The Association Between Doula Care and Childbirth-Related Post-Traumatic Stress Disorder Symptoms: The Mediating Role of Childbirth Experience.

INTRODUCTION: Although the benefits of doula care during childbirth are well-known, its impact on childbirth-related post-traumatic stress disorder (CB-PTSD) symptoms are less thoroughly characterized. This study aimed to explore the association between doula care and CB-PTSD symptoms and the potential mediating role of childbirth experience on this association. METHODS: A prospective cohort study was conducted in a hospital in China, enrolling women with singleton live vaginal births. The exposure and primary outcome factors of interest were doula care and CB-PTSD symptoms, with childbirth experience as a mediating factor. Questionnaires were administered to collect baseline data and childbirth experience at 3 days postpartum, and CB-PTSD symptoms from participants at 42 days postpartum. Linear regression analysis was used to analyze the relationship between doula care, childbirth experience, and CB-PTSD symptoms, while the mediating role of childbirth experience was analyzed using the SPSS (PROCESS) modeling tool. RESULTS: A total of 445 eligible women were included in the final analysis, including 120 who received doula care and 325 who did not. Linear regression analyses found that doula care was independently associated with CB-PTSD symptoms (ß = -0.11, p < 0.05) and childbirth experience (ß = 0.50, p < 0.001). Childbirth experience was significantly associated with CB-PTSD symptoms (ß = -0.17, p < 0.001). Childbirth experience mediated the association between doula care and CB-PTSD symptoms (indirect effect = -1.08, 95% CI -1.91 to -0.10), even after adjusting for potential confounders. CONCLUSIONS: Childbirth experience serves as a mediator of the association between doula care and CB-PTSD symptoms. By providing supportive care for women during childbirth, their childbirth experience could be improved, thereby reducing the risk of CB-PTSD symptoms.

Piezodynamic Eradication of Both Gram-Positive and Gram-Negative Bacteria by Using a Nanoparticle Embedded Polymeric Membrane.

Nowadays, bacterial infection is regarded as a serious threat to humankind, which needs to be taken care of. The emergence of antibiotic resistance and multidrug resistance (MDR) is rendering this situation more troublesome. However, several alternative treatment regimens have aided such diseases quite well in the recent past, among which dynamic antibacterial therapies combat this situation quite well. Among various dynamic therapies, piezodynamic therapy is a very recent avenue, in which mechanical stimuli have been exploited to treat bacterial infections. Herein, piezo-active bismuth ferrite-loaded poly(vinylidene fluoride-co-hexafluoropropylene) polymer has been utilized to eradicate gram-positive bacteria (E. faecalis) and gram-negative bacteria (E. coli). The sample has been designed in a free-standing membrane form, which, under soft ultrasound (~10 kHz), generates reactive radicals to ablate bacteria. Initially, the structure and morphology of the membrane have been substantiated by using X-ray diffraction and scanning electron microscopy methods; besides, Fourier transform infrared spectrum of the sample depicts a tremendously high value of polarizability and further confirms the piezo-activity of the membrane. More than 99% of E. coli and E. faecalis have been successfully eradicated within 30 min of ultrasound. Moreover, the solid-state structure and hydrophobic nature of the membrane help us to reuse it in a cyclic manner, which is possibly reported herein for the very first time. This novel membrane could be deployed in healthcare systems and pigment industries and could be exploited as a self-cleaning material.

Fortified Fermented Rice-Acid Can Regulate the Gut Microbiota in Mice and Improve the Antioxidant Capacity.

