Beyond the binary: Characterizing the relationships between sex and neuropeptide receptor binding density measures in the rat brain.

Sex differences exist in numerous parameters of the brain. Yet, sex-related factors are part of a large set of variables that interact to affect many aspects of brain structure and function. This raises questions regarding how to interpret findings of sex differences at the level of single brain measures and the brain as a whole. In the present study, we reanalyzed two datasets consisting of measures of oxytocin, vasopressin V1a, and mu opioid receptor binding densities in multiple brain regions in rats. At the level of single brain measures, we found that sex differences were rarely dimorphic and were largely persistent across estrous stage and parental status but not across age or context. At the level of aggregates of brain measures showing sex differences, we tested whether individual brains are 'mosaics' of female-typical and male-typical measures or are internally consistent, having either only female-typical or only male-typical measures. We found mosaicism for measures showing overlap between females and males. Mosaicism was higher a) with a larger number of measures, b) with smaller effect sizes of the sex difference in these measures, and c) in rats with more diverse life experiences. Together, these results highlight the limitations of the binary framework for interpreting sex effects on the brain and suggest two complementary pathways to studying the contribution of sex to brain function: (1) focusing on measures showing dimorphic and persistent sex differences and (2) exploring the relations between specific brain mosaics and specific endpoints.

Effect of an Intrapartum Pelvic Dilator Device on Levator Ani Muscle Avulsion During Primiparous Vaginal Delivery: A Pilot Randomized Controlled Trial.

INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the safety and effectiveness of an intrapartum electromechanical pelvic floor dilator designed to reduce the risk of levator ani muscle (LAM) avulsion during vaginal delivery. METHODS: A multicenter, randomized controlled trial enrolled nulliparous participants planning vaginal delivery. During the first stage of labor, participants were randomized to receive the intravaginal device or standard-of-care labor management. The primary effectiveness endpoint was the presence of full LAM avulsion on transperineal pelvic-floor ultrasound at 3 months. Three urogynecologists performed blinded interpretation of ultrasound images. The primary safety endpoint was adverse events (AEs) through 3 months. RESULTS: A total of 214 women were randomized to Device (n = 113) or Control (n = 101) arms. Of 113 Device assignees, 82 had a device placed, of whom 68 delivered vaginally. Of 101 Control participants, 85 delivered vaginally. At 3 months, 110 participants, 46 Device subjects who received full device treatment, and 64 Controls underwent ultrasound for the per-protocol analysis. No full LAM avulsions (0.0%) occurred in the Device group versus 7 out of 64 (10.9%) in the Control group (p = 0.040; two-tailed Fisher's test). A single maternal serious AE (laceration) was device related; no neonate serious AEs were device related. CONCLUSIONS: The pelvic floor dilator device significantly reduced the incidence of complete LAM avulsion in nulliparous individuals undergoing first vaginal childbirth. The dilator demonstrated an acceptable safety profile and was well received by recipients. Use of the intrapartum electromechanical pelvic floor dilator in laboring nulliparous individuals may reduce the rate of LAM avulsion, an injury associated with serious sequelae including pelvic organ prolapse.

Evaluation of pelvic structural abnormalities in primiparous women with stress urinary incontinence.

INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the morphological characteristics of pelvic floor structure specific to de novo stress urinary incontinence (SUI) in primiparous women using three-dimensional (3D) reconstruction fusion technology based on static MRI combined with dynamic MRI. METHODS: Eighty-one primiparous women after the first vaginal delivery were studied, 40 with SUI and 41 without SUI. 3D reconstruction models based on static MRI were used to describe the anatomical abnormalities of pelvic floor tissues. Dynamic MRI was used to describe segmental activities of the urethra and vagina. The relationship between the morphometry and postpartum SUI was evaluated by logistic regression analysis and receiver operator characteristic curve. RESULTS: The differences in the distance from the bladder neck to the pubic symphysis (BSD), the angle between the posterior wall of the urethra and the anterior wall of the vagina, the width of the distal region of the vagina, urethral length, urethral compression muscle volume (CUV), and pubovisceral muscle volume, puborectal muscle volume, were measured, and except for the extremity of the anterior urethral wall, the total displacements (TDs) of the other sites between the two groups were statistically significant (p < 0.05). Logistic regression analysis showed that the BSD decreased, the CUV decreased, the TDs of the first site and the eighth site increment correlated significantly with postpartum SUI occurrence (p < 0.05). CONCLUSIONS: 3D reconstruction fusion technology provides an important support for a precise assessment of the pelvic floor dysfunction. The BSD, CUV, and iliococcygeus muscle volume have certain values in predicting de novo SUI after first vaginal birth.

