising for enhanced detection and outcomes.CONCLUSION Effective PPD management requires integrative,culturally sensitive approaches,prioritizing scalable,personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.
文摘Postpartum depression(PPD)is a severe mental health disorder affecting 10%to 15%of postpartum women worldwide.Pre-eclampsia is a hypertensive disorder of pregnancy that has been identified as a significant factor for PPD due to its vascular dysfunction,systemic inflammation and neurobiological alterations.The neuroinflammatory mechanisms common to both pre-eclampsia and PPD,that contribute to depressive symptoms include elevated proinflammatory cytokines(interleukin-6,tumor necrosis factor-alpha),activation of the kynurenine pathway,and oxidative stress.To critically evaluate Wu et al's study,which investigates blood pressure variability(BPV)and gestational body mass index(BMI)as independent predictors of PPD.To integrate recent findings on the metabolic and cardiovascular links between depression,pre-eclampsia,and postpartum mental health outcomes.Pre-pregnancy BMI is found to be a stronger predictor of PPD than gestational weight gain.A vascular-neuropsychiatric connection has been indicated in pre-eclamptic women,indicating a significant correlation between BPV and depressive postpartum symptoms.There is increased susceptibility to depression due to neuroinflammation contributed by blood pressure fluctuations and metabolic dysregulation.The incidence of PPD could be reduced by early identification and intervention for BP fluctuations.Early detection and intervention in high-risk pregnancies should be conducted through public health strategies that prioritize awareness,education,and accessibility to mental health care.
文摘AIM： To review the safety （infection, perforation） and efficacy （expulsion, continuation rates, pregnancy） of intrauterine device （IUD） insertion in the postpartum period. METHODS： MEDLINE, PubMed and Google Scholar were searched for randomized controlled trials and prospective cohort studies of IUD insertions at different times during the postpartum period. Time of insertion during the postpartum period was documented speci-fically, immediate post placenta period （within 10 min）, early post placenta period （10 min to 72 h）, and de-layed/interval period （greater than 6 wk）. Other study variables included mode of delivery, vaginal vs cesarean, manual vs use of ring forceps to insert the IUD. RESULTS： IUD insertion in the immediate postpartum （within 10 min of placental delivery）, early postpartum （10 min up to 72 h） and Interval/Delayed （6 wk onward） were found to be safe and effcacious. Expulsion rates were found to be highest in the immediate postpartum groups ranging from 14% to 27%. Immediate post placental insertion found to have expulsion rates that ranged from 3.6% to 16.2%. Expulsion rate was significantly higher after insertion following vaginal vs cesarean delivery. The rates of infection, perforation and unplanned pregnancy following postpartum IUD insertion are low. Method of insertion such as with ring forceps, by hand, or another placement method unique to the type of IUD did not show any signifcant difference in expulsion rates. Uterine perforations are highest in the delayed/interval IUD insertion groups.Breastfeeding duration and infant development are not affected by delayed/interval insertion of the non-hormonal （copper） IUD or the Levonorgestrel IUD. Timing of the Levonorgestrel IUD insertion may affect breastfeeding. CONCLUSION： IUD insertion is safe and efficacious during the immediate postpartum, early postpartum and delayed postpartum periods. Expulsion rates are highest after vaginal delivery and when inserted during the immediate postpartum period. IUD associated infection rates were not increased by insertion during the postpartum period over interval insertion rates. There is no evidence that breastfeeding is negatively affected by postpartum insertion of copper or hormone-secreting IUD. Although perforation rates were higher when inserted after lactation was initiated. Randomized controlled trials are needed to further elucidate the consequence of lactation on postpartum insertion. Despite the concerns regarding expulsion, perforation and breastfeeding, current evidence indicates that a favorable risk beneft ratio in support of postpartum IUD insertion. This may be particularly relevant for women for whom barriers exist in achieving desired pregnancy spacing.
