Saúde mental de puérperas durante a pandemia de Covid-19 no Brasil / Postpartum women mental health during the Covid-19 pandemic in Brazil / Salud mental de mujeres posparto durante la pandemia de Covid-19 en Brasil

Estudos internacionais têm reportado níveis elevados de sintomas de depressão e ansiedade em mulheres no período perinatal em resultado da atual pandemia. O presente estudo avaliou a sintomatologia de depressão e ansiedade em puérperas durante a pandemia de COVID-19 no Brasil. Participaram 625 mulheres, com idades entre 18 e 44 anos (M = 31.6; DP = 5.3), que tinham um bebê até 6 meses de idade. Foram administrados o Questionário de Transtorno de Ansiedade Generalizada (GAD-7) e a Escala de Depressão Pós-Natal de Edimburgo (EPDS). Os resultados mostraram níveis clinicamente significativos de depressão (EPDS ≥13) em 47.4% das participantes, níveis clinicamente significativos de ansiedade generalizada (GAD-7 ≥10) em 41.8% dos casos, e sintomas comórbidos em 33.1% da amostra. Registrou-se uma correlação positiva significativa entre os sintomas de depressão e ansiedade. Além disso, mais dias de vida do bebê, idade mais jovem da mãe e menor nível de escolaridade estavam associados a níveis potencialmente clínicos de sintomas. Assim, é prioritária a definição de programas de prevenção e intervenção na saúde mental perinatal durante o atual período pandêmico, com continuidade para o futuro.

International studies have reported high levels of depression and anxiety symptoms in perinatal women due to the ongoing pandemic. The present study examined symptoms of depression and anxiety in postpartum women during the COVID-19 pandemic in Brazil. Participants were 625 women, aged between 18 and 44 years (M = 31.6; SD = 5.3), who had an infant up to 6 months of age. The Generalized Anxiety Disorder Questionnaire (GAD-7) and the Edinburgh Postnatal Depression Scale (EPDS) were administered. Results showed clinically significant levels of depression (EPDS ≥13) in 47.4% of the participants, clinically significant levels of generalized anxiety (GAD-7 ≥10) in 41.8% of the cases, and comorbid symptoms in 33.1% of the participants. There was a significant positive correlation between symptoms of depression and anxiety. Furthermore, infant's older age, mother's younger age, and lower educational level were associated with potentially clinical levels of symptoms. Thus, prevention and intervention programs targeting perinatal mental health during the ongoing pandemic and beyond should be developed and prioritized.

Estudios internacionales han reportado altos niveles de síntomas de depresión y de ansiedad en mujeres em el período perinatal como consecuencia de la actual pandemia. El presente estudio examinó los síntomas de depresión y ansiedad en mujeres posparto durante la pandemia de COVID-19 en Brasil. Las participantes fueron 625 mujeres, con edades entre 18 y 44 años (M = 31.6; SD = 5.3), que tenían un hijo de hasta 6 meses de edad. Se administró el Cuestionario de Trastorno de Ansiedad Generalizada (GAD-7) y la Escala de Depresión Postnatal de Edimburgo (EPDS). Los resultados mostraron niveles clínicamente significativos de depresión (EPDS ≥13) en el 47.4 % de las participantes, niveles clínicamente significativos de ansiedad generalizada (GAD-7 ≥10) en el 41.8 % de los casos y síntomas comórbidos en el 33.1 % de las participantes. Hubo una correlación positiva significativa entre los síntomas de depresión y ansiedad. Además, más días de vida del bebé, menor edad de la madre y menor nivel educativo se asociaron con niveles potencialmente clínicos de síntomas. Por lo tanto, se debe priorizar la definición de programas de prevención e intervención dirigidos a la salud mental perinatal durante la pandemia en curso, con continuidad para el futuro.

Factors Related to Low COVID-19 Vaccination Rate in Pregnant and Postpartum Women with and without COVID-19 / Fatores relacionados à baixa taxa de vacinação contra COVID-19 em gestantes e puérperas com e sem COVID-19

Abstract Objective This study focused on pregnant and postpartum women during the COVID-19 pandemic, aiming to determine the attitudes and behaviors of vaccinated and unvaccinated groups, and the vaccination behaviors in the groups with and without the disease. The reasons for refusing the vaccine were also questioned. Methods This cross-sectional study was performed from September 2021 to October 2021. The study data were collected using a face-to-face questionnaire. The participants were pregnant women who applied to the hospital for routine antenatal care and were hospitalized, and women in the postpartum period. Additionally, pregnant and postpartum patients who were diagnosed with COVID-19 at the time of admission and were hospitalized and admitted to the intensive care unit due to this disease were also included in the study. Results A total of 1,146 pregnant and postpartum women who completed the questionnaire were included in our study. Only 43 (3.8%) of the participants were vaccinated; 154 (13.4%) of the participants had comorbidities. The number of COVID-19-positive patients was 153. The lack of sufficient information about the safety of the COVID-19 vaccine is the most common reason for the refusal. Conclusion Vaccine refusal can significantly delay or hinder herd immunity, resulting in higher morbidity and mortality. Considering the adverse effects of COVID-19 on pregnancy, it is essential to understand pregnant and postpartum women's perceptions toward vaccination to end the pandemic.

