Factors associated with postpartum fatigue: an exploration of the moderating role of resilience.

Background: Postpartum fatigue (PPF) can impair the physical and mental well-being of women. The aims of this study were to assess the associations between fatigue and maternal health-related variables, specifically, sleep quality, depression symptoms, and resilience, and to explore the moderating role of resilience in the relationships between sleep quality, depression symptoms, and fatigue. Methods: This cross-sectional study used data collected from mothers during the postpartum period via an online platform. PPF was assessed using the Fatigue Severity Scale, whereas sleep quality and depression symptoms were assessed using the Pittsburgh Sleep Quality Index and Edinburgh Postnatal Depression Scale, respectively. The Brief Resilience Scale was used to assess resilience. Simple and multiple binary logistic regression analyses were performed to examine the association of each independent variable with PPF and to determine the most significant predictors of PFF. The data were analyzed using SPSS, and structural equation modeling was performed using AMOS 23. A moderation analysis was performed to explore the moderating role of resilience using the Hayes PROCESS macro. Results: A total of 1,443 postpartum mothers were included in the analysis. The simple binary logistic regression analysis showed that having chronic disease (odds: 1.52; p = 0.02), mother's age (odds: 0.97; p = 0.03), mother's body mass index (BMI; odds: 1.03; p = 0.01), depression symptoms (odds: 1.09; p ≤ 0.0001), sleep quality (odds: 1.17; p ≤ 0.0001), and resilience (odds: 0.42; p ≤ 0.0001) all contributed to fatigue during postpartum. Multivariate logistic regression showed that the mother's BMI, sleep quality, depression symptoms, and resilience were significant predictors of PPF. Moderation analyses showed that resilience was not a significant moderator between the main effects of sleep quality and fatigue (interaction effect: ß = 0.01, p = 0.31, 95% CI: -0.01 to 0.04) or between the main effects of depression symptoms and fatigue during postpartum (interaction effect: ß = 0.01, p = 0.82, 95% CI: -0.01 to 0.02). Conclusion: Given the deleterious effects of PPF on maternal health outcomes, factors associated with PPF should be assessed regularly. In addition to mothers' BMI, sleep quality, and depression symptoms, resilience could also be a crucial factor in predicting fatigue severity during this critical time for mothers even though it was not a significant moderator among this sample.

Associated factors of sexual dysfunction among postpartum women in Taiwan- a cross-sectional study.

Sexual function among postpartum women is often overlooked by health-care professionals. This study aimed to investigate associated factors of sexual dysfunction among postpartum women. This study used a cross-sectional study design. A total of 135 postpartum women from a teaching hospital in northern Taiwan who met the inclusion criteria were recruited. SPSS version 22.0 was used to analyze data including descriptive and bivariate analysis. A multiple linear regression was using to identify the predictors of sexual dysfunction among Taiwanese postpartum women. Results indicated that the categories of sexual dysfunction that most commonly experienced in postpartum women were lack of sexual desire, delay or absence of orgasm, pain during intercourse, and inability to become physically aroused. Parity, types of delivery, perineal laceration, breastfeeding, postpartum fatigue, and postpartum depression were significantly associated with sexual dysfunction (p< .05). Sexual counseling and mental support should be necessary for women at risk of postpartum sexual problems such as nulliparous with perineal laceration, breastfeeding mothers, experiencing postpartum fatigue and depressive symptoms to improve their sexual health and quality of life.

