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Objective To investigate the effect of ‘two-step’ delivery and early (ECC) or delayed cord clamping (DCC) on placental transfusion in term infants.Methods Randomised clinical trial (NCT04459442). 90 infants were randomised to ECC (at 1 minute) or DCC (at 3 minutes) before two-step delivery wherein 83 (39 with ECC and 44 with DCC) received the allocated intervention. The primary outcome was the placental transfusion defined by ∆ haematocrit (Hct) from cord blood at birth and capillary heel blood at 48 h of age, accounting for body weight decrease, with the power estimate based on haematocrit (Hct) levels, in ECC and DCC neonate groups. The secondary outcomes were the contemporary readings of arterial cord blood gases, lactate, and glucose.Results It was found that Hct levels, comparable at birth between neonates who underwent ECC or DCC (49.501 ± 0.909 vs 48.764 ± 0.824, p 0.551), were significantly increased at 48 hours of age in the DCC group (50.778 ± 1.102 vs 55.051 ± 0.979, p 0.0051) representing a significantly higher ∆ Hct (1.278 ± 5.29 vs 6.287 ± 0.998, p 0.011) despite a comparable body weight decrease, all pointing to a higher placental transfusion in the DCC group, presenting with an acid–base and metabolic equilibrium.Conclusion In term infants born by ’two-step’ delivery, DCC results in a higher blood volume in the newborn and facilitates the maternal–placental–foetal exchange of circulating compounds, without potentially detrimental neonatal outcomes.

To explore the relationship between calcium and lactate in arterial cord blood of healthy term neonates in response to the stress of labor.This was a prospective cohort study of consecutive, vaginal, term births in a community medical center (April 2029 to February 2020). Calcium and lactate were measured in cord blood gas analysis immediately after delivery.In the arterial cord blood of 480 neonates, calcium levels were 1.5 (1.4; 1.5) mmol/L and lactate levels were 3.8 (2.9; 4.9) mmol/L. Calcium and lactate showed a statistically significant positive correlation (Pearson's correlation,In healthy term vaginally delivered neonates, it was found that calcium and lactate were strongly correlated, together pointing to a neonatal response to the stress of labor and delivery. Cord blood calcium regulation may have an ancillary role in defining neonatal adaptation to extrauterine life.

In animal and human neonates, expansion of the extracellular fluid volume is associated with "wet" lung and poor respiratory outcomes. To define fluid status changes during the transition from fetal to neonatal life in infants of diabetic mothers (IDM), we conducted a single-centre (Policlinico Abano Terme, Abano Terme, Italy) study of 66 IDM and a 1:2 matched control group from January 1 to September 30, 2020. Fluid status changes were assessed by computing Δ Hct from umbilical cord blood at birth and capillary heel Hct at 48 h, accounting for body weight decrease. IDM presented with significantly lower cord blood Hct levels in comparison to controls (47.33 ± 4.52 vs 50.03 ± 3.51%, p < 0.001), mainly if delivered by elective cesarean Sect. (45.01 ± 3.77 vs 48.43 ± 3.50%, p = 0.001). Hct levels at 48 h were comparable (55.18 ± 5.42 vs 54.62 ± 7.41%, p = 0.703), concurrently with similar body weight decrease (- 217.21 ± 113.34 vs - 217.51 ± 67.28 g, p = 0.614). This supports significantly higher ∆ Hct in IDM (5.13 ± 5.24 vs 7.29 ± 6.48, p < 0.01) and extra circulating fluid loss of 2-3%.Conclusion: Gestational diabetes is associated with an excess of circulating fluids during the transition from fetal to neonatal life, challenging the current assumption that is per se at risk of wet lung. What is Known: • In neonates, evidence suggests that expansion of the extracellular fluid volume prior to the postnatal diuresis is associated with poor respiratory outcomes. What is New: • Gestational diabetes is associated with an excess of circulating fluids during the transition from fetal to neonatal life, challenging the current assumption that is per se at risk of wet lung.

We aimed to determine if and to what extent a woman's exposure to stressful life events were associated with impaired maternal bonding by using a sample of high-income Italian women.In the second day postpartum, 425 healthy puerperae responded to Life Experiences Survey (LES), Mother-to-Infant Bonding Scale (MBS), and to the Edinburgh Postnatal Depression Scale (EPDS).Analysis revealed that the stressful life events scored by LES were a significantly predictor of impaired bonding as measured by MIBS (The findings emphasize the importance of identifying mothers with negative experiences toward pregnancy and delivery to address possible interventions beyond hospital-based antenatal care to improve bonding and maternal mental outcomes.

