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    The influence of postpartum PTSD on breastfeeding: A longitudinal population-based study. Garthus-Niegel Susan,Horsch Antje,Ayers Susan,Junge-Hoffmeister Juliane,Weidner Kerstin,Eberhard-Gran Malin Birth (Berkeley, Calif.) BACKGROUND:In most Western countries, breastfeeding rates are lower than what is recommended by the World Health Organization. Depression has been shown to influence breastfeeding outcomes; however, there is very little research on the role of postpartum posttraumatic stress disorder (PTSD). This study examined to what extent maternal postpartum PTSD predicted breastfeeding initiation, exclusive breastfeeding during the first 6 months, and continuation up to 1 and 2 years. METHODS:The study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record and questionnaire data from 8 weeks and 2 years postpartum were used (n = 1480). All breastfeeding variables significantly correlated with postpartum PTSD were entered into stepwise logistic regression analyses. RESULTS:Although most mothers (97.1%) initiated breastfeeding, considerably fewer adhered to the World Health Organization's breastfeeding guidelines about exclusive breastfeeding during the first 6 months (13.4%) or continued breastfeeding for 12 or 24 months postpartum (37.7% and 4.2%, respectively). Even after adjustment for important confounding variables, maternal postpartum PTSD was significantly associated with not initiating breastfeeding (aOR 5.98 [95% CI 1.79-19.97]). Postpartum PTSD was also significantly related to not continuing breastfeeding up to 12 months, although this association did not hold after adjusting for confounding variables. CONCLUSION:Identifying women at risk of not initiating breastfeeding is crucial to prevent a negative influence on infant development and the development of the mother-infant bond. Early screening and treatment of women at risk of developing postpartum PTSD might be a way forward. 10.1111/birt.12328
    Fear of Childbirth, Postpartum Depression, and Birth-Related Variables as Predictors of Posttraumatic Stress Disorder After Childbirth. Çapik Ayla,Durmaz Hatice Worldviews on evidence-based nursing BACKGROUND:Childbirth may be a significant cause of postpartum posttraumatic stress disorder (PTSD) in women. AIMS:The objective of this study is to examine the effect of fear of childbirth, postpartum depression, and certain birth-related variables on postpartum PTSD. METHODS:This study is a cross-sectional study. The study was carried out in a maternity hospital nonstress unit between December 1, 2015, and February 29, 2016. Three hundred and one pregnant women who met the criteria for inclusion in the study made up the research sample. RESULTS:Fear of childbirth and postpartum depression significantly and positively predicted the level of posttraumatic stress after childbirth (β = 0.17, p < .01; β = 0.68, p < .001). Fear of childbirth explains 3% of the total variance in posttraumatic stress (R  = .03, adjusted R  = .02, F = 7.141, p < .01), while postpartum depression explains 47% of it (R  = .47, adjusted R  = .46, F = 196.35, p < .001). Satisfaction with the attitudes of the medical staff during childbirth, defining the childbirth experience, and the state of experiencing postpartum problems by the mother are significant predictors of postpartum posttraumatic stress (β = -0.21, p < .01; β = -0.14, p < .05; β = 0.17, p < .01). When these three variables are addressed together, they explain 14% of the total variance (R  = .14, adjusted R  = .13, F = 9.33, p < .001). LINKING EVIDENCE TO ACTION:Postpartum PTSD is a situation that must be carefully emphasized in terms of maternal, baby, and family health. For this reason, it is necessary to evaluate postpartum PTSD more quickly and objectively, and healthcare providers have major duties in this respect. 10.1111/wvn.12326
    Detection and Prevention of Postpartum Posttraumatic Stress Disorder: A Call to Action. Canfield Dana,Silver Robert M Obstetrics and gynecology The rising maternal mortality rate has drawn increased focus to postpartum depression. However, other mental health conditions, such as birth-related postpartum traumatic stress disorder, have not garnered the same level of attention. The majority of research about postpartum posttraumatic stress disorder (PTSD) is published in journals focused on psychiatry, psychology, and nursing, where this phenomenon is well recognized. In contrast, there is a lack of awareness among most obstetricians. Consequently, few recommendations are available to guide clinical practice. This commentary will present a clinical vignette, provide background that is key to the detection of PTSD, explore available data on postpartum PTSD, and provide recommendations for recognition and prevention of this disorder. 10.1097/AOG.0000000000004093
    The association between social capital and quality of life among a sample of Iranian pregnant women. RezaeiNiaraki Masoumeh,Roosta Sadaf,Alimoradi Zainab,Allen Kelly-Ann,Pakpour Amir H BMC public health BACKGROUND:Quality of life (QoL) is a multidimensional concept that is affected by various factors. According to the literature, social capital is one of the key determinants of QoL that improves the living conditions of the entire community. This study aimed to investigate the association between social capital and QoL in pregnant women. METHODS:This cross-sectional study included 240 pregnant women with a mean age of 27.98 years who were referred to healthcare centers in Qazvin, Iran. A two-stage random sampling method was used to select the health centers and participants. Social capital, QoL, demographic and obstetric characteristics were assessed. RESULTS:The mean scores of social capital, physical and mental dimensions of quality of life were 67.43, 70.2 and 71.88 respectively. All dimensions of social capital except for family and friends' connection and tolerance of diversity had positive significant correlations with the physical and mental health dimensions of quality of life (r = 0.17 to 0.28 p < 0.05). A univariate regression model revealed that social capital had a significant association with both the physical health (B = 0.40, 95% CI: 0.19-0.61, p < 0.001) and mental health (B = 0 .44, 95% CI: 0.18-0.58, p < 0.001) dimensions of pregnant women's quality of life. In the adjusted model, each unit increase of social capital increased pregnant women's QoL in both the physical health and mental health dimensions. CONCLUSION:Social capital has a significant association with women's QoL during pregnancy. Therefore, QoL during pregnancy could be improved by considering physical, psychological and social components of their healthcare. 10.1186/s12889-019-7848-0