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Vo T. The Lived Experience of Postpartum Intergenerational Conflict of Vietnamese American Women with their Vietnamese Immigrant Parents: It's A Generational Thing! MCN Am J Matern Child Nurs 2024; 49:157-164. [PMID: 38241006 DOI: 10.1097/nmc.0000000000001003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2024]
Abstract
PURPOSE US-born Vietnamese women who are in their childbearing years are more likely to identify with "western" perspectives when compared to their immigrant mothers who were born in Vietnam. Still, a gap in knowledge exists of their intergenerational differences. The purpose of this study was to explore and better understand Vietnamese American women's experiences of postpartum intergenerational conflict. STUDY DESIGN AND METHODS van Manen's methodological approach (1997) was used. The purposive sample included 11 US-born Vietnamese women who experienced postpartum intergenerational conflict with their parents. Data were transcribed verbatim and analyzed using thematic analysis. The researcher transcended the themes through music. Songs and lyrics were arranged for guitar to bring the phenomenon to life. RESULTS Four themes were identified: (1) "It's a Generational Thing!" (Một điều thế hệ): Leaning both ways; (2) "To rebel or not" (Nổi loạn hay không): Weighing the evidence of postpartum cultural practices; (3) "Stand My Ground" (Giữ vững lập trường của tôi): Keeping my newborn safe and healthy; and (4) "See Me" (Nhìn con): My mental health overshadowed by my mother's thoughts. This study revealed that the intergenerational conflict was influenced by the family's understanding over the division of infant care tasks, disagreements over cultural practices, and generational differences such as age, consistent with previous research. CLINICAL IMPLICATIONS Tailored interventions for Vietnamese American women should consider the family as a whole. Nurses can assess proactively in prenatal care if there are cultural issues such as family hierarchy, gender, and history influencing one's choices or maternal autonomy.
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Affiliation(s)
- Timothea Vo
- Timothea Vo was a Jonas Scholar 2021-2023 in the School of Nursing at the University of Connecticut, Storrs, CT when this study was conducted. She is now a postdoctoral research fellow at the Bouvé College of Health Sciences School of Nursing at Northeastern University in Boston, MA. Dr. Vo can be reached at
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Parker-Collins W, Njie F, Goodman DA, Cox S, Chang J, Petersen EE, Beauregard JL. Pregnancy-Related Deaths by Hispanic Origin, United States, 2009-2018. J Womens Health (Larchmt) 2023; 32:1320-1327. [PMID: 37672570 PMCID: PMC11002520 DOI: 10.1089/jwh.2023.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
Objective: To describe pregnancy-related mortality among Hispanic people by place of origin (country or region of Hispanic ancestry), 2009-2018. Materials and Methods: We conducted a cross-sectional descriptive study of pregnancy-related deaths among Hispanic people, stratified by place of origin (Central or South America, Cuba, Dominican Republic, Mexico, Puerto Rico, Other and Unknown Hispanic), using Pregnancy Mortality Surveillance System data, 2009-2018. We describe distributions of pregnancy-related deaths and pregnancy-related mortality ratios (number of pregnancy-related deaths per 100,000 live births) overall and by place of origin for select demographic and clinical characteristics. Results: For 2009-2018, the overall pregnancy-related mortality ratio among Hispanic people was 11.5 pregnancy-related deaths per 100,000 live births (95% confidence intervals [CI]: 10.8-12.2). In general, pregnancy-related mortality ratios were higher among older age groups (i.e., 35 years and older) and lower among those with higher educational attainment (i.e., college degree or higher). Approximately two in five pregnancy-related deaths among Hispanic people occurred on the day of delivery through 6 days postpartum. Place of origin-specific pregnancy-related mortality ratios ranged from 9.6 (95% CI: 5.8-15.0) among people of Cuban origin to 15.3 (95% CI: 12.4-18.3) among people of Puerto Rican origin. Hemorrhage and infection were the most frequent causes of pregnancy-related deaths overall among Hispanic people. People of Puerto Rican origin had a higher proportion of deaths because of cardiomyopathy. Conclusions: We identified differences in pregnancy-related mortality by place of origin among Hispanic people that can help inform prevention of pregnancy-related deaths.
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Affiliation(s)
- Wilda Parker-Collins
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Fanny Njie
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - David A. Goodman
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shanna Cox
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeani Chang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Emily E. Petersen
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- U.S. Public Health Service, Commissioned Corps, Rockville, Maryland, USA
| | - Jennifer L. Beauregard
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- U.S. Public Health Service, Commissioned Corps, Rockville, Maryland, USA
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Silesh M, Lemma T. Maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia. PLoS One 2021; 16:e0260710. [PMID: 34852019 PMCID: PMC8635333 DOI: 10.1371/journal.pone.0260710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 11/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Maternal satisfaction is an essential indicator of the quality and the efficiency of the health care systems. At a time when efforts are being made globally to reduce maternal and neonatal mortality and morbidity, assessing maternal satisfaction is essential. There is a dearth of studies on maternal satisfaction with intrapartum care, particularly in the study area. This study aimed to assess maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia. METHODS A facility-based cross-sectional study with a systematic random sampling technique was conducted from May1-30/ 2020. Data were entered into EpiData version 4.6 and analyzed using a statistical package for the social sciences version 25. Bivariate and multivariable logistic regression were employed. In multivariable logistic regression analysis, level of statistical significance was declared at variables with p < 0.05 and the strength of the association was measured by an adjusted odds ratio and 95% confidence interval. RESULT Of the total 394 participants, 111 (28.2%) [95% CI: 23.9, 32.5] of postpartum women were satisfied with the intrapartum care. Place of residence [AOR: 1.934; 95% CI (1.183, 3.162)], planned status of the pregnancy [AOR: 2.245; 95% CI, (1.212, 4.158)], number of antenatal care visit [AOR: 2.389; 95% (1.437, 3.974)] and duration of labour [AOR: 2.463; 95% (1.378, 4.402)] were factors significantly associated with maternal satisfaction with intrapartum care. CONCLUSION The proportion of maternal satisfaction with intrapartum care was low. Therefore, designing strategies to enhance maternal satisfaction by strengthening adherence to antenatal care visits, provision of family planning to prevent unplanned pregnancy, and strict utilization of partograph to prevent prolonged labour and childbirth-related complications are crucial.
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Affiliation(s)
- Mulualem Silesh
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tesfanesh Lemma
- Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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Somerville K, Neal-Barnett A, Stadulis R, Manns-James L, Stevens-Robinson D. Hair Cortisol Concentration and Perceived Chronic Stress in Low-Income Urban Pregnant and Postpartum Black Women. J Racial Ethn Health Disparities 2021; 8:519-531. [PMID: 32613440 DOI: 10.1007/s40615-020-00809-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/20/2020] [Accepted: 06/23/2020] [Indexed: 11/25/2022]
Abstract
Black women are more likely to experience short- or long-term health consequences from their labor and delivery and die from pregnancy-related causes than White women. Similarly, infants born to Black women also have heightened health risks. Developing research suggests that a contributing factor to Black health disparities may be maternal chronic stress. A widely used biomarker for chronic stress is hair cortisol concentration (HCC). Few prior studies have explored the HCC of pregnant Black women or comprehensively examined perceived chronic stress in this population. Using a mixed-methods focus group framework, we assessed HCC and perceived chronic stress among low-income pregnant and postpartum Black women. Four focus groups were conducted (N = 24). The mean HCC for our pregnant Black participants was greater than pregnant White women in reviewed published studies. The high levels of stress evidenced at all pregnancy stages indicate that many of these women are experiencing chronic stress, which can contribute to higher Black maternal morbidity and mortality rates, and possibly infant mortality rates. From the open coding of the focus group transcripts, 4 themes emerged: chronic stress, experiences of racism, experiences of trauma, and negative thinking. Selective coding based on these themes revealed cumulative experiences of chronic stress, various traumatic experiences, and frequent encounters with racism. Negative thinking styles were observed across the 4 focus groups. More studies of HCC and perceived stress among pregnant Black women are encouraged. Findings suggest the need for tailored multi-level interventions given the layers of stressors present in this population.
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Affiliation(s)
- Keaton Somerville
- Department of Psychological Sciences, Kent State University, 600 Hilltop Drive, Kent, OH, 44242, USA.
| | - Angela Neal-Barnett
- Department of Psychological Sciences, Kent State University, 600 Hilltop Drive, Kent, OH, 44242, USA
| | - Robert Stadulis
- Department of Psychological Sciences, Kent State University, 600 Hilltop Drive, Kent, OH, 44242, USA
| | - Laura Manns-James
- Department of Midwifery and Women's Health, Frontier Nursing University, Versailles, KY, USA
| | - Diane Stevens-Robinson
- Department of Psychological Sciences, Kent State University, 600 Hilltop Drive, Kent, OH, 44242, USA
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Winstone LK, Luecken LJ, Crnic KA, Gonzales NA. Patterns of family negativity in the perinatal period: Implications for mental health among Mexican-origin women. J Fam Psychol 2020; 34:642-651. [PMID: 32162941 PMCID: PMC7373671 DOI: 10.1037/fam0000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Negativity in the family environment during the perinatal period is likely to have detrimental effects on maternal well-being, especially among low-income ethnic minority mothers who are at increased risk for experiencing postpartum depressive symptoms. With a sample of 322 Mexican and Mexican American families, this study used latent class growth analysis to identify meaningful subgroups of women based on their perceived family negativity reported prenatally and at 6, 12, 18, and 24 weeks postpartum. A 4-trajectory model of family negativity fit the data well: low-stable (58%), moderate-increasing (26%), high-decreasing (8%), and high-increasing (8%). Higher prenatal depressive symptomatology predicted membership in the moderate-increasing, high-decreasing, and high-increasing trajectories, relative to the low-stable trajectory. Findings suggest substantial heterogeneity in family negativity, identifying three significant growth patterns during the perinatal period with differential implications for maternal depressive symptomatology at 24 weeks and 12 months after delivery. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Power JM, Phelan S, Hatley K, Brannen A, Muñoz-Christian K, Legato M, Tate DF. Engagement and Weight Loss in a Web and Mobile Program for Low-Income Postpartum Women: Fit Moms/ Mamás Activas. Health Educ Behav 2020; 46:114-123. [PMID: 31742447 DOI: 10.1177/1090198119873915] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Internet-based weight loss programs can be effective in promoting weight loss and are less-intensive than traditional face-to-face approaches, which may provide more flexibility for postpartum, low-income women to engage in such programs. Few studies have examined patterns of engagement in internet-based programs for this population. This article used data from the internet-based Fit Moms/Mamás Activas intervention, a 12-month cluster randomized controlled trial that was effective in promoting postpartum weight loss among low-income, predominantly Hispanic women. The overall objectives of this study were to (1) characterize patterns of engagement with the Fit Moms/Mamás Activas website among intervention participants and (2) explore associations between engagement and 12-month weight loss outcomes among study completers (87.4%). A number of engagement variables were calculated for each participant, including website logins; time spent on the website; number of posts to the "Discussion Forum;" number of days tracking weight, diet, and physical activity; number of page visits to various website components; and number of in-person visits attended. The average number of logins was 70.74 (approximately once weekly), and average total time spent on the website was 185.35 minutes (approximately 3 hours) over 1 year. Self-monitoring ("Web Diary") and social support ("Discussion Forum") were the most frequently visited components of the website, and more frequent engagement with these components, as well as greater attendance at in-person group sessions, predicted greater percent weight loss at 12 months. Interventions highlighting these features may be particularly effective for weight loss in this population.
