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Introduction: Congenital anomalies are one of the major causes of the global burden of diseases, and low- and middle-income countries (LMICs) are disproportionately affected. This review assesses the prenatal and postnatal screening methods and compares the prevalence of major congenital anomalies in LMICs. Methodology: We conducted a systematic search in MEDLINE/PubMed, CINAHL, Cochrane databases of systematic reviews, clinical trials.gov for relevant studies using Medical Subject Headings and keywords. We categorized the studies into different systems and screening methods depending on the time the tests were conducted (prenatal or postnatal). The studies were then subjected to detailed descriptive analysis. Results: A total of 59 studies were selected for analysis; these focused on screening methods for congenital anomalies and compared their prevalence with regards to different systems. The most common screening techniques both prenatal and postnatal included antenatal ultrasound, fetal echocardiography, pulse oximetry, and clinical examination. The most common congenital abnormalities involved the central nervous system (neural tube defects) and musculoskeletal (clubfoot), followed by gastrointestinal (omphalocele and gastroschisis) and cardiovascular (structural heart defect). Overall, different systems had varying prevalences of different birth defects, ranging from 0.28 to 8.5%. In contrast, the prevalence of musculoskeletal system disorders varied from 1.01% to 3.96%, in the cardiovascular system from 0.57% to 10.4%, and in the urogenital group from 0.83% to 5.9%. Conclusion: The review highlights the lack of screening programs and studies, especially in the primary and secondary care settings in LMICs, and limited studies do indicate a high burden of various congenital anomalies. There is a need for guidelines and programs in global maternal and child health programs to include timely screening and management of common birth defects in LMICs. [ABSTRACT FROM AUTHOR]

This study aims to determine the postnatal sense of security of primiparous and multiparous mothers and to evaluate the affecting factors. This is a descriptive comparative study, in which 484 mothers (242 primiparous and 242 multiparous) were included. Data were collected using a Questionnaire Form and the Mothers' Postnatal Sense of Security Scale. The average age of primiparous mothers is 25.52 ± 3.75, and the average age of multiparous mothers is 34.57 ± 5.17. The overall average score of the Mothers' Postnatal Sense of Security Scale is 52.02 ± 7.18 for primiparous mothers and 52.16 ± 7.77 for multiparous mothers. A statistically significant difference was found between postnatal sense of security and marriage age, educational level, employment status, educational level of spouse, income status, pregnancy desire, making routine pregnancy check-ups done, hospitalization during pregnancy, support from spouse and family members during pregnancy, having postnatal education, postnatal support from spouse and family members for primiparous mothers; while between postnatal sense of security and educational level, income status perception, pregnancy desire, making routine pregnancy check-ups done, having education during pregnancy, involvement of spouse in education during pregnancy, support from spouse during pregnancy, support from family members during pregnancy, involvement of spouse in postnatal education, postnatal support from spouse and family members for multiparous mothers. It was found that the average score of postnatal sense of security scale was high in primiparous and multiparous mothers who had pregnancy desire, made routine pregnancy check-ups done, were not hospitalized during pregnancy, and had no health problem during pregnancy. [ABSTRACT FROM AUTHOR]

This study aimed to determine the levels of maternal and paternal attachment and the factors that affect them in individuals who had a baby after infertility treatment. This study followed a descriptive cross-sectional design in accordance with STROBE guidelines. The research was conducted in the infertility clinic of a university hospital and included 128 participants, consisting of 64 mothers and 64 fathers. Data were collected using the 'Personal Information Form-Mother', 'Personal Information Form-Father', 'Maternal Attachment Inventory (MAI)', and 'Postnatal Paternal-Infant Attachment Questionnaire (PPAQ)'. The study found that the mothers had an average MAI score of 102.35 ± 3.05, while the fathers had an average PPAQ score of 82.21 ± 4.27. A significant correlation was observed between the mothers' MAI score and the duration of their marriage. Similarly, a significant correlation was observed between the fathers' PPAQ score and the duration of their marriage, the duration of their infertility diagnosis, and the duration of their infertility treatment (p < 0.05). The correlation analysis between the MAI score and the mean score of the PPAQ's subscale of pleasure in interaction was weakly significant and positive (r = 0.26; p = 0.032). However, there was no significant relationship between the MAI score and the PPAQ score (r = 0.18; p = 0.146). The study findings indicate that parents who conceive through infertility treatment exhibit high levels of attachment to their babies. Healthcare professionals should assess the attachment levels of both mothers and fathers who have undergone infertility treatment and be mindful of the factors that influence it. • Mothers who have babies after infertility treatment have a high level of maternal-infant attachment. • Fathers who have babies after infertility treatment have a high level of paternal-infant attachment. • Duration of marriage for mothers and duration of marriage, infertility diagnosis and treatment for fathers affect attachment levels. [ABSTRACT FROM AUTHOR]

Introduction: Postnatal period is a vulnerable time for women, with 85% experiencing mood disturbances due to physical and emotional changes. Depression, being one such common occurrence is known to have large impact on morbidities of mother and child. Hence it is crucial to know the factors effecting post-partum depression (PPD). Aims: To assess the burden of postpartum depression and factors associated with it. Materials and methods: The cross-sectional study was conducted in a private tertiary care hospital on women in their postnatal period (6 – 8 weeks). Data was collected using pretested semi-structured questionnaire, and depression was assessed using Edinburgh Postnatal Depression Scale; data was analyzed using SPSS. Results: Around 34% had probable depression. Risk factors were found be: those having lower educational status, semi/unskilled occupation, non-nuclear family, lower SES, complications in present / past pregnancy, multiple gestation, unwanted pregnancy, pressure for female child, poor relationship with family members including husband’s absence during delivery. Conclusion: Prevalence of depression in postnatal women is high. Modifiable psychosocial factors have a close association with PPD, which constitute the potential factors of intervention. [ABSTRACT FROM AUTHOR]

Purpose: Studies examining the associations between maternal social relationships and early childhood development have mainly focused on social relationships after childbirth. We aimed to prospectively examine the associations between the transition of maternal social isolation from the prenatal to postnatal period and early childhood development. Methods: We analyzed data for 6692 mother–child pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Social isolation in the prenatal and postnatal periods was assessed by the Lubben Social Network Scale-abbreviated version and categorized into four groups: none, prenatal only, postnatal only, and both. The Ages and Stages Questionnaire, Third Edition, which consists of five developmental areas, was used to assess developmental delays in children at 2 and 3.5 years of age. Multiple logistic regression analyses were conducted to examine the associations between maternal social isolation and developmental delays. Results: The prevalence of social isolation in both the prenatal and postnatal periods was 13.1%. Social isolation in both the prenatal and postnatal periods was associated with developmental delays in children at 2 and 3.5 years of age: the multivariate-adjusted odds ratios (95% confidence intervals) were 1.68 (1.39–2.04) and 1.43 (1.17–1.76), respectively. Social isolation in the prenatal period only and social isolation in the postnatal period only were not associated with developmental delays in children at 2 and 3.5 years of age. Conclusion: Maternal social isolation in both the prenatal and postnatal periods was associated with an increased risk of developmental delays in early childhood. [ABSTRACT FROM AUTHOR]