The study aimed to explore the effects of fortified fermented rice-acid on the antioxidant capacity of mouse serum and the gut microbiota. Hair characteristics, body mass index, intestinal villus height, intestinal crypt depth, serum antioxidant capacity, and gut microbiota of mice were first measured and the correlation between the antioxidant capacity of mouse serum and the gut microbiota was then explored. The mice in the lactic acid bacteria group (L-group), the mixed bacteria group (LY-group), and the rice soup group (R-group) kept their weight well and had better digestion. The mice in the L-group had the better hair quality (dense), but the hair quality in the R-group and the yeast group (Y-group) was relatively poor (sparse). In addition, the inoculation of Lactobacillus paracasei H4-11 (L. paracasei H4-11) and Kluyveromyces marxianus L1-1 (K. marxianus L1-1) increased the villus height/crypt depth of the mice (3.043 ± 0.406) compared to the non-inoculation group (R-group) (2.258 ± 0.248). The inoculation of L. paracasei H4-11 and K. marxianus L1-1 in fermented rice-acid enhanced the blood antioxidant capacity of mouse serum (glutathione 29.503 ± 6.604 umol/L, malonaldehyde 0.687 ± 0.125 mmol/L, catalase 15.644 ± 4.618 U/mL, superoxide dismutase 2.292 ± 0.201 U/mL). In the gut microbiota of L-group and LY-group, beneficial microorganisms (Lactobacillus and Blautia) increased, but harmful microorganisms (Candidatus Arthromitus and Erysipelotrichales) decreased. L. paracasei H4-11 and K. marxianus L1-1 might have a certain synergistic effect on the improvement in antibacterial function since they reduced harmful microorganisms in the gut microbiota of mice. The study provides the basis for the development of fortified fermented rice-acid products for regulating the gut microbiota and improving the antioxidant capacity.

Should singleton birth weight standards be applied to identify small-for-gestational age twins?: analysis of a retrospective cohort study.

BACKGROUND: Twin birth weight percentiles are less popular in clinical management among twin pregnancies compared with singleton ones in China. This study aimed to compare the incidence and neonatal outcomes of small for gestational age (SGA) twins between the use of singleton and twin birth weight percentiles. METHODS: This was a retrospective cohort study of 3,027 pregnancies with liveborn twin pairs at gestational age of > 28 weeks. The newborns were categorized as SGA when a birthweight was less than the 10th percentile based on the singleton and twin references derived from Chinese population. Logistic regression models with generalized estimated equation (GEE) were utilized to evaluate the association between SGA twins and neonatal outcomes including neonatal unit admission, neonatal jaundice, neonatal respiratory distress (NRDS), neonatal asphyxia, ventilator support, hypoxic ischemic encephalopathy (HIE), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intracranial hemorrhage (ICH), culture-proven sepsis, neonatal death within 28 days after birth as well as the composite outcome. RESULTS: The incidence of SGA was 33.1 % based on the singleton reference and 7.3 % based on the twin reference. Both of SGA newborns defined by the singleton and twin references were associated with increases in neonatal unit admission, neonatal jaundice and ventilator support. In addition, SGA newborns defined by the twin reference were associated with increased rates of BPD (aOR, 2.61; 95 % CI: 1.18-5.78) as well as the severe composite outcome (aOR, 1.93; 95 % CI: 1.07-3.47). CONCLUSIONS: The use of singleton birth weight percentiles may result in misdiagnosed SGA newborns in twin gestations and the twin birth weight percentiles would be more useful to identify those who are at risk of adverse outcomes.

Associations Between Maternal Thyroid Function and Birth Outcomes in Chinese Mother-Child Dyads: A Retrospective Cohort Study.

Objective: Although research suggests a close association between maternal thyroid function and birth outcomes, no clear conclusion has been reached. We aimed to explore this potential association in a retrospective cohort study. Methods: This study included 8985 mother-child dyads. The maternal serum free tetraiodothyronine (FT4), thyroid-stimulating hormone (TSH), and thyroid peroxidase antibody (TPO Ab) concentrations and birth outcome data were reviewed from medical records. Subjects with TPO Ab concentrations of >34 and ≤34 IU/ml were classified into the TPO Ab positivity (+) and TPO Ab negativity (-) groups, respectively. Results: Compared with subjects in the normal group (0.1 ≤ TSH < 2.5 mIU/L and TPO Ab-), those with TSH concentrations of 2.5-4.0 mIU/L and TPO Ab- had a 0.65-fold lower risk of low birth weight (LBW). In contrast, those with TSH concentrations of >4.0 mIU/L, regardless of the TPO Ab status, had a 2.01-fold increased risk of LBW. Subclinical hypothyroidism, regardless of the TPO Ab status, was associated with a 1.94-fold higher risk of LBW when compared with that in subjects with euthyroidism and TPO Ab-. No other significant associations were observed. Conclusion: A maternal TSH concentration of 2.5-4.0 mIU/L was associated with a lower risk of LBW when combined with TPO Ab-, whereas subjects with a TSH concentration of >4.0 mIU/L had an increased risk of LBW. Subclinical hypothyroidism appears to be associated with a higher risk of LBW.