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Affiliation(s)
| | - Suzanne Phelan
- California Polytechnic State University, San Luis Obispo, CA, USA
| | - Karen Hatley
- University of North Carolina at Chapel Hill, NC, USA
| | - Anna Brannen
- California Polytechnic State University, San Luis Obispo, CA, USA
| | | | - Maria Legato
- California Polytechnic State University, San Luis Obispo, CA, USA
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LeMasters K, Andrabi N, Zalla L, Hagaman A, Chung EO, Gallis JA, Turner EL, Bhalotra S, Sikander S, Maselko J. Maternal depression in rural Pakistan: the protective associations with cultural postpartum practices. BMC Public Health 2020; 20:68. [PMID: 31941468 PMCID: PMC6964000 DOI: 10.1186/s12889-020-8176-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traditional postpartum practices are intended to provide care to mothers, but there is mixed evidence concerning their impact on postpartum depression (PPD). It remains unknown if there is a unique impact of postpartum practices on PPD separately from other types of social support, or if practices differentially affect those with existing prenatal depression. In Pakistan, chilla (چله) is a traditional postpartum practice in which women receive relief from household work, additional familial support, and supplemental food for up to 40 days postpartum. This study aims to understand if chilla protects against PPD independent of other support and whether this relationship varies by prenatal depression status. METHODS Data come from the Bachpan cohort study in rural Pakistan. Chilla participation and social support (Multidimensional Scale of Perceived Social Support) were assessed at 3 months postpartum. Women were assessed for major depressive episodes (MDE) with the Structured Clinical Interview, DSM-IV and for depression symptom severity with the Patient Health Questionnaire (PHQ-9) in their third trimester and at 6 months postpartum. Adjusted linear mixed models were used to assess the relationship between chilla participation and PPD. RESULTS Eighty-nine percent of women (N = 786) participated in chilla and almost 70% of those that participated took part in all of chilla's aspects. In adjusted models, chilla participation was inversely related to MDE (OR = 0.56;95%CI = 0.31,1.03) and symptom severity (Mean Difference (MD) = - 1.54;95%CI: - 2.94,-0.14). Chilla participation was associated with lower odds of MDE (OR = 0.44;95%CI = 0.20,0.97) among those not prenatally depressed and with lower symptom severity among those prenatally depressed (MD = -2.05;95%CI:-3.81,-0.49). CONCLUSIONS Chilla is inversely associated with both MDE and symptom severity at 6 months postpartum above and beyond social support. Specifically, chilla is inversely associated with MDE among those not prenatally depressed and with lower symptom severity among those prenatally depressed. This relationship signals an opportunity for interventions aimed at preventing and treating PPD in this region to draw upon chilla and similar traditional postpartum practices in creating community-based, low-cost, sustainable interventions for maternal mental health. TRIAL REGISTRATION NCT02111915. Registered 18 September 2015. NCT02658994. Registered 22 January 2016. Both trials were prospectively registered.
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Affiliation(s)
- Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB# 7435, Chapel Hill, North Carolina NC 27599 USA
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin St, Chapel Hill, North Carolina NC 27516 USA
| | - Nafeesa Andrabi
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin St, Chapel Hill, North Carolina NC 27516 USA
- Department of Sociology, University of North Carolina at Chapel Hill, 102 Emerson Dr, Chapel Hill, North Carolina NC 27514 USA
| | - Lauren Zalla
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB# 7435, Chapel Hill, North Carolina NC 27599 USA
| | - Ashley Hagaman
- School of Public Health, Yale University, 60 College St, New Haven, CT 06510 USA
| | - Esther O. Chung
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB# 7435, Chapel Hill, North Carolina NC 27599 USA
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin St, Chapel Hill, North Carolina NC 27516 USA
| | - John A. Gallis
- Department of Biostatistics and Bioinformatics, Duke University, 2424 Erwin Road, Durham, North Carolina NC 27705 USA
- Duke Global Health Institute, Duke University, Durham, North Carolina USA
| | - Elizabeth L. Turner
- Department of Biostatistics and Bioinformatics, Duke University, 2424 Erwin Road, Durham, North Carolina NC 27705 USA
- Duke Global Health Institute, Duke University, Durham, North Carolina USA
| | - Sonia Bhalotra
- Department of Economics and Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ UK
| | - Siham Sikander
- Human Development Research Foundation, H 06, Street 55, Sector F-7/4, Islamabad, 44000 Pakistan
- Health Services Academy, Islamabad, Pakistan
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB# 7435, Chapel Hill, North Carolina NC 27599 USA
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin St, Chapel Hill, North Carolina NC 27516 USA
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Hou Y, Hou D. Validation of the Australian Pelvic Floor Questionnaire in Chinese pregnant and postpartum women. Eur J Obstet Gynecol Reprod Biol 2020; 245:102-106. [PMID: 31891892 DOI: 10.1016/j.ejogrb.2019.12.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To test the psychometric properties of the culturally adapted Chinese version of the self-administered Australian Pelvic Floor Questionnaire (APFQ) in pregnant and postpartum women. STUDY DESIGN Between November 2018 and December 2018, a total of 316 pregnant women who met the inclusion criteria in an outpatient setting were enrolled. The participants completed the questionnaire during the third trimester and twice after delivery. The test for validity was composed of face/content validity and construct validity. Reliability testing included internal consistency and test-retest reliability. The degree of responsiveness was assessed using effect size (ES) and standardized response mean (SRM). RESULTS Two hundred and seventy-four women completed all questionnaires. Content validity, missing data did not exceed 4 % for any questions in the Chinese version of the self-administered APFQ. Construct validity, there was statistically significant difference in the symptoms scores of women with and without subjective suffering bothersome symptoms in bladder function, bowel function, prolapse and sexual function during pregnancy and postpartum periods. Reliability, the total Cronbach's alpha coefficients of the questionnaire in pregnancy and postpartum periods were 0.8, 0.9 and 0.9, respectively, and the intraclass correlation coefficient (ICC) of the total questionnaire was 0.8 during the test-retest. Responsiveness, the Chinese version of APFQ can track changes in bladder function domain and bowel function domain for the women with standardized response mean equal to 0.6 and 0.2, respectively. CONCLUSIONS The Chinese version of the self-administered APFQ had satisfactory reliability and validity, and can longitudinally monitor changes in pelvic floor symptoms during pregnancy and postpartum periods.
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Affiliation(s)
- Yuqing Hou
- School of Nursing, China Medical University, Shenyang 110122, China.
| | - Dan Hou
- Health Management Center, General Hospital of Northern Theater Command, Shenyang 110003, China.
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Al Tarawneh T, Shoqirat N, Almalik M. "Being relieved and puzzled": A qualitative study of first time fathers' experiences postpartum in Jordan. Women Birth 2019; 33:e320-e325. [PMID: 31371178 DOI: 10.1016/j.wombi.2019.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although the transition to fatherhood is a point of attention for researchers, little is known about the first time father's postpartum experience. This study aims to explore the first time fathers postpartum experience in the country of Jordan. METHODS An exploratory qualitative design was used. Semi-structured interviews were conducted with a purposive sample consisting of twelve first time fathers. The study was conducted in a public university in Jordan. The data was collected in 2017 and was thematically analysed using the colour and file index method. RESULTS The analysis revealed two main themes. The first theme centred around a feeling of relief which can be further divided into two sub-themes of self-actualisation and continuation of the family line. The second theme centred around the feeling of puzzlement, and this can also be further divided into two sub-themes of feeling unable to deal with a newborn baby and struggling to care for a recovering wife. The study identified fathers as willing to engage in the private care of their new babies and recovering wives but at a limited level of engagement. The fathers verbalised the lack of knowledge and exhibited sociocultural stereotypes related to masculinity and the role of the man in the family. CONCLUSIONS The first time fathers' experiences ranged from feelings of relief to puzzlement. The fathers experiences were shaped by religion, culture, and masculinity which suggests education during antepartum may enhance the experience.
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Affiliation(s)
- Tamador Al Tarawneh
- Maternal and Child Health Nursing Department, Faculty of Nursing, University of Mutah, P.O. Box 7, Al-Karak 61710, Jordan.
| | - Noordeen Shoqirat
- Adult Health Nursing, Nursing Faculty, Mutah University, Karak, 61710, Jordan.
| | - Mona Almalik
- Maternal and Child Health Nursing Department, Faculty of Nursing, University of Mutah, P.O. Box 7, Al-Karak 61710, Jordan.
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Hawkins M, Marcus B, Pekow P, Rosal MC, Tucker KL, Spencer RMC, Chasan-Taber L. Physical activity and sleep quality and duration among Hispanic postpartum women at risk for type 2 diabetes: Estudio PARTO. Sleep Health 2019; 5:479-486. [PMID: 31171492 DOI: 10.1016/j.sleh.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 03/05/2019] [Accepted: 04/12/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Poor sleep among postpartum women is associated with adverse maternal outcomes. Physical activity (PA) is associated with better sleep. However, few studies have been conducted among postpartum Hispanic women. The objective of this study was to examine the association between PA and sleep quality and duration among postpartum Hispanic women. DESIGN A cross-sectional analysis using baseline data from Estudio PARTO, an ongoing randomized controlled trial aimed at reducing type 2 diabetes risk among Hispanic women. SETTING Baystate Medical Center, in Western Massachusetts, which serves an ethnically and socioeconomically diverse population. PARTICIPANTS Hispanic women, at elevated risk for type 2 diabetes, at a mean of 11 weeks (SD = 4.5) postpartum. MEASUREMENTS PA was measured with the Pregnancy Physical Activity Questionnaire (PPAQ), and sleep was measured with the Pittsburgh Sleep Quality Index (PSQI). RESULTS Mean sleep duration was 5.9 hour/night (SD = 1.7) and PSQI score was 6.5 (SD = 3.9). In multivariable logistic models, sports/exercise was associated with lower odds of very poor sleep quality (PSQI >10) (OR = 0.18, 95% CI = 0.05 to 0.69). Sports/exercise (OR = 0.05, 95% CI = 0.01 to 0.26) and vigorous intensity PA (OR = 0.13, 95% CI = 0.04 to 0.42) were associated with lower odds of short (vs normal) sleep duration. There were no statistically significant relationships between PA in any other domain or intensity and sleep quality or duration CONCLUSIONS: Findings can inform interventions designed to improve postpartum sleep via increasing opportunities for exercise among postpartum women.