Purpose In Italy, where neonatal jaundice treatment is required, it is largely carried out in hospitals. However, it is possible to safely administer home phototherapy (HPT). We report our pilot centre’s experience of HPT and its potential benefits during the COVID-19 enforced national lockdown. Methods This is an observational study performed at the Policlinic Abano Terme, a suburban hospital that covers a large catchment area near the Euganean Hills in Northeast Italy with around 1,000 deliveries per year. HPT was started after regular nursery discharge, and the mothers brought the neonates back to the hospital maternity ward each day to check infants’ bilirubin levels, weight, and general state of health, until it was deemed safe to stop. The efficacy of HPT in bilirubin reduction, hospital readmission rates, and parental satisfaction were evaluated.Results 30 infants received HPT. In 4 of these infants HPT was associated with total serum bilirubin (TSB) between 75th and 95th percentile (high- intermediate-risk zone) and in 26 infants HPT was associated with TSB >95th percentile (high-risk zone) of the Bhutani nomogram. Among these 30 infants, 27 (90%) completed the HPT with a progressive decrease of TSB levels with 4 neonates requiring a second course and 3 infants requiring a third course of 24-hour HPT. 3 (10%) neonates failed HPT and were readmitted after one 24-hour phototherapy course. No abnormalities of breastfeeding, body weight (defined as >10% decrease), temperature, nor COVID infections were detected following HPT consultation in the neonatal ward. Home treatment efficacy with varying degrees of parental satisfaction occurred in all but 3 cases that involved difficulties with the equipment and inconsistent lamp manipulation practices. Conclusions Our pilot study suggests that HPT for neonatal jaundice can be carried out effectively and with parental satisfaction as supported by daily back bilirubin monitoring in the maternity ward during the enforced COVID-19 national lockdown in Italy.

This prospective cohort study took place at the Division of Perinatal Medicine of Policlinico Abano Terme, Italy, from January to November 2018. In the second day postpartum, 463 healthy at term puerperae, 122 (26.35%) with inadequate gestational weight gain (GWG), 210 (45.46%) with adequate GWG, and 131 (28.29%) with excessive GWG, were studied by EAT-26, through distinguishing three factors: 'Dieting', 'Bulimia and food preoccupation', and 'Oral control'. EAT-26 Global score increased from inadequate, to adequate, and excessive GWG puerperae, resulting significantly higher in excessive GWG group (

Objective To examine the association of gestational weight gain (GWG), categorized according to 2009 IOM guidelines as adequate, inadequate, and excessive, with symptoms of mental disorders perceived by mothers after childbearing as anhedonia, anxiety, and depression, defined by the Edinburgh Postnatal Depression Scale (EPDS). Previous studies indicated that disorders related to GWG are associated with an increased risk of postpartum psychological distress. Methods A prospective cohort study took place at the Policlinico Abano Terme, Italy, from May 2016 to November 2018. Results The sample included 1268 healthy at term puerperae, 557 (43.9%) with adequate, 388 (30.6%) with inadequate, and 323 (25.5%) with excessive GWG. Mean EPDS scores were comparable among inadequate, adequate, and excessive GWG groups. However, mean factor scores for anhedonia and anxiety were significantly higher (P = 0.041 and P = 0.001, ANOVA) in mothers with excessive GWG. Conversely, factor scores for depression were significantly higher (P = 0.008, ANOVA) in mothers with inadequate GWG. Conclusion It was found that excessive GWG across an uncomplicated pregnancy is a warning sign of symptoms of anhedonia and anxiety, whereas inadequate GWG is a significant indicator of symptoms of depression. These relationships highlight the potential for interventions directed toward psychosocial support to have beneficial effects upon GWG.

OBJECTIVE: To explore whether quarantine measures and hospital containment policies among women giving birth in a COVID-19 "hotspot" area in northeastern Italy enhanced psycho-emotional distress in the immediate postpartum period. METHODS: We designed a non-concurrent case-control study of mothers who gave birth during a COVID-19 quarantine period between March 8 and May 3, 2020 (COVID-19 study group), with an antecedent group of matched postpartum women (control group) who delivered in the same period in 2019. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) on the second day postpartum. RESULTS: The COVID-19 study group (n=91) had significantly higher mean EPDS scores compared with the control group (n=101) (8.5 ± 4.6 vs 6.34 ± 4.1; P

Aim Evidence suggests that caesarean section is associated with a reduced placental transfusion and poor iron-related haematological indices, both in cord and peripheral blood, compared with vaginal delivery. We assessed determinants and effects of fluid status changes on placental transfusion in neonates delivered by elective (ElCD) and emergency (EmCD) caesarean section. Methods Placental transfusion was estimated by ∆ haematocrit (Hct) increase from birth to 48 hours of life, accounting for contemporaneous ∆ body weight decrease, in 143 women/infant pairs, 62 who underwent ElCD and 81 EmCD, respectively. Results Cord blood Hct levels at birth of ElCS neonates were significantly lower than those of EmCD neonates (44.58 + 4.87vs 49.93 + 4.29, P = .01). At 48 hours of life, capillary heel Hct levels of ElCD and of EmCD neonates were comparable. ElCD had a higher ∆ body weight decrease (ElCD -7.25 ± 1.74% vs EmCD -6.31 ± 2.34% [P: .011]) and ∆ Hct increase ([ElCD + 5.93 ± 4.92 vs EmCD + 3.59 ± 5.29, [P: .011]). In a linear regression model analysis, gestational age in ElCD neonates had a significant effect on the differences in arterial cord blood Hct, body weight at birth and body weight decrease at 48 hours after birth. Conclusion Early-term surgical delivery is a determinant of transient dilutional anaemia in ElCD neonates, lacking neuroendocrine response of labour and delivery.

