Objective To investigate the related demographic and obstetrical factors of postpartum depressive symptoms.Methods The study was carried out in four hospitals selected by stratified sampling in Changsha city.The 320 nullipara women who met the designed including criteria at 6 weeks postpartum were recruited by cluster sampling from the four hospital.Three hundred and twenty nullipara women were assessed by using Edinburgh Postpartum Depression Scale(EPDS),self-designed demographic and obstetrical factors questionnaires.Results The study showed that the careers like cadre and clerisy were demographic risk factors(P=0.011,OR=0.886).There were four obstetrical risk factors,including assisted reproductive technology(ART)(P=0.005,OR=4.585),the time of the first stage of labor(P=0.024,OR=2.269),instrumental delivery(P=0.000,OR=49.767),and birth defect(P=0.000,OR=28.386).The normal delivery was a protective factor(P=0.003,OR=0.151).Conclusion Multiple factors are involved in the incidence of postpartum depression.Preventive intervention should be taken actively to prevent against postpartum depression.

Objective:To determine associations between postpartum depression (PPD) and plasma neurotransmitters.Methods:We conducted a case-control study nested to a prospective cohort established in 3 comprehensive tertiary hospitals in Changsha,Hunan,China from February to September 2007.The Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was used at 2 weeks postpartum to screen PPD,with a score of 13 or higher as the cut-off for PPD.The women with matched age but without PPD and delivery within 5 years were selected as controls.The levels of plasma monoamine neurotransmitters including serotonin (5-hydroxytryptamine,5-HT),dopamine (DA),and norepinephrine (NE),and peptide neurotransmitters including neuropeptide Y (NPY) and substance P (SP) in maternal blood samples taken at 2 weeks postpartum were measured and compared between PPD women (n=42) and controls (n=42).Results:Plasma levels of 5-HT and NPY were significantly lower while plasma levels of NE and SP were significantly higher in PPD women than those in the controls.For women with PPD,a negative correlation between NPY and NE (r=-0.36,P＜0.05) was observed.Conclusion:There are changes in plasma levels of neurotransmitters in women with PPD,and there are potential interactions between different neurotransmitters.

OBJECTIVE: A proportion of elective repeated cesarean sections where a trial of labor in a uterus with a previous scar was not attempted is on the increase. This study aimed to assess how reduced the use of trial of labor has impacted on neonatal outcomes in the United States. METHODS: Pregnant women with one previous cesarean delivery and a singleton live birth of the index pregnancy were abstracted from the 1995 to 2002 birth registration data of the United States. Adjusted odds ratios for adverse neonatal outcomes of trial of labor were estimated by multiple logistic regression models, in overall study subjects and in the two periods with high and low rates of trial of labor. RESULTS: A total of 1833407 eligible subjects were included in the analysis. Rate of trial of labor after one previous cesarean section dropped from 38.5% in 1995 to 15.0% in 2002. No significant change was observed in the patient population profile. Successful vaginal birth after cesarean delivery (VBAC) also declined from 76.6% in 1995 to 66.0% in 2002. A trial of labor after one previous cesarean section was correlated with increased risks of asphyxia-related neonatal death and neonatal morbidity. This risk was even more pronounced in low risk women and in the last study years with the lowest rate of trial of labor. CONCLUSION The reduced use of trial of labor after one cesarean delivery in recent years in the United States has actually resulted in increased risk of adverse neonatal outcomes associated with a trial of labor.
Adult ; Asphyxia Neonatorum ; epidemiology ; etiology ; Cesarean Section, Repeat ; Female ; Humans ; Infant Mortality ; Infant, Newborn ; Pregnancy ; Trial of Labor ; United States ; epidemiology ; Vaginal Birth after Cesarean ; adverse effects ; statistics & numerical data ; Young Adult

OBJECTIVE: It is uncertain whether preeclampsia (PE) is caused by pre-existing factors or by pregnancy itself. We want to answer this important question in public health by conducting a large pre-conception cohort in China. METHODS: A prospective and pre-conception cohort study with a target recruitment of 5000 couples who plan to have a baby within 6 months was performed and their conception, delivery, and postpartum were followed up in Liuyang county, Hunan Province of P. R. China. RESULTS: A total of 1915 young couples have been recruited into this unique pre-conception cohort till now. In general, both systolic blood pressure and diastolic blood pressure decreased in early second trimester from pre-conception level but increased in third trimester and at delivery. CONCLUSION The proposed pre-conception cohort study will have important theoretical and practical implications on the prevention of PE and its associated cardiovascular disease risks.
Adult ; Blood Pressure ; physiology ; China ; Female ; Humans ; Pre-Eclampsia ; etiology ; physiopathology ; prevention & control ; Pregnancy ; Pregnancy Complications, Cardiovascular ; physiopathology ; prevention & control ; Prospective Studies ; Young Adult

BACKGROUNDChanging health care providers frequently breaks the continuity of care, which is associated with many health care problems. The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C, D and X drugs.

METHODSA 50% random sample of women who gave a birth in Saskatchewan between January 1, 1997 and December 31, 2000 were chosen for this study. The association between the number of changes in health care providers and with pregnancy exposure to category C, D, and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression, with adjusted odds ratios (ORs) and its 95% confidence intervals (CIs) as the association measures.

RESULTSA total of 18 568 women were included in this study. Rates of FDA C, D, and X drug uses were 14.35%, 17.07%, 21.72%, and 31.14%, in women with no change of provider, 1-2 changes, 3-5 changes, and more than 5 changes of health care providers. An association between the number of changes of health care providers and pregnancy exposure to FDA C, D, and X drugs existed in women without chronic diseases but not in women with chronic disease.

CONCLUSIONChange of health care providers is associated with pregnancy exposure to FDA category C, D and X drugs in women without chronic diseases.

Adult ; Continuity of Patient Care ; Databases, Factual ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; Female ; Health Personnel ; Humans ; Logistic Models ; Pharmaceutical Preparations ; Pregnancy ; drug effects ; Saskatchewan ; United States ; United States Food and Drug Administration