Background: The Three Delays Framework was instrumental in the reduction of maternal mortality leading up to, and during the Millennium Development Goals. However, this paper suggests the original framework might be reconsidered, now that most mothers give birth in facilities, the quality and continuity of the clinical care is of growing importance. Methods: The paper explores the factors that contributed to maternal deaths in rural Pakistan and Mozambique, using 76 verbal autopsy narratives from the Community Level Interventions for Pre-eclampsia (CLIP) Trial. Results: Qualitative analysis of these maternal death narratives in both countries reveals an interplay of various influences, such as, underlying risks and comorbidities, temporary improvements after seeking care, gaps in quality care in emergencies, convoluted referral systems, and arrival at the final facility in critical condition. Evaluation of these narratives helps to reframe the pathways of maternal mortality beyond a single journey of care-seeking, to update the categories of seeking, reaching and receiving care. Conclusions: There is a need to supplement the pioneering "Three Delays Framework" to include focusing on continuity of care and the "Four Critical Connection Points": (1) between the stages of pregnancy, (2) between families and health care workers, (3) between health care facilities and (4) between multiple care-seeking journeys. Trial registration: NCT01911494, Date Registered 30/07/2013. [ABSTRACT FROM AUTHOR]

The purpose of the research is to detect long-term effects of repeated oral administration of supramolecular complex of ivermectin Aniverm-2.0% on the postnatal development of rat offspring.Materials and methods. The studies were conducted on 16 white pregnant rats that were divided into two experimental and one control groups. The animals were kept under standard conditions of keeping and feeding. The supramolecular complex of ivermectin Aniverm-2.0% was administered to pregnant female rats (n = 6) of group 1 in the form of a suspension using an intragastric tube daily for 7 days at a dose of 15 mg/kg, and group 2 was given the substance of ivermectin (n = 5) at a dose of 8.25 mg/kg. The control female rats (n = 5) were administered 1 mL of distilled water during the experiment. The experimental pregnant females were left until delivery, and then, the development of their offspring was monitored for 45 days. After rat pups were born, the following were recorded: pregnancy duration, litter size, dynamics of weight gain in the rat pups for 21 days, postnatal death during the first 30 days, the ratio of males and females in the litter, periods of eye opening, incisor eruption, detachment of the auricle, appearance of hair coat, descent of testicles, and opening of the vagina. Then we assessed the maturation rate of sensory-motor reflexes in the offspring obtained from the experimental and control groups, the emotional motor behavior and ability for fine coordination of movements in the offspring, and conducted the open field-2 test on day 45 after birth.Results and discussion. No negative effect was detected for supramolecular complex of ivermectin Aniverm-2.0% on the parameters of physiological development of the offspring of the experimental rats within 45 days after birth. The dynamics of their mass, developmental parameters, and formation of motor reflexes during the feeding period remained within the normal values. Developmental indicators of sensory motor reflexes in the control and experimental rat pups had no statistically significant differences.

Increase in the morbidity of women during pregnancy and in the postnatal period, the known limitations using of modern synthetic drugs cause the search for ways of medical assistance, in particular use of phytotherapy. Aim: highlight the world and own experience of using phytotherapeutic agents during pregnancy and in the postnatal period, indications, limitations and threats. Materials and methods: used available monographic and journal sources in the electronic systems MED Line, EMBASE, Scopus, Web of Science using methods of analysis, comparison and generalization. Results. It has been established that scientists from the world’s leading scientifi c centers state a growing interest in using of phytotherapy methods as one of the important approaches of medical pluralism in the pathology of pregnancy and in the postnatal period. depending on the level of economic development and the state of the medical industry of the state and the commonality and diff erences of the principles and forms of providing phytotherapeutic assistance. Commonality is that even ancient and simple methods and means of phytotherapy in this contingent of patients, along with modern ones in developed countries, are, albeit to varying degrees, eff ective and safe. In countries with a low socio- ecological level, simple methods according to ancient traditions are still forced to be used, mainly as a self-initiative or on the advice of friends, family, rarely – on the recommendations of specialists without clear recommendations regarding the duration and remote consequences of application, which is unfavorable. There are some diff erence between of using phytotherapy in the developed countries of Europe and USA is that various means, forms of plant factors are mainly manufactured in accordance with modern requirements of the Ministry of Health, are recommended on the basis of evidence- based medicine by properly trained obstetrics and gynecology personnel, modern sources of information are available for the improvement of medical personnel, training of pregnant women. The clear eff ectiveness and side eff ects of herbal preparations, their impact on the body of the mother, fetus and lactation processes are monitored. Various trainings and forms of improving using of herbal medicines are carried out and need for close contacts of obstetriciangynecologists with specialists in complementary and alternative medicine. Conclusions: Modern scientifi c studies testify to the eff ectiveness, safety and necessity of using herbal preparations in the pathology of pregnancy and the postnatal period as one of the important components of medical pluralism. The specifi cs of their use must comply with the requirements of the DMR and be recommended on the basis of evidence- based medicine.

Increase in the morbidity of women during pregnancy and in the postnatal period, the known limitations using of modern synthetic drugs cause the search for ways of medical assistance, in particular use of phytotherapy. Aim: highlight the world and own experience of using phytotherapeutic agents during pregnancy and in the postnatal period, indications, limitations and threats. Materials and methods: used available monographic and journal sources in the electronic systems MED Line, EMBASE, Scopus, Web of Science using methods of analysis, comparison and generalization. Results. It has been established that scientists from the world's leading scientific centers state a growing interest in using of phytotherapy methods as one of the important approaches of medical pluralism in the pathology of pregnancy and in the postnatal period. depending on the level of economic development and the state of the medical industry of the state and the commonality and differences of the principles and forms of providing phytotherapeutic assistance. Commonality is that even ancient and simple methods and means of phytotherapy in this contingent of patients, along with modern ones in developed countries, are, albeit to varying degrees, effective and safe. In countries with a low socio-ecological level, simple methods according to ancient traditions are still forced to be used, mainly as a self-initiative or on the advice of friends, family, rarely - on the recommendations of specialists without clear recommendations regarding the duration and remote consequences of application, which is unfavorable. There are some difference between of using phytotherapy in the developed countries of Europe and USA is that various means, forms of plant factors are mainly manufactured in accordance with modern requirements of the Ministry of Health, are recommended on the basis of evidence-based medicine by properly trained obstetrics and gynecology personnel, modern sources of information are available for the improvement of medical personnel, training of pregnant women. The clear effectiveness and side effects of herbal preparations, their impact on the body of the mother, fetus and lactation processes are monitored. Various trainings and forms of improving using of herbal medicines are carried out and need for close contacts of obstetriciangynecologists with specialists in complementary and alternative medicine. Conclusions: Modern scientific studies testify to the effectiveness, safety and necessity of using herbal preparations in the pathology of pregnancy and the postnatal period as one of the important components of medical pluralism. The specifics of their use must comply with the requirements of the DMR and be recommended on the basis of evidence-based medicine. [ABSTRACT FROM AUTHOR]

Abstract Background Exclusive breastfeeding to six months of age is a major global public health priority. Several characteristics are known to be associated with early cessation of breastfeeding, however, limited evidence exists regarding whether women’s reported reasons for cessation are associated with maternal, pregnancy and infant characteristics. The aims of this study were to: i) describe women’s reported intention to breastfeed and their subsequent breastfeeding practices; ii) describe women’s reported reasons for breastfeeding cessation prior to the infant being five months of age; and iii) examine associations between these factors and maternal, pregnancy and infant characteristics. Methods Telephone and online surveys were conducted between October 2019 and April 2020 with 536 women who had given birth in the previous eight to 21 weeks at four public maternity services in Australia. Results The majority of women intended to (94%), and did, initiate (95%) breastfeeding. At the time the survey was conducted, 57% of women were exclusively breastfeeding. Women who: had less than University level education, had a pre-pregnancy BMI in the overweight or obese category, and who smoked tobacco at the time of the survey had lower odds of exclusively breastfeeding. The most common self-reported reasons for breastfeeding cessation were breastfeeding challenges (47%) and low milk supply (40%). Women aged 26–35 years and 36 + years had greater odds of reporting breastfeeding cessation due to low milk supply (OR = 2.92, 95% CI: 1.11, 7.66; OR = 5.57, 95% CI: 1.70, 18.29) compared to women aged 18–25 years. While women who had completed a TAFE certificate or diploma had lower odds of reporting this as a reason for breastfeeding cessation (OR = 0.28; 95% CI: 0.11, 0.73) compared to women who had University level education. There were no other significant associations found between characteristics and reasons for ceasing breastfeeding. Conclusions The most common reasons for breastfeeding cessation may be modifiable through the provision of breastfeeding support in the early postpartum period, with such support being tailored to women’s age and level of education. Such support should aim to increase women's self-efficacy in breastfeeding, and be provided from the antenatal period and throughout the first six months postpartum.

