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At least 19 recordsLinked to original sources
PubMed1988

Changes of lymphocyte subsets in normal pregnant and postpartum women: postpartum increase in NK/K (Leu 7) cells.

Changes in lymphocyte subsets in whole blood of normal pregnant and postpartum women were examined by flow cytometry with an automated leukocyte differential system. From the first trimester and throughout pregnancy, the absolute counts of T(CD3) and B(CD20) and T-cell subsets (CD4, CD8) decreased with a decrease in the absolute lymphocyte count, although the proportions of these cells remained unchanged except for a decrease in the percentage of T helper-inducer (CD4) cells in the first trimester. On the contrary, the percentage of NK/K (Leu 7) cells, but not of NK/K (CD16) cells, increased in the first trimester and then both gradually decreased in the second and third trimesters. In the postpartum period, the percentages and absolute counts of T(CD3) and NK/K (Leu 7) cells, but not of other cells, increased transiently. These changes of lymphocyte subsets may indicate suppression of immunological activity during pregnancy and its "increase" in the postpartum period.

Adult↗
PubMed2004

[Interventions to prevent health risks due to tobacco smoke in pregnant women, postpartum women and their infants].

The aim of this study was to develop recommendations for interventions aiming at reducing health risks due to tobacco smoking in pregnant women, women postpartum and their infants. Meta-Analyses and selected studies are summed up. Epidemiological findings and health risks due to smoking are summed up. Subsequently findings from intervention studies are cross-referenced and integrated as recommendations. Interventions may be divided into three categories: 1. interventions to obtain abstinence in pregnancy, 2. interventions for relapse prevention after abstinence has been attained in pregnancy, 3. interventions aimed at reducing exposure to environmental tobacco smoke in homes with children. Empirical evidence is cross-referenced to the following points: 1. Self-help materials, 2. brief counselling, 3. more time-consuming counselling, 4. interventions to reduce exposure to environmental tobacco smoke and 5. interventions by midwives. Results from meta-analyses as well as results from selected studies suggest the following recommendations: 1. use of a trusting relationship in counselling, 2. repeated counselling, 3. complementary use of self-help materials; self-help material alone is not effective enough, 4. use of state-of-the-art counselling approaches and, 5. theoretical foundation and appropriate individualized counselling.

Causality↗
PubMed1995

A longitudinal study of urinary calcium, magnesium, and zinc excretion in lactating and nonlactating postpartum women.

Postpartum lactating (n = 12) and nonlactating (n = 11) women and never pregnant women (n = 14) collected urine samples and diet records 2 d each month for 6 mo to determine whether postpartum women conserved urinary calcium, magnesium, or zinc. Mean daily excretions were analyzed by repeated-measures analysis of variance and covariance to assess group and time effects. Lactating women excreted less urinary calcium (1-6 mo) than never pregnant (n = 8) and nonlactating (n = 4) women who did not use oral contraceptives (P < 0.01); however, excretion rose (P < 0.05) by 3 mo postpartum. In the nonlactating and never pregnant groups, women using oral contraceptives excreted less urinary calcium than the other women (P < 0.01). Lactating women excreted less urinary zinc (1-6 mo) than did control and non-lactating women (P < 0.01). Mechanisms may possibly be operating during lactation that depress urinary calcium for > or = 2 mo and urinary zinc < or = 6 mo postpartum.

Adult↗
PubMed1995

Pulsatile GnRH stimulates normal cyclic ovarian function in amenorrheic lactating postpartum women.