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Affiliation(s)
- Marquis Hawkins
- University of Massachusetts, Department of Biostatistics and Epidemiology, Amherst, MA 01003.
| | - Bess Marcus
- Brown University School of Public Health, Department of Behavioral and Social Sciences, Providence, Providence, Rhode Island
| | - Penelope Pekow
- University of Massachusetts, Department of Biostatistics and Epidemiology, Amherst, MA 01003
| | - Milagros C Rosal
- University of Massachusetts Medical School, 55 Lake Avenue North, S7-755, Division of Preventive and Behavioral Medicine, Department of Medicine, Worcester, MA 01655
| | - Katherine L Tucker
- University of Massachusetts Lowell, Dugan Hall - 110-O, Department of Biomedical and Nutritional Sciences, Lowell, MA 01854
| | - Rebecca M C Spencer
- University of Massachusetts, Tobin 419, Department of Psychological and Brain Sciences, Amherst, MA 01003
| | - Lisa Chasan-Taber
- University of Massachusetts, Department of Biostatistics and Epidemiology, Amherst, MA 01003
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Kinnunen TI, Richardsen KR, Sletner L, Torgersen L, Sommer C, Waage CW, Mdala I, Jenum AK. Ethnic differences in body mass index trajectories from 18 years to postpartum in a population-based cohort of pregnant women in Norway. BMJ Open 2019; 9:e022640. [PMID: 30798304 PMCID: PMC6398684 DOI: 10.1136/bmjopen-2018-022640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore ethnic differences in changes in body mass index (BMI) from the age of 18 years to 3 months postpartum. DESIGN A population-based cohort study. SETTING Child Health Clinics in Oslo, Norway. PARTICIPANTS Participants were 811 pregnant women (mean age 30 years). Ethnicity was categorised into six groups. PRIMARY OUTCOME MEASURES The outcome variable was BMI (kg/m2) measured at the age of 18 and 25 years, at prepregnancy and at 3 months postpartum. Body weight at 18 years, 25 years and prepregnancy were self-reported in early pregnancy, while body height and weight at 3 months postpartum were measured. The main statistical method was generalised estimating equations, adjusted for age. The analyses were stratified by parity due to ethnicity×time×parity interaction (p<0.001). RESULTS Primiparous South Asian women had a 1.45 (95% CI 0.39 to 2.52) kg/m² higher and Middle Eastern women had 1.43 (0.16 to 2.70) kg/m2 higher mean BMI increase from 18 years to postpartum than Western European women. Among multiparous women, the mean BMI increased 1.99 (1.02 to 2.95) kg/m2 more in South Asian women, 1.48 (0.31 to 2.64) kg/m2 more in Middle Eastern women and 2.49 (0.55 to 4.42) kg/m2 more in African women than in Western European women from 18 years to prepregnancy. From 18 years to postpartum, the mean increase was 4.40 (2.38 to 6.42) kg/m2 higher in African women and 1.94 to 2.78 kg/m2 higher in the other groups than in Western European women. CONCLUSIONS Multiparous women of ethnic minority origin seem substantially more prone to long-term weight gain than multiparous Western European women in Norway.
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Affiliation(s)
- Tarja I Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kåre R Richardsen
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Line Sletner
- Department of Child and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Leila Torgersen
- Department of Child Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Christin W Waage
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
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12
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Guardino CM, Hobel CJ, Shalowitz MU, Ramey SL, Dunkel Schetter C. Psychosocial and demographic predictors of postpartum physical activity. J Behav Med 2018; 41:668-679. [PMID: 29740746 PMCID: PMC6814308 DOI: 10.1007/s10865-018-9931-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 04/24/2018] [Indexed: 10/17/2022]
Abstract
Physical activity promotes better health outcomes across the lifespan, and provides physical and mental health benefits for women who have recently given birth. However, research has not adequately characterized physical activity levels or risk factors for inadequate physical activity during the postpartum period. The objective of the present study was to describe levels and correlates of physical activity at 6 months postpartum in mothers of diverse race/ethnicity (55% African American, 23% White, 22% Hispanic/Latina), with the majority living in or near poverty. We analyzed data collected by the five-site Community Child Health Network study. Women (n = 1581) were recruited shortly after the birth of a child. Multinomial logistic regression models tested associations of demographic factors and self-reported stress in several life domains with total physical activity levels at 6-9 months postpartum, including activities done at work, at home, for transportation, and leisure. Thirty-five percent of participants in this sample reported low levels of physical activity. African American race, Latina ethnicity, and living in a rural area were associated with low levels of physical activity, whereas working outside the home was associated with high physical activity. Contrary to hypotheses, chronic stress was not associated with physical activity with the exception of financial stress, which predicted greater likelihood of being highly physically active. These findings suggest that optimal postpartum care should integrate physical activity promotion, and that African American, Latina, and rural-dwelling women may benefit most from efforts to promote activity following birth.
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Affiliation(s)
- Christine M Guardino
- Department of Psychology, Dickinson College, P.O. Box 1773, Carlisle, PA, 17013-2896, USA.
| | - Calvin J Hobel
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Madeleine U Shalowitz
- North Shore University Health System Research Institute and Department of Pediatrics, University of Chicago, Evanston, IL, USA
| | - Sharon L Ramey
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA, USA
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13
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Coop Gordon K, Roberson PNE, Hughes JA, Khaddouma AM, Swamy GK, Noonan D, Gonzalez AM, Fish L, Pollak KI. The Effects of a Couples-Based Health Behavior Intervention During Pregnancy on Latino Couples' Dyadic Satisfaction Postpartum. Fam Process 2018; 57:629-648. [PMID: 29603202 PMCID: PMC6436102 DOI: 10.1111/famp.12354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Many couples tend to report steadily decreasing relationship quality following the birth of a child. However, little is known about the postpartum period for Latino couples, a rapidly growing ethnic group who are notably underserved by mental and physical health caregivers in the United States. Thus, this study investigated whether a brief couples' intervention focused on helping couples support each other while increasing healthy behaviors might improve dyadic functioning postpartum. This study presents secondary analyses of data regarding couple functioning from a larger randomized controlled trial with 348 Latino couples to promote smoking cessation. Portions of the intervention taught the couple communication and problem-solving skills to increase healthy behavior. Couples participated in four face-to-face assessments across 1 year starting at the end of the first trimester. Latent growth curve analyses revealed that the treatment group reported an increase in relationship satisfaction and constructive communication after the intervention, which diminished by 1-year follow-up, returning couples to their baseline levels of satisfaction. Results suggest that incorporating a brief couple intervention as part of a larger health intervention for Latinos may prevent postpartum decreases in relationship satisfaction.
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Affiliation(s)
| | | | - Jessica A Hughes
- Department of Psychology, University of Tennessee, Knoxville, TN
| | | | - Geeta K Swamy
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
| | - Devon Noonan
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
| | - Alicia M Gonzalez
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
| | - Laura Fish
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
| | - Kathryn I Pollak
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC
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14
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Teo C, Chia AR, Colega MT, Chen LW, Fok D, Pang WW, Godfrey KM, Tan KH, Yap F, Shek LPC, Chong YS, Meaney M, Chen H, Chong MFF. Prospective Associations of Maternal Dietary Patterns and Postpartum Mental Health in a Multi-Ethnic Asian Cohort: The Growing up in Singapore towards Healthy Outcomes (GUSTO) Study. Nutrients 2018; 10:nu10030299. [PMID: 29498695 PMCID: PMC5872717 DOI: 10.3390/nu10030299] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 02/09/2018] [Accepted: 02/28/2018] [Indexed: 01/17/2023] Open
Abstract
Diet in the first month postpartum, otherwise known as “the confinement diet” in Asia, has unique characteristics that are influenced by traditions, cultures, and beliefs. We aimed to characterize dietary patterns during confinement period in a multi-ethnic Asian cohort and examined their associations with postpartum depression (PPD) and anxiety (PPA). Dietary intakes of 490 women were ascertained in the first month postpartum using 3-day food diaries and dietary patterns were derived by factor analysis. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) and State-Trait Anxiety Inventory (STAI) at three months’ postpartum; higher scores are indicative of more depressive and anxiety symptoms, respectively. Four dietary patterns were identified: Traditional-Chinese-Confinement diet, Traditional-Indian-Confinement diet, Eat-Out diet and Soup-Vegetables-Fruits diet. The Traditional-Indian-Confinement diet was associated with less PPD symptoms [β (95% CI) −0.62 (−1.16, −0.09) EPDS score per SD increase in diet score] and a non-significant trend with reduced probable PPD (EPDS scores ≥ 13) [OR (95% CI) 0.56 (0.31, 1.01)]. The Soup-Vegetables-Fruits diet was associated with less PPA symptoms [β (95% CI) −1.49 (−2.56, −0.42) STAI-state score]. No associations were observed for other dietary patterns. Independent of ethnicity, adherence to the Traditional-Indian-Confinement diet that is characterized by intake of herbs and legumes, and Soup-Vegetables-Fruits diet high in fruits, vegetables and fish during the postpartum period were associated with less PPD and PPA symptoms, respectively.
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Affiliation(s)
- Cherlyen Teo
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
| | - Ai-Ru Chia
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
| | - Marjorelee T Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
| | - Ling-Wei Chen
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
| | - Doris Fok
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
| | - Wei Wei Pang
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, UK.
| | - Kok Hian Tan
- Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore.
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore.
| | - Fabian Yap
- Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore.
- Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore 229899, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
| | - Michael Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
- Douglas Mental Health University Institute, McGill University, Montreal, QC H4H 1R3, Canada.
| | - Helen Chen
- Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore.
- Department of Psychological Medicine, KK Women's & Children's Hospital, Singapore 229899, Singapore.
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
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15
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Hall JT, Ebeling M, Shary JR, Forestieri N, Wagner CL. The relationship between physical activity and vitamin D status in postpartum lactating and formula-feeding women. J Steroid Biochem Mol Biol 2018; 177:261-265. [PMID: 28867355 PMCID: PMC5826772 DOI: 10.1016/j.jsbmb.2017.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/25/2017] [Accepted: 08/30/2017] [Indexed: 01/10/2023]
Abstract
Existing research shows an association between physical activity levels and vitamin D status in the elderly, men, women, children, and adolescent populations. This association has not yet been investigated in postpartum women. We hypothesized that based on the relationship between vitamin D and physical activity found in other populations, greater physical activity levels in postpartum women will be associated with higher serum 25(OH)D levels. A post hoc analysis of 286 postpartum women with self reported physical activity data from the America on the Move survey, and measured circulating serum 25(OH)D (measured by RIA) as an indicator of vitamin D status, was gathered at baseline (4-6 weeks postpartum), 4 months, and 7 months postpartum. The data were analyzed using SAS 9.4 (Cary, NC). 39.9% of women at visit 1 (baseline), 52.8% of women at visit 4 (month 4), and 55.9% of women at visit 7 (month 7) were meeting the NIH recommendation of 150min of moderate intensity (3-6 METs) physical activity per week. Significant differences were seen in physical activity by race (p=0.007). Caucasians were more likely to meet the standard recommendation than African Americans or Hispanics. Using multiple regression models to examine associations between duration of physical activity and 25(OH)D concentration, controlling for race, BMI, feeding type, and METs, it was found that at visit 1, an increase in physical activity was associated with an increase in 25(OH)D of 1.3nmol/L (p=0.03) and achieving at least 2.5h/wk of physical activity had a trending association with an increase in 25(OH)D of 7.23nmol/L (p=.05). At visit 4 (also controlling for treatment group and sun exposure) achieving at least 1.5h/wk of physical activity was associated with an increase in 25(OH)D of 11.73nmol/L (p=.04). By visit 7, no association between physical activity and maternal 25(OH)D was observed. In a repeated measures, mixed model analysis predicting maternal 25(OH)D during the study, achieving at least the recommended 150min per week of physical activity (>2.5h) was not significantly associated with vitamin D status (pNS). While no definitive conclusions can be drawn regarding precise levels of physical activity influencing 25(OH)D levels in postpartum women, the data suggest that increased activity during the first 4 months after birth is associated with improved vitamin D status. Additional research is needed because of the inconsistency seen at visit 7.