Background: Globally, the overall prevalence of caesarean section (CS) is estimated at 18.6%, with 27% in high-income countries and 6% in low- and middle-income countries. There is an increase in trends of CS in Uganda from 8.5% in 2012 to 11% in 2016. No studies have been carried out to account for the high rates of CS at Kisiizi Hospital in Uganda. This study determined the proportion and factors associated with CS delivery at a rural hospital in southwestern Uganda. Methods: This was a cross-sectional study of 321 immediate postnatal women in a rural hospital in southwestern Uganda. A structured questionnaire and data abstract forms were used to collect information on the proportion and factors associated with CS. Eligible participants were enrolled consecutively. Logistic regression analysis was done to identify the factors associated with CS taking into account potential confounders. Results: This study recruited 321 women with a mean age of 25.8 ± 6.086 years, mean parity of 2.6 ±1.673 and mean antenatal care visits of 4.27 ± 1.197. The proportion of CS in this study was 38.3% (123/321). Of these, 110 (89.4%) were emergencies and 27(10.6%) were electives. Only 8.4% of the respondents were referrals. The commonest indications of CS were fetal distress (28.5%), history of previous CS (18.7%), and poor progress of labour (11.4%). No factors were significantly associated with CS in this study. Conclusion: There is a high proportion of CS at Kisiizi Hospital in Uganda and this is three times higher than the WHO-recommended CS rates. The majority of CS are emergencies due to fetal distress and poor progress of labour. There is a need for additional studies exploring the reasons for the much higher-than-expected CS rates.

Background: During the early postnatal life, gut microbiota development experiences dynamic changes in their structural and functional composition. The postnatal period is the critical window to develop a host defense mechanism. The maturation of intestinal mucosal barrier integrity is one of the essential defense mechanisms to prevent the entry of pathogens. However, the co-development of intestinal microbial colonization, formation of barrier integrity, and intestinal epithelial cell layer is not entirely understood. Methods: We studied the gut microbial composition and diversity using 16S rRNA marker gene-based sequencing in mice to understand postnatal age-dependent association kinetics between gut microbial and intestinal development. Next, we assessed the intestinal development by in vivo gut permeability assay, mRNA gene expression of different tight junction proteins and intestinal epithelial cell markers, goblet cells population, villus length, and cecal IgA quantification. Results: Our results showed a significant shift in gut microbial structural and functional composition from postnatal day 14 onwards with early life Proteobacteria abundance. Relative abundance of Verrucomicrobia was maximum at postnatal day 14 and showed a gradual decrease over time. We also observed an age-dependent biphasic pattern in barrier integrity improvement and differentiation of intestinal epithelial cells (IECs). A significant improvement in barrier integrity between days 1 and 7 showed the host factor contribution, while that beyond day 14 revealed an association with changes in microbiota composition. Our temporal correlation analysis associated Bacteroidetes phylum with the mucosal barrier formation during postnatal development. Conclusions: The present study revealed the importance and interplay of host factors and the microbiome in gut development and intestinal mucosal homeostasis.

Background: Exclusive breastfeeding to six months of age is a major global public health priority. Several characteristics are known to be associated with early cessation of breastfeeding, however, limited evidence exists regarding whether women's reported reasons for cessation are associated with maternal, pregnancy and infant characteristics. The aims of this study were to: i) describe women's reported intention to breastfeed and their subsequent breastfeeding practices; ii) describe women's reported reasons for breastfeeding cessation prior to the infant being five months of age; and iii) examine associations between these factors and maternal, pregnancy and infant characteristics. Methods: Telephone and online surveys were conducted between October 2019 and April 2020 with 536 women who had given birth in the previous eight to 21 weeks at four public maternity services in Australia. Results: The majority of women intended to (94%), and did, initiate (95%) breastfeeding. At the time the survey was conducted, 57% of women were exclusively breastfeeding. Women who: had less than University level education, had a pre-pregnancy BMI in the overweight or obese category, and who smoked tobacco at the time of the survey had lower odds of exclusively breastfeeding. The most common self-reported reasons for breastfeeding cessation were breastfeeding challenges (47%) and low milk supply (40%). Women aged 26–35 years and 36 + years had greater odds of reporting breastfeeding cessation due to low milk supply (OR = 2.92, 95% CI: 1.11, 7.66; OR = 5.57, 95% CI: 1.70, 18.29) compared to women aged 18–25 years. While women who had completed a TAFE certificate or diploma had lower odds of reporting this as a reason for breastfeeding cessation (OR = 0.28; 95% CI: 0.11, 0.73) compared to women who had University level education. There were no other significant associations found between characteristics and reasons for ceasing breastfeeding. Conclusions: The most common reasons for breastfeeding cessation may be modifiable through the provision of breastfeeding support in the early postpartum period, with such support being tailored to women's age and level of education. Such support should aim to increase women's self-efficacy in breastfeeding, and be provided from the antenatal period and throughout the first six months postpartum. [ABSTRACT FROM AUTHOR]

One of the most important factors influencing the development of each person is the period of prenatal development. According to the results of numerous studies, it has been established that the psycho-emotional state of the future mother during pregnancy has an influence on the course of pregnancy and the process of childbirth, on the peculiarities of the prenatal development of the child and, as a result, on his/her personality in adulthood. During the research, Taylor’s Manifest Anxiety Scale was used in order to assess the anxiety levels for pregnant women. Moreover, the Family Adaptation and Cohesion Scale was applied to estimate the level of family cohesion and the level of family adaptation. The study of the psychological state of women during pregnancy suggests that the pregnancy has its own dynamics of aggravation and weakening of a woman’s existing problems and various psycho-emotional aspects of perception of the pregnancy and corresponding behavior. A particularly characteristic aspect is the aggravation of the existing personal, psycho-emotional and social problems in families, which are characterized by a disharmonious relationship with friends and ambiguous attitude to pregnancy and the future child. Modern researchers in the field of psychology of pregnancy set the task of studying factors influencing the development of the child and the welfare of the mother-child dyad, the emotional state of pregnant women, changes in their perception of the surrounding world, their attitude to the future child, and the influence of relationships with close people during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Postnatal care plays a great role in the health of mothers and their neonates. This study aimed to evaluate the mothers’ perceptions of the provided postnatal care and the associated factors. Methods: In this cross-sectional study, the health centers of Sirik city in Hormozgan province, Iran, were selected using convenience sampling. The study was conducted on 160 mothers who had referred to the selected centers for postnatal care from 7 August 2018 to 2 August 2020 and had given birth to live full-term neonates (>37 weeks of gestation) 40 days to 12 months before sampling. The Mothers’ Perceptions of the Quality of Postnatal care questionnaire was designed by the research team; it included 18 questions about mothers’ perception of care. The collected data were analyzed using the SPSS software, version 21. Results: The mothers’ mean score of perception was 69.84±16.04; most mothers rated the provided postnatal care and their relationship with the personnel as good or excellent. The mean total scores of the mothers’ perceptions were not different based on their satisfaction with postnatal care (P=0.646) and time of the first referral after birth (P=0.251), but they were significantly different according to the number of referrals (P=0.023) and their satisfaction with the health personnel (p