The postpartum period is characterized hormonally by elevated levels of PRL and low levels of gonadotropins and sex steroids. In breast feeding, this state of postpartum amenorrhea can persist for an extended period, even though PRL levels decrease slowly. Although the action of PRL on multiple target sites has frequently been suggested as the cause of this ovarian quiescence, a suckling-induced alteration in hypothalamic gonadotropin-releasing hormone (GnRH) production has also been hypothesized. To test this latter hypothesis, we provided a uniform pulsatile GnRH stimulus to eight exclusively breast-feeding women for an 8-week duration beginning at 4 weeks postpartum. Five women with functional hypothalamic amenorrhea served as a comparison group. All women received GnRH administered at a dose of 200 ng/kg every 90 min sc via a portable infusion pump. Serial blood sampling for LH, FSH, and PRL was performed weekly for 5 h at 10-min intervals beginning immediately before initiation of GnRH, during the period of GnRH, and 1 week after the cessation of GnRH. The women collected daily urine aliquots for estrone-3-glucuronide, pregnanediol-3-glucuronide, and LH determinations. Serial transvaginal sonography was used to monitor follicular development. Before GnRH treatment the urinary steroid and serum gonadotropin levels of the two groups were low and similar. As expected, PRL levels were higher in the postpartum women (87 micrograms/mL vs. 4.25 micrograms/L, P < 0.05). After initiation of pulsatile GnRH, LH values increased and FSH values decreased in both groups. The LH increase with GnRH was significantly greater in the breast-feeding group than in the hypothalamic amenorrhea group (19.75 mIU/mL vs. 12.34 mIU/mL, P < 0.05). Analysis of pulse frequency and amplitude revealed a nearly complete 1:1 induction of LH pulses by the exogenous GnRH in both groups, with the breast-feeding group showing a greater amplitude (12.26 mIU/mL vs. 5.34 mIU/mL, P < 0.05). The cycle lengths, urinary steroids, and vaginal ultrasonography demonstrated a more rapid initial ovarian responsiveness in the breast-feeding group, as determined by the length of the first follicular phase. The breast-feeding group also showed a brisker ovarian response, as evidenced by a greater number of follicles that were 12 mm or greater (2.3 vs. 1.2, P < 0.05), and a greater luteal phase peak and integrated pregnanediol excretion, respectively (3.02 micrograms/L creatinine and 39.87 micrograms/L creatinine/cycle vs. 1.89 micrograms/L creatinine and 7.69 micrograms/L creatinine/cycle, P < 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMedDate not supplied

Responses to laboratory psychosocial stress in postpartum women.

OBJECTIVE: Lactation has been associated with attenuated hormonal responses to exercise stress in humans. This study was designed to determine the effect of lactation on hypothalamic-pituitary-adrenal axis, autonomic nervous system, and anxiety responses to psychological stress. METHOD: The Trier Social Stress Test was administered to 24 lactating women, 13 postpartum nonlactating women, and 14 healthy control women in the early follicular phase of the menstrual cycle. Lactating women were stressed at least 40 minutes after last feeding their infant. RESULTS: ACTH, cortisol, heart rate, diastolic blood pressure, systolic blood pressure, and subjective anxiety ratings were all significantly increased in response to the psychological stress (all p <.0001). There were no differences among the three groups in any of these responses to the stress. However, postpartum nonlactating women did have a persistently higher systolic blood pressure and lower cardiac vagal tone than the lactating women and control subjects. In addition, the typical negative correlation between cardiac vagal tone and heart rate was consistently higher in lactating women than nonlactating postpartum women and controls, which suggests stronger vagal control of heart rate in lactating women. In addition, there was no change in oxytocin or allopregnanolone in response to the stress, and baseline oxytocin and allopregnanolone levels did not differ among the three groups. CONCLUSIONS: These results indicate that physiological and subjective responses to social stress are not attenuated in lactating women tested at least one hour after feeding their infant. However, enhanced vagal control of cardiac reactivity was observed in lactating women. In addition, postpartum women who did not lactate showed evidence of increased sympathetic and decreased parasympathetic nervous system tone.

Adult↗
PubMed1989

Gentamicin dosing in postpartum women with endometritis.

