Postnatal

产后
  • 文章类型: Journal Article
    自杀是25-44岁男性死亡的主要原因,通常与成为父亲相吻合的年龄。这篇综述旨在综合围产期父亲自杀和自残观念流行的证据,产后和早期育儿期。
    搜索了五个数据库(PsycINFO,Medline,WebofScience,PubMed和Cochrane系统评论数据库),以确定2000年1月1日至2023年3月9日之间发表的论文。在纳入的研究中,进行了荟萃分析以估计自杀和自残观念的患病率。进行亚组和敏感性分析以探索异质性的潜在来源。
    共确定了4215篇文章,14项研究纳入审查。自杀和自残观念的合并患病率为4.2%(95%CI[2.6%,6.2%])。自残观念的患病率估计值更高,为5.1%(95%CI[2.6%,6.2%])比3%的自杀率(95%CI[0.9%,6.1%])。
    这项审查发现,相当比例的父亲在养育子女的早期经历过自杀和自残的想法。然而,缺乏严格的患病率研究表明,迫切需要在这一领域进行进一步的研究。
    UNASSIGNED: Suicide is a leading cause of death in males aged 25-44 years, an age which often coincides with becoming a father. This review aims to synthesise the evidence of the prevalence of suicidal and self-harm ideation in fathers during the perinatal, postnatal and early parenting period.
    UNASSIGNED: Five databases were searched (PsycINFO, Medline, Web of Science, PubMed and the Cochrane Database of Systematic Reviews) to identify papers published between 1 January 2000 and 9 March 2023. A meta-analysis was conducted to estimate the prevalence of suicidality and self-harm ideation across the included studies. Subgroup and sensitivity analyses were conducted to explore potential sources of heterogeneity.
    UNASSIGNED: A total of 4215 articles were identified, with 14 studies included in the review. The combined pooled prevalence of suicidal and self-harm ideation was 4.2% (95% CI [2.6%, 6.2%]). Prevalence estimates were higher for self-harm ideation at 5.1% (95% CI [2.6%, 6.2%]) than for suicidality at 3% (95% CI [0.9%, 6.1%]).
    UNASSIGNED: This review found that a considerable proportion of fathers experience suicidal and self-harm ideation during the early years of parenting. However, the paucity of rigorous prevalence studies indicates that further research in this area is needed urgently.
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  • 文章类型: Journal Article
    背景:分娩教育,在Salutogenesis的支持下,提出了孕产妇保健的范式转变。目前没有关于接受过Salutary分娩教育的妇女的产妇经历的信息。
    目的:本研究旨在深入探究女性的妊娠状况,参加“Salutary分娩教育计划”的出生和产后经历,并阐明了Salutogeness促进孕产妇健康的机制。
    方法:对15名母亲进行了描述性定性研究。这项研究是在2023年4月至10月期间进行的。数据是通过半结构化、深入的个人纵向访谈,涵盖所有产妇期。进行了专题分析。
    结果:女性表示,她们“获得了以正常为导向的观点”,这提供了“对这一时期的积极意义”和“摆脱了对风险焦点的关注”。妇女经历了这一过程的自然性,并处于流动之中。他们描述说,他们“意识到自己的内部资源”,并获得了“资源建设技能”和“管理时期的能力”。除了获得的自主权之外,“情感力量”和“自己的投资能力”为他们提供了一种积极参与经验的力量。
    结论:本研究探讨了参加Salutary分娩教育计划的妇女的经历,并描述了该计划的组成部分对其经历的机制。通过这样做,它的目的是增进对医疗保健专业人员如何通过使用Salutogenesis模型提供有效的分娩教育的理解。
    作者要感谢并感谢参加教育计划并愿意接受采访的女性。
    BACKGROUND: Childbirth education, underpinned by Salutogenesis, presents a paradigm shift in maternal care. There was no present information about the maternal experiences of women who had received Salutary childbirth education.
    OBJECTIVE: The present study aimed to deeply explore women\'s pregnancy, birth and postnatal experiences who attended the \'Salutary Childbirth Education Program\' and shed light on the mechanisms of Salutogenesis on maternal health promotion.