Abstract Background The changes experienced during the transition to first-time or subsequent fatherhood are mainly positive; however, fathers can also experience adverse mental health outcomes such as stress, anxiety, and depression. The aim of this study was to investigate the prevalence and associated factors of paternal stress, anxiety, and depression symptoms in the early postnatal period. Methods A quantitative, descriptive correlational design was used. Data were collected using a self-administered questionnaire comprising of the Perceived Stress Scale, the State-Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale. Results A total of 336 fathers were included in the study. The prevalence rates were 41.1% (n = 138) for moderate/high stress symptoms, 20.8% (n = 70) for state anxiety symptoms, 25.9% (n = 87) for trait anxiety symptoms, and 13.4% (n = 45) for depression symptoms. In the multivariable analysis, several factors were associated with increased stress, anxiety, and depression symptoms including being a subsequent father (p = 0.009), not living in a house (p = 0.009), having a history of adverse mental health (p = 0.008), and having a partner with a history of anxiety (p = 0.040). Conclusion The findings suggest that fathers are at risk of adverse mental health in the early postnatal period which is a pivotal time for fathers in terms of bonding with their infant and redefining their relationship with their partner.

This study describes the experiences of women in rural Bangladesh, and the cultural practices related to how they take care of themselves and their babies, in the early postnatal period. Data were gathered through immersion in the field for six months, participant observation, document collection and in-depth interview techniques to gain a deep understanding of women's everyday lives and practices during the postnatal period. In-depth interviews were undertaken with 28 mothers who had had at least one live child within the five years before the date of data collection, in Purba Sharifabad village of the Barisal Division in Bangladesh. The key findings of this study highlight the role of culture in the experiences of women during the postnatal period, and reveal that cultural practices, beliefs and traditions are deeply embedded in the lives of rural women. This study focuses on cultural practices which have an effect on the choices of women regarding care and support from healthcare facilities. Culture, together with poverty and low levels of education, leads them to resist healthcare from a skilled birth attendant and encourages them to believe in and trust traditional care practices during the postnatal period. Therefore, the findings of this study may contribute to future policies, planning, programs and research in Bangladesh by providing an understanding of the importance of culturally and socially rooted traditional beliefs and cultural practices. These need to be addressed for maternal and newborn healthcare initiatives to be effective, particularly in rural Bangladesh.

Objective Stroking calves during the postnatal period could effectively improve human-calf relationships. The objective of this study is to examine how daily calf stroking frequency during the postnatal period affects the establishment of human-calf relationships. Methods Six calves were stroked by a trainer for 6 minutes once daily for 5 days after birth (D1). Six calves were stroked by a trainer for 3 minutes twice daily for 5 days after birth (D2). A further four calves were stared at but not stroked as the control group. The overall stroking or staring duration was the same for all groups, at 6 min/d and 30 min over 5 days. The tests for reactions to the stationary trainer in an unfamiliar environment and avoidance distance measurements for an approaching trainer were conducted at 1 month and 3 months after the treatment. Results Calves in both stroking groups approached significantly closer to the stationary trainer, vocalized less, and looked at the trainer shorter than the control group at 1 month. However, at 3 months, there was no significant difference between the D1 and the control group, whereas the D2 approached significantly closer to the trainer and vocalized less, and looked at the trainer for a shorter time than the control group. For the avoidance distance, the trainer could approach closer to both stroking groups than the control at 1 month, however, there was no difference among groups at 3 months. Conclusion Our results suggested that the difference in the calf stroking procedure affected the established human-calf relationships, even though the total stroking duration was the same for all stroked calves. It is likely to be more effective to stroke more frequently than intensively when the aim is to establish better human-calf relationships within limited labor time.

Background: Postnatal period is a transition period marked by physical, emotional and relationship changes. Yet, the most neglected period than before and during childbirth. Quality of Life (QOL) is an individual's perception of their position in life in relation to their goals and expectations that indicates unmet needs and intervention outcomes. Demands made by childbirth on mother’s wellbeing can lead to poor QOL in postnatal period. Thus, the objective of the study was to identify QOL among postnatal mothers. Method: Descriptive cross-sectional research design was used to find QOL. 217 postnatal mothers were selected using convenience sampling technique. Data was collected using structured interview schedule containing WHOQOL-BREF questionnaires. Data analysis was done using descriptive statistics i.e. frequency, percentage, mean and standard deviation to summarize data and inferential statistics i.e. independent t-test and one way ANOVA to compare domain scores with selected variables. Result: The highest mean score was on social relationship domain (70.06 ± 14.62) denoting highest QOL in this domain, followed by psychological (68.36 ± 17.90), Physical (67.08 ± 24.79) and environment domain (64.38 ± 16.59) respectively. Significant difference was found between domain scores and age, education, pregnancy type, ANC visit, delivery type, perineal trauma (p

IntroductionGlucocorticoids are currently used for the co-therapeutic management of autoimmune hepatitis and some cholestatic diseases. Thus far, we do not know the efficacy of glucocorticoids in the treatment of parenteral nutrition-associated cholestasis. We aimed to analyze whether the administration of late postnatal dexamethasone for treating bronchopulmonary dysplasia influence the occurrence of parenteral nutrition-associated cholestasis in preterm neonates.MethodsA retrospective study was conducted for 78 preterm neonates without major anomalies (gestational age was

Introduction The postnatal period is a period of adjustment for both the mother and her new family member. This is a critical stage because a large proportion of maternal and neonatal deaths occur during the postnatal period. This study aimed to identify the factors that influence mothers' use of postnatal care services. Methods Descriptive cross-sectional study was conducted among 163 mothers with children aged eight days to less than one year. The data was collected through face-to-face interviews using a semi- structured interview schedule using a non-probability purposive sampling technique. SPSS version 20 was used to analyze the data, which was then described using descriptive and inferential statistics. Results Only 10.4% had received full postnatal care services within seven days following last childbirth. There was a signiicant association with respondents' education level (p-value = 0.03), history of abortion (p-value = 0.005), importance of PNC at the ANC checkup (p-value = 0.001), place of delivery (p-value = 0.004), duration of hospital stay (p-value <0.001), and health complications during recent childbirth (p value= <0.001). In binary logistic regression analysis, it showed that respondents' education more than secondary 4.6 times than up to secondary and duration of hospital stay more than 24 hours 85.5 times more than less than 24 hours were more likely to fully utilize the postnatal care services. Conclusion Despite the accessibility and availability of postnatal care services, the level of utilization is low. Respondents fully utilize the first postnatal service but do not use the full package as recommended by protocol. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to explore the risk factors for progression to type 2 diabetes in women with gestational diabetes mellitus and the long‐term impact of gestational diabetes mellitus on the health of their children. Background: The occurrence of gestational diabetes mellitus in women is the strongest predictor of the development of type 2 diabetes in the future. Design: A non‐concurrent cohort and case–control study design and the guidelines for STROBE checklist were used for the study. Methods: We reviewed medical records for the time period from the archives of the hospitals. The short‐listed women and their children were invited to participate in a 'Women with gestational diabetes mellitus' research activity from November 2012–February 2016. Blood tests, physiological indicators and demographic questionnaires were applied for data collection. Results: A total of 57 women and 57 children participated in the research activity. The risk factors for progression of gestational diabetes mellitus to type 2 diabetes included education level and the 1‐h blood glucose level for the antepartum 100‐g oral glucose tolerance test and the 2‐h blood glucose level for the postpartum 75‐g oral glucose tolerance test. However, these risk factors did not have a significant impact on the body mass index and body fat of the women's children. Conclusion: Healthcare providers should adopt a breadth of health education strategies to remind women with gestational diabetes mellitus to be aware of certain risk factors, and to urge them and their children to return for regular follow‐up visits. Relevance to clinical practice: Identification of the risk factors developing type 2 diabetes can make healthcare units incorporate the postpartum follow‐up of gestational diabetes mellitus into their standard protocol and case managers continue to follow‐up and manage the health of the women and that of their children to reduce adverse health of them. [ABSTRACT FROM AUTHOR]