Health-related quality of life: The neglected facet of women's health in India

Quality of life (QoL) is a multidimensional concept and an essential health component that usually includes both positive and negative aspects of life. The measure of health-related QoL (HRQOL) enables health agencies and social partners to address areas of public health importance and formulate policies which eventually demonstrate the impact of health on QoL. Women form an important pillar of society as they are the primary caretaker of children and elders in every country of the world and therefore, the QoL of women determines the health of the next generation and future public health challenges for families, communities, and the health-care system. Providing health services at par with quality is the need of the hour and a very important health goal considering women's health. Poor delivery of clinical care, failure to meet the professional standards of patient care by health-care providers, mistreatment and abuse by health-care professionals, and inequitable delivery of care are some of the key issues in the delivery of quality maternal health-care services in India and therefore primary health-care professionals should be made familiar with the concept of the HRQoL in the community they are serving. Indian health-care systems need to address to the inequalities and taking off the consumer-centric, market approach of privately run corporate health facilities along with setting up of accountability of all the stakeholders to provide quality care, especially in the government-run facilities and creating a promising environment in health care for women focusing on pregnant and postpartum mothers.

Does the Mode of Delivery Affect the Health-Related Quality of Life? A Comparative Analysis

Background: Health?related quality of life (HRQoL) of postpartum mothers is a multidimensional concept and is relatively neglected in both researches and in practice as most postpartum researches have focused on the physical complications. In line with the global trends, India has witnessed a sharp rise in cesarean section (CS) deliveries and has become a global concern for the health of the mother as well as her quality of life. Objectives: This study was conducted to analyze and compare the HRQoL after normal vaginal delivery and CS in the postpartum women. Methods: It was a community-based cross-sectional study and a predesigned, pretested interview schedule was used in the form of a questionnaire including the Medical Outcomes Study Short Form 36 Health Survey for HRQoL. The study was conducted in a resettlement colony, Kalyanpuri located in Delhi, India with a total population of 25,754 with 4596 eligible couples in 4302 households from November 2018 to March 2020. The study participants comprised of a sample size of 330 post?partum women and the data were collected in the 6th week of post-partum period. Results: In our study, there were statistically significant (P < 0.05) differences with mode of delivery as one of the predictors of HRQoL of postpartum mothers. The study subjects with vaginal delivery had higher mean HRQoL score under all the domains. Conclusion: In CS, reduced physical activity, body pain not only affected the mental health domain score but also significantly impacted the emotional domain. Promoting the use of family planning services is also significant in improving maternal health and should be made a provision of quality of care and strengthening of quality improvement and sustainable quality assurance mechanisms are major problem-solving steps in improving access to healthcare.

Determinants of Health-Related Quality of Life among Post-Partum Women Residing in a Resettlement Colony of East Delhi.

Abstract: The postpartum period marks a transition phase in the life of the mother as well as the whole family. Health Related Quality of Life (HRQoL) is an important aspect for not only mother’s physical and psychological health. The study was conducted in a resettlement colony, Kalyanpuri located in Delhi, India with a sample size of 330 post-partum women and the data was collected in the 6th week of post-partum period using the MOS SF-36 (Medical Outcomes Study Short Form 36 Health Survey) for health related quality of life. Among the study subjects, 34.2% had the birth order two and they showed the best mean HRQoL score. The mean score was low for the study subjects with complications in the antepartum, intrapartum and postpartum period (52.9 ± 18.4) as well as in foetal complications where the intrapartum period complications had the worst mean HRQoL score. Healthcare workers of the study area visited 91.5% of the subjects during the post-partum period and had better HRQoL mean score. Also, 22.4% subjects had history of mistreatment and abuse with decline in the mean HRQoL scores. Across the study subjects, 54.4% had financial hardships faced by their family members which had poor HRQoL mean scores. This study uncovered various horizons of health related quality of life for assessment of women in the post-partum period which emphasised the modifications and considerations to include quality as one of the determinant and indicator of health.

