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PubMed1999

Structure of depressive symptoms in pregnancy and the postpartum period.

BACKGROUND: The present study investigated the structure of depressive symptoms in the perinatal period. METHOD: The Zung Self-Rating Depression Scale (SDS) was administered to a total of 1329 women in early, middle and late pregnancy and 5 days, 1 month, 6 months, 12 months and 18 months after the delivery. RESULTS: A number of somatic items and the suicidal ideation item of the SDS made low contributions to the evaluation of the severity of depression, and as a consequence these were excluded in the principal component analysis. Three factors were interpretable as "Cognitive", "Affective insomnia" and "Attentional" emerged at all eight assessment points. The goodness-of-fit index (GFI) generated by confirmatory factor analyses (LISREL 7.20) proved sufficiently high on all eight occasions. LIMITATION: The present study investigated only one self-rating scale and the sample comprised Japanese mothers only. CONCLUSION: The three-factor model of the SDS in the perinatal period was derived from exploratory and confirmatory factor analyses. It is noteworthy that the same three-factor structure emerged at all eight collection points in the present study.

Adolescent↗
PubMed1990

[The postpartum period following preterm labor].

The course of the puerperium following the preterm labour is considered. The hormonal and lactation characteristics are analysed, and their characteristics are compared with those obtained following the term labour.

Estradiol↗
PubMed1979

Serum levels of neurophysin in pregnancy and in the postpartum period: relation to 17beta-estradiol levels.

Changes in serum neurophysin levels were studied in women during normal pregnancy and after delivery. Neurophysin was elevated as early as the sixth week of gestation and gradually increased until, at the latest, the twentieth week. A significant positive correlation was obtained between serum concentrations of neurophysin and those of 17beta-estradiol. In serum samples with 17beta-estradiol levels exceeding 5 ng/ml, neurophysin was consistently elevated above the normal control range. After delivery, serum neurophysin concentrations declined quite rapidly. The levels returned to those of nonpregnant women by 6 days postpartum. These results support the view that a high rate of secretion of 17beta-estradiol may be one of the factors responsible for the elevated levels of serum neurophysin in pregnancy and that this effect disappears rapidly after the disposal of estrogen, independent of the duration of the elevated estrogen levels.

Estradiol↗
PubMed1987

The postpartum period constitutes an important risk for the development of clinical Graves' disease in young women.

In the present study, 93 consecutive women, 20-40 years of age, referred to our clinic from 1976-85 with Graves' disease, were examined with respect to a possible relation between onset of disease and previous pregnancy. An increased relative risk of 6.5 (3.8-11.0, 95% confidence interval) of developing Graves' disease within one year following delivery was found. After excluding the nulliparous women, almost 2 out of 3 women who developed Graves' disease in the principal child-bearing age of 20-35 years had a postpartum onset, suggesting an important role of immunomodulatory events following delivery for the development of this disease in young women. Future studies will ascertain to which extent the recognition of postpartum Graves' disease has implications on the choice of therapy in this group of women.

Adult↗
PubMed1976

Human pregnancy-associated plasma proteins during the postpartum period.

The plasma levels of four pregnancy-associated plasma proteins (PAPP's) and pregnancy zone protein (PZP) were studied in women after delivery of a single viable infant by gel immunodiffussion methods. Data from 89 random samples and 85 serial specimens from five women revealed that both PAPP-B and HPL (PAPP-D) disappeared within a day after delivery. PAPP-A showed a rapid drop in the first 2 or 3 days post partum and became nondetectable in 4 to 6 weeks, with a half-life of 3 to 4 days. PAPP-C had a sharp decrease by the second postpartum day and was not detected 3 to 4 weeks later, with a half-life of 1 to 2 days. None of the PAPP's was detected again during the rest of the 14 postpartum weeks studied. In contrast, the PZP showed a much slower decrease or even a temporary increase during the first 2 weeks post partum; it remained readily detectable over the entire 14 weeks studied.

Blood Proteins↗
PubMed2003

Retinal capillary blood flow in diabetic and nondiabetic women during pregnancy and postpartum period.

PURPOSE: To evaluate the response of retinal capillary circulation to pregnancy in women with diabetes and to correlate microcirculatory changes with progression of retinopathy during pregnancy. METHODS: A prospective follow-up study of 32 pregnant women with insulin-dependent diabetes and 11 nondiabetic pregnant women. Perimacular capillary blood flow measured noninvasively by retinal flowmetry in the inferior perimacular retina. Eleven nonpregnant diabetic women served as diabetic control subjects. RESULTS: In diabetic women, blood flows, measured by small-box analysis, were 233 +/- 69 (mean +/- SD) arbitrary units (AU) during the first trimester, 248 +/- 55 AU during the third trimester, and 238 +/- 46 AU 3 months postpartum, compared with 204 +/- 32, 195 +/- 22, and 196 +/- 34 AU in nondiabetic pregnant women (P = 0.007 between groups). A difference of the same magnitude was evident between the two groups when the mean of the 50th (P = 0.032), 75th (P = 0.004), and 90th (P = 0.007) percentiles of the individual pixel flow values were used in point-wise analysis. In nonpregnant diabetic women, the small-box mean value was 201 +/- 36, and the mean of the 75th percentile value in point-wise analysis was 316 +/- 49. Blood flow was lower in nonpregnant than in pregnant diabetic women during the third trimester (P = 0.023 and P = 0.012, respectively). CONCLUSIONS: Compared with nondiabetic pregnant women, retinal capillary blood flow was higher in diabetic women during pregnancy and after delivery. Together with the hormonal and metabolic changes occurring during pregnancy, hyperdynamic retinal capillary circulation may contribute to the progression of retinopathy in pregnant diabetic women.