    METHODS: A descriptive qualitative study was conducted with 15 mothers. The study was conducted during April-October 2023. Data were obtained through semi-structured, in-depth individual longitudinal interviews to cover all maternal periods. A thematic analysis was performed.
    RESULTS: Women stated that they \'acquired normality oriented perspective\' which provides \'attribution of positive meanings to the period\' and \'freedom from their risk focus concerns\'. Women experienced the naturality of the process and were in the flow. They described that they became \'aware of their internal resources\', and gained \'skills for the construction of resources\' and \'ability to manage the period\'. The \'emotional strength\' and \'Investment ability for themselves\' in addition to obtained autonomy provided them a feeling of strength to actively engage in their experience.
    CONCLUSIONS: This study explores the experiences of women who participated in the Salutary Childbirth Education Program and describes the mechanisms of the program\'s components on their experiences. By doing so, it aims to enhance understanding of how healthcare professionals can present effective childbirth education through the use of the Salutogenesis Model.
    UNASSIGNED: The authors would like to acknowledge and thank the women who attended the education program and were willing to interview.
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  • 文章类型: Journal Article
    背景:COVID-19检测呈阳性与有害的心理社会和身体健康结局的发生率更高相关。COVID-19大流行对日常生活造成了前所未有的破坏。这包括孕产妇的重大重新配置,孩子,以及围产期心理健康和护理服务和提供。这项研究旨在调查那些在怀孕期间检测出COVID-19阳性的人的经历,分娩和分娩,或产后早期。
    方法:来自英国各地的全国在线招聘导致16位母亲被邀请参加定性半结构化面试,以了解怀孕期间感染COVID-19的母亲的经历,分娩和分娩,或产后早期。进行了访谈,记录,并使用视频会议软件转录。采用扎根理论方法分析了女性在怀孕期间对COVID-19诊断阳性的经历所收集的数据,分娩和分娩,或产后早期。
    结果:提出了“振荡自治-通过争取代理失去并寻求重新获得控制权”的理论,包括三个主要主题:“焦虑的预期:对感染的恐惧比COVID-19本身更糟糕”;“波动机构:当COVID-19控制时发生了什么变化”;“回收控制:在COVID-19阳性期间寻求安慰”。怀孕期间COVID-19检测呈阳性,在分娩或分娩期间,或在产后早期与感知到的失控有关。那些能够重新获得控制权的人在他们的处境中感到更加安全。
    结论:支持对于管理增加的漏洞至关重要,通过寻求信息和采取积极行动,包括增加健康监测和COVID-19疫苗接种,也获得了安慰。
    BACKGROUND: Testing positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The COVID-19 pandemic caused unprecedented disruption to everyday life. This included major reconfiguration of maternal, child, and perinatal mental health and care services and provision. This study aimed to investigate the experiences of those who tested positive for COVID-19 during pregnancy, labour and birth, or the early postnatal period.
    METHODS: National on-line recruitment from across the United Kingdom resulted in sixteen mothers being invited to qualitative semi-structured interviews to understand the experiences of mothers who had been infected by COVID-19 during pregnancy, labour and birth, or the early postnatal period. Interviews were conducted, recorded, and transcribed using video-conferencing software. A Grounded Theory approach was used to analyse the data gathered pertaining to women\'s experiences of their positive COVID-19 diagnosis during pregnancy, labour and birth, or the early postnatal period.
    RESULTS: The theory of \'Oscillating Autonomy - Losing and Seeking to Regain Control by Striving for Agency\' was developed, comprising three main themes: \'Anxious Anticipation: The fear of infection was worse than COVID-19 itself\'; \'Fluctuating Agency: What changed when COVID-19 took control\'; and \'Reclaiming Control: Seeking reassurance during COVID-19 positivity\'. Testing positive for COVID-19 whilst pregnant, during labour or birth, or in the early postnatal period was associated with a perceived loss of control. Those who were able to regain that control felt more secure in their situation.