Background: The changes experienced during the transition to first-time or subsequent fatherhood are mainly positive; however, fathers can also experience adverse mental health outcomes such as stress, anxiety, and depression. The aim of this study was to investigate the prevalence and associated factors of paternal stress, anxiety, and depression symptoms in the early postnatal period. Methods: A quantitative, descriptive correlational design was used. Data were collected using a self-administered questionnaire comprising of the Perceived Stress Scale, the State-Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale. Results: A total of 336 fathers were included in the study. The prevalence rates were 41.1% (n = 138) for moderate/high stress symptoms, 20.8% (n = 70) for state anxiety symptoms, 25.9% (n = 87) for trait anxiety symptoms, and 13.4% (n = 45) for depression symptoms. In the multivariable analysis, several factors were associated with increased stress, anxiety, and depression symptoms including being a subsequent father (p = 0.009), not living in a house (p = 0.009), having a history of adverse mental health (p = 0.008), and having a partner with a history of anxiety (p = 0.040). Conclusion: The findings suggest that fathers are at risk of adverse mental health in the early postnatal period which is a pivotal time for fathers in terms of bonding with their infant and redefining their relationship with their partner. [ABSTRACT FROM AUTHOR]

Introduction. Iron deficiency (ID) is in almost 90% of pregnant woman by the third trimester, persisting in 55% of cases after childbirth. This study aims identification of deficiencies in the routine diagnostics and correction of iron deficiency anemia (IDA) in pregnant women, women in labor and postpartum.Methods. the study included 150 pregnant women from 18 to 43 years old, in whom iron therapy during pregnancy and the postpartum period analyzed in a complex of blood-saving technologies.Results. Serum ferritin (SF) detected only in 45% of pregnant women with anemia. In the first trimester, mild anemia diagnosed in 10% of women, moderate - in 0.6%; in the second trimester - in 47.3% and 1.2%, respectively. In the third trimester, mild anemia was in 94% of patients, moderate - in 4%. Correction of IDA in 94% of cases carried out with oral iron. In the postpartum period, all women have IDA: mild anemia in 82.7%, moderate in 15.3%, severe in 2% of cases. Mild anemia treated with oral iron, moderate - with intravenous iron in 61%, in other cases used oral iron.Conclusion. An increased severity of IDA before childbirth, in spite of it’s correction during pregnancy; it is necessary to diagnose anemia by SF in all pregnant women, with an assessment of the oral iron therapy response by hemoglobin and tolerance; in the absence of a result, intravenous non-dextran iron is indicated in the required calculated dose. Complex correction of obstetric blood loss and postpartum anemia by autoerythrocytes, blood coagulation factors and rational IDA therapy with non-dextran high-dose intravenous iron will allow us to implement restricting approach of the use of donor blood components.

The Chhaupadi culture contributes to the huge proportion of mother and infant mortality in Nepal. Despite a large provision in eliminating this culture in the last almost decades, the culture remains constant. The Chhaupadi Pratha after childbirth is still in practice, especially in Far-western province. Several quantitative studies described the Chhaupadi culture and some qualitative studies have also carried out on exploring the perceptions of community people regarding Chhaupadi culture, but most of the studies had taken this practice as only for monthly menstruation. To fill this gap, I aimed at exploring the perceptions of community people and their experiences related to Chhaupadi Pratha in Kailali district. A prospective qualitative study was conducted among thirty mothers and five other key informants from Godawari municipality. Data were collected through in-depth interviews, key informant interviews, and focus group discussions. Data analysis was guided by the Kenneth McLeroy's social-ecological model (SEM) including five levels of factors which influenced the maternal and child health (MCH) care practices of mothers. While mothers showed little decision-making autonomy, interpersonal factors played an important role in their use of modern health services. Besides, community and social factors as well as organizational and health system factors also shaped mothers' MCH care practices. To improve the MCH care practices of mothers, all the five levels of SEM should be taken into account while developing health programs targeting mothers.

BackgroundNeonatal mortality remains a persisting public health challenge in Ethiopia. Most of the factors that lead to neonatal deaths could be prevented through postnatal checkups. However, in Ethiopia, the provision of postnatal care (PNC) continues to be low. This study aims to assess the socioeconomic and demographic factors associated with PNC visits and the timing of PNC among newborns in Ethiopia.MethodsUsing the Ethiopia Mini Demographic and Health Survey (EMDHS) 2019, a total weighted sample of 2,105 women aged 15–49 giving birth in the 2 years preceding the survey were included in the study. The generalized linear mixed models were separately fitted to identify factors associated with any PNC for newborns delivered at home and health facilities. Multinomial logistic regression was used to assess the timing of PNC with their associated factors.ResultsOverall, only 13% (95% CI: 11.2, 14.0) of the newborns received PNC in Ethiopia. Among newborns delivered at home, utilization of any PNC was determined by region, maternal educational status, and birth order. On the other hand, among newborns delivered in a health facility, region, number of antenatal care (ANC) visits, and religion were determinants of any PNC. Furthermore, utilization of the first PNC within 48 h after the delivery was determined by region and religion. On the other hand, utilization of the first PNC after 48 h after the delivery was determined by region number of ANC visits, maternal educational status, and religion.ConclusionThe finding of the current study revealed low coverage of PNC among newborns regardless of the place of delivery in Ethiopia. The study makes the following recommendation: increase community health education on PNC, encourage delivery at health facilities, and link community home birth with PNC. It will be more valuable if there is sharing good practice.

Introduction: To determine the value of shear wave elastography (SWE) in assessing abdominal wall muscles, including rectus abdominis (RA), external oblique muscle (EO), internal oblique muscle, and transversus abdominis (TrA) in patients with diastasis recti abdominis (DRA) and healthy controls. Methods: From October 2018 to December 2019, 36 postpartum DRA patients and 24 nulliparous healthy women were identifed. Inter-rectus distance (IRD) measurements were taken by B-mode ultrasound. Shear wave speed (SWS) values were acquired by one operator at ten specifc locations. Clinical and ultrasound variables, including demographics, IRD, muscle thickness, and muscle SWS, were compared between the two groups using Student's t test or Fisher's exact test. Pearson correlation analyses were conducted for the variables of IRD, muscle thickness, and SWS in the 36 DRA patients. Results: The maximum diameter of recti abdominus separation was located at the umbilicus in DRA patients (4.59±1.14 cm). The SWS value was signifcantly lower in the RA (p=0.003) and higher in the TrA muscle (p < 0,001) in DRA patients compared with the age-matched controls. However, SWS in both muscles (RA and TrA) showed a statistically positive correlation with IRD (p<0,05) In addition, the SWS value in EO statistically decreased in DRA patients compared with the healthy controls (1.65±0.15 vs. 1.79±0.14, p=0.001). Conclusion: The application of SWE to abdominal wall muscles in DRA patients is feasible. The correlation between SWS value and IRD in RA should be interpreted with caution. [ABSTRACT FROM AUTHOR]

