Anesthesiologists' Role in Recognition, Prevention, and Treatment of Childbirth-Related Posttraumatic Stress Disorder.

Childbirth-related posttraumatic stress disorder (CB-PTSD) is increasingly common and consequential for pregnant patients. Throughout the labor experience and beyond, anesthesiologists are central to creating a psychological safe space for patients and play an essential role in preventing, recognizing, and treating CB-PTSD. This narrative review summarizes the current literature surrounding risk factors for CB-PTSD that are relevant to anesthesiologists; patients' symptoms or signs anesthesiologists should look out for; and ways anesthesiologists may be involved in preventing and treating this condition.

Considerations for the Future: Family Planning and Infertility During Psychiatry Training.

During medical school, residency, or fellowship, many trainees struggle to balance their careers with starting a family. Some may feel the optimal time for parenthood is after completion of training, but the effect of increasing age on fertility is a real consideration for female physicians.1 Several studies have explored the impact of pregnancy and parental leave during surgical residency, yet little has been published on these topics during psychiatry training. This is surprising as psychiatry residents often address the challenges of integrating work and parenthood with their patients, yet it has not traditionally been within the culture of medicine to openly discuss this with colleagues. It is critical to address pregnancy and parenthood routinely during training and in the literature to reiterate the importance of work-life integration. In this article, we discuss current practices for psychiatry residents and advocate for the development of a standardized policy across psychiatry training programs that considers multiple aspects of childbearing including maternal mental health, family leave, and infertility.

Dysglycemia, Not Altered Sex Steroid Hormones, Affects Cognitive Function in Polycystic Ovary Syndrome.

CONTEXT: Polycystic ovary syndrome (PCOS) is a complex endocrine condition characterized by multiple reproductive and metabolic abnormalities. Because individual reproductive and metabolic abnormalities modulate working memory in the general population, there is growing interest in whether cognitive function is dually and negatively affected in PCOS. OBJECTIVE: To examine the association of reproductive and metabolic features with cognitive function in women with and without PCOS. DESIGN: An observational, cross-sectional study was conducted at an academic clinical research center in North America between 2006 and 2009. Common tests of working memory (i.e., manual dexterity, perceptual speed, and visuospatial ability) were performed by women with PCOS (n = 40) and control subjects (n = 40). Markers of sex steroid hormones, ovulatory function, and cardiometabolic health were also assessed. RESULTS: Reduced visuospatial ability was observed in women with PCOS compared with control subjects (P < 0.01). Reduced visuospatial ability was linked to higher levels of hemoglobin A1c in the entire study cohort, independent of body mass index or PCOS status. No associations were observed between visuospatial ability and reproductive features, after controlling for confounding variables. CONCLUSION: Our findings support a role for glycemic control, and not PCOS per se, in cognitive dysfunction in women of reproductive age. Additional studies are needed to understand the short- and long-term effects of dysglycemia on brain health in women with PCOS, given their increased propensity for metabolic comorbidities, compared with control subjects.