Mothers' Breastfeeding Self-Efficacy after a High-Risk or Normal Pregnancy: A Greek Longitudinal Cohort Study.

BACKGROUND: the objective of this longitudinal study (from pregnancy to the end of the sixth month postpartum) is to elucidate the association between maternal self-efficacy, defined as a mother's confidence in her ability to breastfeed, and breastfeeding outcomes. METHODS: This prospective cohort study was conducted among high-risk pregnant women (including those with conditions such as gestational diabetes, hypertension, pre-eclampsia, and other pathological medical conditions) and normal-risk pregnant women in Greece. The high-risk group included 164 women, while the normal-risk group comprised 154 women. Data were collected using validated psychometric scales, including the Breastfeeding Self-Efficacy Scale-Short Form, State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, Maternal Antenatal Attachment Scale, and Iowa Infant Feeding Attitude Scale. RESULTS: Higher maternal self-efficacy was significantly associated with a longer duration and greater exclusivity of breastfeeding. A statistically significant relationship between the type of breastfeeding and the degree of breastfeeding self-efficacy was observed at multiple postpartum milestones: in the first and third 24 h postpartum, and at the end of the sixth week, third month, and sixth month postpartum. CONCLUSION: The findings underscore the critical role of maternal self-efficacy in breastfeeding success, influenced by individual psychological factors and broader socio-cultural contexts. Strengthening maternal self-efficacy is essential for improving breastfeeding outcomes.

Breastfeeding Intention and Breastfeeding Postpartum Outcomes between High-Risk and Low-Risk Pregnant Women: A Greek Prospective Cohort Study.

BACKGROUND: This prospective cohort study, conducted from pregnancy to six months postpartum and grounded in STROBE methodology, quantitatively explores the relationship between antenatal breastfeeding intentions and subsequent breastfeeding outcomes among high-risk pregnant women, compared to a low-risk pregnancy group. METHODS: The study was conducted in one of the largest public hospitals in Attica that provides care to pregnant women, enrolling 380 participants divided into high-risk (n = 200) and low-risk (n = 180) cohorts. Data were collected over 20 months (starting from the end of May 2020 until January 2022), spanning from pregnancy to six months postpartum, via comprehensive questionnaires. RESULTS: Statistical analysis revealed a pronounced correlation between prenatal breastfeeding intentions and actual breastfeeding behaviors across both groups. Specifically, 81.1% of women in the high-risk group and 82.5% in the low-risk group expressed intentions of exclusively breastfeeding during pregnancy. By six months postpartum, 54.9% of the high-risk and 64.3% of the low-risk pregnancy group managed to sustain breastfeeding. Extended antenatal hospitalization emerged as a statistically significant factor (p = 0.045) negatively impacting exclusive breastfeeding intentions among high-risk pregnancies. CONCLUSION: The findings illuminate the critical influence of antenatal intentions on breastfeeding outcomes, particularly among high-risk pregnancies. Moreover, the study identifies the detrimental effect of prolonged hospital stays on breastfeeding aspirations. These insights underscore the necessity for nuanced, supportive interventions aimed at bolstering breastfeeding rates, thereby advancing maternal and neonatal health objectives aligned with World Health Organization recommendations.

Incidence of Hyponatremia During a Continuous 246-km Ultramarathon Running Race.

Purpose: The purpose of this observational study was to examine the incidence of exercise-associated hyponatremia (EAH) in a 246-km continuous ultra-marathon. Methods: Over 2 years, 63 male finishers of the annual Spartathlon ultra-marathon foot race from Athens to Sparta, Greece were included in the data analysis. A blood sample was drawn from an antecubital vein the day before the race as well as within 15 min post-race and analyzed for sodium concentration. During the second year of data collection, blood was also drawn at the 93-km checkpoint (n = 29). Height and weight were measured pre and post-race. Results: Mean race time of all subjects was 33 ± 3 h with a range of 23.5 and 36.0 h. Of the 63 finishers recruited, nine began the race with values indicative of mild hyponatremia. Seven runners were classified as hyponatremic at the 93-km checkpoint, three of whom had sodium levels of severe hyponatremia. After the race, 41 total finishers (65%) developed either mild (n = 27, 43%) or severe hyponatremia (n = 14, 22%). Mean change in bodyweight percentage and serum sodium from pre-race to post-race was -3.6 ± 2.7% (-2.5 ± 1.9 kg) and -6.6 ± 5.6 mmol·L-1, respectively. Pre-race serum sodium level was not a significant predictor of post-race serum sodium levels (ß = 0.08, R 2 = 0.07, P = 0.698), however, there was a significant negative association between change in bodyweight percentage and post-race serum sodium concentration (ß = -0.79, R 2 = 0.29, P = 0.011). Conclusion: The incidence of EAH of 52 and 65%, when excluding or including these individuals with pre-race hyponatremia, was the highest reported in current literature.

Robotic Management of Endometriosis: Discussion of Use, Criteria and Advantages: a Review of the Literature.

Endometriosis is a very common benign condition affecting fertility and quality of life. Different methods, either definitive or fertility sparing are used for its management by using open, laparoscopic, and robotic techniques. This is a literature review presenting the role and the advantages of robotic surgery in endometriosis. Such a management is effective, safe, and feasible in hands of well-trained multidisciplinary teams even for severe cases of endometriosis.

Infant feeding and professional advice in the first half of the 20th century in Greece.

This study aims to assess the role that health professional and State policies played in shaping breastfeeding practices and attitudes in Greece during the first half of the 20th century. Original texts were used; including those concerned with breastfeeding traditions, health professionals' attitudes to breastfeeding, infant feeding patterns, partial breastfeeding, artificial feeding and State policies for the promotion of breastfeeding. Content analysis was used and breastfeeding rates were considered. In the first two decades of the 20th century, most Greek women breastfed their children, as advised by other experienced women. In the succeeding decades, health professionals and policy makers wrote books and articles praising breastfeeding albeit stressing the nursing mothers' ignorance of sanitary measures. Many health professionals were influenced by trends in developed countries and advocated novel infant feeding practices. Consequently, full breastfeeding was not promoted.

Prevalence and determinants of exclusive breastfeeding during hospital stay in the area of Athens, Greece.

AIM: To assess breastfeeding practices, focusing on the prevalence and the determinants of exclusive breastfeeding during hospital stay. METHODS: A cross-sectional study of 1603 healthy women, who delivered healthy infants weighing more than 2500 g, was conducted in the area of Athens, Greece. Participants completed a self-administered questionnaire on the day they were discharged from the maternity ward. Classification of breastfeeding and recall period from birth to discharge were in accordance with the WHO criteria. Hierarchical logistic regression analysis was used to study determinants of exclusive breastfeeding initiation. RESULTS: Breastfeeding initiation was reported by 96.1% of the participants. However, exclusive breastfeeding was initiated only in 19.1% and predominant breastfeeding in 7.2% of the cases. The univariate analysis showed that maternal younger age, low educational level, unemployment, vaginal delivery, infant birthweight >3000 g, multiparity, early initiation of breastfeeding, rooming-in and awareness on the existence of breastfeeding centres were associated with higher rates of exclusive breastfeeding. Logistic regression analysis revealed that rooming-in (OR 3.72, p<0.01), demand feeding (OR 2.18, p<0.01), type of delivery (OR 1.61, p<0.01) and the source of information received about breastfeeding are more important determinants of exclusive breastfeeding than the socio-demographic parameters. CONCLUSIONS: Exclusive breastfeeding during hospital stay in the area of Athens is low. Demand feeding and rooming-in positively influence exclusive breastfeeding initiation, while caesarean section and information by mass media have a negative impact.