0
selected
-
1.
Maternal and newborn outcomes of antenatal breastmilk expression: a scoping review protocol.
Foudil-Bey, I, Murphy, MS, Keely, EJ, El-Chaâr, D
BMJ open. 2020;(5):e033101
Abstract
INTRODUCTION Mothers with diabetes face unique challenges associated with breastfeeding initiation and maintenance. Antenatal breastmilk expression (BME) may be suggested to mothers, including mothers with diabetes, to improve breastfeeding, maternal, and infant outcomes postpartum. However, there have been few evaluations of the potential harms and benefits of this practice. The objective of our scoping review will be to broadly examine the literature describing maternal and infant outcomes of antenatal BME. METHODS AND ANALYSIS This scoping review will address the research question: 'Among women who engaged in antenatal BME, what maternal and infant outcomes have been evaluated?' A search of published and unpublished studies available in English will be conducted in February 2020 using the following databases: Medline (OVID), Embase (OVID), CINAHL (EBSCOHost), and Cochrane Database of Systematic Reviews (OVID). A search of the British Library E-Theses Online Services (EThOS) database and OpenGrey will be conducted to identify relevant grey literature. This scoping review will use a five-step framework to guide the selection, extraction, and analysis of eligible studies. Clinical consultation will be included as a sixth step to our methodology. Literature reporting on the effect of antenatal BME on maternal and infant outcomes, breastfeeding initiation and duration, and the experiences of women who have engaged in the practice will be considered. The data will be summarised with attention paid to high-risk obstetrical populations such as women with diabetes. Our results will be reported as outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. ETHICS AND DISSEMINATION Research ethics board approval will not be required due to the nature of the study's methodology. The results of this review will be disseminated through peer-reviewed publication and presentation at relevant conferences. TRAIL REGISTRATION NUMBER Open Science Framework (osf.io/gfp2q).
-
2.
Breastfeeding and postpartum weight loss.
Lambrinou, CP, Karaglani, E, Manios, Y
Current opinion in clinical nutrition and metabolic care. 2019;(6):413-417
Abstract
PURPOSE OF REVIEW Postpartum weight retainment is common in women, increasing the long-term likelihood of overweight and/or obesity. On the other hand, breastfeeding entails a high energy cost that contributes to the total energy expenditure of the mother, increasing the chances of a negative energy equilibrium that could potentially lead to weight loss. This review explores this association as depicted in the latest literature available. RECENT FINDINGS Several studies reported a positive association between breastfeeding and postpartum weight loss while others reported no significant association. Several potential mechanisms, metabolic pathways and determinants have been described. SUMMARY Even though several studies support the potentially beneficial role of breastfeeding in postpartum weight loss, more studies with robust designs are needed to reach a reliable conclusion. Healthcare providers should encourage breastfeeding, not only for its health benefits for both the mother and the offspring but also for its potential role in weight loss.
-
3.
Maternal Sleep in Pregnancy and Postpartum Part II: Biomechanisms and Intervention Strategies.
Carroll, JE, Teti, DM, Hall, MH, Christian, LM
Current psychiatry reports. 2019;(3):19
Abstract
PURPOSE OF REVIEW As described in Part I of this two-part review, maternal sleep has wide-ranging implications for maternal health and overall family functioning. In addition, poor sleep quality and insufficient sleep are highly prevalent and characterized by considerable racial disparities. RECENT FINDINGS Part II of this review discusses physiological mechanisms, including inflammation and appetite hormones, by which sleep impacts multiple facets of women's health during pregnancy and postpartum. These mechanisms are increasingly being delineated, but require further study and better integration with studies of behavioral and physical health outcomes. Further, there are multiple potential strategies for improving maternal sleep, providing the opportunity to tailor treatment approaches to individual needs. Ultimately, as a critical health behavior that is amenable to intervention, sleep provides a promising future direction for measurably impacting clinically relevant health parameters in women of childbearing age.
-
4.
The management of anaemia and haematinic deficiencies in pregnancy and post-partum.