Analysis of the ST segment of the fetal electrocardiogram (ECG) waveform is a relatively new adjunct to support the cardiotocograph in assessing the risk of significant intrapartum fetal acidosis. The use of ST analysis (STAN) combined with cardiotocography (CTG) was reported to significantly lower the incidence of metabolic acidosis. We aimed to assess the role of "baseline T/QRS rise" associated with a normal CTG on the risk of neonatal acidemia.This is a prospective cohort study performed at the Division of Perinatal Medicine of Policlinico Abano Terme, Italy. Women in labor with a singleton fetus in cephalic position beyond 36 weeks of gestation were monitored with STAN and CTG.The relationship between "baseline T/QRS rise" and neonatal cord arterial acidemia and hypoxic distress were assessed using a linear mixed-model analysis. Magnitude of "baseline T/QRS rise", neonatal cord blood acidemia, electrolytes, lactacidemia, and glycemia levels were measured."Baseline T/QRS rise" was not associated with neonatal acidemia in the presence of normal CTG, regardless of the magnitude of the T/QRS rise. However, in a linear mixed-model analysis, cord blood sodium levels were negatively (In the presence of a normal CTG, "baseline T/QRS rise" does not predict neonatal acidemia or biochemical derangement. Greater knowledge of fetal ECG parameters including "baseline T/QRS rise" and their associations with normal, intermediary, and abnormal CTG tracing, is required in assessing the performance of the STAN.

Background: Women undergo adaptive physical and psychological changes during pregnancy, which make them vulnerable to psychological disorders.Methods: This study used a prospective observational design and included concurrent validation analysis of the 16-item Maternity Blues Scale (MBS) Dutch version to determine the direction and magnitude on the Edinburgh Postnatal Depression Scale (EPDS) symptoms, including three factors, anhedonia, anxiety, and depression in 320 puerperae early after childbirth.Results: We found a statistically significant correlation between MBS and EPDS global scores (0.22, p p p p p p p p p p n = 33, 10.3%) with EPDS > 12 presented significantly higher global MBS score (2.51 ± 0.38 versus 2.26 ± 0.38, p = .01), with negative affect (2.88 ± 0.67 versus 2.62 ± 0.38, p=.04), positive affect (2.52 ± 0.69 versus 2.32 ± 0.38, p = .04), and depression (2.09 ± 0.75 versus 1.82 ± 0.36, p = .02).Conclusion: These findings together suggest that women with higher maternity blues scores may represent a distinct subgroup at increased risk of depression.

Highlights • RHF-DSP new auxiliary method for the sight deprivation support in children. • High VAS scores achieved for experimental online support method. • “Face to face” and “Hands on” methodology still essential in visually impaired children., The COVID-19 pandemic imposed dramatic changes to everyone’s daily routines, but especially to children with developmental disabilities. The Robert Hollman Foundation decided not to interrupt its service to all the visually impaired children and initiated a Distance Support Project. It was an online process covering all aspects of support for the children and involving audio-video calls, videos and tailored-made multisensory material created specifically for each child. A questionnaire, carried out after the 5-month project duration, was created to collect feedback from parents and professionals to understand the impact this project had on everyone involved. Overall both parents and professionals indicated high levels of satisfaction, but in a significant number of questions parents reported consistently higher levels of satisfaction (p-value

Aim Although an increased risk of gestational diabetes mellitus (GDM) has been noted in women exposed to stressful conditions and traumatic events, limited information is available about such risk in the context of the COVID-19 pandemic. Methods The study was designed as a non-concurrent case-control study on the prevalence of GDM, defined according to IADPSG 2010, in women giving birth during the COVID-19 pandemic in the hot spot of Northeast Italy from March 9th to May 18th, 2020, with an antecedent puerperae‐matched group whose women had given birth in 2019. Results Analysis revealed that during the COVID-19 pandemic in 2020, GDM prevalence was significantly higher than in 2019 (GDM, 48/533, 9 vs 86/637, 13.5%, p= 0.01), as illustrated by a higher GDM prevalence in 5/6 months of the final semester of 2020. In addition, logistic regression analysis confirmed a statistically significant temporal relationship between experiencing the lockdown during the first trimester of gestation and later GDM incidence (t=2.765, P=0.012), with an 34% increase in mean number of GDM diagnoses per month (antilog of the parameter =1.34). Conclusion The COVID-19 pandemic negatively impacted GDM prevalence in 2020 compared to 2019, especially for pregnant women in the 1st trimester of gestation.