Postpartum women receiving gentamicin for endometritis were studied to determine if selective determination of gentamicin serum levels was cost-effective in terms of safety and efficacy. The women were randomized into two groups of 30 patients each. In the control group gentamicin serum levels were determined after the third dose. In the study group, levels were determined only if renal dysfunction was evident or if the patient failed to respond to therapy. Determination of serum levels did not assure a better therapeutic outcome in either group, as measured by hospital stay, duration of treatment, total cost of antibiotics, and hospital readmissions. Although pharmacokinetic dosing equations were used, the use of 1.75 mg/kg every 8 hours based on actual body weight in patients with average heights and weights would have produced acceptable results. We conclude that routine monitoring of gentamicin serum levels is not required in otherwise healthy postpartum women with endometritis.

Adult↗
PubMed1994

The needs of postpartum women.

The postpartum period is characterized by a revival of the pregnancy and birth experiences, as well as adjustment to new roles, and the adjustment of the family to the new family member. In the case of a first baby, it also represents a developmental milestone for the man and woman whose lives will no longer be unfettered. Adequate education in accordance with the needs of women is necessary to enable them to handle changes in the postpartum period and to meet these demands. This researcher is aware of several postpartum education programmes in operation in South Africa at present, but none have been compiled on the basis of a published investigation of the specific needs of these women. The aim of this study therefore was to determine the needs of postpartum women. An exploratory study was undertaken by means of a qualitative research design. The research was limited to women living in Bloemfontein. White married women, primiparae as well as multiparae, women who breast-fed or bottle-fed their babies and who had either vaginal delivery or a caesarean section were included in the study. Women who were discharged from hospital without their babies were excluded. The researcher concluded that women in the postpartum period experience common needs and problems regarding self-care and baby care but their priorities were needs and problems related to self-care. The reason could be that they had gained experience of baby care in hospital. Moreover, while there are many books and articles on baby care, few are available on self-care. Postpartum education is recommended for all mothers, both primiparae and multiparae.

Adaptation, Psychological↗
PubMed1997

Thromboelastographic changes in healthy parturients and postpartum women.

Thromboelastography (TEG) using disposable plastic cups and pins was performed with native whole blood (native group) in 17 nonpregnant volunteers, 134 healthy term pregnant women (>36 wk gestation), and 69 postpartum women. Thromboelastography was also performed with celite-activated whole blood (celite group) in 15 nonpregnant female volunteers, 38 healthy term pregnant women, and 34 postpartum women. The thromboelastographic parameters r and K were significantly decreased in pregnant and postpartum women compared with nonpregnant women in both groups (P < 0.05). The maximum amplitude MA, elastic shear modulus, and alpha angles were significantly increased in pregnant and postpartum women compared with nonpregnant women in both groups (P < 0.05). The TEG coagulation index was significantly greater in pregnant and postpartum women compared with nonpregnant women in both groups. In this study, TEG showed that pregnancy is a hypercoagulable state and that postpartum women remain hypercoagulable through the first 24 h postdelivery. The use of celite in TEG accelerated the speed of TEG analysis.

Blood Coagulation↗
PubMed2004

A comparative study of values and attitudes of inner-city and middle-class postpartum women.

This study compared postpartum women from the inner city (n = 94) and postpartum women from the urban middle class (n = 80) on values and goals for themselves and their newborn children. Terminal values of inner-city women for themselves related more to social and religious goals in contrast to the more intrapersonal and personal goals of middle-class women. Instrumental values of inner-city women for their newborn children demonstrated concern with conformity and control, whereas for the middle class there was more concern with competence. Goals for the near future of the inner-city mothers were based on a desire for jobs and education.

Achievement↗
PubMed1995

[Longitudinal study of postpartum women knowledge needs--parity and time series perspectives].

The purpose of this study was to explore the knowledge needs of postpartum women. A postpartum knowledge needs questionnaire was administered to 70 postpartum women during the 1st and 4th week postpartum. Data were analyzed by factor analysis to determine the relationships within categories of knowledge needs. Data were also analyzed by 2-factor repeated measure analysis of variance (ANOVA). The two factors included parity and time (period of measurement). The results indicated that the knowledge needs of postpartum women can be categorized as follows: (1) Knowledge of caring for the baby, (2) Knowledge of caring for one's self and (3) Knowledge of caring for other family members. The women during the 1st week postpartum reported a significantly higher need in knowledge of infant care than women during the 4th week postpartum. Multiparas showed a significantly higher need in knowledge of caring for other family members than primiparas.

