Comorbid anxiety and depression (CAD) at early stages of the pregnancy. A multicultural cross-sectional study.

INTRODUCTION: When anxiety and depression are comorbid (CAD), symptoms are more severe and the response to treatments is worse. Given the links between mood disorders and poor perinatal outcomes, CAD and its correlates deserve special clinical attention during pregnancy. The main objective of this study was to learn about the prevalence of comorbid anxiety and depression (CAD) in early stages of the pregnancy analyzing the relationship between CAD and cultural and sociodemographic factors. METHODS: We have studied a multicultural sample of 514 Turkish and Spanish pregnant women (264 in Málaga, 102 in Istambul and 148 in Antalya) recruited at the moment of their first pregnancy medical check-up between 10 and 12 weeks of pregnancy. These women completed a questionnaire that included the Turkish or Spanish validated versions of the Edinburg postnatal depression scale (EDS), the state and trait anxiety scale (STAI) and a series of questions related to health status, general mood, and sociodemographic variables. RESULTS: We found a CAD prevalence rate of 26.9% and a significant higher prevalence rate among Turkish women (47.6%) when compared to Spanish participants (9.5%) (p<0.001). The multivariate analysis showed that the lack of someone who provided emotional support was the variable that best predicted CAD symptoms. CONCLUSION: The CAD prevalence rate was high and significant differences were found depending on the geographic and cultural context.

Oxytocin administered during labor and breast-feeding: a retrospective cohort study.

OBJECTIVE: The relationship between labor physiology and the onset of lactation leads to assess the potential correlation between oxytocin administration during labor and duration of breast-feeding. METHODS: This study was designed as a retrospective cohort study where patients given synthetic oxytocin during labor induction were considered as the exposed cohort, and patients not given oxytocin formed the non-exposed cohort. Four hundred of the 7465 children born at our maternity during 2006 were randomly selected. Information about breast-feeding was available for 316 of these children. Eventual confounding or adjustment factors were analyzed using stratified and multivariate analysis. RESULTS: Oxytocin was used for delivery of 189 (59.8%) newborns, multiplying the risk of bottle-feeding by 1.451 (95% CI 1.28-1.63). The best-fit regression model of oxytocin use effect on bottle-feeding included sex and gestational age of the newborn. The use of oxytocin also multiplies the risk of breast-feeding withdrawal at 3 months by 2.29 (95% CI 1.41-3.74). This effect is confounded by maternal age, being higher for mothers under 27 years. CONCLUSION: Oxytocin administration during labor had some impact on both onset and duration of breast-feeding, particularly in mothers under 27 years of age and newborns delivered at term. Clinical Study registered at U.S. NIH, ID: NCT01951040.