Gender of the baby and its impact on the health-related quality of life of postpartum women

Introduction: Health-related quality of life (HRQoL) is a multidimensional concept and is relatively neglected in both research and practice. Gender equality is a crucial measure of human rights for millions of women and girls around the world. Most postpartum researches have focused on physical complications. This study was conducted to analyze the impact of gender of the baby on the HRQoL of postpartum women at 6 weeks. Material and Methods: The study was conducted in a resettlement colony, Kalyanpuri, located in Delhi, India, with a sample size of 330 postpartum women. The data were collected in the 6th week of postpartum period using the Medical Outcomes Study Short Form 36 Health Survey for HRQoL. Results: The findings showed that the birth of a male baby led to a significantly (P < 0.05) better mean HRQoL score than the birth of a female baby. The mean scores of general health, vitality, social functioning, and mental health domains were significantly less in the case of a female newborn child. Conclusion: The male dominance in the Indian society which leads to financial supremacy and coercion for continuation of family lineage was an important predictor of lower HRQoL of the women in the postpartum period. This demonstrates the need for risk factor for gender equity to and achieve universal health coverage.

Incidencia de depresión en mujeres embarazadas y puérperas mediante la aplicacion de la escala de edimburgo en el hospital de la mujer de la ciudad de la paz, entre los meses de noviembre y diciembre de 2020 en el contexto de la pandemia de la enfermedad por sars cov 2 / Incidence of depression in pregnant and puerperal women through the application of the Edinburgh scale in the women's hospital of the city of La Paz, between the months of November and December 2020 in the context of the pandemic of the disease by sars cov 2

Introducción: El objetivo del presente estudio es determinar la incidencia de depresión en mujeres embarazadas y puérperas mediante la escala de Edimburgo en el Hospital de la Mujer de la ciudad de La Paz entre noviembre y diciembre de 2020, en el contexto de la pandemia de la enfermedad por SARS COV 2. Material y Métodos: Se aplicó un estudio descriptivo, observacional de corte transversal. Conclusiones: La incidencia de depresión en mujeres embarazadas y puérperas de consulta externa e internadas en el Hospital de la Mujer de la ciudad de La Paz mediante la aplicación de la escala de Edimburgo con puntuación igual o mayor a 13, es de 37% que corresponde a 44 pacientes. Los factores sociodemográficos asociados son: 21 pacientes se encontraban en etapa de puerperio mediato. 17 pacientes entre los 16 a 25 años, 24 pacientes tenían como estado civil unión libre, 34 pacientes eran de la ciudad de área urbana, 15 pacientes tenían como nivel de formación bachillerato, la ocupación más frecuente era labores de casa en 36 pacientes, 5 eran primíparas, 4 tuvieron hijos fallecidos, 8 pacientes tuvieron hijo con enfermedad grave, 3 paciente tuvieron un embarazo no deseado, 8 tuvieron antecedente de aborto, 38 pacientes pertenecen a familias nucleares, 6 pacientes viven violencia intrafamiliar, 3 presentan abuso de bebidas alcohólicas, 5 pacientes tenían enfermedad crónica, 10 tuvieron antecedente de depresión. Los síntomas más frecuentes son: ansiedad en 42 pacientes, llanto en 41, pánico en 39 y desesperanza en 36.

Introduction: The objective of this study is to determine the incidence of depression in pregnant and postpartum women using the Edinburgh scale at the Women's Hospital in the city of La Paz between November and December 2020, in the context of the pandemic of the disease due to SARS COV 2. Material and methods: A descriptive, observational cross-sectional study was applied. Conclusions: The incidence of depression in pregnant and postpartum women in out patient clinics and in patients at the Women's Hospital in the city of La Paz through the application of the Edinburgh scale with a score equal to or greater than 13, is 37%, which corresponds to 44 patients. The associated sociodemographic factors are: 21 patients were in the immediate puerperium stage. 17 patients between 16 and 25 years old, 24 patients marital status free union, 34 patients were from the city of urban area, 15 patients had a high school education level, the most frequent occupation was housework in 36 patients, 5 were primiparous, 4 had deceased children, 8 patients had children with serious illness, 3 patients had an unwanted pregnancy, 8 had a history of abortion, 38 patients belong to nuclear families, 6 patients experience domestic violence, 3 have alcohol abuse, 5 patients had a chronic disease, 10 had a history of depression. The most frequent symptoms are: anxiety in 42 patients, crying in 41, panic in 39 and hopelessness in 36.