PROBLEM: Dyspareunia research following childbirth usually includes women who received an episiotomy during childbirth. Few studies have examined dyspareunia after childbirth in women who had no episiotomy or perineal trauma. PURPOSE: The purpose of this study was to compare the incidence of dyspareunia in women with perineal trauma related to childbirth to women without perineal trauma related to childbirth. The second aim was to assess risk factors for dyspareunia after childbirth. METHODS: A quantitative cross-sectional study was designed and data were collected from a questionnaire that were sent via the internet (online). The study was performed in Slovenia. The study design included purposive and snowball sampling. Participants were assured anonymity. Analysis of data was conducted using SPSS 20.0. Factor analysis determined the validity and Cronbach's coefficient alpha determined the reliability of the questionnaire. The adequacy of a correlation matrix for factorization was assessed with the Kaiser–Meyer–Olkin (KMO) test and the Bartlett's test. To determine statistically significant differences, the chi-square (χ 2) test was used. Kullback–Leibler divergence was used to measure how one probability distribution was different from the other probability distribution when the χ 2 test was not satisfactory. FINDINGS: There were 387 respondents to the online questionnaire and 22% of the women who received an episiotomy prior to childbirth reported dyspareunia after childbirth; 13.69% reporteddyspareunia when they had no perineal trauma associated with childbirth. Dyspareunia persisted up to 18 months in 11% of participants who had an episiotomy and in 8% of women who experienced no perineal trauma. DISCUSSION: After an atraumatic childbirth, women can also experience dyspareunia. Pregnant women may benefit when their provider knows the risk factors for dyspareunia and limits episiotomy to those situations when there is a clear indication. Additional research may elucidate risk factors for dyspareunia following an atraumatic delivery. [ABSTRACT FROM AUTHOR]

Objective: To analyze prevalence and severity of postnatal depression among females of a major but socio-culturally traditional city of Pakistan, with an aim to pinpoint eminent demographic and medical accomplices. Study Design: Cross Sectional Study. Setting: Combined Military Hospital Peshawar. Period: Feb 2016 to Feb 2017. Material & Methods: Sample was collected via random probability technique. A self-designed questionnaire was used; encompassing demographic details and information regarding obstetric and family history. Screening tool was Standardized “Edinburgh Postpartum Depression Scale (EPDS)”. Descriptive analysis done via SPSS-21. Outcome variable (EPDS) was cross-tabulated with independent variables, correlations were generated by Pearson 2-tailed bivariate analysis; p-value<0.05 was considered as significant. Results: Response rate was 52.2% (n-402). Low, moderate and high risk patients for developing depression were 27.1% (n-109), 15.4% (n-62) & 12.9% (n-52) respectively. There was a strong relation between outcome and age(p<0.001), education(p-0.001), socio-economic class(p-0.013), bad obstetric history(BOH)( p-0.009), age of Last Child Born(LCB)( p-0.010), mode of delivery(p-0.011), postpartum phase(p<0.001) and postpartum complications(p-0.003). Number of sons was negatively correlated with EPDS scores (Pearson correlation co-efficient -0.128 and p-0.01). There was no significant impact of years since married (p-0.349; husband’s education (p-0.397), number of children (p-0.966) or daughters (p-0.063) and previous offspring’s death (p-0.076). Conclusion: Considerable risk of developing postpartum depression was detected among the respondents. Sociodemograhic aggravators were identified to be maternal age, less interpregnancy interval, delivery by SVD, gender of children and postpartum complications. Postpartum depression can be detected by screening/diagnosing every postnatal woman and then promptly treating the sufferers. Imperative measures are opined to identify and vigorously address the sociodemographic and medical aggravating factors. Collaboration of psychiatrists/psychologists is highly recommended in obstetric set-ups. [ABSTRACT FROM AUTHOR]

This paper aimed to emphasize the role played by prophylactic physiotherapy during the postnatal period, in order to re-educate the troubled functions and to heal the injuries suffered during pregnancy and at birth. The prophylactic physiotherapy intervention during the postpartum period can influence/improve the troubled functions and accelerate the healing of the injuries suffered during pregnancy and after birth.

The article provides information on the possibilities of using postnatal ultrasound screening of the uropoietic tract illustrated by the results of using this method in the Slovak Republic. Its main task is to identify malformations of the uropoietic system that were not diagnosed during prenatal diagnosis. The most clinically significant malformations of the kidneys are associated with impaired urine flow (obstructive uropathy). Patients with these malformations often require surgical intervention in the neonatal period or in early childhood. Early diagnosis and timely correction of obstructive uropathy allows maintaining the normal functioning and morphological integrity of the kidneys, preventing the development of chronic kidney disease, improving the quality and life expectancy of patients. Thus, the costs of screening research are incommensurate with the consequences of an untimely diagnosed pathology and the treatment of complications such as chronic kidney disease, kidney failure, recurrent urinary tract infections (antibiotic therapy, hemodialysis, etc.).

Background: This study examined the prevalence of depressive symptoms (depression hereafter) and its association with quality of life (QOL) among pregnant and postnatal women in China.Methods: In this multi-center, cross-sectional study, 1,060 pregnant and postnatal women from eight hospitals were assessed. Depression and QOL were measured using the Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life Questionnaire - brief version, respectively.Results: The prevalence of depression was 7.45% (95% CI: 5.87–9.04%) in the sample. Women with depression had lower QOL in physical, psychological, social and environmental domains compared to those without. Women with physical comorbidities were more likely to suffer from depression (OR = 2.391, 95% CI = 1.384–4.130, P = 0.002).Conclusion: Due to its negative association with QOL, increased attention should be paid to depression in pregnant and postnatal women. Regular screening assessment and preventive measures should be adopted to reduce risk of depression in this population.

Background: This study examined the prevalence of depressive symptoms (depression hereafter) and its association with quality of life (QOL) among pregnant and postnatal women in China. Methods: In this multi-center, cross-sectional study, 1,060 pregnant and postnatal women from eight hospitals were assessed. Depression and QOL were measured using the Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life Questionnaire - brief version, respectively. Results: The prevalence of depression was 7.45% (95% CI: 5.87–9.04%) in the sample. Women with depression had lower QOL in physical, psychological, social and environmental domains compared to those without. Women with physical comorbidities were more likely to suffer from depression (OR = 2.391, 95% CI = 1.384–4.130, P = 0.002). Conclusion: Due to its negative association with QOL, increased attention should be paid to depression in pregnant and postnatal women. Regular screening assessment and preventive measures should be adopted to reduce risk of depression in this population. [ABSTRACT FROM AUTHOR]

Objective: The aim of this review was to explore the unique contribution of shame (negative evaluation of the self) and guilt (negative evaluation of behaviour) to postnatal psychological symptoms. Background: Although shame and guilt are related to psychological symptoms, the separate effect of each in postnatal psychological symptoms are not yet known. Methods: Seven electronic databases were systematically reviewed for articles on: (1) quantitative measures of shame, guilt, and psychological symptoms (2) in the postnatal period for infants under two years of age (3) published in English. Results: Of the 1,615 articles retrieved using PRISMA guidelines, five met criteria and were analysed independently by two reviewers using the STROBE criteria. In mothers, shame was significantly related to stress and postnatal depression. Shame significantly predicted postnatal depression. Guilt was significantly related to postnatal depression; however, the relationship was substantially reduced when included with shame. In fathers, shame, but not guilt, was significantly related to stress, anxiety, and depression. Conclusion: Shame and guilt are trans-diagnostic phenomena, negatively impacting on postnatal psychological health, and potentially the parent-child relationship. More research is needed to develop awareness of the unique effects of shame and guilt to optimise perinatal intervention. [ABSTRACT FROM AUTHOR]