    CONCLUSIONS: Support was paramount to manage increased vulnerability, as was reassurance achieved by information seeking and positive action including increased health monitoring and COVID-19 vaccination.
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  • 文章类型: Journal Article
    由于缺乏提供者和/或资源,在围产期寻求护理的妇女通常会在医疗机构面临延误或长时间等待。导致次优结果。我们实施了一项计划,使有问题的患者可以几乎从助产士那里接受当日护理,而不是到诊所或医院接受护理。实施策略包括虚拟培训,患者体积的阶段性增加,助产士之间通过文本频繁交流,电子邮件,每月的会议。虚拟访问包括各种投诉,最常见的五个是建立护理,妊娠早期出血,恶心和呕吐,心理健康问题,和产后乳房问题。在前6个月中,虚拟访问增加了三倍,92%的患者不需要紧急面对面随访。助产士能够提供高质量的远程医疗服务,以满足患者的需求,并减少对医院服务的需求。随着手机和互联网的普及,这种策略可能有效地提供优质护理,同时降低对物理基础设施的需求。需要更多的研究来评估在其他情况下的可接受性。如果妇女无法在电话或笔记本电脑上进行视频会议,则资源匮乏的环境中的可重复性可能会受到限制。
    Women seeking care during the perinatal period often face delays or long waits at healthcare facilities due to lack of providers and/or resources, leading to sub-optimal outcomes. We implemented a program whereby patients with concerns could receive same-day care virtually from a midwife rather than presenting to the clinic or hospital for care. Implementation strategies included virtual training, a staged increase in patient volume, and frequent communication between the midwives via text, email, and monthly meetings. Virtual visits included a variety of complaints, the five most common being to establish care, first-trimester bleeding, nausea and vomiting, mental health concerns, and postnatal breast problems. There was a threefold increase in virtual visits during the first 6 months with 92% of patients not requiring urgent face-to-face follow-up. Midwives were able to provide high-quality telehealth care that met the patients\' needs and decreased the demand on hospital-based services. With the growing ubiquity of mobile phones and internet access, this strategy may be effective in providing quality care while decreasing demands on physical infrastructure. More research is needed to assess acceptability in other contexts. Reproducibility in low-resource settings may be limited if women lack access to video conferencing on phones or laptops.
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  • 文章类型: Journal Article
    目的:患有持续性精神分裂症和相关疾病的孕妇可能需要持续的抗精神病药物治疗,包括氯氮平.然而,孕期和产后使用氯氮平的潜在风险仍不确定.
    方法:我们使用国家妊娠期抗精神病药物注册(NRAMP)数据库进行了嵌套病例对照研究。我们的研究评估了诊断为精神分裂症谱系障碍并在妊娠早期接受氯氮平治疗的澳大利亚女性(n=14)的妊娠结局。将这些妇女与两个亚组进行比较:在怀孕期间接受喹硫平治疗的妇女(n=53)和未服用任何药物的妇女(n=24)。
    结果:我们观察到与喹硫平和无药组相比,氯氮平组的流产率更高。与其他组相比,氯氮平组的早期妊娠体重指数较高,但总体妊娠体重增加较低。氯氮平组妊娠期糖尿病的患病率明显较高。氯氮平组的阴道分娩百分比高于其他两组。新生儿结局,如胎龄,两组的Apgar评分相似。氯氮平组的出生体重低于其他两组。
    结论:这项研究表明,与其他组相比,服用氯氮平的孕妇及其婴儿的不良结局更大。氯氮平似乎与更大的流产风险有关,孕妇妊娠期糖尿病,低出生体重。然而,胎龄,阿普加得分,和入院NICU/SCN在所有组之间具有可比性。
    OBJECTIVE: Pregnant women with persistent schizophrenia and related disorders may require ongoing antipsychotic treatment, including clozapine. However, the potential risks of using clozapine during pregnancy and the postnatal period remain uncertain.