文摘Objective To evaluate the clinical efficacy of acupuncture in treatment of postpartum depression. Methods Pubmed database and Embase database were retrieved online in English, and China National Knowledge Internet （CNKI）, China Biology Medicine disc （CBM）, VIP database and Wanfang Data were retrieved in Chinese. Literature in recent 10 years relating to clinical randomized controlled trials of acupuncture in treatment of postpartum depression were collected, and Meta analysis was performed by adopting RevMan5.3. Results Fourteen articles were included in the study in total; it was shown from HAMD result that after combination, WMD=-2.27, 95%CI （-2.55, 0.01）; according to Z-test, Z=2.95, P=0.05, and the difference in efficacy between treatment group and control group was statistically significant. It was shown from EPDS result that after combination, WMD=-0.53, 95%CI （-0.92, -0.03）; according to Z-test, Z=2.08, P〈0.05, and the difference in efficacy between treatment group and control group was statistically significant. During the analysis taking estradiol as standard, it was shown from the result that after combination, WMD=63.99, 95%CI （13.39, 114.60）; according to Z-test, Z=2.48, P〈0.05, and the difference in efficacy between treatment group and control group had remarkably statistical significance. During the analysis taking effective rate as standard, it was shown from the result that after combination, OR=3.15, 95%CI （2.19, 4.55）; according to Z-test, Z=6.14, P〈0.05, and the difference in efficacy between treatment group and control group had remarkably statistical significance. Conclusion Acupuncture treatment for postpartum depression is effective, but more clinical randomized controlled trials with high quality and large sample size are still needed to verify the result.
文摘Objective To explore the efficacy of Tuina for postpartum lactation and work out an optimal protocol involved. Methods With a randomized, controlled and clinical method, Eighty-four full-term primiparas were divided into a Tuina group （58 cases） and a control group （26 cases）. While the patients in the control group received rooming in conventional nursing, those in the Tuina group were additionally treated with Tuina, including local manipulations at the breasts combined with acupoint manipulations. The colostrum time, lactation volume and serum prolactin were observed to make the comparisons between the two groups. Results The scores of lactation quantity after the 1st, 2nd, 3rd of the treatment were 1.660±0.785, 2.530±1.030, 2.880±1.171 in the Tuina group and 1.270±0.533, 1.460±0.811, 1.500±0.583 in the control group respectively, where there were significant differences in each time stage between the two groups （all P0.001）. The time of colostrum was （21.6±10.5） h in the Tuina group and （22.5±9.7） h in the control group, in which the difference was not statistically significant （P0.05）. The levels of prolactin were （314.35±110.37） ng/mL and （321.56±109.61） ng/mL in the Tuina group, （385.78±85.19） ng/mL and （340.12±103.10） ng/mL in the control group before and after treatment respectively, suggested that there were no significant difference （both P0.05）. Conclusion Postpartum Tuina at the breasts could increase the quantity of lactation and delay the decreasing of the levels of prolactin, which contributes primiparas to lactate more and sooner.
基金Supported by Huzhou Science and Technology Bureau,No.2021GY39.
文摘BACKGROUND Rectus abdominis separation(DRA)affects pelvic stability and body image.No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression.AIM To analyze the curative effect of massage on early postpartum DRA and its impact on postpartum depression and thus its ability promote the overall psychosomatic rehabilitation of postpartum women.METHODS Data were retrospectively collected on 70 primiparous women with postpartum DRA who underwent rehabilitation at the Postpartum Rehabilitation Center of Huzhou Maternal and Child Health Hospital from October 2022 to September 2023.The patients were divided into the Group S(35 cases,biomimetic electrical stimulation treatment)and Group L(35 cases,biomimetic electrical stimulation combined with manual massage treatment).Baseline data,the edinburgh postpartum depression scale(EPDS)score,and the visual analog scale(VAS)scores for rectus abdominis distance,waist circumference,and lower back pain before and after treatment were compared.RESULTS No significant differences were found in the baseline data,rectus abdominis distance,waist circumference,and VAS and EPDS scores between the two groups before treatment(P>0.05).After treatment,the distance between rectus abdominis and waist circumference in Group L were significantly smaller than those in Group S(P<0.05).Furthermore,lower back pain(VAS score)and the EPDS score in Group L were significantly lower than those in Group S(P<0.05).CONCLUSION Manual massage can significantly reduce early postpartum DRA,waist circumference,and back pain and improve the patient’s mental state and postpartum depression.