Quasi-Experimental study of effects of lighting on rest, activity and melatonin in postpartum women / Estudo Quasi-Experimental dos efeitos da iluminação no repouso, atividade e melatonina em puérperas / Estudio cuasiexperimental de los efectos de la iluminación em reposo, actividad y melatonina em mujeres posparto

ABSTRACT Objectives: to compare the parameters of the activity/rest cycle of early postpartum breastfeeding women under a controlled and uncontrolled long wavelength ray light regimen. Methods: quasi-experimental study with breastfeeding women and their babies during postnatal rooming-in, São Paulo, Brazil. Participants were allocated to either an experimental (intervention) or a comparison group. The intervention involved exposure of the woman in a controlled room with artificial long wavelength ray light at night. Each woman's level of 6-sulfatoxymelatonin at 24 hours and activity/rest times was analyzed. Results: the mean activity/rest times of women in the experimental and comparison groups were similar. The mean percentages of total load of 6-sulfatoxymelatonin during the day and night were similar (p=0.09). At 24 hours, the experimental group presented a significantly lower mean percentage of total load compared to the comparison group (p=0.04). Conclusions: women who stayed in the room with long-wavelength artificial light showed no difference in activity/rest and 6-sulfatoxymelatonin levels in the early postpartum period.

RESUMO Objetivos: comparar os parâmetros do ciclo de atividade/descanso de puérperas lactantes no início do pós-parto sob regime de iluminação com raios de comprimento de onda longo controlado e descontrolado. Métodos: estudo quase-experimental com lactantes e seus bebês em alojamento conjunto, São Paulo, Brasil. Os participantes foram alocados para grupos experimental (intervenção) ou de comparação. A intervenção consistia na exposição em uma sala controlada com iluminação artificial de raios de comprimento de onda longo à noite. Foram analisados os horários de atividade/repouso (horas) e nível de 6-sulfatoximelatonina em 24 horas. Resultados: a atividade média e os tempos de repouso das mulheres nos grupos experimental e comparação foram semelhantes. Os percentuais médios de volume total de 6-sulfatoximelatonina durante o dia e a noite foram semelhantes (p=0,09). Em 24 horas, o grupo experimental apresentou percentual médio significantemente menor de volume total em relação ao grupo comparação (p=0,04). Conclusões: as mulheres que permaneceram no quarto com luz artificial de comprimento de onda longa não apresentaram diferenças nos níveis de atividade/repouso e 6-sulfatoximelatonina no início do período pós-parto.

RESUMEN Objetivos: comparar parámetros del ciclo actividad/descanso en madres lactantes en posparto temprano bajo régimen lumínico de rayos de longitud de onda larga controlado y no controlado. Métodos: estudio cuasiexperimental con madres lactantes y sus bebés, São Paulo, Brasil. Las participantes fueron asignadas a grupos experimental (intervención) y comparación, consistente en exposición en habitación controlada con luz artificial de rayos de longitud de onda larga durante la noche. Se analizaron tiempos de actividad/descanso (horas) y nivel de 6-sulfatoximelatonina a las 24 horas. Resultados: actividad media y tiempos de descanso fueron similares en grupos comparación e intervención. Porcentajes promedio de volumen total de 6-sulfatoximelatonina durante día y noche resultaron similares (p=0,09). A las 24 horas, el grupo intervención presentó porcentaje promedio de volumen total significantemente menor comparado con grupo comparación (p=0,04). Conclusiones: las mujeres expuestas a luz artificial de longitud de onda larga no mostraron diferencias en niveles actividad/descanso y 6-sulfatoximelatonina durante el posparto temprano.

Associations of education and income with hazardous drinking among postpartum women in Japan: results from the TMM BirThree Cohort Study

BACKGROUND@#Although the postpartum period is suggested to provide an ideal opportunity for interventions to prevent hazardous drinking, evidence on the associations of education and income with hazardous drinking during this period is limited, including in Japan.@*METHODS@#We analyzed data from 11,031 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Hazardous drinking was defined as ethanol intake of ≥20 g/day 1 year after delivery. We conducted multiple logistic regression analyses to examine whether educational attainment or equivalent household income was associated with hazardous drinking, adjusting for age, parity, drinking status during pregnancy, work status, postpartum depression, breastfeeding, and income/education. We also conducted stratified analyses by income and education groups.@*RESULTS@#The prevalence of hazardous drinking 1 year after delivery was 3.6%. Lower education was associated with hazardous drinking; the odds ratio (95% confidence interval) of high school education or lower compared with university education or higher was 2.17 (1.59-2.98). Lower income was also associated with hazardous drinking, but this association disappeared after further adjustments for education; the odds ratios (95% confidence intervals) of the lowest compared with highest level of income were 1.42 (1.04-1.94) and 1.12 (0.81-1.54), respectively. A significant interaction was detected; lower education and lower income were associated with increased risks of hazardous drinking only in a lower income group and lower education group, respectively.@*CONCLUSIONS@#Postpartum women with lower education and lower income had higher risks of hazardous drinking in Japan.