La fonction sexuelle des femmes en post-partum est souvent négligée par les professionnels de la santé. Cette étude visait à étudier les facteurs associés au dysfonctionnement sexuel chez les femmes en post-partum. Cette étude a utilisé un plan d'étude transversal. Au total, 135 femmes en post-partum provenant d'un hôpital universitaire du nord de Taiwan et répondant aux critères d'inclusion ont été recrutées. SPSS version 22.0 a été utilisé pour analyser les données, y compris une analyse descriptive et bivariée. Une régression linéaire multiple était utilisée pour identifier les prédicteurs de dysfonctionnement sexuel chez les femmes taïwanaises en post-partum. Les résultats ont indiqué que les catégories de dysfonctionnement sexuel les plus fréquemment rencontrées chez les femmes en post-partum étaient le manque de désir sexuel, le retard ou l'absence d'orgasme, la douleur pendant les rapports sexuels et l'incapacité d'être physiquement excitée. La parité, les types d'accouchement, les lacérations périnéales, l'allaitement, la fatigue post-partum et la dépression post-partum étaient significativement associés à la dysfonction sexuelle (p < 0,05). Des conseils sexuels et un soutien mental devraient être nécessaires pour les femmes présentant un risque de problèmes sexuels post-partum, telles que les nullipares présentant une lacération périnéale, les mères allaitantes, les femmes souffrant de fatigue post-partum et de symptômes dépressifs, afin d'améliorer leur santé sexuelle et leur qualité de vie.

Do postpartum insomnia, fatigue and depression affect the maternal role of primiparous women?

Many factors negatively affect the motherhood role. Fatigue, insomnia and depression, which are among these factors, have not been investigated together in any study. Therefore, we carried out this study to determine the effect of insomnia, fatigue and depressive symptoms on the motherhood role in primiparous mothers. In this descriptive and cross-sectional study, we included 153 women who met the inclusion criteria using the simple, random sampling method. To determine the independent variables affecting the motherhood role, we used the backward regression model. In this study, we determined that the women's spending more energy while they performed the activities of daily living in the postpartum period, their suffering from insomnia due to baby care and their depressive symptoms affected their motherhood role by 32.6 percent. We also determined that there was a moderately significant relationship between insomnia, fatigue and depressive symptoms in the postpartum period. In particular, because depressive symptoms are the variable most related with the motherhood role (r = -0.520; p < .001), women should be followed-up regularly in the postpartum period from this aspect. It is also important to deal with insomnia in the early postpartum period, because it is a common problem in most women after childbirth.

Oxytocin changes in women with emergency cesarean section: Association with maternal blues by delivery mode.

Introduction: Women with emergency cesarean section (CS) have presumed effects of an unscheduled surgery on their salivary oxytocin (OXT) level and psychological state. This study aimed to measure changes in the salivary OXT levels of women with emergency CS and change in the OXT levels by delivery mode, and to investigate the association between changes in OXT levels and maternity blues. Methods: We used a longitudinal observational study. The eligibility criteria were primipara pregnant women who were planning to have vaginal delivery. The salivary OXT levels of women were measured at 36 weeks gestation, 38 weeks gestation, 1 day postpartum, and 5 days after childbirth. Maternity blues was diagnosed using the Maternity Blues Scale (13 items), 'Fatigue after Childbirth' was diagnosed using the Visual Analogue Scale (0-100), and the subjective symptoms of fatigue was diagnosed using the Jikaku-sho shirabe. The three groups ("Without EA", "With EA", and "Emergency CS") were analyzed separately. The changes in the oxytocin levels of women with emergency CS at four time points were analyzed by using a repeated measure analysis of variance. Results: The mean OXT levels of women with emergency CS (n = 6) were significantly lower at 5 days after childbirth than at 36 weeks gestation, 38 weeks gestation, and 1 day postpartum. There was a significant middle correlation between changes in the mean maternity blues scores between 1 day and 5 days, and the mean changes in OXT levels from 38 weeks gestation to 5 days after childbirth. Conclusion: It could be assumed that women with emergency cesarean section may be affected psychologically by the unplanned method of delivery. In the present study, it was not possible to analyze this association because of the small sample size; however, it is possible to clarify predictors as the sample size accumulates in the future.

The effect of acupressure on postpartum fatigue in women delivering by caesarean section: A randomized controlled study.

