RESUMO
Postpartum depression (PPD) is the most frequent psychiatric complication during the postnatal period. According to existing evidence, an association exists between the development of PPD and the maintenance of breastfeeding. A brief motivational intervention (bMI), based on the motivational interview, seems effective in promoting breastfeeding. The objective of this study was to analyse the impact of a bMI aiming to promote breastfeeding on the development of PPD and explore the mediating/moderating roles of breastfeeding and breastfeeding self-efficacy in the effect of the intervention on developing PPD. Eighty-eight women who gave birth by vaginal delivery and started breastfeeding during the immediate postpartum period were randomly assigned to the intervention group (bMI) or control group (breastfeeding education). Randomisation by minimisation was carried out. The breastfeeding duration was longer in the intervention group (11.06 (± 2.94) weeks vs 9.02 (± 4.44), p = 0.013). The bMI was associated with a lower score on the Edinburgh Postnatal Depression Scale, with a regression ß coefficient of - 2.12 (95% CI - 3.82; - 0.41). A part of this effect was mediated by the effect of the intervention on the duration of breastfeeding (mediation/moderation index ß = - 0.57 (95% CI - 1.30; - 0.04)). These findings suggest that a bMI aiming to promote breastfeeding has a positive impact preventing PPD mainly due to its effectiveness in increasing the duration of breastfeeding.
Assuntos
Afeto , Aleitamento Materno/psicologia , Depressão Pós-Parto/terapia , Entrevista Motivacional , Psicoterapia Breve , Adulto , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/psicologia , Feminino , Humanos , Espanha , Fatores de Tempo , Resultado do TratamentoRESUMO
The Expanded Susceptibility to Smoking Index (ESSI) is based on the combination of susceptibility to smoking and curiosity about smoking. The ESSI can identify young people who are at risk of starting to smoke cigarettes and related products. The objective of this study was to analyse the ESSI results and to examine factors associated with ESSI scores in students between 12 and 16 years of age. Sociodemographic, social/environmental and personal variables were analysed, and the ESSI value was determined for non-smoking students recruited from three schools in western Spain. Regression models were used to examine the factors associated with smoking for the entire sample and the factors associated with ESSI scores in the non-smoking population. Of the 377 participants who were analysed, 20.4% were smokers. Among the non-smokers, 53.5% and 55.3% presented medium-high ESSI scores for cigarettes and e-cigarettes, respectively, and 39.8% presented medium-high ESSI scores for hookah use. A higher ESSI score was associated with greater exposure to people smoking in the home, having more friends who smoke, alcohol consumption, and a higher impulsivity scale score. These findings reinforce the importance of reducing peer pressure and suggest the important role of resolve under conditions of positive affect on reducing impulsivity. Approaches based on self-efficacy could be addressed in preventive programmes developed in educational settings.
Assuntos
Fumar/psicologia , Estudantes/psicologia , Produtos do Tabaco/efeitos adversos , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Sistemas Eletrônicos de Liberação de Nicotina , Comportamento Exploratório , Feminino , Humanos , Masculino , Grupo Associado , Influência dos Pares , Instituições Acadêmicas , Fumar/epidemiologia , Espanha/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: To assess the relationship between human blastocyst chromosomal ploidy established by niPGT-A and increasing age. METHODS: This is a prospective multicenter study carried out by ten assisted reproduction centers after their embryologists acquired training and validated their results with the previous use of niPGT-A. A total of 94 couples with indication for niPGT-A due to increase maternal age, male factor, repeated implantation failures, recurrent abortion or because they requested niPGT-A were included in this study. The couples had no karyotype abnormalities. After ICSI, the embryos were cultured until blastocyst stage using one or two step culture systems, single or sequential media respectively, at 37°C in an atmosphere of 6-7% CO2 and 5-20% O2 incubators. On day 3, we re-evaluated cleavage embryos to complete cumulus cells removal. The embryos were then cultured in individual well, with 20µl of medium under oil until they reached blastocyst stage. The blastocysts were vitrified and stored in liquid nitrogen. After that, the spent blastocyst culture medium (20µl) was transferred to a PCR tube and sent for analysis in the genetic laboratory, where it was stored at -80°C until sequencing. A total of 243 samples of spent blastocyst culture medium were collected on the 5th/6th day. Cell-free DNA secreted on culture medium was amplified using NICS Sample Preparation Kit (Yikon Genomics), based on the MALBAC technology. After whole genome amplification, the DNA was measured using a Qubit 2.0 fluorometer and subjected to next generation sequencing (NGS) using Illumina MiSeq® platform. The data were analyzed using the ChromGo® software (Yikon Genomics). RESULTS: The mean age of the patients was 38±4.08 years with an interval of 20-44 years. The euploid was diagnosed in 36.4% (80/220) of cases, aneuploidy in 31.3% (69/220), and mosaicism in 32.3% (71/220; with ≥60% aneuploidy) of blastocysts. Mosaic values ranged from 29.8% to 33.8% in different age groups. Individually, the most frequent chromosomal abnormality was XXY (Klinefelter Syndrome) occurring in 18 cases, followed by chromosome 21 (trisomy/monosomy) in 8 cases. The niPGT-A data showed a ≥60% incidence of aneuploid cells in all cases of chromosomal mosaicism (n=71). CONCLUSION: A high degree of mosaicism with aneuploidy cells was detected, and some hypotheses were suggested for this data (niPGT-A sensitivity in detecting the self-correction of chromosomal abnormalities phenomenon). However, it did not vary remarkably with age. On the other hand, euploidy levels had a negative correlation with age and aneuploidy levels had a positive relationship. This is the first report in the literature to relate chromosomal ploidy in blastocysts using niPGT-A and increasing patient age.
Assuntos
Aneuploidia , Blastocisto , Testes Genéticos/métodos , Diagnóstico Pré-Implantação/métodos , Adulto , Fatores Etários , Técnicas de Cultura Embrionária , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Mosaicismo , Gravidez , Adulto JovemRESUMO
OBJECTIVE: This study aimed to correlate male age with embryo morphokinetic parameters on D3 considering the timing and the exact moment of embryo cleavage. METHODS: Time-lapse imaging was used to produce an ideal cleavage curve for the embryos analyzed. The percentage of embryos under the curve was analyzed and correlated with male age. RESULTS: 32.6% of the embryos from patients aged 28-33 years were under the curve; 36.2% of the embryos from patients aged 34-39 years were under the curve; 41.3% of the embryos from patients aged 40-45 years were under the curve; and 26.3% of the embryos fro patients aged 46-57 years were under the curve. CONCLUSIONS: a statistically non-significant decrease was observed in the percentage of embryos under the optimal cleavage curve on D3 in the group of men aged between 40 and 45 years. Further studies looking into embryos in the blastocyst stage (D5 or D6) are required.