Objective To compare levels of anhedonia, anxiety, and depression in women following elective and emergency cesarean delivery. Methods An observational study was conducted between January 1, 2015, and May 31, 2017, among Italian women who delivered healthy neonates at term at the Policlinico Abano Terme, Italy, by vaginal, elective cesarean delivery (ElCD) or emergency cesarean (EmCD) delivery. The women completed the Edinburgh Postnatal Depression Scale (EPDS), including specific factors within each category, 2 days post-delivery to measure postpartum depressive symptomatology. Results Of the 2234 women enrolled in the study, 1702 (76.2%) had a vaginal delivery and 532 (23.8%) a cesarean delivery, of which 264 (11.8%) were emergency and 268 (12.0%) were elective. Mean EPDS scores (P=0.075) and the number of women with EPDS scores >12 (P=0.718) were comparable among the delivery groups. However, mean anxiety factor scores were significantly higher in the ElCD group (P=0.031), and conversely, mean anhedonia factor scores were significantly higher in the EmCD group (P=0.001). Conclusion Postpartum depressive symptomatology of women who have had a cesarean delivery was characterized by higher levels of anxiety after ElCD and by higher levels of anhedonia after EmCD.

Background Fetal supraventricular tachycardia (SVT), characterized by fetal heart rate between 220 and 260 bpm, is a rare but most commonly encountered fetal cardiac arrhythmia in pregnancy that may be associated with adverse perinatal outcome. Case presentation We describe a 36/6 week near term fetus who presented morphine-induced SVT after maternal treatment of a renal colic. Following emergency cesarean section, the neonate had resolution of symptoms. Conclusions The pathophysiology of morphine-related SVT, previously documented in experimental animal models, and for the first time reported in the human fetus, is presented.

Objective We evaluated whether intact umbilical cord milking (UCM) is more effective than immediate cord clamping (ICC) in enhancing placental transfusion after elective cesarean delivery. Study Design In a randomized trial, volume of placental transfusion was assessed by Δ hematocrit (Hct) between neonatal cord blood and capillary heel blood at 48 hours of age, corrected for the change in body weight. Results There were no significant differences in cord blood mean Hct values at birth (UCM, 44.5 ± 4.8 vs. ICC, 44.9 ± 4.2%, p = 0.74). Conversely, at 48 hours of age, the UCM group had significantly higher capillary heel Hct values (UCM, 53.7 ± 5.9 vs. ICC, 49.8 ± 4.6%, p Conclusion Higher Δ Hct between cord blood at birth and capillary heel blood at 48 hours of age, corrected for the change in body weight, suggests that intact UCM is an efficacious and safe procedure to enhance placental transfusion among neonates born via elective cesarean delivery. Clinical Trial Registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT03668782.

The human female's areolar region is the point of arrival of a natural progression from birth to breastfeeding continuum, supported by numerous functional features.The aim of this study was to look more closely into the areola' skin chemical signals that are uniquely important for mother-infant chemoemission, chemoreception, and breastfeeding continuum.A dermatological study of the areolae and corresponding breast quadrants was undertaken on 71 healthy, at-term women. Areolar and corresponding breast quadrant pH were assessed pre-partum and 1 and 2 days post-partum using a corneometer (Soft Plus 5.5; Callegari S.P.A., Parma, Italy).Pre-partum, the pH of the areola was significantly higher than the pH of the breast quadrant (4.25 ± 0.26 vs. 4.06 ± 0.44, p 0.015). Post-partum, the pH of the areola was significantly higher that the pH of the breast quadrant both on day one (4.28 ± 0.31 vs 4.01 ± 0.25, p 0.001) and on day two (4.39 ± 0.19 vs 4.01 ± 0.16, p 0.001), respectively. In addition, pre-labor pH of the areola increased on day one post-partum and significantly on day two postpartum (4.25 ± 0.26 vs 4.39 ± 0.19, p 0.004). Moreover, the pH of the areola increased significantly from day one to day two post-partum (4.28 ± 0.31 v s 4.39 ± 0.19, p 0.041).Our findings show, for the first time, that the areola has a higher pH than the surrounding breast skin, and this increases from day one to day two postpartum. We believe that the pH changes of the areolar region may act as a unique chemical signal to guide the infant directly to the nipple.