    METHODS: We conducted a nested case-control study using the National Register of Antipsychotic Medication in Pregnancy (NRAMP) database. Our study assessed pregnancy outcomes among Australian women diagnosed with schizophrenia spectrum disorder and treated with clozapine (n = 14) during the first trimester. These women were compared to 2 subgroups: those treated with quetiapine (n = 53) and those not taking any medication (n = 24) during pregnancy.
    RESULTS: We observed higher rates of miscarriage in the clozapine group compared to the quetiapine and drug-free groups. The clozapine group had a higher early pregnancy body mass index but lower overall pregnancy weight gain than the other groups. The prevalence of gestational diabetes was significantly higher in the clozapine group. The percentage of vaginal delivery was higher in the clozapine group than in the other 2 groups. Neonatal outcomes such as gestational age, and Apgar scores were similar across groups. The birth weight was lower in the clozapine group compared to the other 2 groups.
    CONCLUSIONS: This study suggests that pregnant women taking clozapine and their babies have greater adverse outcomes compared to other groups. Clozapine appears to be associated with a greater risk of miscarriages, maternal gestational diabetes, and lower birth weight. However, the gestational age, Apgar scores, and admission to NICU/SCN were comparable between all groups.
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  • 文章类型: Journal Article
    这里,通过证明有丝分裂后肠神经元(EN)的神经支配潜力,我们确定可塑性存在于出生后肠神经系统中。使用BAF53b-Cre小鼠进行选择性神经元示踪,在多个模型系统中显示了成熟的产后EN的神经支配能力。分离的ENs在体外再生神经突,神经突复杂性和方向受与肠胶质细胞(EGC)接触的影响。来自移植EN的神经纤维仅与固有肌层内的EGC连接并沿着EGC传播。居民EGCs在Cre依赖性ENs消融后持续存在,并控制肠肌间神经丛的结构以恢复ENs的神经,如神经纤维投影追踪所示。体内移植和光遗传学实验突出了有丝分裂后神经元的快速神经支配潜力,导致2周内恢复肠道肌肉收缩活动。这些研究说明了有丝分裂后ENs的结构和功能神经支配能力以及EGC在引导和图案化其轨迹中的关键作用。
    Here, we establish that plasticity exists within the postnatal enteric nervous system by demonstrating the reinnervation potential of post-mitotic enteric neurons (ENs). Employing BAF53b-Cre mice for selective neuronal tracing, the reinnervation capabilities of mature postnatal ENs are shown across multiple model systems. Isolated ENs regenerate neurites in vitro, with neurite complexity and direction influenced by contact with enteric glial cells (EGCs). Nerve fibers from transplanted ENs exclusively interface and travel along EGCs within the muscularis propria. Resident EGCs persist after Cre-dependent ablation of ENs and govern the architecture of the myenteric plexus for reinnervating ENs, as shown by nerve fiber projection tracing. Transplantation and optogenetic experiments in vivo highlight the rapid reinnervation potential of post-mitotic neurons, leading to restored gut muscle contractile activity within 2 weeks. These studies illustrate the structural and functional reinnervation capacity of post-mitotic ENs and the critical role of EGCs in guiding and patterning their trajectories.
