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Rates of perinatal depression and pregnancy hyperglycemia are higher in Hispanic women as compared to non-Hispanic white women. In turn, depressive symptoms may reduce a woman's ability to engage in lifestyle changes that could reduce their subsequent diabetes risk.We conducted a secondary analysis using data from Estudio Parto to evaluate sociodemographic, behavioral, psychosocial, and medical factors associated with perinatal depressive symptoms. Estudio Parto was a randomized controlled trial conducted in Western Massachusetts from 2013 to 17. Eligible participants had pregnancy hyperglycemia. The Edinburgh Postnatal Depression Scale (EPDS) was administered at 24-28 weeks gestation and at 6 weeks, 6 months, and 12 months postpartum. An EPDS cutpoint of 10 or greater defined the presence of depressive symptoms.In this sample of Puerto Rican women with pregnancy hyperglycemia, 32% and 27% showed prenatal and postpartum depressive symptoms, respectively. Among participants, 35.5% were diagnosed with GDM, 44.3% with isolated hyperglycemia, and 20.2% with impaired glucose tolerance. In multivariable models, being unmarried (OR 3.87; 95% CI 1.51-9.94), prenatal substance use (smoking or alcohol consumption; OR 2.96; 95% CI 1.41-6.18), and maternal age (1.11 for each year; 95% CI 1.04-1.18) were associated with higher odds of prenatal depressive symptoms. None of the risk factors were associated with subsequent postpartum depression in adjusted analyses.Identifying factors associated with prenatal and postpartum depression in Puerto Rican women with pregnancy hyperglycemia can inform targeted lifestyle interventions in this at-risk group, increase the likely adoption of healthy lifestyle behaviors, and thereby work to address health disparities.gov NCT01679210; date of registration 08/07/2012.

Trauma is common among those seeking Ob-Gyn care and may have pervasive impact on obstetrical and gynecological health, social functioning, and healthcare engagement. While guidelines exist on the detection and treatment of perinatal mood and anxiety disorders within Ob-Gyn care, the role of Ob-gyn clinicians in identifying and addressing patients' traumatic experiences and related symptoms is less clearly delineated. This manuscript provides an overview of trauma-related symptoms in the context of Ob-Gyn care and practical guidance of clinicians aiming to improve their detection and response to trauma in their clinical practice.Posttraumatic stress disorder (PTSD) describes a psychiatric illness which develops as a response to a traumatic event. Women who have experienced trauma are also at increased risk for borderline personality disorder and other psychiatric comorbidities. Postpartum PTSD has particular relevance to obstetrical care.Screening for trauma in Ob-Gyn care can provide an opportunity to address risk and offer targeted intervention. Several brief evidence-based screening tools are available. Individuals who screen positive require assessment of immediate safety and targeted referrals. Trauma informed care describes an approach to healthcare aimed to enhance physical and emotional safety for patients and clinicians.Given the prevalence and the potentially devastating and enduring impact of trauma and trauma-related symptoms, there is a critical need to address trauma within Ob-Gyn care. By recognizing the signs of trauma and initiating or referring to appropriate treatments, Ob-Gyn clinicians have a unique opportunity to better understand their patients and to improve their care.

OBJECTIVES: This study examined the risk of postpartum hospital admissions and emergency department (ED) visits among U.S. women with intellectual and developmental disabilities (IDD). METHODS: We used the 2002–2012 Pregnancy to Early Life Longitudinal Data System and identified deliveries to women with and without IDD. Women with IDD (n=1,104) or case subjects were identified from the International Classification of Diseases and Related Health Problems 9th Revision (ICD-9 CM) codes. The study primary outcome measures were any postpartum hospital admission and any ED visit during three critical postpartum periods (1–42 days, 43–90 days, and 1–365 days). We conducted unadjusted and adjusted survival analysis using Cox proportional hazard models to compare the occurrence of first hospital admission or ED visits between women with and without IDD. RESULTS: We found that women with IDD had markedly higher rates of postpartum hospital admissions and ED visits during the critical postpartum periods (within 1–42 days, 43–90 days and 91–365 days) after a childbirth. CONCLUSION FOR PRACTICE: Given the heightened risk of pregnancy complications and adverse birth outcomes and the findings of this study, there is an urgent need for clinical guidelines related to the frequency and timing of postpartum care among new mothers with IDD. Further, this study provides evidence of the need for evidence-based interventions for new mothers with IDD to provide preventive care and routine assessments that would identify and manage complications for both the mother and the infant outside of the traditional postpartum health care framework.

Objectives To examine clinical and demographic characteristics associated with availability of self-reported and measured pre-pregnancy weight, differences in these parameters, and characteristics associated with self-report accuracy. Methods Retrospective cohort of 7483 women who delivered at a large academic medical center between 2011 and 2014. Measured pre-pregnancy weights recorded within a year of conception and self-reported pre-pregnancy weights reported anytime during pregnancy were abstracted from electronic medical records. Difference in weights was calculated as self-reported minus measured pre-pregnancy weight. Logistic and linear regression models estimated associations between demographic and clinical characteristics, and presence of self-reported and measured weights, and weight differences. Results 42.2% of women had both self-reported and measured pre-pregnancy weight, 49.7% had only self-reported, and 2.8% had only measured. Compared to white women, black women and women of other races/ethnicities were less likely to have self-reported weight, and black, Asian, and Hispanic women, and women of other races/ethnicities were less likely to have measured weights. For 85%, pre-pregnancy BMI categorized by self-reported and measured weights were concordant. Primiparas and multiparas were more likely to underreport their weight compared to nulliparas (b = -1.32 lbs, 95% CI -2.24 to -0.41 lbs and b = -2.74 lbs, 95% CI -3.82 to -1.67 lbs, respectively). Discussion Utilization of self-reported or measured pre-pregnancy weight for pre-pregnancy BMI classification results in identical categorization for the majority of women. Providers may wish to account for underreporting for patients with a BMI close to category cutoff by recommending a range of gestational weight gain that falls within recommendations for both categories where feasible.

Objective Only 9 % of women with young children consume a high quality diet. The association between sleep duration and health may be U-shaped. We examined diet quality in relation to sleep duration among US women within 5 years of childbirth. Methods Data were from non-pregnant women aged 20-44 years within 5 years of childbirth who completed two 24-h dietary recalls (N = 896) in the National Health and Nutrition Examination Survey 2005-2012. Self-reported weekday/workday sleep duration was categorized as short (≤6 h), adequate (7-8 h), or long (≥9 h). The Healthy Eating Index (HEI-2010, range 0-100) estimated overall and components of diet quality. Multivariable-adjusted linear regression models estimated the association between sleep duration and diet quality, adjusting for age, race/ethnicity, and education. Results Thirty-four percent of women reported short, 57.1 % adequate, and 8.6 % long sleep duration. The average diet quality total score was 47.4 out of 100. Short sleep duration was not associated with diet quality. Long sleep duration was associated with lower quality diet (β = -4.3; 95 % CI -8.1 to -0.4), lower consumption of total fruit (β = -0.7; 95 % CI -1.3 to -0.1), whole fruit (β = -0.9; 95 % CI -1.6 to -0.2), and total protein (β = -0.7; 95 % CI -1.3 to -0.03), and higher consumption of empty calories (β = 2.2; 95 % CI -4.3 to -0.1). Conclusions for practice Future studies should examine the longitudinal association between sleep duration and diet quality among women following childbirth and whether interventions to improve sleep can enhance diet quality.