Research has shown that mother's obesity and underweight are major risk factors for reduced initiation, duration, and exclusivity of breastfeeding.We compared breastfeeding practices from discharge until the third postnatal month in women, accounting to prepregnancy body mass index (BMI) and its shift across gestation.Data on maternal shifts in BMI category from prepregnancy to gestational BMI by gestational weight gain (GWG) were defined according to 2009 Institute of Medicine (IOM) guidelines. Logistic regression models were estimated to assess the effect of prepregnancy and gestational BMI on breastfeeding, adjusting for clinically relevant factors.The analysis included 658 women. According to prepregnancy BMI, 84 (12.8%) mothers were underweight, 444 (67.4%) were normal weight, 94 (14.3%) were overweight, and 36 (5.5%) were obese. Although in the range defined by IOM 2009, GWG shifted across the BMI categories in 445 (67.6%). Thus, while underweight women shifted in higher BMI categories, normal weight women category halved (230, 35%), and both overweight women (301, 45.7%) and obese women (127, 19.3%) tripled. Breastfeeding patterns at discharge, at first month, and at third month were comparable among prepregnancy and gestational BMI groups, except for prepregnancy BMI groups at third month (p 0.03). At multivariable analysis, neither prepregnancy BMI nor gestational BMI was associated with reduced exclusive breastfeeding within 3 months after discharge.Prepregnancy BMI and gestational BMI, in women with adequate GWG, do not affect exclusive breastfeeding initiation, duration, and exclusivity until the third month postpartum. Women need information and support to gain adequate weight during pregnancy.

Vincenzo Zanardo,1 David Giarrizzo,2 Francesca Volpe,1 Lara Giliberti,1 Gianluca Straface1 1Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, 2CALANTHA Physiology of Lactation Laboratory, Padua, Italy Abstract: Both appropriate hydration and skin surface pH are fundamental in preventing baby skin barrier damage during transition from intrauterine to extrauterine life. However, effects of topical moisturizers on neonatal stratum corneum temperature, pH, hydration, and elasticity have not been scientifically evaluated in vivo. We checked 31 full-term breastfeeding neonates by non-invasive bioengineering method, which is able to evaluate the basal skin barrier (left heel), and assessed at 6±1hours after birth, and at 1 and 24hours after emu oil-based topical treatment. The basal skin barrier of right heel (no oil exposure) of each newborn was considered as control. We found that a single application of an emu oil-based lotion was effective in improving heel stratum corneum hydration, which increases both skin pH and elasticity without any effect on temperature. Further studies are needed to confirm long-term beneficial effects of this treatment in a very sensitive patient population. Keywords: skin barrier, neonate, emu oil-based lotion, topical treatment

Objective To investigate the applicability of the Edinburgh Postnatal Depression Scale (EPDS) for identifying depressive symptoms following vaginal or cesarean delivery. Methods The present observational study included consecutive Italian-speaking women who underwent vaginal or cesarean deliveries of uncomplicated singleton pregnancies at term at Policlinico Abano Terme, Abano Terme, Italy, between February 1, 2014, and May 31, 2015, who completed the EPDS 2 days after delivery. EPDS scores and the depression, anxiety, and anhedonia subscale items were compared between delivery methods to identify factors predictive of high EPDS scores. Results There were 950 patients included in the analysis; 694 (73.1%) and 256 (26.9%) patients underwent vaginal and cesarean deliveries, respectively. Total EPDS scores were higher among patients who had cesarean deliveries compared with vaginal deliveries (6.95±4.80 vs 6.05±4.20; P=0.007); the depression (0.53±0.72 vs 0.37±0.65; P=0.007), anxiety (1.07±0.88 vs 1.16±0.93; P=0.021), and anhedonia (0.32±0.59 vs. 0.19±0.48; P=0.009) subscale scores were all higher among patients who underwent cesarean deliveries. Conclusions Women who underwent cesarean deliveries demonstrated higher EPDS scores and could be at increased risk of developing early postpartum depressive symptomatology, particularly anhedonia, anxiety, and depression. This article is protected by copyright. All rights reserved.

Background Labor induction has been associated with breastfeeding suppression, but reasons for why this association exists have not been well determined. Methods We examined the influence of elective labor induction by vaginal prostaglandin at gestational week 41 + 3 days on affective, cognitive, and behavioural adaptations early in puerperium and on breastfeeding pattern at 1 and 3 months. Results One hundred and eighty consecutive puerperae were assigned to two groups: mothers having received vaginal prostaglandin E2 gel (Prepidil®, dinoprostone) before labor (PGE group, n = 90) and mothers having received no treatment (unmedicated group, n = 90). The day of discharge mothers completed the Edinburg Postnatal Depression Scale, (EPDS), State and Trait Anxiety Inventory (STAI-Y), and Mother to-Infant Bonding Scale (MIBS). Later they participated in telephone interviews concerning their breastfeeding practices at 1 and 3 months, which were classified according to WHO definitions. When compared with unmedicated, PGE group puerperae scored [median, (IQR)] significantly higher EPDS [9 (7–13) vs 5 (3–8), p 0.003], STAI-state [46 (39–51) vs 39 (34–48), p 0.002], STAI-trait [39 (36–48) vs 34 (32–45), p 0.04], and MIBS [10 (5.25–10) vs 5 (3–4), p 0.002] scores. In addition, while the breastfeeding practices were similar at hospital discharge, at follow-up the labor induced mothers were less likely to maintain full breastfeeding with respect to untreated mothers: 1 month (p 0.001); and 3 months (p 0.003). Conclusion We present evidence that elective induction of labor by prostaglandins at gestational week 41 + 3 days is associated with reduced exclusive breastfeeding rates at 1 and 3 months after discharge and higher EPDS, STAI, and MIBS scores.