Aim: This study identifies the impact of intimate partner violence (IPV) during pregnancy, and childhood maltreatment on mothers' perpetration of child maltreatment on 1‐month postnatal infants. Methods: A longitudinal study was conducted on women in the third trimester of pregnancy in two obstetric hospitals in Tokyo, Japan, from June 2016 to September 2017. Participants were asked to complete online self‐reported questionnaires during their pregnancy period and at 1 month postnatal. The relationship between suffering from IPV during pregnancy, experiencing childhood maltreatment before the age of 18 years, and perpetration of child maltreatment toward infants was measured among mothers using the Violence Against Women Screen and a survey of four and 14 ad hoc questions. To identify the impact of poly‐victimizations of IPV and childhood maltreatment on maternal–infant maltreatment, the study implemented logistic regression models. Results: The data from 533 respondents to the first and second surveys were analyzed. Maternal–infant maltreatment at 1 month postnatal was strongly associated with poly‐victimizations of IPV during pregnancy and childhood maltreatment (adjusted odds ratio [AOR] = 5.17; p <.001; 95% CI = 2.39–11.20), single victimization of IPV (AOR = 3.43, p <.001, 95% CI = 1.76–6.72), and single victimization of childhood maltreatment (AOR = 1.75, p =.03, 95% CI = 1.04–2.93; neither = reference). Conclusion: The results emphasize the importance of individuating pregnant women with poly‐victimizations of IPV during pregnancy and childhood maltreatment and providing intensive and continuous support for such women to prevent maternal–infant maltreatment after childbirth. [ABSTRACT FROM AUTHOR]

Abstract Background From the individual perspective, security, which is essential to life quality, is characterised as an elementary human need that requires fulfilment. During the transition to parenthood, mothers and fathers are confronted with changes in physical and psychosocial processes that are accompanied by uncertainty and insecurity. Feelings of insecurity may have consequences affecting their pregnancy and childbirth experiences as well as their adaption to the parental role in the first weeks following childbirth. In this context, it is important to understand how parents express and interpret their sense of security to effectively support their security needs. This integrative review aimed to provide a critical synthesis of existing research on parents’ experiences of their sense of security associated with pregnancy, childbirth and the postnatal period. Methods A literature search of the PubMed, CINAHL, PsycINFO and GESIS Sowiport databases was performed. Peer-reviewed papers that were published in English or German between 1990 and 2017 focusing on mothers’ and fathers’ experiences of sense of security in the context of maternity care were included. A thematic analysis was performed to organise and describe the findings. Results Eleven research-based papers met the inclusion criteria. Four key themes among the data were analysed: the meaning and manifestation of sense of security, sense of security in relation to confidence and control, lack of feeling secure and coping strategies, and factors influencing sense of security. Conclusions The findings revealed a complex profile of the perception of security associated with pregnancy, childbirth and the postnatal period. Sense of security can depend on multiple internal and external factors, which can differ between mothers and fathers. Research on the experiences and perceptions associated with fathers’ sense of security is lacking. Further research focused on the experiences of security from the parents’ perspective is necessary. Midwives and other involved health professionals should be aware of their role in creating a sense of security among parents. Based on a local specific understanding of security experiences, professional caregivers have the opportunity to support parents more effectively with regard to their specific security needs.

It is known that the features of the perinatal period influence on the further mother-child interaction. This article presents the results of a comparative study of the interaction of mothers with children at an early age. The study was conducted in two groups. The experimental group included 69 dyads of mothers with prematurely born children and 26 dyads of mothers with children born on time, who were placed in the intensive care unit in the postpartum period. The control group consisted of 90 dyads of mothers with children who did not need resuscitation and hospitalization. The age of children at the time of the study is from 12 to 36 months. Methods: collection and analysis of anamnestic data from children's medical records, a questionnaire of mothers (a questionnaire for mothers Lantsburg M.E.), instrumental structured observation (quantitative and qualitative analysis of video recording of game actions of mother and child using the program The Observer XT Noldus and beyond). As a result of the study, a specificity was revealed in the mother-child interaction in dyads with a complicated postnatal period. Mothers of children who have been in intensive care in the postpartum period showed lower sensitivity and responsiveness in interaction with children than mothers of children with uncomplicated postnatal period.

Background: The research described in this paper is a cross-sectional study which surveys women who delivered their babies in a regional hospital inGreeceto investigate their satisfaction with their postnatal care. This is the first published study which measures satisfaction of postnatal services inGreece. The aim of this study is to determine which factors most influence postnatal satisfaction, which areas are lacking and therefore identify specific areas which should be targeted to improve the performance of health services. Methods: A cross sectional, quantitative study of 300 women who gave birth in a regional Greek hospital between January 2015 and July 2017 were surveyed 40 days after birth using a self-administered questionnaire. The questionnaire contained sociodemographic and clinical characteristic questions and a selection of questions from the WOMen’s views of Birth Postnatal Satisfaction Questionnaire (WOMBPNSQ). Results: This study found that the dimensions with the higher satisfaction scores were “Professional support” and “Continuity”. The lower satisfaction scores were for the dimensions “Woman’s health”, “Contraceptive advice” and “Social support” indicating that these are areas for improvement. The three dimensions most correlated with general satisfaction were “Time with woman”, “Feeding baby” and “Professional support”. Conclusions: This study highlights the important role of health professionals showing that they can enhance postnatal satisfaction by spending time with the women, giving guidance on the care of the newborn and baby feeding. Focusing on improving these areas is expected to enhance the quality of postnatal care.

Iron deficiency anemia occurs frequently in pregnancy and in the postnatal period. It is associated with the increased maternal, fetal and infant morbidity. The article considers the main points of iron deficiency diagnosis and the existing options of its correction depending on the duration of pregnancy, the severity of anemia, the necessary rate of recovery of iron deficiency, contraindications and adherence to the therapy. It emphasizes the high efficacy and safety of treatment of iron deficiency anemia with intravenous administration of iron carboxymethyltosate during the 1st, 2nd and 3rd trimesters of pregnancy, and in the postnatal period.

Background: Studies have indicated that parental depression was slightly related to the increased risk of offspring attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). However, the association between exposure to parental depression at different neurodevelopmental stages (i.e., perinatal or postnatal period) and subsequent ADHD and ASD development remained uncertain.Method: 708,515 children born between 2001 and 2008 were screened for ADHD and ASD based on ICD-9-CM codes of 314 and 299 given by psychiatrists from their birth to the end of 2011. Paternal and maternal depression was separately assessed during five periods, namely those before pregnancy (pre-pregnancy), during pregnancy (perinatal), and <1, 1-3, and >3 years after childbirth (postnatal). Cox regression analyses were performed.Results: Both paternal and maternal depression occurring in the pre-pregnancy, perinatal and postnatal periods were significantly associated with subsequent ADHD and ASD in the offspring, with hazard ratios between 1.42 (95% confidence interval [CI]: 1.35-1.49) and 2.25 (2.09-2.41). The chronicity and additive effect of paternal and maternal depression were related to increased risks of offspring ADHD and ASD. The effects of maternal depression were stronger than the effects of paternal depression for offspring ADHD (HR: 1.35, 95% CI: 1.27-1.45) and ASD (HR: 1.23, 95% CI: 1.05-1.46) risks.Conclusion: Both paternal depression and maternal depression in the pre-pregnancy, perinatal and postnatal periods increases offspring ADHD and ASD risks, and these risks increase further with increases in the duration of parental depression and with the additive effect of parental and maternal depression. [ABSTRACT FROM AUTHOR]