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  • 文章类型: Journal Article
    空气污染(AP)暴露与许多神经发育和精神疾病有关,包括自闭症谱系障碍,注意缺陷多动障碍和精神分裂症,从生命早期到青春期后期/成年早期的所有男性偏见疾病。虽然先前的实验研究集中在早期大脑发育过程中AP暴露的影响,大脑发育实际上一直延伸到成年早期。目前对小鼠的研究试图扩大对青春期发育大脑脆弱性的理解,大脑发育和成熟到AP的超细颗粒(UFP)成分的后期但重要的时期,被认为是其最具反应性的成分。此外,它检查了青少年对UFP的反应,确定影响的轨迹和潜在的增强或缓解不利后果。结果集中在与多种神经发育障碍相关的共同特征上。为此,将两种性别的C57Bl/6J小鼠暴露于环境浓缩的UFP或来自PND(出生后第4-7天)和PND10-13的过滤空气,并再次暴露于PND39-42和45-49,导致每个性别3个暴露于出生后/青少年治疗组:空气/空气,空气/UFP,和UFP/UFP。在PND50检查了神经发育障碍的常见特征。出生后暴露的质量暴露浓度平均为44.34μg/m3,青少年暴露平均为49.18μg/m3。男性大脑在青春期对UFP暴露表现出特别的脆弱性,额叶皮质和纹状体谷氨酸能和色氨酸/5-羟色氨酸能神经递质的改变,以及call体星形胶质细胞水平和血清细胞因子水平的同时降低,联合暴露导致call体髓鞘形成和血清皮质酮显著减少。男性血清皮质酮的降低与神经递质水平的降低相关,纹状体谷氨酸能功能的减少与call体星形胶质细胞的减少特别相关。UFP诱导的男性神经递质水平的变化通过先前的产后暴露得到缓解,暗示潜在的适应性,而出生后和青少年联合暴露进一步加强了皮质酮和call体神经病理效应的降低。UFP引起的女性变化主要发生在纹状体多巴胺系统中,而血清细胞因子的减少仅是对产后和青少年联合暴露的反应。男性的研究结果强调了对神经毒性机制进行更综合的生理评估的重要性。Further,这些发现为越来越多的将空气污染与神经发育和精神疾病联系起来的流行病学文献提供了生物学上的合理性.因此,他们支持需要考虑对UFP空气污染组成部分的监管。
    Air pollution (AP) exposures have been associated with numerous neurodevelopmental and psychiatric disorders, including autism spectrum disorder, attention deficit hyperactivity disorder and schizophrenia, all male-biased disorders with onsets from early life to late adolescence/early adulthood. While prior experimental studies have focused on effects of AP exposures during early brain development, brain development actually extends well into early adulthood. The current study in mice sought to extend the understanding of developmental brain vulnerability during adolescence, a later but significant period of brain development and maturation to the ultrafine particulate (UFPs) component of AP, considered its most reactive component. Additionally, it examined adolescent response to UFPs when preceded by earlier developmental exposures, to ascertain the trajectory of effects and potential enhancement or mitigation of adverse consequences. Outcomes focused on shared features associated with multiple neurodevelopmental disorders. For this purpose, C57Bl/6 J mice of both sexes were exposed to ambient concentrated UFPs or filtered air from PND (postnatal day) 4-7 and PND10-13, and again at PND39-42 and 45-49, resulting in 3 exposure postnatal/adolescent treatment groups per sex: Air/Air, Air/UFP, and UFP/UFP. Features common to neurodevelopmental disorders were examined at PND50. Mass exposure concentration from postnatal exposure averaged 44.34 μg/m3 and the adolescent exposure averaged 49.18 μg/m3. Male brain showed particular vulnerability to UFP exposures in adolescence, with alterations in frontal cortical and striatal glutamatergic and tryptophan/serotonergic neurotransmitters and concurrent reductions in levels of astrocytes in corpus callosum and in serum cytokine levels, with combined exposures resulting in significant reductions in corpus callosum myelination and serum corticosterone. Reductions in serum corticosterone in males correlated with reductions in neurotransmitter levels, and reductions in striatal glutamatergic function specifically correlated with reductions in corpus callosum astrocytes. UFP-induced changes in neurotransmitter levels in males were mitigated by prior postnatal exposure, suggesting potential adaptation, whereas reductions in corticosterone and in corpus callosum neuropathological effects were further strengthened by combined postnatal and adolescent exposures. UFP-induced changes in females occurred primarily in striatal dopamine systems and as reductions in serum cytokines only in response to combined postnatal and adolescent exposures. Findings in males underscore the importance of more integrated physiological assessments of mechanisms of neurotoxicity. Further, these findings provide biological plausibility for an accumulating epidemiologic literature linking air pollution to neurodevelopmental and psychiatric disorders. As such, they support a need for consideration of the regulation of the UFP component of air pollution.