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Affiliation(s)
- Jordan T Hall
- Department of Pediatrics- Neonatology, Medical University of South Carolina, 165 Ashley Avenue, MSC 971 Charleston, SC 29425, USA.
| | - Myla Ebeling
- Department of Pediatrics- Neonatology, Medical University of South Carolina, 165 Ashley Avenue, MSC 971 Charleston, SC 29425, USA
| | - Judy R Shary
- Department of Pediatrics- Neonatology, Medical University of South Carolina, 165 Ashley Avenue, MSC 971 Charleston, SC 29425, USA
| | - Nina Forestieri
- Department of Pediatrics- Neonatology, Medical University of South Carolina, 165 Ashley Avenue, MSC 971 Charleston, SC 29425, USA
| | - Carol L Wagner
- Department of Pediatrics- Neonatology, Medical University of South Carolina, 165 Ashley Avenue, MSC 971 Charleston, SC 29425, USA
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16
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Dennis CL, Brown HK, Wanigaratne S, Vigod SN, Grigoriadis S, Fung K, Marini F, Brennenstuhl S. Determinants of comorbid depression and anxiety postnatally: A longitudinal cohort study of Chinese-Canadian women. J Affect Disord 2018; 227:24-30. [PMID: 29049932 DOI: 10.1016/j.jad.2017.09.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/13/2017] [Accepted: 09/23/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Women with comorbid depression and anxiety in the postpartum period experience more complex and severe symptoms than women with depression or anxiety alone; however, little is known about what influences these symptoms, especially among women from specific ethnic backgrounds. The objective of this study was to identify determinants of comorbid depression and anxiety symptomatology by 24 weeks postpartum in a cohort of Chinese-Canadian women. METHODS A longitudinal cohort study was completed where 549 Chinese immigrant and Canadian-born women in Toronto were followed to 24 weeks postpartum. Questionnaires included risk factors measured at 4 weeks. Logistic regression was used to develop a model of comorbidity (Edinburgh Postnatal Depression Scale score > 9; State-Trait Anxiety Inventory score > 40) up to and including 24 weeks. RESULTS Previous history of postpartum (AOR 2.42, 95% CI 1.42-4.14) and non-postpartum (AOR 4.20, 95% CI 2.21-7.98) depression, maternal age < 26 years (AOR 1.83, 95% CI 1.04-3.22), perception of support (AOR 0.97, 95% CI 0.94-1.00), acculturative stress (AOR 1.03, 95% CI 1.01-1.04), maternal fatigue (AOR 1.12, 95% CI 1.07-1.17), and perceived infant sleep problems (AOR 2.06, 95% CI 1.27-3.43) were significantly associated with comorbid depression and anxiety in the first 24 weeks postpartum. LIMITATIONS Our sample consisted of Chinese-Canadian women; this study should be replicated in other ethnic groups to see if and how risk factors of postpartum comorbidity differ. CONCLUSION The factors identified herein offer insight into groups of Chinese-Canadian women who might benefit most from early identification and treatment and suggest targets for prevention.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
| | - Hilary K Brown
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Interdisciplinary Centre for Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Susitha Wanigaratne
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Simone N Vigod
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Sophie Grigoriadis
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kenneth Fung
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Flavia Marini
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Abstract
International migrant women of childbearing age represent a large proportion of immigrants to high-income countries, yet research focusing on their postpartum health is limited. We investigated predictive factors for breast and non-breast pain 1 week post-birth in migrant and non-migrant women in Canada. Among migrant women, difficulty accessing health services; being from a middle-or high-income country; poor functionality in English and French; living with the father of their infant; and having no regular care provider were predictive of breast pain. Among non-migrant women, difficulties accessing health services, multiparity and prenatal education were predictive of breast pain, while receiving an epidural and having no regular care provider were predictive of non-breast pain. Among both groups, difficulties accessing health services and having no regular care provider were predictive of breast pain, while second degree or higher perineal tearing was predictive of non-breast pain. Migration-specific indicators should be considered in postpartum care planning.
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Affiliation(s)
- Abbey Mahon
- Ingram School of Nursing, McGill University, 3506 University Street, Montreal, QC, H3A 2A7, Canada
| | - Lisa Merry
- Ingram School of Nursing, McGill University, 3506 University Street, Montreal, QC, H3A 2A7, Canada
| | - Olivia Lu
- Ingram School of Nursing, McGill University, 3506 University Street, Montreal, QC, H3A 2A7, Canada
| | - Anita J Gagnon
- Ingram School of Nursing, McGill University, 3506 University Street, Montreal, QC, H3A 2A7, Canada.
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
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18
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Jewell SL, Letham-Hamlett K, Hanna Ibrahim M, Luecken LJ, MacKinnon DP. Family Support and Family Negativity as Mediators of the Relation between Acculturation and Postpartum Weight in Low-Income Mexican-Origin Women. Ann Behav Med 2017; 51:856-867. [PMID: 28470505 PMCID: PMC5670022 DOI: 10.1007/s12160-017-9909-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Obesity presents a significant health concern among low-income, ethnic minority women of childbearing age. PURPOSE The study investigated the influence of maternal acculturation, family negativity, and family support on postpartum weight loss among low-income Mexican-origin women. METHODS Low-income Mexican-origin women (N=322; 14% born in the U.S.) were recruited from a prenatal clinic in an urban area of the Southwest U.S. Acculturation was assessed during a prenatal home visit (26-38 weeks gestation), and post-birth family support and general family negativity were assessed at 6 weeks postpartum. Objective maternal weight measures were obtained at five time points across the first postpartum year. RESULTS Higher acculturation predicted higher family support and family negativity. Higher family support predicted decreasing weight across the first postpartum year, and higher family negativity predicted higher weight at 6 weeks postpartum and increasing weight across the first postpartum year. In combination, family negativity and support mediated the impact of acculturation on postpartum weight gain. CONCLUSIONS Cultural and family-related factors play a significant role in postpartum weight gain and loss for low-income Mexican-origin women.
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Affiliation(s)
- Shannon L Jewell
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA
| | - Kirsten Letham-Hamlett
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA
| | - Mariam Hanna Ibrahim
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA
| | - Linda J Luecken
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA.
| | - David P MacKinnon
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA
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19
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Abstract
OBJECTIVES The postpartum period represents a crucial transition period in which weight gain or loss can affect lifetime obesity risk. This study examined the prevalence of obesity and the influence of childhood abuse and family conflict on postpartum weight among low-income Mexican-origin women. Depressive symptoms and partner support were evaluated as mediators. METHODS At a prenatal assessment, low-income Mexican-origin women (N = 322; mean [SD] age, 27.8 [6.5]) reported on childhood abuse and family conflict. Weight was measured 7 times between 6 weeks and 2 years postpartum and calculated as body mass index. Regression and growth models were used to estimate the impact of childhood abuse, childhood family conflict, partner support, and depressive symptoms on weight and weight change. RESULTS Higher family conflict predicted higher weight across the first (β = .12; p = .037) and second (β = .16; p = .012) postpartum years. Family conflict (β = .17; p = .018) and low partner support (β = -.16; p = .028) also predicted increasing weight in the first year. Partner support partially mediated the effect of childhood abuse on weight change in the first year (p = .031). Depressive symptomatology mediated the effects of childhood abuse and family conflict on weight status in the second year (abuse: p = .005; conflict: p = .023). CONCLUSIONS For low-income Mexican-origin women with a history of childhood abuse or high family conflict, depression and low partner support may be important targets for obesity prevention efforts in the postpartum period.
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Affiliation(s)
- Linda J Luecken
- From the Department of Psychology, Arizona State University, Tempe, Arizona
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Phelan S, Hagobian T, Brannen A, Hatley KE, Schaffner A, Muñoz-Christian K, Tate DF. Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women: A Randomized Clinical Trial. JAMA 2017; 317. [PMID: 28632867 PMCID: PMC5815021 DOI: 10.1001/jama.2017.7119] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
IMPORTANCE Postpartum weight retention increases lifetime risk of obesity and related morbidity. Few effective interventions exist for multicultural, low-income women. OBJECTIVE To test whether an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) for low-income postpartum women could produce greater weight loss than the WIC program alone over 12 months. DESIGN, SETTING, AND PARTICIPANTS A 12-month, cluster randomized, assessor-blind, clinical trial enrolling 371 adult postpartum women at 12 clinics in WIC programs from the California central coast between July 2011 and May 2015 with data collection completed in May 2016. INTERVENTIONS Clinics were randomized to the WIC program (standard care group) or the WIC program plus a 12-month primarily internet-based weight loss program (intervention group), including a website with weekly lessons, web diary, instructional videos, computerized feedback, text messages, and monthly face-to-face groups at the WIC clinics. MAIN OUTCOMES AND MEASURES The primary outcome was weight change over 12 months, based on measurements at baseline, 6 months, and 12 months. Secondary outcomes included proportion returning to preconception weight and changes in physical activity and diet. RESULTS Participants included 371 women (mean age, 28.1 years; Hispanic, 81.6%; mean weight above prepregnancy weight, 7.8 kg; mean months post partum, 5.2 months) randomized to the intervention group (n = 174) or standard care group (n = 197); 89.2% of participants completed the study. The intervention group produced greater mean 12-month weight loss compared with the standard care group (3.2 kg in the intervention group vs 0.9 kg in standard care group, P < .001; difference, 2.3 kg (95% CI, 1.1 to 3.5). More participants in the intervention group than the standard care group returned to preconception weight by 12 months (32.8% in the intervention group vs 18.6% in the standard care group, P < .001; difference, 14.2 percentage points [95% CI, 4.7 to 23.5]). The intervention group and standard care group did not significantly differ in 12-month changes in physical activity (mean [95% CI]: -7.8 min/d [-16.1 to 0.4] in the intervention group vs -7.2 min/d [-14.6 to 0.3] in the standard care group; difference, -0.7 min/d [95% CI, -42.0 to 10.6], P = .76), calorie intake (mean [95% CI]: -298 kcal/d [-423 to -174] in the intervention group vs -144 kcal/d [-257 to -32] in the standard care group; difference, -154 kcal/d [-325 to 17], P = .06), or incidences of injury (16 in the intervention group vs 16 in the standard care group) or low breastmilk supply from baseline to month 6 (21 of 61 participants in the intervention group vs 23 of 72 participants in the standard care group) and from month 6 to 12 (13 of 32 participants in the intervention group vs 14 of 37 participants in the standard care group). CONCLUSIONS AND RELEVANCE Among low-income postpartum women, an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) compared with the WIC program alone resulted in a statistically significant greater weight loss over 12 months. Further research is needed to determine program and cost-effectiveness as part of the WIC program. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01408147.
