Postpartum depression is a depressive episode that can start at any point during the first year after childbirth. There are several tools that can be used for PPD screening. The need to define a predictive tool that is clinically useful and has acceptable sensitivity and sensitivity is important especially to be used in the primary care setting. This systematic review investigates the evidence of the sensitivity and specificity of screening tools used for PPD screening. The Standard for Reporting of Diagnostic Accuracies (STARD) guidelines were used to conduct the review as a basis for our methodology. PubMed, ScienceDirect and Springerlink databases between 2007 until 2017 were comprehensively searched EPDS and BDI instrument has sensitivity of more than 80% but findings for specificity was inconclusive. The heterogeneity across studies could be the result of methodological differences in validation of the instruments. In addition, these studies were conducted across continents and settings with different cultures, languages and resources. We have identified 5 different instruments used to screen for postpartum depression. The EPDS was the most validated instrument in the review and we found that EPDS and BDI have higher accuracy to screen postpartum depression because the sensitivity reported were more than 80%.

Abstract Introduction: Even though exclusive breastfeeding prevalence has increased from 19.3% in 2006 to 47.1% in 2016, this practice was slightly higher in urban areas (48.3%) compared to rural area (45.1%) in Malaysia. National Plan of Action for Nutrition of Malaysia III has set an indicator to achieve at least 70% exclusive breastfeeding by 2025. Therefore this study is to identify predictors that influenced exclusive breastfeeding practice in rural areas. Methods: This cross-sectional study was conducted in six rural health clinics in Hulu Langat District, Selangor among mothers with youngest child aged 6-48 months old. Respondents were selected through systematic random sampling. Validated self-administered questionnaire was used to assess sociodemographic factors, maternal factors, external factors and child’s factors. Mother’s height and weight was measured and body mass index was calculated. Data were analyzed using SPSS version 23. Multivariate logistic regression was used to determine the predictors for exclusive breastfeeding practice. Results: Response rate was 96% with a total of 311 mothers participated in this study. More than half of the mothers exclusively breastfed (52.4%). The predictors for exclusive breastfeeding were Malay ethnicity (AOR=3.951, 95% CI: 1.374-11.358), having tertiary education (AOR=2.401, 95% CI: 1.100-5.241) and positive attitude toward breastfeeding (AOR=7.755, 95% CI: 1.382-43.502). Conclusion: Prevalence of exclusive breastfeeding was higher in this study than the national level. Programme planners should pay special attention to Chinese and Indian ethnicities, mothers with lower level of education and negative attitude in order to improve breastfeeding practice among rural mothers.

Abstract Women with gestational diabetes mellitus (GDM) during their pregnancy have a greater risk of developing overt diabetes mellitus and dysglycemia (prediabetes, impaired glucose tolerance or impaired fasting glucose) later in future, compared to mothers with normal pregnancy. Postpartum screening is crucial for early identification of type 2 diabetes (T2DM) in women with GDM. Nevertheless, despite various strategies, its rate remains low. A systematic review using databases of PubMed/Medline, Science Direct and CINAHL from 2008 to 2018, was conducted to identify the factors influencing the attendance of postpartum diabetes screening. Open access English articles, focusing on observational studies were reviewed. Primary screening of titles and abstracts of 91 articles were done, secondary screening of 31 articles resulted in 6 articles, included in this manuscript. Various factors identified to be associated with the attendance to postpartum diabetes screening, which are age, education, ethnicity, some obstetric factors like multiparty, and history of insulin usage previously. Many women fail to be screened for diabetes during the postpartum period, and this delays T2DM diagnosis, which in turn gives rise to various complications. Further research that considers these factors is necessary for developing interventions to improve postpartum T2DM screening for mothers with GDM during their pregnancy

Objective: To investigate the cytotoxicity of Smilax myosotiflora (S. myosotiflora) methanolic extract and its effects on sexual hormone levels and testicular histology in male rats. Methods: The cytotoxicity of S. myosotiflora methanolic extract was investigated by employing brine shrimp lethality assay. Forty eight male rats were randomly divided into four groups (Groups I-IV) of 12 each. Rats in Group I were administered with 0.5 mL of distilled water (vehicle), whilst Groups II, III and IV received 200, 400 and 800 mg/kg of the methanolic extract of S. myosotiflora in 0.5 mL of the vehicle, respectively. Male rats treated with continuous daily dosing were killed and necropsied after a total dose period of 60 days. Sexual hormones were assayed and histological examination of testes was performed according to standard methods. Results: S. myosotiflora extracts did not produce any cytotoxicity to brine shrimp in all concentrations tested. Serum testosterone level was significantly higher in rats treated with high dose of S. myosotiflora. Testicular histology showed normal architecture with all stages of spermatogenesis in all experimental groups. Conclusions: The present work confirmed that S. myosotiflora extract improves reproductive functions, without any cytotoxic activity and produces no histological changes to the testes.