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  • 文章类型: Journal Article
    早产有身体后果,例如较低的出生体重,肌肉质量下降,成人发病代谢性疾病的风险增加。胰岛素样生长因子1(IGF-1)具有改善早产的肌肉和肌腱生长和质量的治疗潜力,从而削弱了这些后遗症中的一些。我们研究了IGF-1对早产仔猪的radi腕伸肌和肱二头肌肌腱的影响。早产组由19日龄早产(提前10天)仔猪组成,用IGF-1或媒介物治疗。足月对照包括9日龄仔猪(D9)和19日龄仔猪(D19)的组。通过免疫荧光分析肌肉样品以确定肌肉纤维的横截面积(CSA),纤维类型成分,卫星细胞含量和肌肉中含有中央细胞核的纤维。分析了肌腱样本的CSA,胶原蛋白含量和成熟度,和血管化。通过RT-qPCR测量肌腱的基因表达。在所有端点中,我们发现IGF-1治疗对早产仔猪没有显著影响.与D9和D19对照组相比,早产仔猪的肌纤维CSA较小。所有组的卫星细胞含量相似。对于肌腱,我们发现年龄对肌腱CSA有影响,和COL1A1,腱调节素和巩膜的mRNA水平。弹性蛋白和CD31的免疫反应性,以及肌腱成熟的几种标志物,与早产仔猪相比,D9增加。各组的胶原含量相似。IGF-1治疗早产仔猪不影响骨骼肌和肌腱的生长和成熟。
    Prematurity has physical consequences, such as lower birth weight, decreased muscle mass and increased risk of adult-onset metabolic disease. Insulin-like growth factor 1 (IGF-1) has therapeutic potential to improve the growth and quality of muscle and tendon in premature births, and thus attenuate some of these sequalae. We investigated the effect of IGF-1 on extensor carpi radialis muscle and biceps brachii tendon of preterm piglets. The preterm group consisted of 19-day-old preterm (10 days early) piglets, treated with either IGF-1 or vehicle. Term controls consisted of groups of 9-day-old piglets (D9) and 19-day-old piglets (D19). Muscle samples were analysed by immunofluorescence to determine the cross-sectional area (CSA) of muscle fibres, fibre type composition, satellite cell content and central nuclei-containing fibres in the muscle. Tendon samples were analysed for CSA, collagen content and maturation, and vascularization. Gene expression of the tendon was measured by RT-qPCR. Across all endpoints, we found no significant effect of IGF-1 treatment on preterm piglets. Preterm piglets had smaller muscle fibre CSA compared to D9 and D19 control group. Satellite cell content was similar across all groups. For tendon, we found an effect of age on tendon CSA, and mRNA levels of COL1A1, tenomodulin and scleraxis. Immunoreactivity for elastin and CD31, and several markers of tendon maturation, were increased in D9 compared to the preterm piglets. Collagen content was similar across groups. IGF-1 treatment of preterm-born piglets does not influence the growth and maturation of skeletal muscle and tendon.
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  • 文章类型: Journal Article
    怀孕和分娩涉及大量的身体,生理和心理变化。因此,产后橄榄球运动员应该得到支持,并做好适当的准备,以恢复橄榄球的需求以及母亲的额外需求。这篇综述旨在讨论围产期的具体考虑因素,这些因素为橄榄球运动员产后重返运动做好准备,并提出一种康复方法。在进行全面的橄榄球训练和比赛之前,产后运动员应该已经通过康复和分级运动特定训练的初始阶段取得进展,以使他们为将要承受的负荷做好准备。其他康复考虑因素包括最大限度地减少怀孕期间的营养;医疗问题;腹壁;盆底;围产期乳房变化,母乳喂养和接触乳房损伤的风险;体重;营养需求;激素考虑;运动员身份和心理考虑;加入团队训练;返回接触和解决训练;评估球员负荷耐受性和未来的研究,政策和监督需求。一个完整的系统,在恢复产后橄榄球运动员时,建议采用有证据的重返运动框架后的生物心理社会方法。鼓励健康和运动专业人员使用本综述中针对围产期的建议来指导产后康复方案和资源的开发。
    Pregnancy and childbirth involve substantial physical, physiological and psychological changes. As such, postpartum rugby players should be supported and appropriately prepared to return to the demands of rugby alongside the additional demands of motherhood. This review aims to discuss specific perinatal considerations that inform a rugby player\'s readiness to return-to-sport postpartum and present an approach to rehabilitation. Before engaging in full rugby training and matchplay, postpartum players should have progressed through the initial phases of rehabilitation and graded sports-specific training to prepare them for the loads they will be exposed to. Additional rehabilitation considerations include minimising deconditioning during pregnancy; medical concerns; the abdominal wall; the pelvic floor; perinatal breast changes, breastfeeding and risk of contact breast injury; body mass; nutritional requirements; hormonal considerations; athlete identity and psychological considerations; joining team training; return to contact and tackle training; evaluating player load tolerance and future research, policy and surveillance needs. A whole-systems, biopsychosocial approach following an evidence informed return-to-sport framework is recommended when rehabilitating postpartum rugby players. Health and exercise professionals are encouraged to use the perinatal-specific recommendations in this review to guide the development of postpartum rehabilitation protocols and resources.