Study of choices of contraception in postpartum women in a tertiary care institute in Mumbai, Maharashtra, India

Background: This modern era talks about women strength and empowerment where they are working either equally or one step ahead of men. However, a fall back in making decisions for contraception use and family planning can still be observed. It is most frequently seen among women belonging to some village as they are exposed to a minimal health care. Keeping this in mind, this crucial period was considered as opportunity to test the issue regarding the various choices of contraception available. Objective of this study was to find out the criteria and methods of contraception selected by women in the postpartum period.Methods: A cross-sectional study in the department of obstetrics and gynaecology was conducted over a period of 11/2 years in which a total of 150 postpartum women were interrogated and counselled regarding various methods of contraception.Results: The contraceptive methods most commonly selected in postpartum period are PPIUCD, Barrier, tubal ligation and injectable contraception of which condom is the most common method adopted. The important factors responsible for the choice of contraception include parity, breast- feeding, education and socio-economic status of the women.Conclusions: Postpartum period is particularly important for initiating contraception as the largest proportion with unmet need of contraception is found among those in their first year after child birth. In order to space birth in a healthy manner postpartum contraception should be emphasized upon.

Conhecer na perspectiva da puérpera a relevância do projeto de assistência ao parto baseada na teoria de Virginia Henderson / Knowing from the perspective of puerpera the relevance of the birth care project based on the theory of Virginia Henderson / Conociendo desde la perspectiva de puerpera la pertinencia del proyecto de cuidado de nacimiento basado en la teoría de Virginia Henderson

O objetivo deste estudo é avaliar a assistência ao parto pelo projeto de extensão "Bem Nascer" à luz da Teoria de Virginia Henderson oportunizando o empoderamento da parturiente. Trata-se de uma pesquisa de campo, de caráter descritivo e natureza qualitativa. A pesquisa consistiu em entrevista semiestruturada com roteiro preestabelecido pelo pesquisador com pacientes que foram atendidas pelo projeto de assistência ao parto humanizado, durante o trabalho de parto, no hospital maternidade da Grande Vitória-ES no segundo semestre de 2017, a qual as entrevistas foram gravadas, transcritas e analisadas com base na Teoria das Necessidades Fundamentais de Virginia Henderson. Quanto à avaliação da assistência ao projeto de parto humanizado pelas puérperas, tivemos uma totalidade de relatos positivos. Estes achados evidenciam que o empoderamento feminino na parturição alinhado à autonomia descrita pela Teoria das Necessidades Humanas Fundamentais de Virginia Henderson favorece positivamente a mulher como principal sujeito do seu corpo. O comprometimento pessoal e profissional no atendimento ético e digno à mulher deve ser efetivo e humanizado.(AU)

The aim of this study is to evaluate childbirth assistance through the extension project "Bem Nascer" in the light of Virginia Henderson's Theory, providing opportunities for the empowerment of the parturient. It is a field research, descriptive and qualitative in nature. The research consisted of a semi-structured interview with a script pre-established by the researcher with patients who were assisted by the humanized childbirth care project, during labor, at the maternity hospital of Grande Vitória- ES in the second half of 2017, to which the interviews were recorded , transcribed and analyzed based on Virginia Henderson's Theory of Fundamental Needs. As for the assessment of assistance to the humanized delivery project by the mothers, we had a total of positive reports. These findings show that female empowerment in parturition aligned with the autonomy described by Virginia Henderson's Theory of Fundamental Human Needs positively favors women as the main subject of their body. Personal and professional commitment to ethical and dignified care for women must be effective and humanized.(AU)

El objetivo de este estudio es evaluar la asistencia al parto a través del proyecto de extensión "Bem Nascer" a Luz da Theoria de Virginia Henderson, proporcionando oportunidades para el empoderamiento de la parturienta. Es una investigación de campo, de naturaleza descriptiva y cualitativa. La investigación consistió en una entrevista semiestructurada con un guión preestablecido por el investigador con pacientes que fueron asistidas por el proyecto de atención de parto humanizado, durante el parto, en el hospital de maternidad de Grande Vitória-ES en la segunda mitad de 2017, en el que se grabaron las entrevistas. , transcrito y analizado en base a la Teoría de las necesidades fundamentales de Virginia Henderson. En cuanto a la evaluación de la asistencia al proyecto de parto humanizado por parte de las madres, tuvimos un total de informes positivos. Estos hallazgos muestran que el empoderamiento femenino en el parto alineado con la autonomía descrita por la Teoría de las necesidades humanas fundamentales de Virginia Henderson favorece positivamente a las mujeres como el tema principal de su cuerpo. El compromiso personal y profesional con la atención ética y digna para las mujeres debe ser efectivo y humanizado.(AU)

A comparative study on nutritional knowledge and dietary behavior between Korean and Chinese postpartum women