Adult↗
PubMed2005

Adapting smoking relapse-prevention materials for pregnant and postpartum women: formative research.

OBJECTIVE: To decrease smoking relapse among pregnant and postpartum women by adapting existing, validated relapse-prevention materials to meet the unique needs of pregnant and postpartum women. METHODS: A series of semi-structured interviews and learner verification activities were conducted with pregnant abstinent, postpartum abstinent, and postpartum relapsed women. Results were used to create new relapse-prevention materials, specific to the needs of pregnant and postpartum women, which are currently being used in a randomized clinical trial. RESULTS: Findings are consistent with the recurrent themes in the literature regarding smoking cessation among pregnant and postpartum women and revealed exceptional needs for coping and stress reduction strategies related to remaining abstinent postpartum. Conflict levels were also high in areas of identity, social support, and reasons for quitting. CONCLUSION: By interviewing women about their cessation related needs, the current study was able to produce smoking relapse-prevention materials specific to this population. Having pregnant and postpartum women review the modified program materials before starting the clinical trial enhanced the quality, dependability, and validity of the materials. We await the results of the clinical trial to determine if this intervention is indeed more efficacious than previous attempts to intervene with this population.

Female↗
PubMedDate not supplied

An intervention to support postpartum women to quit smoking or remain smoke-free.

Effectiveness studies among pregnant and postpartum women indicate that pregnancy and the postpartum period provide a window of opportunity to promote smoking cessation and smoke-free families. Yet, there is a lack of information about interventions that are portable to routine care. The goal of this article is to describe the structure, basic strategies, and the application of a smoking cessation and relapse prevention intervention for postpartum women in the general population. By using the stages of change concept and motivational interviewing, a classification of current and former smokers is given, and basic strategies and techniques are described to counsel women postpartum with regard to smoking.

Counseling↗
PubMed1991

Changes in natural killer cell activity in normal pregnant and postpartum women: increases in the first trimester and postpartum period and decrease in late pregnancy.

Changes in the activity and number of natural killer (NK) cells in peripheral blood in normal pregnant and postpartum women were examined. NK activity was measured in a 4-h 51Cr-release assay and evaluated by conventional relative lytic units and absolute lytic units which represent the total NK activity within a fixed volume of circulating blood. The number of NK cells was analyzed with FITC-conjugated monoclonal antibodies and by use of an automated flow cytometer. Unexpectedly, the relative NK activity increased in the first trimester and also for 1 month postpartum compared to the activity in normal non-pregnant controls. On the other hand, absolute NK activity decreased in the third trimester compared to the activity in normal non-pregnant controls. The percentage of CD57+ cells decreased in the second trimester, but the percentage of CD16+ cells did not change during pregnancy or the postpartum period. The absolute counts of CD57+ cells and CD16+ cells decreased in the second and third trimesters and increased transiently in the postpartum period. These findings indicate that the increased NK activity in the first trimester and at 1 month postpartum is induced by increased cytotoxic activity of individual NK cells, and that the decreased NK activity in late pregnancy is induced by a decrease in the numbers of NK cells. These physiological changes may play an important role in implantation in early pregnancy, protection of the fetal allograft in late pregnancy and in the natural defense against infection during the puerperal period.

Adult↗
PubMed2002

Depression in postpartum and non-postpartum women: prevalence and risk factors.

OBJECTIVE: The aim of the study was to assess the prevalence of depression in postpartum women as compared with non-postpartum women, and to identify risk factors of depression in both groups. METHOD: A population based questionnaire study was performed among women 18-40 years in two municipalities in Norway in 1998-1999. A total of 2,730 women were included, of whom 416 were in the postpartum period. RESULTS: The prevalence of depression was higher in non-postpartum as compared with postpartum women. High scores on the life event scale, a history of depression and a poor relationship to the partner were associated with depression in both postpartum and non-postpartum women. When controlling for the identified risk factors of depression the odds-ratio for depression in the postpartum period was 1.6 (95% CI: 1.0-2.6). CONCLUSION: The risk for depression was increased in the postpartum period, when controlling for the uneven distribution of risk factors.