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Affiliation(s)
- Suzanne Phelan
- Kinesiology Department, California Polytechnic State University, San Luis Obispo
| | - Todd Hagobian
- Kinesiology Department, California Polytechnic State University, San Luis Obispo
| | - Anna Brannen
- Kinesiology Department, California Polytechnic State University, San Luis Obispo
| | - Karen E. Hatley
- Departments of Health Behavior and Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Andrew Schaffner
- Kinesiology Department, California Polytechnic State University, San Luis Obispo
| | | | - Deborah F. Tate
- Departments of Health Behavior and Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
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Turner C, Pol S, Suon K, Neou L, Day NPJ, Parker M, Kingori P. Beliefs and practices during pregnancy, post-partum and in the first days of an infant's life in rural Cambodia. BMC Pregnancy Childbirth 2017; 17:116. [PMID: 28403813 PMCID: PMC5389162 DOI: 10.1186/s12884-017-1305-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 04/07/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The aim of this study was to record the beliefs, practices during pregnancy, post-partum and in the first few days of an infant's life, held by a cross section of the community in rural Cambodia to determine beneficial community interventions to improve early neonatal health. METHODS Qualitative study design with data generated from semi structured interviews (SSI) and focus group discussions (FGD). Data were analysed by thematic content analysis, with an a priori coding structure developed using available relevant literature. Further reading of the transcripts permitted additional coding to be performed in vivo. This study was conducted in two locations, firstly the Angkor Hospital for Children and secondarily in five villages in Sotnikum, Siem Reap Province, Cambodia. RESULTS A total of 20 participants underwent a SSIs (15 in hospital and five in the community) and six (three in hospital and three in the community; a total of 58 participants) FGDs were conducted. Harmful practices that occurred in the past (for example: discarding colostrum and putting mud on the umbilical stump) were not described as being practiced. Village elders did not enforce traditional views. Parents could describe signs of illness and felt responsible to seek care for their child even if other family members disagreed, however participants were unaware of the signs or danger of neonatal jaundice. Cost of transportation was the major barrier to healthcare that was identified. CONCLUSIONS In the population examined, traditional practices in late pregnancy and the post-partum period were no longer commonly performed. However, jaundice, a potentially serious neonatal condition, was not recognised. Community neonatal interventions should be tailored to the populations existing practice and knowledge.
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Affiliation(s)
- Claudia Turner
- Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Angkor Hospital for Children, PO Box 50, Siem Reap, Cambodia
| | - Sreymom Pol
- Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kamsan Suon
- Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
| | - Leakhena Neou
- Angkor Hospital for Children, PO Box 50, Siem Reap, Cambodia
| | - Nicholas P. J. Day
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Michael Parker
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Patricia Kingori
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Coburn SS, Gonzales NA, Luecken LJ, Crnic KA. Multiple domains of stress predict postpartum depressive symptoms in low-income Mexican American women: the moderating effect of social support. Arch Womens Ment Health 2016; 19:1009-1018. [PMID: 27329119 PMCID: PMC5106307 DOI: 10.1007/s00737-016-0649-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
Prenatal stress can have a lasting effect on women's mental health after childbirth. The negative effects may be particularly salient in women from low income and ethnic minority backgrounds, who are at increased risk for postpartum depression. However, social support may have the potential to attenuate the negative impact of stress. The present study evaluated 269 Mexican American women (ages 18-42; 83 % Spanish-speaking; median income $10,000-$15,000) for prenatal stress (daily hassles, family stress, partner stress, and culture-specific stress) in relation to depressive symptoms 6 weeks postpartum. Prenatal social support was examined as a buffer against the impact of prenatal stress. Partner stress, family stress, and daily hassles uniquely predicted depressive symptoms. Moderate and high levels of social support attenuated risk for depression due to family stressors. Prenatal interpersonal and daily stressors negatively impact the mental health of women after birth, but social support can mitigate some of these effects. Among Mexican American pregnant women, effective interpersonal support and stress management may be associated with reduced risk for postpartum depression.
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Affiliation(s)
- Shayna S Coburn
- Department of Psychology, Arizona State University, Tempe, AZ, USA.
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - N A Gonzales
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - L J Luecken
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - K A Crnic
- Department of Psychology, Arizona State University, Tempe, AZ, USA
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Iyengar K, Pelto P, Iyengar SD. Huwa Rog, Parhej, and Desi Dawai: Women's Perceptions of Postpartum Maternal Morbidity and Care in Rajasthan, India. Qual Health Res 2016; 26:659-671. [PMID: 26984709 DOI: 10.1177/1049732316631511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Although more maternal deaths occur in the postpartum period, this period receives far less attention from the program managers. To understand how the women and their families perceive postpartum health problems, the culturally derived restrictions, and precautions controlling diets and behavior patterns, we conducted a mixed-method study in Rajasthan, India. The study methods included free listing of maternal morbidity conditions, interviews with 81 recently delivered women, case interviews with eight cases of huwa rog (postpartum illness), and interviews with nine key informants. The study showed that huwa rog refers to a broad category of serious postpartum illness, thought to affect women a few weeks to several months after delivery. Prevention of the illness involves a system of precautions referred to as parhej, which includes a distinctive set of "medicinal dietary items" referred to as desi dawai, or "country medicine," and restrictions about mobility and work patterns of a postpartum woman. This cultural framework around the concept of huwa rog and peoples' beliefs about it are of central importance for planning postpartum health interventions, including place of contact and communication messages.
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Affiliation(s)
- Kirti Iyengar
- Action Research & Training for Health (ARTH), Udaipur, India Karolinska Institutet, Stockholm, Sweden
| | - Pertti Pelto
- University of Connecticut, Storrs, Connecticut, USA
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Ingar C. The Medicine of the Ukhu Pacha. Andean Sacred Teachings around Pregnancy, Birth and Postpartum. Midwifery Today Int Midwife 2016:34-37. [PMID: 27464403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Abstract
Postpartum weight retention (PPWR) is a significant contributor to the development of overweight and obesity in women of childbearing age. Stress may be a key mechanism making it more difficult for mothers to lose weight in the year following delivery. The aim of this study was to assess whether specific aspects of parenting stress and life stress influence postpartum weight retention in new mothers. Women in late pregnancy or up to 2 months postpartum (n = 123) were enrolled in the study and followed through the first year postpartum. Linear regression models evaluated the associations of parenting stress (isolation, attachment and depressive symptoms) as well as overall life stress at 2, 6, and 12 months postpartum with PPWR at 6 and 12 months. During the first year postpartum, higher depression and life stress were significantly associated with greater PPWR. As the effect of depression diminished, the effect of life stress became significant. Contrary to hypothesized relationships, fewer problems with attachment and less social isolation were significantly associated with greater PPWR. Higher gestational weight gain and African American race were also significantly associated with greater PPWR at both 6 and 12 months. Different types of stress predict weight retention in first time mothers during the first year postpartum. Understanding the relationships between parenting stress, concurrent life stress and PPWR can enhance the development of future interventions that specifically target self-identified stressors, leading to improved weight related outcomes.
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Affiliation(s)
- Kara Whitaker
- University of South Carolina, 921 Assembly Street, Suite 318, Columbia, SC, 29208, USA,
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Sommer C, Jenum AK, Waage CW, Mørkrid K, Sletner L, Birkeland KI. Ethnic differences in BMI, subcutaneous fat, and serum leptin levels during and after pregnancy and risk of gestational diabetes. Eur J Endocrinol 2015; 172:649-56. [PMID: 25740849 DOI: 10.1530/eje-15-0060] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/04/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To explore the differences between Europeans and South Asians in BMI, subcutaneous fat, and serum leptin (s-leptin) levels during and after pregnancy and their relationship with gestational diabetes (GDM). DESIGN Multi-ethnic population-based cohort study, whereof 353 Europeans (93.1% of the included) and 190 South Asians (95.0% of the included). METHODS S-leptin, BMI, and subcutaneous fat (sum of triceps, subscapular, and suprailiac skinfolds) were measured at 14 and 28 weeks of gestation, and 14 weeks after delivery. GDM was diagnosed with the WHO criteria 2013. RESULTS South Asians had similar thickness of the triceps and suprailiac skinfolds, thicker subscapular skinfold, and higher s-leptin than Europeans in early pregnancy, despite lower BMI. South Asians retained more subcutaneous fat (mean (95% CI) 10.0 (7.4-12.7) mm vs 3.8 (1.9-5.8) mm) and BMI (1.5 (1.2-1.8) kg/m(2) vs 0.1 (-0.1 to 0.3) kg/m(2)) than Europeans 14 weeks after delivery and s-leptin decreased less in South Asians than Europeans (-0.13 (-0.27 to -0.00) μg/l vs -0.47 (-0.57 to -0.37) μg/l, P<0.001 for all). The prevalence of GDM was 23.8% (n=84) in Europeans and 42.6% (n=81) in South Asians. BMI, subcutaneous fat, and s-leptin were all positively associated with GDM, also after adjustment for covariates. CONCLUSIONS The relatively high amounts of subcutaneous fat and s-leptin in South Asians in early pregnancy contributed to their increased risk of GDM. South Asians retained more weight and subcutaneous fat after delivery, potentially increasing their risk of adiposity and GDM in future pregnancies.
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Affiliation(s)
- Christine Sommer
- Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway
| | - Anne K Jenum
- Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway
| | - Christin W Waage
- Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway
| | - Kjersti Mørkrid
- Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway
| | - Line Sletner
- Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway
| | - Kåre I Birkeland
- Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway Department of EndocrinologyMorbid Obesity and Preventive Medicine, Oslo University Hospital, PO Box 4959 Nydalen, N-0424 Oslo, NorwayFaculty of MedicineInstitute of Clinical MedicineDepartment of General PracticeFaculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Health SciencesOslo and Akershus University College of Applied Sciences, Oslo, NorwayDepartment of International Public HealthNorwegian Institute of Public Health, Oslo, NorwayDepartment of Child and Adolescents MedicineAkershus University Hospital, Lørenskog, Norway
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Cotton A. 'Promoting positive postpartum mental health through exercise in ethnically diverse priority groups'. Pract Midwife 2014; 17:35-38. [PMID: 24804423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Robinson CA, Cohen AK, Rehkopf DH, Deardorff J, Ritchie L, Jayaweera RT, Coyle JR, Abrams B. Pregnancy and post-delivery maternal weight changes and overweight in preschool children. Prev Med 2014; 60:77-82. [PMID: 24370455 PMCID: PMC4069123 DOI: 10.1016/j.ypmed.2013.12.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 12/12/2013] [Accepted: 12/14/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVES High maternal weight before and during pregnancy contributes to child obesity. To assess the additional role of weight change after delivery, we examined associations between pre- and post-pregnancy weight changes and preschooler overweight. METHODS SAMPLE 4359 children from the Children and Young Adults of the 1979 National Longitudinal Survey of Youth (NLSY) born to 2816 NLSY mothers between 1979 and 2006 and followed to age 4-5years old. EXPOSURES gestational weight gain (GWG) and post-delivery maternal weight change (PDWC). OUTCOME child overweight (body mass index (BMI) ≥85th percentile). RESULTS Adjusted models suggested that both increased GWG (OR: 1.08 per 5kg GWG, 95% CI: 1.01, 1.16) and excessive GWG (OR: 1.29 versus adequate GWG, 95% CI: 1.06, 1.56) were associated with preschooler overweight. Maternal weight change after delivery was also independently associated with child overweight (OR: 1.12 per 5kg PDWC, 95% CI: 1.04, 1.21). Associations were stronger among children with overweight or obese mothers. CONCLUSIONS Increased maternal weight gain both during and after pregnancy predicted overweight in preschool children. Our results suggest that healthy post-pregnancy weight may join normal pre-pregnancy BMI and adequate GWG as a potentially modifiable risk factor for child overweight.
