Age-specific determinants of post-partum fatigue in primiparous women

Modification of the association between nausea and vomiting of pregnancy and anxiety by personality trait during early pregnancy: A longitudinal study of Japanese pregnant women

AIM

This study aimed to elucidate whether personality traits modify the relationship between nausea and vomiting of pregnancy (NVP) and anxiety, stratified by three pregnancy periods: 5-8 weeks, 9-12 weeks, and 13-20 weeks.

METHODS

This longitudinal study was conducted from August 2018 to February 2019 at a perinatal outpatient unit in a general hospital. We included 153 pregnant women aged ≥20 years and under 20 weeks of gestation at their first prenatal visit. They completed the Index of Nausea, Vomiting, and Retching, and the State-Trait Anxiety Inventory (STAI) to measure anxiety in terms of both trait (STAI-T) and state anxiety (STAI-S), and retook them at follow-up checkups for a maximum of three times.

RESULTS

Using longitudinal data until 20 weeks' gestation, changes in NVP and trait anxiety were significantly associated with changes in state anxiety independently, with trait anxiety being more strongly involved than the change in NVP. This tendency was pronounced in the high-trait anxiety group with STAI-T scores of ≥45. Cross-sectional analyses by gestational week showed similar results in the low-trait anxiety group (STAI-T < 45). In the high-trait anxiety group, only trait anxiety was significantly associated with state anxiety up to 12 weeks gestation. However, only NVP was significantly associated with state anxiety after 13 weeks.

CONCLUSIONS

Pregnant women who tend to be anxious temperamentally may have other factors that cause anxiety besides nausea immediately after the discovery of pregnancy. Understanding personality traits may help reduce anxiety in pregnant women.

Assessing the effects of exercise on post-partum fatigue symptoms: A systematic review and meta-analysis

Background

The level of activity in women who have given birth is very low despite the great benefits of exercise on their physical and mental health. There are some contradictories between the results of several preliminary studies on the effects of exercise on post-partum fatigue reduction. Therefore, the aim of this study was to assess the effects of exercise on decreasing postpartum fatigue in general and, specifically, in Iran using meta-analysis.

Methods

In this study, the articles printed in international and national centres of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed and Web of Science (WoS), were used to find the studies electronically published up to 2021. The studies' heterogeneity was examined using the I² index, and subsequently, a random-effects model was applied. Data analysis was performed within the Comprehensive Meta-Analysis software (version 2).

Results

Finally, nine articles met the inclusion criteria in this systematic and meta-analysis review. The included samples were 456 patients in the intervention group and 446 in the control group. The mean score of fatigue after the intervention was 8.1 ± 1.1 lower than before intervention in the experimental group, and this difference was statistically significant (p ≤ 0.001).

Conclusion

The results of this study indicate that exercise reduces postpartum fatigue, which can be used for counseling and treatment by gynecologists. Reduce postpartum problems in women and increase the quality of life after childbirth.

A Systematic Review of Studies Using the Multidimensional Assessment of Fatigue Scale

PURPOSE

To review how the Multidimensional Assessment of Fatigue (MAF) has been used and evaluate its psychometric properties.

METHODS

We conducted a database search using "multidimensional assessment of fatigue" or "MAF" as key terms from 1993 to 2015, and located 102 studies.

RESULTS

Eighty-three were empirical studies and 19 were reviews/evaluations. Research was conducted in 17 countries; 32 diseases were represented. Nine language versions of the MAF were used. The mean of the Global Fatigue Index ranged from 10.9 to 49.4. The MAF was reported to be easy-to-use, had strong reliability and validity, and was used in populations who spoke languages other than English.

CONCLUSION

The MAF is an acceptable assessment tool to measure fatigue and intervention effectiveness in various languages, diseases, and settings across the world.

Relationship between the mode of conception and depressive symptoms during the first 6 months post-partum in Japan

PURPOSE

To determine whether conventional treatment and assisted reproductive technology for infertility are associated with depressive symptoms and to identify the predictors of depressive symptoms during the first 6 months' post-partum.

METHODS

A prospective cohort design was used, with the participants being recruited from 13 Japanese hospitals. Using self-report questionnaires, a total of 2709 women (response rate: 71.9%) provided longitudinal data at five time points: during their hospital stay and at 1, 2, 4, and 6 months' post-partum. The depressive symptoms were measured by using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS). A logistic regression analysis was used to examine the association between the mode of conception and depressive symptoms and to identify the predictors of the depressive symptoms.

RESULTS

There was no significant association between the mode of conception and the depressive symptoms at any time point. Six factors that were associated with the EPDS score were first-time childbirth, emergency cesarean delivery, infant feeding, financial burden, having a male infant, and dissatisfaction with social support.

CONCLUSION

There was no significant relationship between the mode of conception and depressive symptoms. Nursing care should be based on individual assessments that focus on parity, the delivery method, infant feeding method, financial burden, the infant's sex, and social support, rather than on the mode of conception.