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  • 文章类型: Journal Article
    背景:产前和产后抑郁症(PND)与母亲的不良结局有关,胎儿,和孩子。研究的目的是检查产前和产后抑郁症状的患病率和危险因素。
    方法:这是一项针对2305名孕妇和产后妇女(18-48岁)的横断面和基于医院的调查,该调查于2020年6月至2021年3月在巴博尔妊娠心理健康登记(BPMHR)数据库中注册。两份问卷,包括人口统计学和抑郁症,在这项研究中进行了分析。此外,采用Edinburg产后抑郁量表(EPDS)评估抑郁症状.采用独立t检验和方差分析比较均数。使用多重逻辑回归来确定抑郁症状的危险因素。
    结果:根据EPDS量表,与产后期间相比,孕妇组抑郁症状的患病率为19.8%(11.6%)。产前抑郁症状的危险因素为胎次(胎次≥4的女性与1奇偶校验,β=1.808,P=0.020),两组胎龄(胎龄≤12周vs.28周,β=1.562P=0.030)以及(胎龄21-27周与28周(β=1.586,P=0.033),和高风险怀孕(高风险与低风险怀孕,β=1.457,P=0.003)。对于产后抑郁症状,这些因素均无显著风险.
    结论:应筛查产前和产后抑郁症状,特别是对于妇女在第一和第二三个月,具有高奇偶校验,那些有高风险怀孕的人,根据本研究的建议。
    BACKGROUND: Prenatal and postnatal depression (PND) is associated with adverse outcomes for mother, fetus, and child. The aim of study was to examine the prevalence and risk factors of prenatal and postnatal depressive symptoms.
    METHODS: This was a cross-sectional and hospital-based survey of 2305 pregnant women and post-partum women (18-48 years) that was registered in the Babol Pregnancy Mental Health Registry (BPMHR) database from June 2020 to March 2021. Two questionnaires, including demographics and depression, were analyzed in this study. Also, the Edinburg Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Independent t test and the analysis of variance were used to compare the means. Multiple logistic regressions were used to determine risk factors for depressive symptoms.
    RESULTS: According to the EPDS scale, the prevalence of depressive symptoms was 19.8% in the pregnant woman group in comparison with the postpartum period (11.6%). Risk factors for antenatal depressive symptoms were parity (women with parity ≥ 4 vs. 1 parity, ß=1.808, P=0.020), two groups of gestational age (gestational age ≤12 weeks vs. 28 weeks, ß=1.562 P=0.030) as well as (gestational age 21-27 weeks vs. 28 weeks (ß=1.586, P=0.033), and high-risk pregnancy (high-risk vs. low-risk pregnancy, ß=1.457, P=0.003). For postnatal depressive symptoms, none of the factors were a significant risk.
    CONCLUSIONS: Prenatal and postnatal depressive symptoms should be screened, particularly for women in the first and second trimesters, with high parity, and those with a high-risk pregnancy, as recommended by the present study.
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