基金Supported by Chongqing Science and Health Joint Medical Research Project,No.2021MSXM034.
文摘BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.AIM To investigate the correlations among mindfulness,marital quality,anxiety,and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.METHODS A cross-sectional study was conducted.The self-administered questionnaire was submitted online through smartphones.The levels of mindfulness,anxiety,depression,and marital quality were respectively investigated by the mindful attention awareness scale(MAAS),the self-rating anxiety scale(SAS),the selfrating depression scale(SDS),and the marriage perception scale(MPS)in these enrolled Han and Tujia primiparas.RESULTS No statistical significance was observed in the prevalence of postpartum anxiety and depression,nor scores of MAAS and MPS-Total in different regions or ethnicities(P>0.05).However,MPSMarital interaction(P<0.05),MPS-Family relationship(MPS-FR)(P<0.01),and MPS-Marital conflict(MPS-MC)(P<0.01)scores of urban primiparas were higher than those of rural primiparas.The MPS-MC score of Han primiparas was higher than that of Tujia primiparas(P<0.05).Negative correlations were observed between MAAS and SAS(r=-0.457,P<0.01),and MAAS and SDS(r=-0.439,P<0.01).SAS has revealed a highly positive correlation with SDS(r=0.720,P<0.01)and a weak negative correlation with MPS(r=-0.200,P<0.05).Besides,a weak negative correlation was observed between MAAS and MPS-MC(r=-0.184,P<0.05),and a weak positive correlation was noticed between SAS and MPS-MC(r=-0.225,P<0.01).Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety(P<0.05,95%CI:-0.384 to 0.033),MPS-MC and postpartum anxiety(P<0.01,95%CI:0.027-0.193),MPS-FR and postpartum depression(P<0.05,95%CI:-0.365 to 0.031),and MPS-MC and postpartum depression(P<0.01,95%CI:0.022-0.206).CONCLUSION Mindfulness demonstrates negative correlations with marital conflict,postpartum anxiety and depression,and it may have cross-ethnic and trans-regional characteristics.Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study,it demonstrates a full mediation effect on the relationships between family relationships,marital conflict,and postpartum anxiety and depression.
文摘Postpartum depression (PPD) is a term applied to describe depressive symptoms occurring during the first year of the postpartum period and is characterized by low mood, loss of enjoyment, reduced energy, and activity, marked functional impairment, reduced self-esteem, ideas or acts of self-harm or suicide. The women’s change into motherhood is a difficult period that involves significant changes in the psychological, social and physiological aspects, and is considered to increase vulnerability for the development of mental illness. In Somalia, 1 in 20 women aged 15 - 49 die due to pregnancy- or birth-related complications every year. This makes being pregnant in Somalia a risk that has its own stress and anxiety. Objective: To evaluate postpartum depression and associated factors among mothers who gave birth in the last 12 months in Mogadishu, Somalia. Methodology: The study is analytic cross sectional study design in which postpartum depression and its associated factors are measured. We used Cochran’s formula (Z<sup>2</sup>p(1 – p)/d<sup>2</sup>). Results: One fifth of the study population was found to have postpartum depression and the factors relating to it included marital status, substance abuse, mode and place of delivery. Conclusion: This shows that neglected mental health of the mothers in Somalia has its burden on the society. Recommendation: Mental health care component should be integrated with maternal care programs available in the country to work on prevention and control of motherhood related stress and depression among mothers who are giving birth under the very difficult circumstances in the country.