Roy, NBA, Pavord, S
Transfusion medicine (Oxford, England). 2018;(2):107-116
Abstract
Anaemia is one of the most common disorders in the world (24·8% of the world population) (de Benoist 2008) and affects patients of all ages and ethnic origins. Underlying causes and prevalences vary by age group and socioeconomic background, but pregnant women everywhere are at high risk of anaemia, the vast majority of cases being due to iron deficiency. One in four pregnant women in Europe are thought to have iron deficiency anaemia (Daru et al., March 2016), whereas in parts of Africa, where hookworm infestation is common, this has been estimated to be as high as 38% (Stevens et al., 2013) to 50% (Bah et al., June 2017). Women of menstruating age are rarely iron replete (Low et al., 18 April 2016) and then enter pregnancy, which carries a major negative iron balance (Bentley, October 1985). Despite a good understanding of the causes of anaemia in pregnancy, there is still uncertainty about how best this should be investigated, prevented and managed. This reflects the limitations of laboratory tests, as well as the poor understanding of how best to replace iron, given the complex physiological mechanisms of iron absorption and distribution. A strategy for iron replacement in a population of anaemic pregnant women needs to be developed not only based on what is biologically and clinically most appropriate but also in the context of each organisation's delivery of care structure, taking into consideration aspects of cost effectiveness. For this reason, management algorithms must be adapted locally, ensuring they meet basic clinical imperatives.
-
5.
Postpartum glucose intolerance: an updated overview.
Pastore, I, Chiefari, E, Vero, R, Brunetti, A
Endocrine. 2018;(3):481-494
Abstract
The prevalence of type 2 diabetes mellitus has increased worldwide over the past three decades, as a consequence of the more westernized lifestyle, which is responsible for the increasing obesity rate in the modern adult's life. Concomitant with this increase there has been a gradual rise in the overall prevalence of gestational diabetes mellitus, a condition that strongly predisposes to overt diabetes later in life. Many women with previous gestational diabetes mellitus show glucose intolerance in the early postpartum period. Although the best screening strategy for postpartum glucose intolerance is still debated, numerous evidences indicate that identification of these women at this time is of critical importance, as efforts to initiate early intensive lifestyle modification, including hypocaloric diet and physical activity, and to ameliorate the metabolic profile of these high-risk subjects can prevent or delay the onset of type 2 diabetes mellitus. Nevertheless, less than one fifth of women attend the scheduled postpartum screening following gestational diabetes mellitus and they are at increased risk to develop type 2 diabetes mellitus later in their lives. Unsatisfying results have also come from early intervention strategies and tools that have been developed during the last few years to help improving the rate of adherence to postpartum glycemic testing, thereby indicating that more effective strategies are needed to improve women's participation in postpartum screening.
-
6.
Depression During Pregnancy and Postpartum.
Becker, M, Weinberger, T, Chandy, A, Schmukler, S
Current psychiatry reports. 2016;(3):32
Abstract
Depression is a common complication of pregnancy and the postpartum period. There are multiple risk factors for peripartum mood disorders, most important of which is a prior history of depression. Both depression and antidepressant medications confer risk upon the infant. Maternal depression has been associated with preterm birth, low birth weight, fetal growth restriction, and postnatal cognitive and emotional complications. Antidepressant exposure has been associated with preterm birth, reductions in birth weight, persistent pulmonary hypertension, and postnatal adaptation syndrome (PNAS) as well as a possible connection with autism spectrum disorder. Paroxetine has been associated with cardiac malformations. Most antidepressant medications are excreted in low levels in breast milk and are generally compatible with breastfeeding. The use of antidepressants during pregnancy and postpartum must be weighed against the risk of untreated depression in the mother.
-
7.
Postpartum Anxiety and Infant-Feeding Outcomes.