Adult↗
PubMed2001

Autoimmune thyroid disease in pregnancy and the postpartum period: relationship to spontaneous abortion.

The aim of this study was to determine the prevalence of autoimmune thyroid disease and the risk of miscarriage in autoimmune thyroid antibody (ATA)-positive women. Eight hundred seventy-six subjects completed the study, and 12.3% were thyroid antibody-positive (4.5% tested positive for both thyroid peroxidase antibody [TPO-Ab] and thyroglobulin autoantibody [Tg-Ab], 4.79% were TPO-Ab-positive only, and 3.1% were Tg-Ab-positive only). Fifty percent of the ATA-positive women and 14.1% of the ATA-negative group had a history of spontaneous abortion. Forty-eight of the ATA-positive women developed postpartum autoimmune thyroid dysfunction (PATD). Of these, 50% had hypothyroidism alone, 31.3% had transient hyperthyroidism followed by hypothyroidism, and 18.8% had transient thyrotoxicosis alone. Of the 48 PATD subjects, 12.5% developed persistent hypothyroidism. None of the ATA-negative women developed any form of thyroid dysfunction. The thyroid-stimulating hormone (TSH) levels in the ATA-positive group were significantly higher than those in the ATA-negative group, and only the ATA-positive women with a history of abortion had significantly higher TSH and lower free thyroxine (FT4) concentrations than the other subgroups. The results revealed a 5.5% prevalence rate for PATD in the study population. In addition to TPO-Ab, Tg-Ab is a useful marker for autoimmune thyroiditis.

Abortion, Spontaneous↗
PubMed2006

An unusual presentation of a pituitary tumour in the early postpartum period.

The case of a parturient, who first presented with a partial oculomotor nerve palsy shortly after caesarean delivery while participating in a clinical trial, is presented. The anaesthesia for the caesarean delivery involved a combined spinal-epidural with intrathecal bupivacaine and postoperative epidural pethidine patient-controlled analgesia. The trial was examining the possible effects of magnesium infusions on acute and chronic pain. The partial oculomotor nerve palsy was an unusual presentation and the signs and symptoms were transient. Magnetic resonance imaging confirmed the presence of a presumed pituitary macroadenoma. Possible reasons for the timing of onset and the rapid resolution of symptoms, and the implications and management of pituitary pathology in the peripartum period, are considered. The uncomplicated course of a later caesarean delivery in the same patient, using the same anaesthesia technique, is also noted.

Adenoma↗
PubMedDate not supplied

Longitudinal changes in fatigue and energy during pregnancy and the postpartum period.

OBJECTIVE: To describe perceived levels of fatigue and energy before, during, and after pregnancy in a group of healthy women experiencing uncomplicated pregnancies; and to examine relationships between their perception of fatigue and energy, parity, and physiologic indicators of sleep disturbances, thyroid function, and iron deficiency. DESIGN: Prospective, longitudinal. SETTING: Participants' homes. PARTICIPANTS: Convenience sample of 24 primiparous and 1 8 multiparous women. MAIN OUTCOME MEASURES: Change in fatigue and energy over time. Measures were obtained at follicular and luteal phases of the menstrual cycle before pregnancy, at each trimester, and at 1 and 3 months after delivery. RESULTS: Younger age and lower prepregnancy levels of iron, ferritin, and hemoglobin explained 1st trimester fatigue. Less total sleep was related to fatigue in the 3rd trimester. Postpartum fatigue was related to reduced amounts of sleep and low levels of ferritin and hemoglobin. CONCLUSIONS: With the exception of premenstrual (luteal) fatigue, progesterone levels were unrelated to fatigue. Neither paid employment nor family variables influenced perception of fatigue. Nurses working with childbearing populations should counsel women about significant 1st trimester fatigue so they can prepare their work and home environments in an attempt to achieve adequate rest.

Adult↗
PubMed2000

Interpersonal constructs of pregnant married women during pregnancy and postpartum period as perceptions of family members.