AIM: The aim of this study was to determine the effect of acupressure on postpartum fatigue in women who gave birth by cesarean section. METHOD: This study is a randomized controlled experimental study. The study was conducted between August 2021 and January 2022 in the maternity wards of hospitals in Turkey. Multiparous women who gave birth by cesarean section were randomly assigned to acupressure (n = 60) and control (n = 62) groups. Acupressure was applied to the acupressure group for a total of four sessions on the points of LI4, ST36, and SP6, for an average of 15 min for each session. The application sessions continued for 48 h after the cesarean section. The data were collected with a Descriptive Information Form and the VAS-F. RESULTS: It was determined that the mean posttest score of the fatigue dimension of the VAS-F was found to be significantly lower in the acupressure group (p = 0.023). Additionally, in the acupressure group, while the differences between the pretest and posttest results of the both fatigue and energy dimensions of the VAS-F were statistically highly significant in the acupressure group (p = 0.000), only the difference in the energy dimension was found to be statistically significant in the control group (p = 0.016). CONCLUSIONS: As a result, acupressure was found to be effective in reducing postpartum fatigue in women who gave birth by cesarean section, and its usability for healthcare professionals was demonstrated.

Infant sleep patterns and maternal postpartum fatigue: A cross-sectional study.

AIM: Unpredictable nature of infant sleep-wake cycles go against that of the adult sleep. Maternal sleep quality is acknowledged as a main factor to postpartum fatigue. This study explored the effects of infant sleep patterns on maternal postpartum fatigue. METHODS: A total of 319 mothers of infants from two teaching hospitals in the Nantong City were enrolled. Maternal fatigue status and infant sleep patterns were assessed by the Fatigue Scale (FS-14) and the Brief Infant Sleep Questionnaire (BISQ). Generalized estimating equation analyses were perform to explored the effect of infant sleep patterns on maternal fatigue. RESULTS: Sleep-onset time later than 10 p.m., and nocturnal wakefulness more than 60 min were risk factors of postpartum fatigue. After controlling the confounding variables, infant sleep patterns were still the determinant factors of postpartum fatigue. CONCLUSION: Infant sleep pattern is a factor of maternal postpartum fatigue. It is recommended to promote infant sleep so as to improve maternal sleep quality and finally alleviate postpartum fatigue.

Predictors of maternal self-efficacy and the mediating role of postpartum fatigue for Jewish and Arab women in Northern Israel.

OBJECTIVE: The study aims to investigate positive and negative social interactions as predictors of maternal self-efficacy and to examine the mediating role of postpartum fatigue. DESIGN: Participants included 450 Arab and Jewish mothers of healthy one-month-old infants who visited 14 well-baby care clinics located in northern Israel. The study used a prospective longitudinal cohort design. Participants completed the first questionnaire and agreed to a follow-up phone interview three months later. Both ethnic groups had a response rate of 90% for the follow-up interview. The questionnaire included six scales that measured socioeconomic status and demographics, obstetric characteristics, social networks and support, negative social interactions, fatigue and maternal self-efficacy (MSE). The phone interview was a shorter version of the written questionnaire focusing on MSE and fatigue. Maternal self-efficacy four month after birth was examined with social support, negative interactions and fatigue, using multiple linear regressions within each ethnic group. FINDINGS: In both groups, negative social interactions decreased perceptions of maternal self-efficacy. Women who reported higher social support after birth experienced a greater sense of maternal self-efficacy four months after birth, though the association was stronger among Jewish women. Post-partum fatigue affects Arab and Jewish mothers differently. Among Arab mothers, fatigue at one month mediates MSE as well as the relationship between social support and negative interactions at four months. Among Jewish mothers, these factors are directly related to MSE, with no mediation effect. IMPLICATIONS FOR PRACTICE: The correlations found between social interactions, fatigue and maternal self-efficacy can be useful in providing appropriate care that includes information and parental support. Health professionals working with postpartum women must assess degree of postpartum fatigue and negative postpartum social interactions as well as social support during the postpartum period.

Sleep deprivation and fatigue in early postpartum and their association with postpartum depression in primiparas intending to establish breastfeeding.

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.

Postpartum Fatigue and Inhibited Lactation.

