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Objective:To investigate the current status of primiparas′ postpartum fatigue and paternal involvement, and to explore the relationship between primiparas′ postpartum fatigue and paternal involvement, and to provide reference basis for developing targeted intervention measures to alleviate postpartum fatigue of primiparas.Methods:A cross-sectional survey was conducted on 347 primiparas from Affiliated Hospital of Yangzhou University, Yangzhou Maternal and Child Health Care Hospital from September to December 2020 by convenience sampling. The survey instruments included the general information questionnaire, the Parenting Alliance Inventory (PAI), and the Postpartum Fatigue Scale (PFS).Results:The total score of PAI was (86.51 ± 12.07) points, and the level of paternal involvement was high. The total score of PFS was (16.68 ± 4.12) points. 95.97% (333/347) of primiparas had varying degrees of postpartum fatigue. There was a significant negative correlation between paternal involvement and primiparas′ postpartum fatigue ( r=-0.327, P<0.01). The results of multiple stratified regression analysis showed that paternal involvement was included in the influencing factor model of primiparas′ postpartum fatigue, which could independently explain 9.7% variation of primiparas′ postpartum fatigue. Conclusions:The higher level of paternal involvement could predict the lower level of primiparas′ postpartum fatigue. Medical staff should pay attention to the participation level of the spouses of primiparas in childcare, and improve the participation level of the spouses of primiparas in scientific ways to alleviate the postpartum fatigue of primiparas.
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Objective: To examine the association of objective sleep and fatigue in the early postpartum period with postpartum depression in Japanese primiparas intending to establish breastfeeding.Materials and Methods: The participants were 34 primiparas who were in the postnatal ward after vaginal delivery and responsively breastfeeding their rooming-in baby. Actigraphy data for objective sleep were collected for three consecutive days starting from the first day postpartum. Fatigue and postpartum depression were assessed using the Postpartum Fatigue Scale and Edinburgh Postnatal Depression Scale, respectively, on numerous days between the first day postpartum and the one-month checkup. Breastfeeding and rooming-in data were also collected.Results: The mean total sleep time was 252.0 ± 73.1 min/day. Mean breastfeeding frequency was 12.4 ± 3.2 times/day and mean total breastfeeding time was 247.4 ± 101.8 min/day. Among the participants, 67.6% were exclusively breastfeeding on the discharge day. Fatigue scores were significantly higher during the hospital stay, compared with one month postpartum. Multiple regression analysis showed that sleep frequency on the third day postpartum and mean total breastfeeding time and fatigue on the fifth day postpartum were factors affecting the Edinburgh Postnatal Depression Scale score.Conclusion: The association between postpartum depression among breastfeeding primiparas in the early postpartum period and objective sleep, fatigue, and total breastfeeding time per day was suggested. An environment wherein breastfeeding mothers can rest and sleep without hesitation will be beneficial. Moreover, the importance of sleep during pregnancy and the early postpartum period must be highlighted. Midwifery and/or nursing care starting while the mother is in a postnatal hospital stay can play a key role in preventing postpartum depression.
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Objective:To explore the effect of postpartum fatigue(PPF) on maternal behavior in rats and its mechanisms.Methods:Sprague-Dawley (SD) rats on the first day after delivery were randomized into the control group and the PPF group using the random number table method, with eight rats in each group.The rat model of PPF was established by forcing rats to stand in a cage with water and last for seven days.To maintain galactosis and lactation, rats and pups were caged for 90 min after every 3 h of separation.The control group was separated routinely without any stimulus.The length and body mass of the pups were recorded at birth and postnatal day 7.On the seven days after modeling, the following maternal behaviors were observed via video recordings: suckling, nesting, clicking and retrieval.The morphology of neurons in the paraventricular nucleus of hypothalamus (PVH) was observed by HE staining.The expression of oxytocin in the paraventricular hypothalamus (OxtPVH) was determined by immunofluorescence and immunohistochemistry.Western blot and qRT-PCR were performed to detect mRNA and protein expression of prolactin (PRL) in pituitary gland, respectively.Statistical analysis was performed by SPSS version 22.0, normally distributed continuous variables were compared between the two groups using an independent-sample t test, and nonnormally distributed continuous variables were compared between the two groups by Mann-Whitney U test. Results:On the seventh day after modeling, the length and weight gain of pups in the PPF group ((5.82±0.17) cm, (5.33±2.54) g)were significantly lower than those of the control group ((6.24±0.36) cm, (7.92±2.54) g, t=3.199, 2.227, both P<0.05). Compared with the control group, the rats in PPF group exhibited abnormal maternal behaviors, such as gnawing cage, biting tails, turning circles, repeatedly nesting and refusal to suckling.The results from the maternal behavioral test revealed that the latency of first pup retrieval and last pup retrieval ((39.25±3.50) s, (280.75±59.16) s) in the PPF group were significantly prolonged compared with those in the control group((19.25±7.68) s, (146.00±49.62) s, t=-4.742, -3.490, both P<0.05), the duration of nesting building ((19.50±12.69) s)and clicking ((95.50±70.55)s) in the PPF group were significantly shorter than those in the control group((68.00±37.59) s, (243.00±62.07) s; t=2.445, 3.139, both P<0.05). Compared with control group, the neurons cells of PVH in the PPF group were in disordered manner and the OxtPVH content in the PPF group decreased significantly.The mRNA (0.33(0.29, 0.38) vs 0.85(0.76, 1.76), Z=-3.576, P<0.05) and protein ((1.00±0.65) vs (4.17±0.49), t=-7.726, P<0.05) levels of PRL in PPF group were significantly decreased compared with those in the control group. Conclusion:The behaviors of holding back, nesting and licking offspring are decreased in postnatal fatigued rats.This may be related to the decreased expression of OxtPVH and PRL in hypothalamus of female rats.
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Objective To explore the impact of postpartum fatigue on the onset of lactation.Methods Totally 553 mother-infant dyads were enrolled from three hospitals in Nantong City using sampling method of probability proportional to size.The timing of the onset of lactation,delayed onset of lactation and maternal postpartum fatigue were measured during the period of hospitalization.Postpartum fatigue was measured by Fatigue Scale-14.The timing of onset of lactation was determined by matemal perception of breast fullness.One-way analysis of variance was used to compare the difference of onset of lactation in four groups with varied fatigue scores.Impact of the maternal fatigue on the onset of lactation was analyzed by multiple linear regression.Results Mothers' fatigue score was related to the onset of lactation(r-0.15,P＜0.001).Mothers with postpartum fatigue scores ranging from 9 to 14 had delayed onset of lactation compared with those with fatigue score ranging from 0 to 3 and from 4 to 5,and the differences were significant (P=0.004),and the rate of delayed onset of lactation was increased (P=0.020).Postpartum fatigue was an independent risk factor,after controlling mode of delivery,mode of anesthesia,duration of infant sucking,maternal pain,and infant sucking gesture(t=3.26,P=0.001).Conclusion Postpartum fatigue is one of reasons leading to delayed onset of lactation.Health care providers and family members should pay more attention to postpartum fatigue and take effective measures to promote a successful onset of lactation and breastfeeding.