Adult↗
PubMed2004

Predictors of postpartum women's health status.

PURPOSE: To determine the effects of postpartum stress, depression, and social support on postpartum women's health. METHODS: With proportional stratified-quota sampling by birth rates in clinics and hospitals in Kaohsiung City, in southern Taiwan, 861 women were recruited for the study. The Hung Postpartum Stress Scale, the Beck Depression Inventory-Second Edition, the Social Support Scale, and the 12-item Chinese Health Questionnaire were used to examine women's postpartum stress, depression, social support, and health status during the postpartum period. RESULTS: The findings strongly supported the hypothesis that the effects of postpartum stress and depression on postpartum women's health are significant. The results also indicated that social support had an indirect effect on women's health. CONCLUSIONS: Interventions to decrease postpartum stress and to improve social support might decrease the likelihood of postpartum women's depression, which in turn might enhance their overall health status.

Adult↗
PubMed2005

Barriers to intrauterine device insertion in postpartum women.

OBJECTIVE: The objective of this study was to determine the proportion of postpartum women at the University of New Mexico who choose an IUD for contraception, the number who actually obtain one and the barriers to postpartum IUD insertion. METHOD: We conducted a retrospective chart review of 1627 postpartum women who delivered at the University of New Mexico. Those women who indicated at hospital discharge that they desired an IUD comprised the study group of 193 women. Medical records were reviewed to identify the timing of IUD placement. If an IUD was not inserted, we attempted to determine the reason by reviewing clinic records. RESULTS: Twelve percent of postpartum women requested an IUD. Records were available for 114 women. Of these, only 69 (60%) actually obtained an IUD. Barriers to postpartum IUD insertion included provider advice against the IUD, patient failure to return for a postpartum visit and early repeat pregnancy. CONCLUSION: We conclude that postpartum women desiring an IUD may have difficulty obtaining one.

Female↗
PubMed1994

Identifying morbidity in postpartum women.

Women with postpartum health problems do not readily initiate consultation, making it necessary for those providing care to devise methods by which problems can be identified. By taking detailed accounts of each woman's labour and delivery details when planning postpartum care, some morbidity could be preempted and its effect limited. Postnatal care requires a planned structure which could be modelled on current antenatal care organisation. All women could routinely be seen at three or six months post-delivery. Care could be given by midwives, with referral to GPs where necessary. Fatigue could put women at greater risk of developing postpartum depression, but few women spontaneously report fatigue as a health problem. Limiting the effects of childbirth on maternal health will have important implications for the future use of the medical services.

Female↗
PubMed2003

[Factors associated with HIV risk perception among hospital postpartum women].

OBJECTIVE: To assess factors associated with perception of HIV infection risk among postpartum women admitted to charitable maternity hospitals. METHODS: The study sample comprised 384 postpartum women admitted to two charitable maternity hospitals in the city of São Paulo, Brazil. Data collection was carried out from January to March 2000. All women were interviewed 12 hours after delivery and data was collected on sociodemographics, STD/AIDS knowledge and attitudes (independent variables) and cultural issues (dependent variables), and "whether she considered herself at risk for HIV infection" (dependent variable). Statistical analysis was performed using Chi-square test and multiple logistic regression. RESULTS: Nearly 29% of postpartum women considered themselves at risk for HIV infection. They were single, had prior STD and believed "married men enjoy himself in the same way as single men do". Prevention and health maintenance behaviors were also identified. CONCLUSIONS: Women's knowledge on AIDS seems to affect their individual risk perception. Future HIV/AIDS prevention campaigns should be focused on increasing couples and adolescents' involvement.

Adolescent↗