Background: Postpartum fatigue is a common disorder worldwide and affects both physical and mental functioning. In breastfeeding women, Prolactin (PRL) is not only involved in immunoregulation, but also responsible for lactation. Prolactin levels in women with chronic fatigue are higher than normal, but a chronic fatigue state inhibits postpartum lactation in humans. Objectives: This paper explored the inhibition mechanism of lactation by postpartum fatigue in rats. Methods: Postpartum fatigue models were built by forcing mother rats to stand in water and divided into 3-hour, 9-hour and 15-hour per day fatigue groups according to the underwater time. Mother rats and their offspring were reunited in a dry cage for 90 minutes every 3 hours for feeding. The expression of PRL, PRL receptor (PRLR), Janus Kinase 2 (JAK 2), and Signal transducers and activators of transcription 5 (STAT5) mRNA were analyzed and the microstructure of mammary gland were observed under light and electron microscopy. Results: The expression of pituitary PRL mRNA and its downstream signaling pathway JAK2 and STAT5 mRNA were down-regulated in the severe postpartum fatigue rats. PRL mRNA responses were dose-related to duration of fatigue. The expression of PRLR mRNA increased. Postpartum fatigue led to functional degeneration of mammary gland. The breast lobules were shrunk and the number of alveoli were decreased. Few milk protein granules and fat droplets were observed in the cytoplasm under transmission electron microscope. Conclusion: Postpartum fatigue inhibits the lactation by down-regulating the expression of PRL and PRL-dependent signaling pathway in rats.

Relationship between primiparas′postpartum fatigue and paternal involvement / 中国实用护理杂志

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.

Sleep deprivation and fatigue in early postpartum and their association with postpartum depression in primiparas intending to establish breastfeeding / Journal of Rural Medicine

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.

Effects of Postpartum Fatigue and Depressive Cognitions on Life Satisfaction and Quality of Life in Arab Postpartum Women: The Intervening Role of Resourcefulness.

The purpose of this study is to explore the relationships among postpartum fatigue (PPF), depressive cognitions, resourcefulness, quality of life, and life satisfaction in Arab postpartum mothers. A conceptual framework is used in this study based on the middle range theory of resourcefulness, which Zauszniewski developed in 2006. The study is a cross-sectional descriptive design with 123 postpartum women who had given birth within the past six months. used WhatsApp and Facebook for recruitment. developed the self-administered online survey in Qualtrics and collected data from 6 January 2017, to 6 February 2017. Correlation analysis is used to address the research aim and used the P value of 0.05 to determine the significance of the results. There were significant correlations among depressive cognitions and resourcefulness, life satisfaction, and quality of life; there were also significant correlations between PPF and life satisfaction, as well as among resourcefulness, quality of life, and life satisfaction. The results of this study emphasized the importance of assessing depressive symptoms and PPF in mothers early in the postpartum period. The results may contribute to designing future intervention studies aimed toward decreasing the risk of mothers with PPF developing more serious depressive symptoms.

Construction and Evaluation of a Rat Model of Postpartum Fatigue.

OBJECTIVES: The aim of the study was to construct and evaluate a rat model of postpartum fatigue. DESIGN: This is an article about animal model building. METHODS: Sprague-Dawley rats on the 1st day after delivery were randomized into control group and fatigue group. The deep sleep of rats was interfered with by forcing them to stand in water, to make the rats experience mental and physical fatigue. 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 model was evaluated from mental and physical fatigue on the 8th day and 15th day. The mental fatigue was evaluated by a water maze test and the rat's 5-hydroxytryptamine (5-HT) level in hippocampus, while the physical fatigue was evaluated using lactic acid level in serum and duration of weight-loaded forced swimming. RESULTS: Among the 7-day and 14-day modeling groups, compared with the control group, the success rate of water maze landing was significantly decreased, the time for water maze landing was significantly prolonged and 5-HT level in hippocampus significantly decreased in the fatigue group. With respect to physical fatigue, among the 7-day and 14-day modeling groups, the lactic acid level in serum in the fatigue group was significantly increased, and the duration of exhaustive swimming of rats was significantly shortened. LIMITATIONS: A small sample size was the main limitation of this study. CONCLUSIONS: We have successfully constructed a rat model of postpartum fatigue by forcing postpartum rats to stand in water, which was similar to a level of stress that contributes to the development of postpartum fatigue. Our model opens the door for future studies evaluating the effectiveness of pharmacological and behavioral therapies.