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Affiliation(s)
- Camille A Robinson
- University of California -San Francisco, School of Medicine, San Francisco, CA, USA; University of California -Berkeley, School of Public Health, Division of Epidemiology, Berkeley, CA, USA
| | - Alison K Cohen
- University of California -Berkeley, School of Public Health, Division of Epidemiology, Berkeley, CA, USA
| | - David H Rehkopf
- Stanford University School of Medicine, Division of General Medical Disciplines, Stanford, CA, USA
| | - Julianna Deardorff
- University of California -Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, CA, USA
| | - Lorrene Ritchie
- University of California -Berkeley, Atkins Center for Weight and Health, Berkeley, CA, USA
| | - Ruvani T Jayaweera
- University of California -Berkeley, School of Public Health, Division of Epidemiology, Berkeley, CA, USA
| | - Jeremy R Coyle
- University of California -Berkeley, School of Public Health, Division of Biostatistics, Berkeley, CA, USA
| | - Barbara Abrams
- University of California -Berkeley, School of Public Health, Division of Epidemiology, Berkeley, CA, USA; University of California -Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, CA, USA.
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Phillips T. An examination of postpartum African American adolescents' sociocultural beliefs, perceptions of body weight, and weight control behaviors. ABNF J 2014; 25:19-23. [PMID: 24660316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Obesity presents a public health challenge and is a serious chronic medical condition that is associated with multiple co-morbidities and reduced survivability/longevity. African American adolescents who retain weight after pregnancy are at the highest risk of becoming obese adults. Obesity is associated with 300,000 deaths per year and expected to cost the US. health care system over 237 million dollars within the next decade. The prevalence of obesity is cause for concern because of its economic costs and its toll in human suffering due to related morbidity and mortality. This study seeks to understand the meaning or essence of the lived experience of obesity among postpartum African American adolescents based on a literature review indicating the need for such a qualitative research. Understanding the influence of their developmental stage, sociocultural perceptions, and perceptions of postpartum weight retention could help develop population-specific interventions that could reduce the health risk of obesity.
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Onoye JM, Shafer LA, Goebert DA, Morland LA, Matsu CR, Hamagami F. Changes in PTSD symptomatology and mental health during pregnancy and postpartum. Arch Womens Ment Health 2013; 16:453-63. [PMID: 23797809 PMCID: PMC3888817 DOI: 10.1007/s00737-013-0365-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 06/10/2013] [Indexed: 01/12/2023]
Abstract
Changes in mental health symptoms throughout pregnancy and postpartum may impact a woman's experience and adjustment during an important time. However, few studies have investigated these changes throughout the perinatal period, particularly changes in posttraumatic stress disorder (PTSD) symptoms. The purpose of this study was to examine longitudinal changes in PTSD, depression, and anxiety symptomatology during pregnancy and postpartum. Pregnant women of ethnically diverse backgrounds receiving services for prenatal care at an outpatient obstetric-gynecology clinic or private physicians' office were assessed by interview on symptoms of PTSD, depression, anxiety, and general stress up to four times, including their first, second, and third trimester, and postpartum visits. Overall, during pregnancy there was a declining trend of PTSD symptoms. For anxiety, there was no overall significant change over time; however, anxiety symptoms were individually variable in the rate of change. For both depression and general stress symptoms, there was a declining trend, which was also variable in the individual rate of change among women during their pregnancy. Visual and post hoc analyses also suggest a possible peak in PTSD symptoms in the weeks prior to delivery. While most mental health symptoms may generally decrease during pregnancy, given the individual variability among women in the rate of change in symptoms, screening and monitoring of symptom fluctuations throughout the course of pregnancy may be needed. Further studies are needed to examine potential spiking of symptoms in the perinatal period.
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Brooks JL, Holditch-Davis D, Landerman LR. Interactive behaviors of American Indian mothers and their premature infants. Res Nurs Health 2013; 36:591-602. [PMID: 24105857 PMCID: PMC5701652 DOI: 10.1002/nur.21561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2013] [Indexed: 11/11/2022]
Abstract
The interactive behaviors of 17 American Indian mothers and their premature infants and selected maternal and infant factors affecting those behaviors were measured using naturalistic observation and the Home Observation for Measurement of the Environment (HOME) Inventory at 3, 6, and 12 months corrected infant age. The frequency of some maternal behaviors changed over the first 12 months. Mothers spent less time holding, looking at, touching, and interacting with their premature infants and more time uninvolved as the infant aged. Maternal education and infant illness severity were associated with mother-infant interactive behaviors and HOME Inventory scores. These findings emphasize the importance of maternal and infant factors affecting the interactions between American Indian premature infants and their mothers.
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Affiliation(s)
- Jada L Brooks
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, Campus Box 7460, Chapel Hill, NC, 27599-7460
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Missal B. Gulf Arab women's transition to motherhood. J Cult Divers 2013; 20:170-176. [PMID: 24575592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM This paper is a report of the findings of a study of Gulf Arab women's perspectives of the transition to motherhood. BACKGROUND Transition to motherhood is a universal phenomenon in which every culture has its own expectations and varying supports for women moving through this transition. International studies have provided models or categories of maternal responses related to cultural aspects of transition to motherhood. However, no known research has focused on transition to motherhood among Gulf Arab women. METHOD In the initial cohort seventeen first time Gulf Arab mothers in the United Arab Emirates were interviewed during the following three times: before childbirth, two-four weeks after childbirth, and forty-days after childbirth. A second cohort of seventeen first time new mothers was interviewed after childbirth in Sultanate of Oman. FINDINGS Four patterns were identified as indicators of change as women transitioned into motherhood: 1) Women's personal transition: women changed from feeling of freedom to feeling of dependency to self-confidence. 2) Mother/baby relationships: women changed from fear, anxiety, and uncertainty to feelings of care and confidence. 3) Family influences: women experienced family support to being integrated and feeling respected by family. 4) Cultural/religious beliefs and practices: women felt they were initially observers of culture, to experiencing cultural/religious beliefs and practices. This was followed by accomplishment in childbearing and childrearing practices. CONCLUSION As Gulf Arab new mothers made the transition to motherhood, four implications for international nursing practice emerged: 1) patient teaching to help relieve anxiety, fears, and uncertainty, 2) facilitation of mother/baby relationships, 3) family-centered care, and 4) the importance of cultural/religious beliefs and practices to new mothers.
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Affiliation(s)
- Bernita Missal
- School of Nursing at Bethel University, 3900 Bethel Drive, St Paul, MN 55112, USA.
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Mørkrid K, Jenum AK, Sletner L, Vårdal MH, Waage CW, Nakstad B, Vangen S, Birkeland KI. Failure to increase insulin secretory capacity during pregnancy-induced insulin resistance is associated with ethnicity and gestational diabetes. Eur J Endocrinol 2012; 167:579-88. [PMID: 22889687 DOI: 10.1530/eje-12-0452] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To assess changes in insulin resistance and β-cell function in a multiethnic cohort of women in Oslo, Norway, from early to 28 weeks' gestation and 3 months post partum and relate the findings to gestational diabetes mellitus (GDM). METHOD Population-based cohort study of 695 healthy pregnant women from Western Europe (41%), South Asia (25%), Middle East (15%), East Asia (6%) and elsewhere (13%). Blood samples and demographics were recorded at mean 15 (V1) and 28 (V2) weeks' gestation and 3 months post partum (V3). Universal screening was by 75 g oral glucose tolerance test at V2, GDM with modified IADPSG criteria (no 1-h measurement): fasting plasma glucose (PG) ≥5.1 or 2-h PG ≥8.5 mmol/l. Homeostatic model assessment (HOMA)-β (β-cell function) and HOMA-IR (insulin resistance) were calculated from fasting glucose and C-peptide. RESULT Characteristics were comparable across ethnic groups, except age (South Asians: younger, P<0.001) and prepregnant BMI (East Asians: lower, P=0.040). East and South Asians were more insulin resistant than Western Europeans at V1. From V1 to V2, the increase in insulin resistance was similar across the ethnic groups, but the increase in β-cell function was significantly lower for the East and South Asians compared with Western Europeans. GDM women compared with non-GDM women were more insulin resistant at V1; from V1 to V2, their β-cell function increased significantly less and the percentage increase in β-cell function did not match the change in insulin resistance. CONCLUSION Pregnant women from East Asia and South Asia were more insulin resistant and showed poorer HOMA-β-cell function than Western Europeans.
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MESH Headings
- Adult
- Cohort Studies
- Diabetes, Gestational/blood
- Diabetes, Gestational/epidemiology
- Diabetes, Gestational/ethnology
- Diabetes, Gestational/metabolism
- Ethnicity/statistics & numerical data
- Female
- Follow-Up Studies
- Geography
- Humans
- Insulin/blood
- Insulin/metabolism
- Insulin Resistance/ethnology
- Insulin Resistance/physiology
- Insulin Secretion
- Postpartum Period/blood
- Postpartum Period/ethnology
- Postpartum Period/metabolism
- Pregnancy/blood
- Pregnancy/ethnology
- Pregnancy/metabolism
- Pregnancy/statistics & numerical data
- Pregnancy Trimester, Second/blood
- Pregnancy Trimester, Second/ethnology
- Pregnancy Trimester, Second/metabolism
- Pregnancy Trimester, Third/blood
- Pregnancy Trimester, Third/ethnology
- Pregnancy Trimester, Third/metabolism
- Young Adult
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Affiliation(s)
- Kjersti Mørkrid
- Department of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital HF, PO Box 4959 Nydalen, 0424 Oslo, Norway.
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Larsen WI, Strong JE, Farley JH. Risk factors for late postpartum preeclampsia. J Reprod Med 2012; 57:35-38. [PMID: 22324265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To determine the risk factors for late postpartum preeclampsia. STUDY DESIGN This was a retrospective case control study of women readmitted in the postpartum period (>48 hours and <4 weeks) with preeclampsia. Inclusion criteria were readmission with confirmed preeclampsia. Variables examined were age, race, parity, gestational hypertension, preeclampsia in labor, mode of delivery and history of preeclampsia in previous pregnancies. RESULTS Data included 51 women who met the criteria for late postpartum preeclampsia. Initial analysis revealed that antenatal preeclampsia, gestational hypertension, preeclampsia in a prior pregnancy, body mass index (BMI) > 30, African American race and cesarean delivery were all predictive of late postpartum preeclampsia. Asian ethnicity was protective. Final analysis using logistic regression concluded that African American race, cesarean delivery, BMI and hypertensive disease during the incident pregnancy were all significant predicators of late postpartum disease. CONCLUSION BMI >30, antenatal hypertensive disease, cesarean delivery and African American race were all predictive of readmission for late postpartum preeclampsia. Asian ethnicity appeared to be protective against developing late postpartum preeclampsia.