Interpersonal constructs and their dynamics in pregnant women during the perinatal period were investigated using a symbol figure placement technique and a semantic differential test. 16 pregnant women represented their interpersonal perceptions of family members (husband, mother, father, mother-in-law, father-in-law, and child) at four different times (34 weeks of pregnancy, 37 weeks of pregnancy, and 3 days and 30 days after delivery). Two tests indicated positive perceptions of the pregnant women (cohesion, confidence, and dependence) of family members changed over the perinatal period and their interpersonal perceptions of self-husband and self-child were the most positive next to self-mother. Based upon these findings, the support system for pregnant women was discussed.

Adult↗
PubMedDate not supplied

Prepared childbirth and marital satisfaction during the antepartum and postpartum periods.

A longitudinal study of 105 couples, this study addresses whether there is a change in marital satisfaction throughout the perinatal period and whether any changes in the marriage or the labor and delivery might be attributable to the type of preparation for childbirth engaged in by the couple. Analysis of the demographic variables indicated that the groups were very similar. The only difference was that the Lamaze women had 16 years and the hospital-instructed women had 15 years of education (p less than 0.048). ANCOVA analysis indicated that there was not a significant difference in the couple or female score from the 24-28 weeks of pregnancy to 3-21 days postpartum, but there was a significant difference (p less than 0.04) in the male score after taking Lamaze vs. hospital-based classes. With both the husbands and wives there was an improvement in the marital satisfaction from 24-36 weeks of pregnancy to 3-21 days postpartum. When the initial level of marital satisfaction was controlled statistically, no correlation was found between the couples marriage score and the male and female years of education, age, SES, length of labor, medication in labor, and choice of rooming-in. The labor variables indicated that the Lamaze group had a slightly longer labor than the hospital group, but they used significantly less medication (p less than 0.05) and chose rooming-in more often (p less than 0.06).

Adolescent↗
PubMed1990

Relationship between ovarian activity and energy status during the early postpartum period of high producing dairy cows.

The effect of energy status upon ovarian activity during early lactation was assessed in 54 multiparous Holstein cows. Dry matter intake and milk yield were measured daily from parturition through 9 wk of lactation. Milk composition and body weight were measured weekly during this time. Energy balance corrected for body weight loss was calculated weekly. Blood was collected via tail vein three times weekly and plasma analyzed for progesterone and nonesterified fatty acids. Fifteen cows were anestrus for the 9 wk based on their plasma progesterone (less than 1 ng/ml). These cows were compared with two cycling groups, one group of 25 cows showing corpus luteum activity within 40 d after parturition and a second group of 14 cows showing corpus luteum activity between 40 and 60 d postpartum. Anestrus cows ate less feed, produced less milk, and lost more body weight, resulting in a more negative energy status than cycling cows. Differences in energy balance among cow groups were greatest the first 3 wk postpartum. Anestrus cows and cows showing corpus luteum activity between d 40 and 60 obtained more energy from body reserves for milk production the first 2 wk of lactation, than cows cycling prior to d 40.

Anestrus↗
PubMed1983

[Premature birth. Retrospective study of 2000 premature births at the Gynecological Clinic of the University of Mannheim. 2: Postpartum period, morbidity and mortality of premature infants].

During a period from 1966 to 1977 a retrospective study on 1982 premature births was conducted. 9,4% of the premature births were dead born; from the births, who died in the postnatal period, 94% died within the first 7 days, perinatal mortality was 27%. Most common cause of death was immaturity (25%), followed by respiratory distress syndrome (16%), in 31% cause of death was unknown. The most common complications of the immature births were icterus neonatorum (25,3%), aspiration (21,3%) and asphyxia (8,9%).

Female↗
PubMed1995

[Level of antifibrinogen antibodies in newborns and women during the postpartum period].

In newborns and women who have just delivered antifibrinogen antibodies level was measured by means of immunoenzymatic method (ELISA). It has been found significantly higher antibodies level in women than in newborns. All newborns had lower antibodies level than their mothers. It has been found significantly lowered antibodies level before 38 week of gestation. Especially high antibodies level was observed in women who gave birth after 42 week of gestation and in newborns born in the same time.

Antibodies↗
PubMed1995

[Tubular sterilization in the immediate postpartum period using local anesthesia and laparoscopy].

Puerperal laparoscopic sterilization was performed in 732 women under anaesthesia at the Maternity of Noumea (New-Caledonia). There were no complications. Among the per-operative and postoperative incidents which occurred, there were 0.8% pregnancies, 3.6% bleeding of the broad ligament which was controlled during laparoscopy and 3% events (adhesion, pain) which required general anaesthesia. It was concluded that the described technique of puerperal laparoscopic sterilization is a safe, simple, rapid, inexpensive and reliable surgical technique in expert hands.

Adult↗
PubMed1981

Hospital referrals of home births in the intrapartum and postpartum periods.

Twenty home birth patients referred for hospital management were reviewed. Eleven mothers were referred in labour and nine infants in the first week after birth. The clinical presentation and neonatal outcome are described. The majority had antenatal factors suggesting increased perinatal risk. Careful patient selection, prompt detection and early referral of complications, and adequate facilities for infant resuscitation should minimise the risks of home birth. More research is required on the population requesting home birth and its outcome.

Adolescent↗