Factors Influencing Quality of Life in Early Postpartum Women.

Postpartum women experience various changes in their physical and psychological health and in their relationships with their spouse and newborn. This study aimed to identify and evaluate the factors that affect the quality of life (QoL) of women within six weeks after childbirth. A prospective, cross-sectional correlational study was used. A convenience sample of 179 postpartum women was recruited from four postpartum care centers in South Korea. Participants completed structured questionnaires on postpartum fatigue, postpartum depression, marital intimacy, breastfeeding adaptation, and quality of life. Marital intimacy (ß = 0.466, p < 0.001) was the most influencing factor on the QoL of women during the postpartum period. In descending order, postpartum fatigue (ß = -0.192, p = 0.001), postpartum depression (ß = -0.190, p = 0.001), breastfeeding adaptation (ß = 0.163, p = 0.002), and occupation (ß = 0.163, p = 0.004) all had a significant influence on QoL (F = 32.09, p < 0.001), and the overall explanatory power was 63.6%. It is necessary to assess and consider the physical, psychological, relational, and demographic factors of women during the early postpartum period. Comprehensive interventions need to be developed to improve the QoL of women during the postpartum period.

Effects of epidural anesthesia on postpartum maternity blues and fatigue and its relation to changes in oxytocin.

AIMS: This study aimed to clarify (a) the association of the delivery mode (i.e., epidural anesthesia or no epidural) with women's changes in longitudinal salivary oxytocin (OT) levels from late pregnancy to early postpartum, and (b) the association of these changes with postpartum maternity blues (MB) and fatigue. METHODS: We used a longitudinal observational design. We performed measurements of the saliva samples at four measurement points: (a) 36-37 gestational weeks, (b) 38-39 gestational weeks, (c) 1-2 days after birth, and (d) 4-5 days after birth. The inclusion criterion was low-risk primiparous women who were planning to have vaginal delivery. We used Stein's MB scale to evaluate postpartum data and a visual analog scale to examine "postpartum fatigue". We determined the association between the MB/fatigue scores and the changes in the OT levels by Spearman's rank correlation coefficient. RESULTS: There were 29 women who delivered with epidural anesthesia and 29 women who did not. A significantly higher mean salivary OT level was observed in the women with epidural anesthesia at 1-2 days after birth than at 36-37 gestational weeks. The mean OT level at 4-5 days postpartum was significantly lower than that at 1-2 days postpartum. The correlation of the MB score with the salivary OT level at 4-5 days postpartum was ρ = -0.33, p = .01. CONCLUSIONS: Early postpartum OT level decreased with epidural anesthesia and showed a negative correlation with postpartum MB and fatigue. Healthcare providers should recognize that women who had epidural anesthesia need specific supportive care.

Effect of postpartum fatigue on maternal behavior in rats and its mechanism / 中华行为医学与脑科学杂志

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.

The effect of maternal fatigue on breastfeeding.

BACKGROUND: Postpartum fatigue means tiredness, sense of suffocation, and decreased physical and mental capacity. Fatigue reduces postpartum women's ability of concentrate, which may increase the frequency of postpartum depression, and their babies and cause babies' weaning off breastmilk earlier. AIM: Postpartum fatigue reduces the ability of mothers to concentrate and has a negative effect on communication between mothers and their babies. This study was performed to determine the effect of fatigue on breastfeeding and breastfeeding behaviors in postpartum women. SUBJECTS AND METHODS: The study had a descriptive desing and was carreid out in a postpartum clinic of a maternal, obstetric, and pediatric diseases hospital. It included 374 women giving normal vaginal birth. Data were gathered with a socio-demographic features form and Visual Analogue Scale for Fatigue. RESULTS: The mean score was 6,91 ± 2,25 for the subscale fatigue and 2,38 ± 0,91 for the subscale energy. The women reporting that it was not difficult to give birth and that they had little or some fatigue had significantly higher scores for energy (P = 0.001). The women starting to breastfeed in the hour of giving birth (P = 0.003) and the women breastfeeding at 1-hour intervals (P = 0.100) had a lower score for fatigue. The women not needing help while breastfeeding had a significantly lower score for fatigue (P = 0.001), while those reporting to give additional food had a significantly higher score for fatigue (P = 0.014). CONCLUSION: Women feel tired in the early postpartum period due to giving birth and their tiredness is increased by breastfeeding and infant care.