To assess whether arterial umbilical cord bilirubin (aUCB) level at delivery predicts predischarge neonatal hyperbilirubinemia, facilitating a safe discharge from the hospital.Prospective analysis of hospital biochemistry records identified near term and term infants with recorded aUCB and predischarge, at 36 h of life, capillary heal bilirubin (cHB), to identify those with a cutoff of bilirubin levels 9 mg/ml,75th percentile on the nomogram of Bhutani et al.Of 616 study neonates, median (IQR) aUCB and cHB levels were 1.5 mg % (IQR 0.7-2.2) and 7.7 mg % (IQR 6.6-8.9), respectively. The values resulted statistically correlated (Pearson correlation coefficient 0.26,These data suggest that aUCB should be added to the list of major risk factors for neonatal hyperbilirubinemia.

The original article [1] contained an error whereby all authors' names were mistakenly inverted.

Objective Limited information is available regarding barriers to breastfeeding during the COVID-19 lockdown. Study design This study was designed as a non-concurrent case-control study on breastfeeding initiation practices, defined according to WHO, in women giving birth during lockdown, between March 8 and May 18, 2020, in the COVID-19 ‘hotspot’ in Northeastern Italy (study group), with an antecedent puerperae-matched group (control group). Exclusive, complementary, and formula feeding practices were collected from maternal charts at hospital discharge, on the second day post-partum, when puerperae filled out the Edinburg Postnatal Depression Scale (EPDS). Results The COVID-19 study group presented significantly lower exclusive breastfeeding rates than the control group who members gave birth the previous year (−15%, p = 0.003), as a consequence of the significantly higher prevalence of complementary feeding practices in the former (+20%, p = 0.002). Conversely, the COVID-19 study group showed significantly higher EPDS scores (8.03 ± 4.88 vs. 8.03 ± 4.88, p, Highlights • Of the various barriers to breastfeeding, limited information is available on the COVID-19 lock down. • Covid-19 lock down was associated with significantly lower exclusive breastfeeding practices. • COVID-19 lock down had detrimental effect on maternal emotions and on breastfeeding exclusivity practices.

The aim of this study was to explore the feasibility of the Lüscher color test (LCT), a psychological instrument based on theory that colors are selected in unconscious way and that the color sensory perception of color is objective and universal. The research has involved 24 Ethiopian women, which delivered at the Getche Health Center in Gurage. It seemed to be relevant for the majority of Ethiopian women identify the rejected color (58.66%), the gray, than the favorite color, the yellow 33.33%). The yellow color suggests that they better express their personality in a physical context, while the gray color indicates that they want to live this experience intensely. This exploratory work lays the foundations for further studies in disadvantaged women, both in developing low-income Countries as well as in industrialized Countries characterized by an high level of emigration, and for clinical applications by the complete LCT version.

Previous studies have indicated that mode of delivery could have a negative effect on bonding.To assess feelings towards newborn infants in mothers who delivered by cesarean delivery, elective (ElCD) or emergency (EmCD).This observational prospective study took place at the Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy, from September 2014 to April 2015.The sample included 573 puerperae divided into three groups: women undergone ElCD (n=73; 12.73%), women undergone EmCD (n=81; 14.13%) and women who underwent vaginal delivery (VD) (n=419; 73.12%).The instrument used was the Mother-to-Infant Bonding Scale (MIBS; Taylor et al., 2005), a self-report test to measure mother's feelings towards her baby. High scores indicate worse mother-to-infant bonding and a score≥2, established as cut-off, indicates an altered bonding.The mean MIBS global score was 0.50±1.05 in the VD mothers, 0.67 (±1.14) for ElCD mothers and 0.92 (±1.05) for EmCD mothers, resulting significantly higher in EmCD mothers (p0.001). The percentage of altered bonding (Score≥2) in the three groups was of 11.21% (n=47) in VD, 17.80% (n=13) in ElCD and 23.45% (n=19) in EmCD, significantly higher in EmCD women (p0.006). In addition, EmCD mothers scored significantly higher Joyful (0.074±0.26 vs 0.185±0.39; p0.005) and Disappointed (0.063±0.25 vs 0.123±0.36; p0.008) subscales.It was found that EmCD negatively affects mother bonding and opening emotions, and originates in mother feelings like sadness and disappointment for the unplanned delivery evolution.