Fallon, V, Groves, R, Halford, JC, Bennett, KM, Harrold, JA
Journal of human lactation : official journal of International Lactation Consultant Association. 2016;(4):740-758
Abstract
There is increasing evidence for the effect of postpartum anxiety (PPA) on maternal and infant health outcomes. Despite evidence linking suboptimal infant-feeding outcomes with other indices of maternal mental health, the relationship between PPA and infant feeding has not yet been reviewed. A systematic review with narrative synthesis was conducted to examine the relationship between PPA and infant-feeding outcomes. Electronic searches were performed using specific keywords (eg, "postnatal anxiet*"; "breastfeed*"). A hand search of selected journals and reference lists of included articles was then conducted. All studies were considered that provided information related to PPA and infant-feeding outcomes. One hundred and two studies were identified, of which 33 were eligible. Two authors independently extracted data including study design, participants, and results. Results indicated that women with symptoms of PPA are less likely to breastfeed exclusively and more likely to terminate breastfeeding earlier. Some evidence also suggests that those experiencing PPA are less likely to initiate breastfeeding and more likely to supplement with formula in the hospital. In those who do breastfeed, PPA reduces self-efficacy, increases breastfeeding difficulties, and may negatively affect breastfeeding behaviors and breast milk composition. Heterogeneous outcomes and methodological limitations somewhat limit the comparability of findings. However, in combination with a review linking depression with similar negative infant-feeding sequelae, the findings provide evidence for the effect of negative postpartum mood on breastfeeding. Additional support for breastfeeding mothers with PPA is warranted.
-
8.
The new paradigm for depression in new mothers: current findings on maternal depression, breastfeeding and resiliency across the lifespan.
Kendall-Tackett, K
Breastfeeding review : professional publication of the Nursing Mothers' Association of Australia. 2015;(1):7-10
Abstract
The results from these recent studies demonstrate that breastfeeding has a much larger role to play in maintaining physical and mental health than we have previously believed. It's not just the milk. Because breastfeeding increases maternal responsivity, it makes the day-to-day experience of mothering more tolerable. It increases the chances that the babies will be securely attached and will not have their stress and inflammatory response systems chronically up-regulated. Breastfeeding is so much more than just a method of feeding. It's a way of caring for a baby that will provide a lifetime's worth of good health because it provides a way for mothers to connect with their babies, even if they did not experience that kind of care themselves. In short, breastfeeding can make the world a happier and healthier place, one mother and baby at a time.
-
9.
Weighing in on obesity and breastfeeding: factors possibly related to lower breastfeeding rates in women with higher BMIs.
Kendall-Tackett, K
Breastfeeding review : professional publication of the Nursing Mothers' Association of Australia. 2015;(2):7-12
-
10.
Postpartum Psychosocial and Behavioral Health: A Systematic Review of Self-Administered Scales Validated for Postpartum Women in the United States.
Walker, LO, Gao, J, Xie, B
Women's health issues : official publication of the Jacobs Institute of Women's Health. 2015;(5):586-600
Abstract
PURPOSE Women's poor postpartum psychosocial and behavioral health may negatively affect them and their infants. Validated postpartum screening scales can help to identify problems early, but currently there is limited knowledge in this area. Thus, we conducted a systematic examination of self-administered psychosocial and behavioral scales validated for postpartum women in the United States in the domains of depression, body image, diet, physical activity, smoking, and alcohol use. We examined the characteristics of included scales, their validation samples, and reported psychometric properties. METHOD Nine databases were searched during October 2014 through February 2015. After meeting inclusion/exclusion criteria, article information was extracted independently by two authors, compared, and differences were resolved through discussions. RESULTS The final sample included 23 published articles covering 19 scales. Seventeen were in the domain of depression, and one each in physical activity and dietary domains. None was found in the domains of body image, smoking, or alcohol use. The number of scale items varied from 2 to 35. The majority of scales were originally designed for postpartum women, and validated in one or two postpartum studies with samples of predominantly adult women. If reported, scale reliability coefficients were generally 0.80 or greater and validity coefficients of 0.70 or greater. Five depression scales had favorable sensitivity and specificity using standard cutpoints, but only one was tested across adolescent, low-income, and predominantly ethnic minority postpartum populations. CONCLUSION No U.S.-validated postpartum scales were found for body image, smoking, or alcohol use. Most scales had limited validity testing, and validation was in predominantly advantaged samples. Further scale development and testing are recommended.