BACKGROUND/OBJECTIVES: Proper nutrition intake during pregnancy and lactation is very important to both mothers and babies. Pregnant women should maintain proper nutritional status to restore decreased physical strength due to pregnancy and childbirth and produce breastmilk for the growth and development of the baby. Recently, the number of Chinese people living in Korea has increased as the exchange between Korea and China becomes active. It is important to provide proper nutrition education for pregnant women of both countries considering cultural differences. SUBJECTS/METHODS: The subjects of this study were postpartum women in Gyeonggi, South Korea and Jinhua, China. The subjects were 20–45 years old less than six months after childbirth. A survey, using self-administered questionnaires, was conducted from October 2018 to January 2019. For data analysis, 221 Korean postpartum women (KPW) and 221 Chinese postpartum women (CPW) questionnaires were used. RESULTS: KPW had significantly higher nutritional knowledge score and dietary attitude score than CPW (P < 0.001). However, overall score for dietary habits was significantly higher in CPW compared to KPW (P < 0.001). In KPW, nutritional knowledge (P < 0.01) and dietary attitude (P < 0.001) had significantly positive correlations with dietary habits. The proportions of KPW and CPW who answered that they had experience of nutrition education were 28.5% and 80.1% (P < 0.001). The score for dietary habits was lower as the hours for watching TV and using mobile phone became longer in postpartum women of both countries, with significant differences in KPW (P < 0.001) and CPW (P < 0.05). In KPW, the score for dietary habits in postpartum women with exercise experience was significantly higher than that in postpartum women without exercise experience (P < 0.001). CONCLUSIONS: More pregnancy-related nutrition education should be provided and various and effective nutrition education programs, which not only transfer information but can be practiced in the actual life, should be developed.

Clinical Report : Successful Application of Treatments with Kampo Medicine that Focused on liver-qi Stagnation Remedies for three Postpartum Women Experiencing Poor Physical Conditions / 日本東洋医学雑誌

Many postpartum women experience various poor physical conditions and are unresponsive to Western medical treatments. In such cases, treatments with Kampo medicine have so far focused on improving qi deficiency alone or both qi and blood deficiencies. This study describes the three cases of the patients for whom a favorable outcome was achieved despite a relatively poor prognosis by better understanding their status before pregnancy and their conditions during pregnancy and delivery, and by combining treatments for liver­qi stagnation with those for improving prenatal or postnatal qi deficiency.

Vitamin A nutritional status in high- and low-income postpartum women and its effect on colostrum and the requirements of the term newborn / Estado nutricional de vitamina A de puérperas de alta e baixa renda e seu efeito sobre o colostro e a necessidade do recém-nascido a termo

Abstract Objective To evaluate the vitamin A status in serum and colostrum of postpartum women with different socioeconomic status, comparing the colostrum retinol supply with the vitamin A requirement of the newborn. Methods Cross-sectional study conducted with 424 postpartum women. Vitamin A maternal dietary intake was estimated using a food frequency questionnaire. Colostrum and serum retinol levels were measured by high performance liquid chromatography (HPLC). Serum retinol concentrations <20 µg/dL were indicative of vitamin A deficiency (VAD). Vitamin A levels provided by colostrum <400 µgRAE/day were considered as insufficient for term newborns. Results The mean maternal vitamin A intake during pregnancy was 872.2 ± 639.2 µgRAE/day in low-income women and 1169.2 ± 695.2 µgRAE/day for high-income women (p < 0.005). The prevalence of vitamin A deficiency was 6.9% (n = 18) in the low-income group and 3.7% (n = 6) in the high-income group. The estimated mean retinol intake by infants of the high- and low-income mothers were 343.3 µgRAE/day (85.8% AI) and 427.2 µgRAE/day (106.8% AI), respectively. Conclusions Serum vitamin A deficiency was considered a mild public health problem in both populations; however, newborns of low-income women were more likely to receive lower retinol levels through colostrum when compared with newborns of high-income mothers.

Resumo Objetivo Avaliar o estado nutricional de vitamina A no soro e colostro de puérperas com diferentes condições de renda, comparando os níveis de retinol fornecido através do colostro coma necessidade de vitamina A do recém-nascido. Métodos Estudo transversal com 424 mulheres pós-parto. A ingestão de vitamina A dietética pelas mães foi estimada através de um questionário de frequência do consumo alimentar. Os níveis retinol no soro e colostro foram quantificados por cromatografia líquida de alta eficiência (CLAE). Concentrações de retinol <20 µg/dL no soro foram indicativas de vitamin A deficiency. Os níveis de vitamina A fornecidas pelo colostro < 400 µg/RAE/dia foram considerados insuficientespara os recém-nascidos a termo. Resultados A ingestão média de vitamina A das mães durante a gravidez foi de 872,2 ± 639,2 µgRAE/dia em mulheres de baixa renda e 1169,2 ± 695,2 µgRAE/dia em mulheresde alta renda (p < 0,005). A prevalência de vitamin A deficiency foi de 6,9% (n = 18) no grupo de baixa renda e de 3,7% (n = 6) no grupo de alta renda. A estimativa dos valores médios de ingestão de retinol por lactentes de mães de baixa e alta renda foi de 343,3 µg/RAE/dia (85,8%AI) e 427,2 µg/RAE/dia (106,8% AI), respectivamente. Conclusões A vitamin A deficiency no soro foi prevalente em ambas as populações, entretanto, recém-nascidos de mães de baixa renda foram mais propensos a receberem níveis inferiores de retinol no colostro em comparação com recém-nascidos de mães de alta renda.