Introduction: Short Interpregnancy interval (IPI) is defined as the interval between the live birth outcome and the next pregnancy conception of less than 24 months. It has been linked to adverse maternal and perinatal outcomes. The objective of this study was to determine the prevalence and the predictors of short IPI among antenatal mothers. Methods: A cross-sectional study was conducted among 452 antenatal mothers attending health clinics in Klang in April 2018. Probability sampling was used and data was collected by using a validated self-administered questionnaire. The dependent variable of the study was short IPI and the independent variables were sociodemographic, obstetric history and planning of pregnancy. Analysis of data collected in the study was performed by using IBM Statistical Package for Social Science (SPSS) version 24. Results: The prevalence of short IPI found in this study was 48%. Seven identified predictors of short IPI were: age less than 25 years old (Adjusted Odd Ratios; AOR 12.16, 95%CI: 4.72, 31.30), age of 26 to 30 years old (AOR 5.20, 95%CI: 2.62, 10.32), age of 31 to 35 years old (AOR 2.90, 95% CI: 1.50, 5.64), higher education (AOR 2.11, 95% CI: 1.34, 3.34), parity more than three (AOR 3.12, 95% CI: 1.42, 6.84), irregular menstruation (AOR 2.17, 95% CI: 1.40, 3.37) and unintended pregnancy (AOR 2.88, 95% CI: 1.88, 4.40). Conclusion: Innovative programmes, for example by making IPI information available through online resources, could effectively target young mothers as the younger generation prefers quick, easily-accessible and reliable information.

Introduction: Despite the importance of postpartum type-2 diabetes mellitus (T2DM) screening to ensure early detection and effective management of T2DM among women previously diagnosed with gestational diabetes mellitus, low uptake has been reported. In view of the proven effectiveness of theory-based interventions, this study aimed to evaluate the effectiveness of Information Motivation Behavioural Skills (IMB)-based intervention to improve postpartum T2DM screening uptake among pregnant women with GDM in Negeri Sembilan, Malaysia. Methods: A prospective quasi-experimental study was carried out among comparable respondents in the intervention and control groups, involving 61 and 55 respondents respectively. Validated and reliable self-administered questionnaire was used to measure pre- and post-intervention of knowledge, attitude and self-efficacy, based on the constructs of the IMB model, with postpartum T2DM screening uptake measured at 6-week postpartum. Results: The IMB-based intervention was effectively improved knowledge on gestational diabetes mellitus (GDM), and attitude as well as self-efficacy related to the screening, with significant difference in the 6-week postpartum T2DM screening uptake between the intervention and control groups. Between groups comparison revealed significantly higher mean scores for knowledge (ηp 2 =0.11), attitude (ηp 2 =0.031) and self-efficacy (ηp 2 =0.52) in the intervention group compared to the control group, with self-efficacy is showing the largest size effect. Conclusion: The IMB-based health intervention had effectively improved the 6-week postpartum T2DM screening among women with GDM in the intervention group, through the significant improvement of knowledge on GDM and attitude as well as self-efficacy related to the screening.

The American College of Obstetricians and Gynaecologists (ACOG), US Department of Health and Human Services (HHS), and American College of Sports Medicine (ACSM) recommend that all pregnancies with medical clearance should engage in moderate-intensity physical activity (PA) at least 150 minutes per week. However, most of them are physically inactive. Thus, this article aims to identify predictors of physical inactivity among antenatal women. Four databases were used to search relevant articles using PICO strategy systematically. The screening began with examining titles, abstracts, and keywords, followed by scrutinizing and assessing full articles. Finally, a total of five studies were included for the data extraction, and the predictors are sociodemographic (trimesters, parity, marital status, and pre-pregnancy PA status), socioeconomic (household income), lifestyle (smoking and eating unhealthy diet) and health-related factors (multiple pregnancies, received fertility treatment, being unwell, musculoskeletal pain, symptom of early pregnancy and uterine contraction). All these predictors provide crucial information for the success of future physical activity intervention.