Factors associated with maternal postpartum fatigue: an observationalstudy.

OBJECTIVES: To assess the prevalence of postpartum fatigue at 10 days, 1 month and 3 months, and to describe the sociodemographic and clinical characteristics of women with fatigue and the associations with infant characteristics, maternal-infant attachment, and partner and midwifery support. SETTING: Maternity care in England. Secondary analysis of 2014 National Maternity Survey. PARTICIPANTS: Participants were a random sample of 10 000 women selected by the Office for National Statistics using birth registration records. Women aged less than 16 years or if their baby had died were excluded. Questionnaires were sent to women at 3 months post partum and asked about well-being and care during pregnancy, labour, birth and post partum. Specifically, women were asked whether they experienced fatigue/severe tiredness at 10 days, 1 month or 3 months post partum. Responses were received from 4578 women (47% response rate). RESULTS: Decreasing but substantial proportions of women, 38.8%, 27.1% and 11.4%, experienced fatigue/severe tiredness at 10 days, 1 month and 3 months, respectively. These figures varied significantly by maternal age, level of deprivation, education and parity. Women reporting depression, anxiety, sleep problems and those breast feeding were at significantly increased risk (eg, OR for depression in women with fatigue at 3 months: 2.99 (95% CI 2.13 to 4.21)). Significantly more negative language was used by these women to describe their babies, and they perceived their baby as more difficult than average (eg, two or more negative adjectives used by women with fatigue at 3 months: OR 1.86 (95% CI 1.36 to 2.54)). Women with postpartum fatigue had greater partner support but were significantly less likely to report seeing the midwife as much as they wanted. CONCLUSIONS: Postpartum fatigue is not inevitable or universal, although early in the postnatal period it affects a substantial proportion of women. Predictors include age and parity, but practical help and support from partners and midwives may be protective factors.

Analysis of the impact of postpartum fatigue on the onset of lactation / 中华护理杂志

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.

Study of the Impact of Educational Behavioral Interventions on Fatigue in Mothers in the Postpartum Period in the Groups of Face-to-Face and Electronic Training.

BACKGROUND: Maternal fatigue in the postpartum period include factors that affect the quality of life and health of both the mother and newborn. This study aimed to investigate two educational approaches regarding mother's fatigue in the postpartum period. MATERIALS AND METHODS: This experimental study was performed among 110 pregnant mothers during their postpartum care using random sampling. The participants were divided in three groups, namely, face-to-face, e-learning, and control groups. Interventions included individual meetings between the researcher and mothers in the face-to-face group and giving educational compact disc to the e-learning department to improve maternal fatigue. Personal information and fertility data was obtained (before training); the maternal fatigue questionnaire Fatigue Severity Scale (FSS) was completed before and after any type of (face-to-face, e-learning, and control) education. Obtained data were analyzed using one-way analysis of variance (ANOVA) and repeated-measures ANOVA. RESULTS: Results showed that both face-to-face and e-learning methods had similar maternal fatigue scores. The average change on the maternal fatigue score in the second treatment was (p = 0.02) and the third treatment was (p < 0.001)among three groups that was indicative of significant statistical differences. Similarly, there was no statistically significant difference in the average maternal fatigue score between the two groups before the intervention and in the second and third groups after the intervention. Therefore, over time, the training was unaffected. CONCLUSIONS: The findings of this study indicate that both face-to-face and e-learning methods are effective to reduce maternal postpartum fatigue.