Considerable studies have been undertaken to assess fathers' feelings and experiences during labor and delivery of their partner, however, investigation describing first-time fathers' coping strategies at elective cesarean delivery remains under explored.To assess and determine the Coping Strategies of first-time fathers at elective cesarean delivery, by looking at both first-time and second time fathers, separately.A quantitative design was utilized in this investigation.A total of 52 fathers, of whom 28 first-time fathers, whose partner had planned elective cesarean section, and 54 fathers, of whom 25 first-time fathers, whose partner had scheduled induction of labor at term.The Coping Inventory for Stressful Situations (CISS; EndlerParker, 1990) was the main tool used to explore by Task-, Emotion- and Avoidance-oriented coping subscales, the feelings and experiences of the expectant fathers relative to the labor and delivery of their partners.Findings indicated that Avoidance-oriented coping values were significantly higher in first-time fathers at elective cesarean section compared to those at in first-time fathers at scheduled induced vaginal delivery (50.93 ± 12.80 vs 40.71 ± 9.38, p 0.001), presenting with the highest percentile (82° centile). In addition, the Avoidance-oriented coping subscale significantly correlated with the subscales assessing Avoidance through Social interaction (rho = 0.90, p 0.001) and Avoidance based on distraction (rho = 0.63, p 0.001).Findings revealed that first-time fathers at elective cesarean section presented significantly higher Avoidance-oriented coping strategies, through Social interaction and based on distraction, in comparison to first-time fathers whose partner had scheduled induction of labor at term.

Objective: Previous studies indicated that gestational weight gain-related disorders share many similarities with feeding and eating disorders (EDs).Design: To examine the association of prepregnan...

The purpose of this prospective study was to investigate the relationship between body image perception and breastfeeding in puerperae with postpartum depression symptoms. The participants (147 healthy puerperae) completed The Edinburgh Postnatal Depression Scale (EPDS) and the Body Uneasiness Test (BUT-A and BUT-B), investigating body image perception and specific worries about particular body parts or functions. One month after discharge, new mothers participated in telephone interview concerning postpartum lactation practices. The subset of puerperae with EPDS score 49 also participated in psychological EPDS and BUT 6-month follow up. Mothers with EPDS score 49 (28/147, 19.04 %) had significantly higher scores on BUT-A Global Severity Index (0.69 ± 0.64 versus 0.37 ± 0.31, p50.0001) and on BUT-B Positive Symptom Distress Index (0.74 ± 0.57 versus 0.41 ± 0.42, p50004). In addition, the mothers with symptoms of depression were more likely (1:2) to interrupt full breastfeeding in the first month postpartum. At the 6-month follow up, the subset of new mothers with depression symptoms maintained elevated BUT-A and BUT-B scores, while EPDS49 persisted in one-third of these. In conclusion, mothers with symptoms of depression have longlasting negative body image perception, persistent depressive symptoms, and they interrupt early full breastfeeding.

To characterize predischarge maternal pain and stress after caesarean delivery and short hospitalization.This is a descriptive study with 60 women in the postoperative period of caesarean section and 60 control women after vaginal delivery. Pain and stress were measured by McGill Pain Questionnaire (MGPQ) and by the Stress Measure (Psychological Stress Measure (PSM)), respectively, at mother-infant dyad discharge, scheduled at 36 hours after delivery.Caesarean section was the delivery modality with the highest MGPQ pain and sensorial, evaluative and mixed pain descriptive categories scores. The pain location involved lower abdomen, with associated localizations at back, breast and shoulders. Conversely, vaginal delivery was the delivery modality with the highest stress scores.This study provides important information on the quality of care implications of early discharge practices in puerperae after caesarean delivery, a critical time characterized by qualitatively and quantitatively high pain and stress.

The potential that obesity in pregnancy has to affect symptoms associated with eating disorders and breastfeeding is unclear.This study analyzed symptoms of eating disorders and breastfeeding practices in obese mothers.Prospective, case-control study.Participants included 25 obese (BMI30 kg/m(2)) and 25 normal-weight puerperae, matched for parity and delivery route.The participants completed the Eating Disorders Inventory (EDI-2), investigating cognitive, emotional, and behavioral symptoms of eating disorders before they were discharged from the maternity hospital and later participated in telephone interviews concerning breastfeeding practices which were classified according to WHO definitions.Although none of the scores fell in the pathological range, the obese mothers had more and more pronounced symptoms of eating disorders in all EDI-2 subscales with respect to normal-weight mothers. They had, in particular, significantly higher scores in body dissatisfaction (p.0001), ineffectiveness (p=.004), interoceptive awareness (p=.005), and maturity fear (p=.007). Finally, while breastfeeding practices were similar in the two groups, the obese mothers were more likely to maintain full breastfeeding at 6 months (20 vs 8%) and their tendency to postpone weaning was found to be significant (p.04).While the obese mothers studied have more pronounced symptoms of eating disorders with respect to their normal-weight counterparts, they tended to maintain breastfeeding longer, postponing weaning.