Introduction: There are a growing number of parents who hesitate to vaccinate their children. Therefore, the current study was conducted to assess future parents-to-be intention to vaccinate their children, as well as to investigate contributing factors of vaccination intention and to identify sources of information on childhood vaccination. Method: A cross-sectional study was conducted among Foundation Program students at a public university for five months, from April to August 2019. Factors studied included sociodemographic characteristics, knowledge and attitudes toward childhood immunization, and religiosity. Data were collected using a validated self-completed questionnaire. Simple random sampling was conducted, with a total of 371 students were recruited as respondents. Multiple logistic regression was performed to determine the predictors. The significance level is set at alpha less than 5%. Results: Approximately 95% of respondents indicated an intention to vaccinate their future. The mean age of respondents was 19 ± 0.37 years old. A motive to vaccinate their future children was high among females (AOR: 4.20, 95% CI: 1.59, 11.08, p: 0.004), having sufficient knowledge about childhood vaccination (AOR: 3.92, 95% CI: 1.23, 12.45, p: 0.021), and having a positive attitude toward childhood vaccination (AOR: 9.56, 95% CI: 2.15, 42.46, p: 0.003). There was no significant association between intention to have their future children vaccinated and religiosity. The sources of information about childhood vaccination were mainly the Internet (72%), mass media (68.2%), and social media (61.7%). Conclusion: Readiness of foundation program students was satisfactory. However, policymakers and program planners should target improving knowledge and attitudes of young people about childhood immunization especially among young men as they will head the household. This effort may sustain the readiness of young people to vaccinate their future children. The approach should include the Internet, mass media, and social media.

Aims: Children below five years have been the target of screen time guidelines. The adverse health outcomes associated with it require focusing on prime strategies for reducing screen time. The current study reviews parental intervention strategies to reduce screen time among preschool-aged children. Design: Systematic review. Data sources: A total of five databases of the Cochrane register of controlled trials, CINAHL, Medline PubMed, and Scopus databases were searched from May 1 to 31, 2020. Review Methods: The keywords of “screen time”, “television”, “video”, “computer”, “mobile device”, “hand phone”, “media use”, “preschool-aged children”, “interventions”, and “strategies” used for search. The inclusion criteria are limited to specific study populations, intervention, comparison and outcomes (PICOs), language, and published study types. The quality of articles was assessed using the Cochrane Risk of Bias (RoB) tool. Results: A total of six studies that met the inclusion criteria were further analysed. It showed that besides providing knowledge and awareness regarding screen time, restrictive practices, offering alternative activities to parents and removing the screen from the child’s bedroom were the most common strategies used by successful studies. The duration of intervention between 6-8weeks was sufficient to observe screen time reduction, while faceto-face methods dominated the mode of delivery. Increasing parental self-efficacy, listing outcome expectations, and reinforcement strategies targeting both the parents and their home environment were beneficial in reducing screen time. Conclusion: Future screen time reduction studies could benefit from incorporating the above approaches for screen time reduction intervention among preschool children.

Introduction: Cerebral palsy is a group of early childhood chronic mobility disorders. Parenting a child with cerebral palsy is often challenging, especially for mothers. This research aimed to identify the determinants of the psychological states of mothers of children with cerebral palsy in Bangladesh. Methods: A cross-sectional study was conducted from December 2019 to February 2020. A total of 344 mothers of children with cerebral palsy was recruited using a simple random sampling technique and guided questionnaires. The data were analysed using the Chi-square test and logistic regression models. Results: The overall response rate was 98.29%. The median (IQR) age of respondents and the children with cerebral palsy were 30 (13) and 6 (6), respectively. The proportions of mothers with good knowledge on cerebral palsy and having higher negative family impact were 57.8% and 41.9%, respectively. Fifty-nine per cent of mothers of children with cerebral palsy had higher levels of maternal psychological stress. The predictors of maternal psychological stress were the mother’s age, marital status, types of family, family income, age of children, gender, and higher levels of the negative maternal appraisal. Conclusions: Mothers of children with cerebral palsy in Bangladesh had a higher level of maternal psychological stress. The factors identified in this study could help to develop policies and strategies to minimise maternal psychological stress associated with parenting children with cerebral palsy in Bangladeshi households.