Epidemiological factors associated with Toxoplasma gondii infection in postpartum women treated in the public healthcare system of Goiânia, State of Goiás, Brazil

Abstract INTRODUCTION: Knowledge of the epidemiological profile and risk factors for Toxoplasma gondii infection among postpartum women is a relevant issue, because this protozoan can be vertically transmitted to the developing fetus, which can cause severe and debilitating disease. The aim of this study was to assess the risk factors associated with T. gondii infection in postpartum women in Goiânia, GO, Brazil. METHODS: This cross-sectional study comprised 229 postpartum women, among whom 204 were chronically infected (IgG+/IgM-), and 25 were seronegative (IgG-/IgM-; control group). All the patients were asked to complete a form to provide sociodemographic, clinical, dietary, and cultural information. The data were analyzed to compare seropositivity and risk factors based on the odds ratio (OR) thereof. RESULTS: The sociodemographic characteristics associated with the risk for toxoplasmosis were: education ≤ 8 years [OR: 2.521, confidence interval (CI): 1.01-6.301, p=0.049], and age ≥ 30 years (OR: 4.090; CI: 1.180-14.112, p=0.023). Clinical and behavioral characteristics related to eating raw and undercooked meat, were not found to be risk factors associated with a positive test for toxoplasmosis. CONCLUSIONS: Our findings concur with the results of other studies conducted in Brazil and abroad, where variables such as low levels of schooling, and advanced age (≥ 30 years) are major risk factors for pregnant women to become infected with T. gondii.

Childbirth satisfaction and maternal role confidence of early postpartum mothers from maternity units

@#<p style="text-align: justify;">Promoting positive birth experiences may help create circumstances amenable to enhancing the quality of obstetric care and improving outcomes for mothers and infants. This study aims to examine the relationship between childbirth satisfaction and maternal confidence during early postpartum period in mothers from maternity units of San Jose, Occidental Mindoro. This is a descriptive cross-sectional study utilizing Women's Views of Birth Labour Satisfaction Questionnaire (WOMBLSQ) and Maternal Confidence Questionnaire (MCQ). To correlate the level of childbirth satisfaction and maternal role confidence of early postpartum mothers, Pearson's R correlation was used. A p value of 0.05 was taken for statistical significance. It revealed that the early postpartum mother respondents in the study were satisfied with their childbirth experience and confident with their maternal role. Moreover, the childbirth satisfaction was positively correlated with maternal role confidence. It is implicated in the practice of healthcare professionals to provide better understanding of the factors that influence maternal role within their particular social contexts.</p>

Evidence- based nursing of cabbage leaves treatment for postpartum women with breast engorgement / 中国实用护理杂志

Objective To choose a reasonable non-drug treatment program for women with postpartum breast pain. Methods Based on an adequate assessment of the patients′ condition, the clinical questions were proposed and the references were searched in a series of databases, such as Cochrane Library, PubMed, Ovid, CINAHL, CNKI, Wanfang, Weipu, CBM. Results A preliminary search of 484 articles on cabbage therapy for postpartum breast pain was carried. Through rigorous preliminary screening and screening, 11 articles were finally included, including 2 systematic reviews, 2 randomized controlled trials and 7 quasi-experiment. Through the analysis of the inclusion literature, the data was extracted, and the evidence and summary evidence were strictly evaluated.According to the results of evidence, based on the patients′ condition and the wishes of the family, the cold and hot cabbage leaves were alternately applied to the breast of 10 postpartum women with breast engorgement, the breast distended pain were improved. Conclusions The method of evidence-based nursing can provide safe and effective treatment for postpartum women with breast engorgement.