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Affiliation(s)
- Wilma I Larsen
- Department of Obstetrics and Gynecology, Scott and White Memorial Hospital, Temple, TX, USA.
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Towle A. Pokot tribe. Midwifery Today Int Midwife 2012:56-58. [PMID: 22856086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Merry L, Clausen C, Gagnon AJ, Carnevale F, Jeannotte J, Saucier JF, Oxman-Martinez J. Improving qualitative interviews with newly arrived migrant women. Qual Health Res 2011; 21:976-86. [PMID: 21441413 DOI: 10.1177/1049732311403497] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
There is a paucity of literature on how to conduct research with migrants, particularly those who do not speak the host country language, those who are newly arrived, and those who have a precarious immigration status. In qualitative research, interviewing is a common method for obtaining rich data and participants' points of view. Gathering and presenting all perspectives when interviewing vulnerable migrant women on health-seeking behaviors is challenging. In this article, we explore the process of developing and implementing a data collection plan and an interview guide for a study carried out with migrant women to explore the inhibitors/facilitators for following through on professional referrals for postbirth care. Adaptability and careful attention to multiple factors throughout the process are essential to maximizing participation and enhancing the trustworthiness of the data. Appropriate health policy and care delivery can only originate from health research with diverse migrant populations.
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Affiliation(s)
- Lisa Merry
- School of Nursing, McGill University, 3506 University St., Montreal, Quebec H3A 2A7, Canada.
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Abstract
The American Academy of Pediatrics recommends exclusive breastfeeding until 6 months-of-age. The authors examined prevalence and risk factors for use of infant formulas, water, and teas at 4-6 weeks in Latino infants in the San Francisco Bay Area, a group at high risk for future obesity. They recruited a cohort of pregnant Latina women (N = 201). Infant dietary recall and postpartum depressive symptoms were assessed at 4-6 weeks. The authors found that 105 women (53.1%) were feeding infant formulas and 48 (25.4%) were supplementing with tea or water. Of those providing water or tea, 60.0% were providing daily supplementation. In multivariate analyses, risk for infant supplementation with water or tea was associated with postpartum depressive symptoms (relative risk, 1.8; 95% confidence interval, 1.1-3.0), cesarean delivery (relative risk, 1.9; 95% confidence interval, 1.3-2.9), and infant formula use (relative risk, 1.3; 95% confidence interval, 1.1-1.6). Early supplementation with water or teas and infant formulas should be discouraged in Latinos, given the high frequency observed in this population.
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Affiliation(s)
- Janet M Wojcicki
- Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, University of California, San Francisco, CA 94143-0136, USA.
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Simmons VN, Cruz LM, Brandon TH, Quinn GP. Translation and adaptation of smoking relapse-prevention materials for pregnant and postpartum Hispanic women. J Health Commun 2011; 16:90-107. [PMID: 21120739 DOI: 10.1080/10810730.2010.529492] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Quitting smoking is one of the most important behavior changes a pregnant woman can make, with health benefits extending beyond pregnancy for the woman and her child. Increasing numbers of pregnant women are quitting smoking; however, the majority resume smoking later in their pregnancy or shortly after giving birth. Previous research has demonstrated the efficacy of self-help smoking relapse-prevention booklets; however, there is a dearth of materials available in Spanish for Hispanic smokers. The goal of the present study was to translate and adapt existing, theoretically based, smoking relapse-prevention materials for pregnant and postpartum Hispanic women. This article describes the transcreation approach used to ensure the Forever Free for Baby and Me booklets were linguistically and culturally relevant for the heterogeneous populations of Hispanic women. The authors conducted multistage formative research to adapt the booklets and modify vignettes and graphics. Compared with previous research conducted with pregnant non-Hispanic women, results revealed the following: (a) a lack of association or concern about smoking and weight gain, (b) the importance of family approval of behavior, and (c) stress related to difficulties surrounding the immigration experience. The authors' qualitative findings confirm and extend past research that has suggested ways to enhance the cultural relevance and acceptability of a health intervention.
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Affiliation(s)
- Vani Nath Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
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Klein M. Blood: a private issue? Midwifery Today Int Midwife 2011:55-57. [PMID: 21524000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Carter-Edwards L, Bastian LA, Revels J, Durham H, Lokhnygina Y, Amamoo MA, Ostbye T. Body image and body satisfaction differ by race in overweight postpartum mothers. J Womens Health (Larchmt) 2010; 19:305-11. [PMID: 20113143 PMCID: PMC2834437 DOI: 10.1089/jwh.2008.1238] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Body image (BI) and body satisfaction may be important in understanding weight loss behaviors, particularly during the postpartum period. We assessed these constructs among African American and white overweight postpartum women. METHODS The sample included 162 women (73 African American and 89 white) in the intervention arm 6 months into the Active Mothers Postpartum (AMP) Study, a nutritional and physical activity weight loss intervention. BIs, self-reported using the Stunkard figure rating scale, were compared assessing mean values by race. Body satisfaction was measured using body discrepancy (BD), calculated as perceived current image minus ideal image (BD<0: desire to be heavier; BD>0: desire to be lighter). BD was assessed by race for: BD(Ideal) (current image minus the ideal image) and BD(Ideal Mother) (current image minus ideal mother image). RESULTS Compared with white women, African American women were younger and were less likely to report being married, having any college education, or residing in households with annual incomes >$30,000 (all p < 0.01). They also had a higher mean body mass index (BMI) (p = 0.04), although perceived current BI did not differ by race (p = 0.21). African Americans had higher mean ideal (p = 0.07) and ideal mother (p = 0.001) BIs compared with whites. African Americans' mean BDs (adjusting for age, BMI, education, income, marital status, and interaction terms) were significantly lower than those of whites, indicating greater body satisfaction among African Americans (BD(Ideal): 1.7 vs. 2.3, p = 0.005; BD(Ideal Mother): 1.1 vs. 1.8, p = 0.0002). CONCLUSIONS Racial differences exist in postpartum weight, ideal images, and body satisfaction. Healthcare providers should consider tailored messaging that accounts for these racially different perceptions and factors when designing weight loss programs for overweight mothers.
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Affiliation(s)
- Lori Carter-Edwards
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
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de Boer H, Lamxay V. Plants used during pregnancy, childbirth and postpartum healthcare in Lao PDR: a comparative study of the Brou, Saek and Kry ethnic groups. J Ethnobiol Ethnomed 2009; 5:25. [PMID: 19737413 PMCID: PMC2749814 DOI: 10.1186/1746-4269-5-25] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 09/08/2009] [Indexed: 05/24/2023]
Abstract
BACKGROUND In many Southeast Asian cultures the activities and diet during the postpartum period are culturally dictated and a period of confinement is observed. Plants play an important role in recovery during the postpartum period in diet, traditional medicine, steam bath and mother roasting (where mother and child placed on a bed above a brazier with charcoal embers on which aromatic plants are laid). This research focuses on the use of plants during pregnancy, parturition, postpartum recovery and infant healthcare among three ethnic groups, the Brou, Saek and Kry. It aims to identify culturally important traditions that may facilitate implementation of culturally appropriate healthcare. METHODS Data were collected in 10 different villages in Khammouane province, Lao PDR, through group and individual interviews with women by female interviewers. RESULTS A total of 55 different plant species are used in women's healthcare, of which over 90% are used in postpartum recovery. Consensus Analysis rejects the hypothesis that the three ethnic groups belong to a single culture for postpartum plant use, and multidimensional scaling reveals non-overlapping clusters per ethnic group. CONCLUSION Medicinal plant use is common among the Brou, Saek and Kry to facilitate childbirth, alleviate menstruation problems, assist recovery after miscarriage, mitigate postpartum haemorrhage, aid postpartum recovery, and for use in infant care. The wealth of novel insights into plant use and preparation will help to understand culturally important practices such as confinement, dietary restrictions, mother roasting and herbal steam baths and their incorporation into modern healthcare.
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Affiliation(s)
- Hugo de Boer
- Department of Systematic Biology, Evolutionary Biology Centre, Uppsala University, Norbyvagen 18D, SE-75236 Uppsala, Sweden
- Department of Integrative Biology, University of California, Berkeley, 3060 Valley Life Sciences Bldg #3140, Berkeley CA 94720, USA
| | - Vichith Lamxay
- Department of Systematic Biology, Evolutionary Biology Centre, Uppsala University, Norbyvagen 18D, SE-75236 Uppsala, Sweden
- Department of Biology, Faculty of Sciences, National University of Laos, Dongdok campus, Vientiane, Lao PDR
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Albright CL, Maddock JE, Nigg CR. Increasing physical activity in postpartum multiethnic women in Hawaii: results from a pilot study. BMC Womens Health 2009; 9:4. [PMID: 19254387 PMCID: PMC2662815 DOI: 10.1186/1472-6874-9-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2008] [Accepted: 03/03/2009] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Mothers of an infant are much less likely to exercise regularly compared to other women. This study tested the efficacy of a brief tailored intervention to increase physical activity (PA) in women 3-12 months after childbirth. The study used a pretest-posttest design. Sedentary women (n = 20) were recruited from a parenting organization. Half the participants were ethnic minorities, mean age was 33 +/- 3.8, infants' mean age was 6.9 +/- 2.4 months, 50% were primiparas, and mean body mass index was 23.6 +/- 4.2. METHODS The two-month intervention included telephone counseling, pedometers, referral to community PA resources, social support, email advice on PA/pedometer goals, and newsletters.The primary outcome of the study was minutes per week of moderate and vigorous leisure-time physical activity measured by the Godin physical activity instrument. RESULTS All women (100%) returned for post-test measures; thus, paired t-tests were used for pre-post increase in minutes of moderate and vigorous leisure-time physical activity and comparisons of moderate and vigorous leisure-time physical activity increases among ethnic groups. At baseline participants' reported a mean of 3 +/- 13.4 minutes per week moderate and vigorous leisure-time physical activity. At post-test this significantly increased to 85.5 +/- 76.4 minutes per week of moderate and vigorous leisure-time physical activity (p < .001, Cohen's d = 2.2; effect size r = 0.7). There were no differences in pre to post increases in minutes of moderate and vigorous leisure-time physical activity among races. CONCLUSION A telephone/email intervention tailored to meet the needs of postpartum women was effective in increasing physical activity levels. However, randomized trials comparing tailored telephone and email interventions to standard care and including long-term follow-up to determine maintenance of physical activity are warranted.