The Chhaupadi culture contributes to the huge proportion of mother and infant mortality in Nepal. Despite a large provision in eliminating this culture in the last almost decades, the culture remains constant. The Chhaupadi Pratha after childbirth is still in practice, especially in Far-western province. Several quantitative studies described the Chhaupadi culture and some qualitative studies have also carried out on exploring the perceptions of community people regarding Chhaupadi culture, but most of the studies had taken this practice as only for monthly menstruation. To fill this gap, I aimed at exploring the perceptions of community people and their experiences related to Chhaupadi Pratha in Kailali district. A prospective qualitative study was conducted among thirty mothers and five other key informants from Godawari municipality. Data were collected through in-depth interviews, key informant interviews, and focus group discussions. Data analysis was guided by the Kenneth McLeroy's social-ecological model (SEM) including five levels of factors which influenced the maternal and child health (MCH) care practices of mothers. While mothers showed little decision-making autonomy, interpersonal factors played an important role in their use of modern health services. Besides, community and social factors as well as organizational and health system factors also shaped mothers' MCH care practices. To improve the MCH care practices of mothers, all the five levels of SEM should be taken into account while developing health programs targeting mothers. [ABSTRACT FROM AUTHOR]

The incidence of hypoglycemia in the immediate postnatal period is rising because of the increasing rate of preterm births, maternal diabetes, and maternal obesity. Severe hypoglycemia has been considered a risk factor for neuronal cell death and adverse neurodevelopmental outcomes. The American Academy of Pediatrics (AAP) suggests a goal of ≥45 mg/dL (≥2.5 mmol/L) for infants who are asymptomatic within the first 48 hours. The Pediatric Endocrine Society (PES) suggests that infants who are unable to maintain their blood glucose >50 mg/dL (>2.77 mmol/L) within the first 48 hours or >60 mg/dL (>3.33 mmol/L) after the first 48 hours are at risk for persistent hypoglycemia. While there is disagreement for target glucose levels within the first 48 hours, both the AAP and the PES suggest further investigation for persistent hypoglycemia beyond 48–72 hours, which is beyond the scope of this article. However, in the immediate postnatal period, much can be gained with familiarization of the two guidelines, as well as current management techniques. This article presents current definitions and treatment modalities for management of hypoglycemia in infants considered at high risk in the immediate postnatal period. [ABSTRACT FROM AUTHOR]

Rationale: Autism spectrum disorder (ASD), the fastest growing neurodevelopmental disorder, is characterized by social deficits, repetitive/stereotypic activity, and impaired verbal and nonverbal communication and is commonly diagnosed at early stages of life. Based on the excitatory-inhibitory imbalance theory of autism, some recent animal experiments have reported amelioration in autistic-like phenotypes in adult animals following acute treatment of NMDA antagonists. However, we suggested the neonatal period as a critical period for NMDA antagonist intervention. Objectives: This experiment was designed to determine the role of postnatal MK-801, an NMDA receptor blocker, in the prenatal valproic acid (VPA) rat model of ASD. Methods: The model of autism was induced by subcutaneous administration of valproic acid (600 mg/kg) to pregnant rats at gestational day 12.5. The effects of MK-801 (0.03 mg/kg, from postnatal day 6–10) in correcting ASD-associated behaviors in male offspring were assessed by open-field, three-chambered social interaction tests. Moreover, the nociceptive threshold was measured by tail flick and hot plate. Behavioral tests were performed on PND 55–60. Nissl staining was performed to confirm the safety of 0.03 mg/kg MK-801 for the brain. Results: We reported that MK-801 rescued social deficits, repetitive behaviors (self-grooming), anxiety-related behavior, and the low nociceptive threshold in the VPA-treated rats. Further, histological examination showed that there were no significant differences among all the groups in terms of the neuronal survival rate. Conclusions: Our results showed that postnatal low-dose MK-801 improved ASD-associated behaviors in the VPA-treated rats and that early exposure to NMDA antagonist resulted in permanent changes in adult behavior. [ABSTRACT FROM AUTHOR]

• Mental health burden led to high early support service utilization and costs. • Family life challenges are associated with high early support services utilization. • The pandemic was associated with high early support service utilization and costs. Limited evidence is available about health care utilization and its determinants in the vulnerable postnatal period for mothers and their children. Thus, the aim of our analyses was to assess determinants of health care and early support services utilization regarding mothers and their children and associated costs in the postnatal period in Germany. Moreover, we aimed to investigate the impact of noticeable mental health and psychosocial burdens on health care and early support services utilization and costs. Using a two-step assessment process of parents from a randomly selected sample of 30,000 recently born children in the multicenter observational population-based cohort study of the SKKIPPI project, we firstly identified mothers who were potentially at risk of mental health and psychosocial burden. These mothers were then invited to participate in an in-depth assessment, including a detailed self-developed questionnaire focusing on early support and health care services utilization. A follow-up after 6 months was conducted. Potential determinants of early support services utilization were analyzed using logistic regression. General linear models with gamma distribution and log link functions were applied to analyze potential determinants of health care costs and to estimate mean adjusted costs. Mothers with a noticeable mental health or psychosocial burden and their children caused mean early support services costs of €1073 and caused total costs of €10,849 in the postnatal period from a payer's perspective compared to €349 (early support services) and €9136 (total costs) for mothers without a noticeable mental health or psychosocial burden and their children. The main determinants of total costs were facing a chronic disease (child), preterm delivery, bad experiences with doctors and midwives, and single parenthood. The majority of participants (69 %) utilized some kind of early support services. The most important determinants of early support service utilization in the postnatal period with respect to the children were facing a chronic disease, being the first child, and being born as a twin. Our findings highlight the importance of sufficient appreciation and treatment of mental health problems in the postnatal period from both a societal and payer's perspective. Future research should investigate whether these and more specific interventions could be a cost-effective way to support mothers with mental health or psychosocial burden and their children. [ABSTRACT FROM AUTHOR]

Abstract Background Optimal breastfeeding has benefits for the mother-infant dyads. This study investigated the prevalence and determinants of cessation of exclusive breastfeeding (EBF) in the early postnatal period in a culturally and linguistically diverse population in Sydney, New South Wales, Australia. Methods The study used routinely collected perinatal data on all live births in 2014 (N = 17,564) in public health facilities in two Local Health Districts in Sydney, Australia. The prevalence of mother’s breastfeeding intention, skin-to-skin contact, EBF at birth, discharge and early postnatal period (1–4 weeks postnatal) were estimated. Multivariate logistic regression models that adjusted for confounders were conducted to determine association between cessation of EBF in the early postnatal period and socio-demographic, psychosocial and health service factors. Results Most mothers intended to breastfeed (92%), practiced skin-to-skin contact (81%), exclusively breastfed at delivery (90%) and discharge (89%). However, the prevalence of EBF declined (by 27%) at the early postnatal period (62%). Younger mothers (

Exposure to heat stress (HS) in utero was postulated to trigger an adaptive molecular response that can be transmitted to the next generation. Hence, this study assessed the impact of HS exposure at different stages of the gestational period of mice on the female F1 population and their offspring. Heat stress exposure (41°C and 65% relative humidity-RH) occurred during the first half (FP), the second half (SP), or the entire pregnancy (TP). A control group (C) was maintained in normothermic conditions (25°C, 45% RH) throughout the experiment. Heat stress had a significant negative effect on intrauterine development, mainly when HS exposure occurred in the first half of pregnancy (FP and TP groups). Postnatal growth of FP and TP mice was hindered until 4 weeks of age. The total number of follicles per ovary did not vary (P > 0.05) between the control and HS-exposed groups. Mean numbers of primordial follicles were lower (P < 0.05) in the sexually mature FP than those in SP and TP F1 females. However, the mean number of viable embryos after superovulation was lower (P < 0.05) in TP compared with C group. The expression of genes associated with physiological and cellular response to HS, autophagy, and apoptosis was significantly affected in the ovarian tissue of F1 females and F2 in vivo-derived blastocysts in all HS-exposed groups. In conclusion, exposure to HS during pregnancy compromised somatic development and reproductive parameters as well as altered gene expression profile that was then transmitted to the next generation of mice., (© The Author(s) 2023. Published by Oxford University Press on behalf of Society for the Study of Reproduction. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)