Postpartum Sexual Functioning and Its Predicting Factors among Iranian Women

Background: Many women experience sexual dysfunction following childbirth but this has not been well investigated in Iran. The aim of this study was to evaluate women’s sexual function in the postpartum period in Iran. It also sought to determine predicting factors associated with their sexual function. Methods: This was a cross-sectional study among 380 postpartum women attending 10 urban health centers in Ilam province in southwestern Iran. Participants were selected using random cluster sampling. Data was collected using the female sexual function index (FSFI) and a checklist of socio-demographic and maternal status for each of the women. Sexual dysfunction was classified according to an FSFI score of ≤ 28. Data were analysed using SPSS version 22. Results: The majority of participants (76.3%) had sexual dysfunction. Primiparity (adjusted odds ratio (aOR): 1.78 (95% Confidence Interval (CI): 1.11, 2.94); P = 0.006) and exclusive breastfeeding (aOR: 2.47 (95% CI: 1.21, 5.03); P = 0.012) were associated with increased odds of experiencing sexual dysfunction in the postpartum period. Other factors such as age, type of delivery, education, time since delivery and family income did not predict women’s postpartum sexual function. Conclusion: This study confirmed findings of previous studies on factors that may have an adverse effect on new mothers’ sexual function in the postpartum period. However the effect of type of delivery on postpartum sexual function remains unclear.

Prácticas de cuidado que realizan las puérperas en los municipios de Sincelejo, Corozal, Tolú, Sampués y San Onofre (Sucre, Colombia) 2014 / Care practices performing postpartum women in the cities of Sincelejo, Corozal, Tolú, Sampués and San Onofre (Sucre, Colombia) 2014

Objetivo: Describir las prácticas de cuidado que realizan consigo mismas un grupo de puérperas en los municipios de Sincelejo, Corozal, Tolú, Sampués y San Onofre (departamento de Sucre, Colombia) (periodo agosto, septiembre y octubre de 2014). Materiales y métodos: Estudio cuantitativo, descriptivo, muestreo por conveniencia. Criterios de inclusión: puérperas con más de 15 días del postparto inmediato y puérperas con parto vaginal sin complicaciones. Instrumento: cuestionario semiestructurado denominado "Prácticas de cuidado que realizan consigo mismas las gestantes en el postparto", versión 2004. Resultados: El 86 % de las puérperas no realizan ejercicios postparto por desconocimiento de cómo hacerlo; su alimentación no cumple los requerimientos nutricionales. El 99 % informó que se ducha diariamente para estar aseadas y brindar higiene a sus bebés. El 87 % manifestó que se cuida de tener relaciones sexuales durante la etapa del puerperio, las evita y espera un tiempo prudencial después del parto para reiniciarlas. Entre los medicamentos de mayor consumo durante la gestación mencionaron vitaminas (76.96 %), hierro (61.78 %), calcio (56.54 %) y analgésicos (54.97 %). La utilización de los servicios de salud en las puérperas entrevistadas con relación a la asistencia del control postparto estuvo representada por el 85.86% de aquellas que asisten al control postparto. Conclusiones: Se encontraron algunas creencias populares, como la duración del reposo en cama, no exponerse a corrientes de aire, evitar las relaciones sexuales durante la dieta; las prácticas de cuidado que realizan las puérperas consigo mismas basadas por un saber cultural. Esta investigación servirá como referente, junto con otras investigaciones, para probar el conocimiento empírico utilizado por las puérpera en sus prácticas de cuidado.

Objective: To describe care practices engaged with themselves a group of new mothers in the cities of Sincelejo, Corozal, Tolu, Sampués and San Onofre (sucre, Colombia) during the months August, September and October 2014. Materials and methods: Quantitative, descriptive study convenience sampling. Inclusion criteria: Postpartum women over 15 days immediately after birth and postpartum women with vaginal delivery without complications. Instrument: semistructured questionnaire called "care practices engaged with themselves pregnant postpartum" 2004 version. Results: 86 % of postpartum women do not realize postpartum exercises ignorance of how to do it; on the other hand they have no power provided to nutritional requirements. 99 % they reported to be performing their daily hygiene neat and provide their babies bathroom. 87 % reported having sex with care during the postpartum stage, avoiding them and waiting a reasonable time after delivery to restart them. Among the most consumed drugs during pregnancy were vitamins (76.96 %), iron (61.78 %); calcium (56.54 %); analgesics (54.97 %). The use of health services in postpartum women interviewed regarding attendance of postpartum was represented by 85.86% of those attending the postpartum control. Conclusions: some popular beliefs as were length of bed rest, not be exposed to drafts, avoid sex during the diet were found; care practices that perform postpartum with themselves are surrounded by a cultural knowledge. This research will serve as a reference along with other research to test the empirical knowledge by the puerperal in their care practices.

Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil

Introduction To determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro, and to detect possible exposure factors associated with T. gondii infection in this population. Methods IgM and IgG anti-T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT) and immunoenzymatic assay (ELISA) techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease. Results Among the 400 samples analyzed, 234 (58.5%) were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti-T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05) with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor. Conclusions The prevalence rate of IgG anti-T. gondii antibodies in the City of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level. .