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Affiliation(s)
- Cheryl L Albright
- Cancer Research Center of Hawaii, University of Hawaii at Manoa, Honolulu, Hawaii, USA
- Prevention and Control Program, Cancer Research Center of Hawaii, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Jason E Maddock
- Cancer Research Center of Hawaii, University of Hawaii at Manoa, Honolulu, Hawaii, USA
- Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Claudio R Nigg
- Cancer Research Center of Hawaii, University of Hawaii at Manoa, Honolulu, Hawaii, USA
- Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
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Liu N, Mao L, Sun X, Liu L, Yao P, Chen B. The effect of health and nutrition education intervention on women's postpartum beliefs and practices: a randomized controlled trial. BMC Public Health 2009; 9:45. [PMID: 19183504 PMCID: PMC2640472 DOI: 10.1186/1471-2458-9-45] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Accepted: 02/01/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 'Sitting month' is the Chinese tradition for postpartum customs. Available studies indicate that some of the traditional postpartum practices are potentially harmful for women's health. However, no intervention study aiming at postpartum practices has been performed. In this paper we evaluated the effect of a health and nutrition education intervention, which focused on improving postpartum dietary quality and optimal health behaviors. METHODS The study design was a randomized controlled trial conducted in both urban and rural area of Hubei between August 2003 and June 2004. A total of 302 women who attended the antenatal clinic during the third trimester with an uncomplicated pregnancy were recruited. Women randomized to the education intervention group in both urban and rural area received two two-hour prenatal education sessions and four postpartum counseling visits. Control group women received usual health care during pregnancy and postpartum period. Women were followed up until 42 days postpartum. Outcome measures were nutrition and health knowledge, dietary behavior, health behavior and health problems during the postpartum period. RESULTS Women in the intervention groups exhibited significantly greater improvement in overall dietary behaviors such as consumption of fruits, vegetables, soybean and soybean products as well as nutrition and health knowledge than those in the control groups. Significantly more women in the intervention groups give up the traditional behavior taboos. The incidence of constipation, leg cramp or joint pain and prolonged lochia rubra was significantly lower in the intervention groups as compared with the control groups. CONCLUSION The study shows that health and nutrition education intervention enable the women take away some of the unhealthy traditional postpartum practices and decrease the prevalence of postpartum health problems. The intervention has potential for adaptation and development to large-scale implementation. TRIAL REGISTRATION NUMBER klACTRN12607000549426.
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Affiliation(s)
- Nian Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan 430030, PR China
- Hubei Maternal and Child Health Hospital, 745 Wuluo Road, Wuhan 430070, PR China
| | - Limei Mao
- Department of Nutrition and Food Hygiene, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, PR China
| | - Xiufa Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan 430030, PR China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan 430030, PR China
| | - Ping Yao
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan 430030, PR China
| | - Banghua Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan 430030, PR China
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Sule-Odu AO, Fakoya TA, Oluwole FA, Ogundahunsi OA, Olowu AO, Olanrewaju DM, Akesode FA, Dada OA, Sofekun EA. Postpartum sexual abstinence and breastfeeding pattern in Sagamu, Nigeria. Afr J Reprod Health 2008; 12:96-100. [PMID: 20695161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This was a prospective study involving 371 mothers. The mean age of the mothers was 27.5 (.3.6) years with a mean years at school (Educational years) of 11.3 (2.9) years. All the mothers had previously breastfed at one of their infants for at least 6 months, while the mothers also breastfed their last child for an average (mean) of 10.3 (4.0) months. The overall mean of previous live births was 1.9 (0.8). In the first month postpartum, 84.6% of the mothers abstained from sexual intercourse, but by the 4th-5th month the proportion had dropped to 18.1%, with just 2.1% of the study population abstaining from sexual intercourse at 11-15 months post-partum. Forty seven (13.5%), 30 (8.6%) and 3 (0.9%) mothers in social classes 2,3 and 1 respectively have resumed sexual intercourse at 4-5 months, while only 12 (3.4%) and 4 (1.1%) in social classes 2 and 3 respectively continued with sexual intercourse at 11-15 months. More mothers resumed sexual intercourse from 1 to 15 months post-partum when they breast fed for 6-10 minutes and 11-15 minutes than those who breast fed for 1-5 minutes, 16-20 minutes and 21-25 minutes. Also more mothers within the 25-29 years age group resumed sexual intercourse from the first month to the fifteenth month post-partum than mothers in the other age groups.
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Affiliation(s)
- A O Sule-Odu
- Department of Obstetrics and Gynaecology, Olabisi Onabanjo University Teaching Hospital, P.M.B. 2001, Sagamu, Ogun State, Nigeria
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Raven JH, Chen Q, Tolhurst RJ, Garner P. Traditional beliefs and practices in the postpartum period in Fujian Province, China: a qualitative study. BMC Pregnancy Childbirth 2007; 7:8. [PMID: 17584930 PMCID: PMC1913060 DOI: 10.1186/1471-2393-7-8] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Accepted: 06/21/2007] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Zuo yuezi is the month postpartum in China associated with a variety of traditional beliefs and practices. We explored the current status of zuo yuezi from social, cultural and western medical perspectives. METHODS We interviewed family members (36) and health workers (8) in Fujian Province, selecting one rural and one rapidly developing urban county. We asked about their traditional beliefs and their behaviour postpartum. We used a framework approach to identify main themes. We categorised reported behaviour against their probable effects on health, drawing on Western standards. RESULTS Respondents reported that zuo yuezi was commonly practiced in urban and rural families to help the mother regain her strength and protect her future health. Zuo yuezi included: dietary precautions, such as eating more food and avoiding cold food; behavioural precautions, such as staying inside the home, avoiding housework and limiting visitors; hygiene precautions, such as restricting bathing and dental hygiene; and practices associated with infant feeding, including supplementary feeding and giving honeysuckle herb to the infant. Respondents reported that the main reasons for adhering to these practices were respect for tradition, and following the advice of elders. Categorised against Western medical standards, several zuo yuezi practices are beneficial, including eating more, eating protein rich food, avoiding housework, and daily vulval and perineal hygiene. A few are potentially harmful, including giving honeysuckle herb, and avoiding dental hygiene. Some women reported giving infants supplementary feeds, although zuo yuezi emphasises breast feeding. CONCLUSION Zuo yuezi is an important ritual in Fujian. In medical terms, most practices are beneficial, and could be used by health staff to promote health in this period. Further research on reported potentially harmful practices, such as supplements to breast feeding, is needed.
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Affiliation(s)
- Joanna H Raven
- International Health Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Qiyan Chen
- Health Care Department, Fujian Provincial Maternity and Children's Hospital, Fuzhou, Fujian Province, China
| | - Rachel J Tolhurst
- International Health Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Paul Garner
- International Health Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
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Hanley J. The emotional wellbeing of Bangladeshi mothers during the postnatal period. Community Pract 2007; 80:34-7. [PMID: 17536469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
There have been significant studies commenting on the postnatal experience and the emotional well-being of mothers following the birth of their child. This paper focuses on the emotional well-being and health beliefs of Bangladeshi mothers during this period. An attempt was made to understand if postnatal depression was recognised, how it was interpreted and to explore the effect it has on the well-being of the mother, her family and the wider community. A qualitative approach was used to explore the values and views of the mothers by means of a focus group interview. Ten mothers who resided in Wales and were brought up within a Muslim community participated in the study. Findings suggest that when mothers experienced emotional issues they sought the support of their family, friends and religious leaders, and, although familiar with some primary care services, they were not always their first point of contact. It is proposed that health visitors could discuss their role, particularly in relation to perinatal mental health, with the Bangladeshi mothers. This may help the mothers to access support and services. It is important for health visitors to understand the significance of cultural diversity and the competing interpretations of postnatal depression and also to recognise why mothers might seek alternative methods to manage their health during the ante and postnatal period.
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Bloch JR. Postpartum health, service needs, and access to care experiences of immigrant and Canadian-born women. J Obstet Gynecol Neonatal Nurs 2007; 36:172-3; author reply 173. [PMID: 17371519 DOI: 10.1111/j.1552-6909.2007.00131_1.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Fiscella K, Meldrum S, Franks P. Post partum discharge against medical advice: who leaves and does it matter? Matern Child Health J 2007; 11:431-6. [PMID: 17334926 DOI: 10.1007/s10995-007-0194-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Accepted: 02/07/2007] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine risk factors and sequela for post partum discharge against medical advice. METHODS We conducted cross-sectional analyses of hospital discharge data linked to American Hospital Association data for women discharged following a live birth for California, Florida, and New York in the years 1998-2000. We examined rates, risk factors, hospital readmission rate and mortality (California only), associated with discharge against medical advice after controlling for patient and hospital characteristics. RESULTS Post partum discharge against medical advice averaged 0.10%. Rates were lowest among women following uncomplicated cesarean and vaginal births (0.07%), intermediate following complicated vaginal birth (0.21%) and highest following complicated cesarean birth (0.29%). African American race, lower income, public health insurance, no health insurance, or greater comorbidity, particularly drug abuse or psychotic illness, discharge from a hospital in California or New York (compared to Florida), and location in medium or large metropolitan areas, were associated with significantly higher rates of discharge against advice. Asian or Hispanic race or ethnicity and delivery at an obstetrical specialized hospital were associated with lower risk. Patients discharged against medical advice in California were significantly more likely to be re-admitted within 30 days (adjusted odds ratio 2.7; 95% confidence interval [CI] 1.8-3.9), though none died during the period. CONCLUSIONS Discharge against medical advice among post partum patients is uncommon, but occurs primarily among vulnerable women with psychosocial and medical risk factors. Thus, discharge against medical advice may help identify women who may benefit from additional maternal and/or child services.
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Affiliation(s)
- Kevin Fiscella
- Department of Family Medicine, University of Rochester School of Medicine and Dentistry, 1381 South Ave, Rochester, NY 14620, USA.
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Geçkil E, Sahin T, Ege E. Traditional postpartum practices of women and infants and the factors influencing such practices in South Eastern Turkey. Midwifery 2007; 25:62-71. [PMID: 17335945 DOI: 10.1016/j.midw.2006.12.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Revised: 10/15/2006] [Accepted: 12/20/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE to gain an understanding of traditional postpartum practices for women and babies, and to investigate the factors influencing such practices. DESIGN descriptive study. SETTING Maternity and Children's Hospital in Adiyaman city, Turkey. PARTICIPANTS 273 women who gave birth at the Maternity and Children's Hospital in Adiyaman city from March to June 2004. FINDINGS more than half of the 273 women (55.7%) were aged between 25 and 32 years (mean 27.85, standard deviation [SD] 5.45). A total of 22.3% of women were illiterate, and most were unemployed. The most popular practices among new mothers were eating a kind of dessert, called 'Bulamaç' (82.8%). A number of women (69.6%) drank a mixture of grape molasses and butter, 64.5% had their abdomen tightly wrapped, 62.6% were not left alone at home, and more than half of the women (57.9%) avoided sexual intercourse for 40 days after giving birth. Nearly, half of the women (45.4%) fed their babies with water containing sugar just after the birth, and 77.1% of women kept their babies' umbilical cord in a special place. Afterwards, the mothers threw the cords into a river or they buried them in the grounds of a mosque or a school. Most of the mothers (89%) reported that they covered their babies with a yellow cloth in order to protect them from jaundice. A relationship between traditional postpartum practices and demographic characteristics of women was observed. The women's mothers and mothers-in-law (66.7%) usually encouraged such practices. KEY CONCLUSIONS postpartum care of women and their babies are important cultural practices. Some of these practices may have harmful effects on women and their babies. IMPLICATIONS FOR PRACTICE it is important to gain an understanding of cultural beliefs and traditional practices relating to the postpartum care of women and their babies. Midwives and nurses should discuss these findings and their implications when they educate new mothers and their families about contemporary methods of postnatal maternal and infant care.
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Affiliation(s)
- Emine Geçkil
- Adiyaman University, School of Health, Kavi Yolu Son Durak, 02030 Adiyaman, Turkey.
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