Aim The human female's nipple-areolar complex (NAC) is the point of arrival of a natural progression from birth to breastfeeding, linked to functional, chemical and biophysical cues that promote the breast crawl soon after birth. We investigated the thermal gradient generated by the lips of the neonate and warmth of the NAC, which may drive the infant directly to the nipple. Methods We prospectively studied 41 full-term singleton infants and their mothers at the Policlinico Abano Terme, Italy, between January 1, 2015, and February 28, 2015. NAC and breast quadrant temperatures were assessed 6 ± 2 hours prepartum and one and two days postpartum, together with the neonates’ lip temperature. Results The temperature of the neonates’ lips was significantly lower than the forehead temperature on days one and two postpartum (delta = −1.24°C, p

Objective To evaluate the association between prenatal stress and gestational weight gain (GWG). Study Design This was an analysis of women recruited between 2013-2015 from 4 sites in the US. We tested associations between responses at 32-35wks to the Life Experiences Survey (LES), a 37-item measure of events and perceived stress, and GWG categories. Bivariable comparisons and logistic regression were used to estimate the association between the total LES score and the odds of achieving adequate GWG. Result Among the 725 women, those with adequate GWG had lower median LES scores (5) compared to women with inadequate (7) and excessive (7) GWG, p=0.02. After adjusting for age, initial BMI, income, education, marital status and gestational diabetes, lower LES scores (multiples of the median) were associated with adequate GWG (aOR 0.81, 95%CI 0.67-0.98). Conclusion Lower reported stress, as measured by the LES, was associated with a greater chance of women achieving adequate GWG. This relationship highlights the potential for interventions directed toward psychosocial support to have salutary effects upon GWG.

This study analyzed body image perceptions and breastfeeding practices in obese mothers. Prospective, case–control study on 25 obese (BMI >30 kg/m2) and 25 normal-weight puerperae, matched for parity and delivery route. The participants completed the Body Uneasiness Test, a two-part, self-report questionnaire, investigating body image perception before they were discharged from hospital and participated in telephone interviews concerning breastfeeding practices. Obese women demonstrated body image dissatisfaction related to their obesity. On average, they reported significantly higher scores on Global Severity Index (p

Socio-demographic factors were strongly associated with coping styles in pregnant women. We studied fertility postponement, a new increasing phenomenon in industrialized countries.We studied coping (The Coping Inventory for Stressful Situations, CISS) in 341 healthy pregnant women, with a median age of 34 years (IQR 31-36), in their third trimester, living in Veneto, region of Italy which emerges for its low and late fertility.Task-oriented coping was the most frequently used coping styles (Median, IQR: 48, 44-53), followed by Emotion-oriented coping (Median, IQR: 44, 39-49). Avoidance-oriented coping with subscales Social Diversion and Distraction were used least frequently (Median, IQR: 44, 38-49; 21, 18-24, and 14, 12-16, respectively). Socio-demographic factors were not associated with coping styles, but maternal age was inversely correlated with task coping (Spearman coefficient rho = -0.13, p = 0.02).Fertility postponement leads to the selection and use of ineffective coping strategies in an effort to alleviate anxiety.

OBJECTIVE: We evaluated the effect of oxygen (O2) flow rate on the corresponding delivered fraction of oxygen (FiO2) during positive pressure ventilation (PPV) when using a neonatal self-inflating bag (SIB). METHODS: Fifteen health care professionals administered PPV at a respiratory rate of 40 to 60 breaths per minute and at peak inspiratory pressures of 25 and 35 cm H2O to a manikin by using a SIB with reservoir connected to an O2 source equipped with a flowmeter (flow rates: 0–10 L/min). The FiO2 corresponding to each flow rate was measured at the inflow to the facial mask for 60 seconds. RESULTS: In total, 2520 FiO2 data points were collected. At every O2 flow rate, the FiO2 gradually increased from time 0 seconds to time 60 seconds, both at 25 cm H2O and at 35 cm H2O. After 1 minute of PPV at 25 cm H2O, the delivered FiO2 was 31.5% ± 2.1% and 43.1% ± 3.1% at O2 flow rates of 0.1 and 0.5 L/min, respectively. After 1 minute of PPV at 35 cm H2O, the delivered FiO2 was 29.4% ± 2.0% and 42.1% ± 4.6% at O2 flow rates of 0.1 and 0.5 L/min, respectively. At all O2 flow rates >5 L/min, the delivered FiO2 was >85% and >95%, after 1 minute of PPV at 25 and 35 cm H2O, respectively. CONCLUSIONS: Delivered FiO2 during PPV depends on 3 factors: oxygen flow rate, peak inspiratory pressures, and time elapsed. These data can be used to develop a scheme correlating the oxygen flow rate and the corresponding delivered FiO2 when using a neonatal SIB.