Observation of the effect of physical rehabilitation therapy combined with the medication on pelvic floor dysfunction

We observed the effects of physical rehabilitation therapy combined with medication on pelvic floor dysfunction (PFD). We collected the medical records of 84 maternal patients with PFD who received treatment at the Affiliated Hospital of Hebei University between May 2015 and October 2016. These patients were randomly divided into two groups, the control group (n=42) and observation group (n=42). In the control group, patients received conventional physical rehabilitation therapy while in observation group, patients received the shixiao powder combined with siwu decoction in addition to the physical rehabilitation. The therapeutic effects were compared between the two groups. The total effective rate of the observation group was 97.6%, which was significantly higher than 78.6% in the control group (P<0.05). In observation group, the index scores of pelvic floor function under rest state, such as electromyo-graphy amplitude, contraction force, coordinate strength and urine flow rate, were significantly higher than those in control group (P<0.05). The rate of Grade II perineal muscle strength in the observation group was 7.32%, which was significantly lower than 47.62% in control group (P<0.05). In observation group, the rates of Grade III and Grade IV muscle strength were respectively 43.91 and 29.26%, which were significantly higher than those in control group (P<0.05). Before the administration of treatment, there were no significant differences in the comparison of the urinary incontinence and sexual life quality of patients between the two groups (P>0.05). In observation group, after treatment, the rehabilitation effects of urinary incontinence and sexual life quality at 3 months post-delivery were significantly better than those in control group (P<0.05). Before treatment, there were no significant differences in the comparison of levels of C-reactive protein (CRP) and interleukin-10 (IL-10) between the two groups (P>0.05), however, after treatment, the levels of CRP and IL-10 of patients in observation group were significantly lower than those in control group (P<0.05). In the observation group, the incidence rate of complications (7.14%) were significantly lower than that in control group (23.81%; P<0.05). Therefore, physical rehabilitation therapy combined with the shixiao powder and siwu decoction exhibits significant efficacy in the treatment of PFD by effectively improving the pelvic floor functions, increasing perineal muscle strength, and decreasing expression levels of inflammatory factors, which can significantly ameliorate life quality and reduce the incidence rate of complications. Thus, this treatment method shows great application value in clinical practice.

The Spanish version of the Fatigue Assessment Scale: reliability and validity assessment in postpartum women

Background

Fatigue is the most widely reported symptom by women during pregnancy, labour, the postpartum period, and early parenting. The objective was to translate the Fatigue Assessment Scale (FAS) into Spanish and assess its psychometric properties.

Methods

Instrumental Design. The FAS was translated into Spanish (FAS-e) using forward and back translation. A convenience sample was constituted with 870 postpartum women recruited at discharge from 17 public hospitals in Eastern Spain. Data was obtained from clinical records and self-administered questionnaires at discharge. Internal consistency, factor structure, comparisons between known groups and correlations with other variables were assessed.

Results

Cronbach’s alpha coefficient was .80. Findings on the dimensionality of the FAS-e scale indicated that it was sufficiently unidimensional. FAS-e scores were higher among women who had undergone caesarean births (p < .05), had a higher level of postpartum pain (p < .01), experienced difficulties during breastfeeding (p < .01) and had lower levels of self-efficacy for breastfeeding (p < .01).

Conclusions

An equivalent Spanish version of the FAS was obtained with good reliability and validity properties. FAS-e is an appropriate tool to measure postpartum fatigue.

Association between physical and depressive symptoms during the first 6 months postpartum

AIM

To examine the relationship between physical symptoms and depressive symptoms among new mothers during the first 6 months postpartum.

METHODS

Prospective cohort study design was used in this study. Participants were recruited in 13 Japanese hospitals between 2012 and 2013. A total of 2709 women (response rate of those invited 71.9%) provided longitudinal data using self-report questionnaires at 5 time points: during the hospital stay and at 1, 2, 4, and 6 months postpartum. Depressive symptoms were measured using the Japanese version of the Edinburgh Postnatal Depression Scale. Also, 37 physical symptoms were measured using a yes-or-no checklist. To examine the association between physical symptoms and depressive symptoms, logistic regression analysis was used.

RESULTS

There was a significant positive association between physical symptoms and depressive symptoms during the first 6 months postpartum. Fifteen physical symptoms were associated with significantly increased odds of depression at 1, 2, 4, and 6 months post-partum. These symptoms included: loss of appetite, tiredness/languor, and palpitation/shortness of breath.

CONCLUSION

Multiple physical symptoms after childbirth were associated with depressive symptomatology. Health professionals should assess for postpartum depression when puerperal women report multiple physical symptoms as independent complaints.

Characteristics and related factors of Japanese mothers who have faced difficulties with childrearing

OBJECTIVE

To identify characteristics of mothers who face difficulties with childrearing.

DESIGN AND SAMPLE

Cross-sectional study. During 2014, 221 mothers and 248 children living in City A within the Tokyo metropolis were registered as requiring help with childrearing. Nursing records of 205 mothers (92.8%) and their 227 children (91.5%) were available. We excluded 29 mothers and children owing to incomplete data for a final sample of 176 mothers (79.6%) and 198 children (79.8%).

MEASURES

Difficulties with childrearing were assessed by self-reported questionnaires at the newborn child's 4-month health checkups. Data on maternal and child variables were collected from nursing records.

RESULTS

The "Difficulties group" included 59 mothers (35.4%) and their 70 children. Logistic regression analysis showed that mothers who were aged 40 years or older, who had a total score on the Edinburgh Postnatal Depression Scale of 9 or greater, who used more child-care support services, and who were monitored more frequently by public health nurses had a high risk of facing difficulties with childrearing.

CONCLUSIONS

Periodic monitoring by PHNs is a key strategy to improve the impact of the difficulties of childrearing for mothers of yoshien jido and their children.