Effects of perineal massage at different stages on perineal and postpartum pelvic floor function in primiparous women: a systematic review and meta-analysis.

BACKGROUND: Perineal massage, as a preventive intervention, has been shown to reduce the risk of perineal injuries and may have a positive impact on pelvic floor function in the early postpartum period. However, there is still debate concerning the best period to apply perineal massage, which is either antenatal or in the second stage of labor, as well as its safety and effectiveness. Meta-analysis was used to evaluate the effect of implementing perineal massage in antenatal versus the second stage of labor on the prevention of perineal injuries during labor and early postpartum pelvic floor function in primiparous women. METHODS: We searched nine different electronic databases from inception to April 16, 2024. The randomized controlled trials (RCTs) we included assessed the effects of antenatal and second-stage labor perineal massage in primiparous women. All data were analyzed with Revman 5.3, Stata Statistical Software, and Risk of Bias 2 was used to assess the risk of bias. Subgroup analyses were performed based on the different periods of perineal massage. The primary outcomes were the incidence of perineal integrity and perineal injury. Secondary outcomes were perineal pain, duration of the second stage of labor, postpartum hemorrhage, urinary incontinence, fecal incontinence, and flatus incontinence. RESULTS: This review comprised a total of 10 studies that covered 1057 primigravid women. The results of the analysis showed that perineal massage during the second stage of labor reduced the perineal pain of primigravid women in the immediate postpartum period compared to the antenatal period, with a statistical value of (MD = -2.29, 95% CI [-2.53, -2.05], P < 0.001). Additionally, only the antenatal stage reported that perineal massage reduced fecal incontinence (P = 0.04) and flatus incontinence (P = 0.01) in primiparous women at three months postpartum, but had no significant effect on urinary incontinence in primiparous women at three months postpartum (P = 0.80). CONCLUSIONS: Reducing perineal injuries in primiparous women can be achieved by providing perineal massage both antenatally and during the second stage of labor. Pelvic floor function is improved in the postnatal phase by perineal massage during the antenatal stage. TRIAL REGISTRATION: CRD42023415996 (PROSPERO).

Dairy cow parity affects relationships among nutritional parameters in the blood of dams, umbilical cords, and calves and placental development at calving.

Heifer growth and milk production in lactating cows may diminish the nutrient supply to the fetus. This study aimed to analyze the characteristics of the nutrient supply to the fetus in primiparous and multiparous cows. We investigated maternal, umbilical cord, and calf blood glucose and amino acid levels, as well as placental development in 28 primiparous (PP) and 30 multiparous (MP) Holstein cows. Although the total cotyledonary weight and surface area showed no significant differences, the MP group exhibited larger individual cotyledons (P < 0.01) and fewer medium-sized cotyledons (P < 0.05). Within the PP group, total cotyledonary weight and surface area positively correlated with blood glucose (r = 0.71-0.77; P < 0.01) and total essential amino acid (r = 0.55; P < 0.05) concentrations in the umbilical veins. However, no significant correlation was observed in the MP group. Blood glucose and amino acid concentrations in the umbilical vein, umbilical artery, and calf were significantly lower in the MP group (P < 0.05), although no difference was observed in the dams between the groups. In conclusion, the nutrient status of primiparous cows can alter fetal nutrient supply. Moreover, multiparous cows have larger individual cotyledons as an adaptive response to increased milk production during pregnancy. However, this adaptive response in multiparous cows did not completely restore nutrient supply to the fetus to the same extent as that in primiparous cows. Therefore, the nutritional management of multiparous cows during pregnancy must be reconsidered.

The Importance of Personal and Familial Factors on Breastfeeding Intention and Practices, and Postpartum Distress during the Pandemic: A Longitudinal Observational Study.

BACKGROUND: The COVID-19 pandemic has significantly impacted pregnant and breastfeeding women. Both low- and high-risk groups adopted preventive approaches such as mask-wearing and handwashing to slow down and prevent viral transmission during critical periods that may affect mother-child interactions. METHODS: A longitudinal observational study was conducted with primiparous women recruited using convenience sampling from the postpartum care ward of Afzalipour Teaching Hospital in Kerman from August 1, 2020 to March 30, 2021. The research questionnaires included demographic information, preventive behaviors, breastfeeding intention and practices, postpartum distress, and Edinburgh Postpartum Depression Scale. All the questionnaires were self-reported online in three stages: before discharge from the postpartum ward, the first month after delivery, and the third month after delivery. RESULTS: A Total of 160 primiparous women were included. The results showed significant changes in preventive behaviors and postpartum distress levels during the study. Breastfeeding intention and practices were negatively affected by postpartum distress (P = 0.034), unwanted pregnancies (P = 0.009), and cesarean delivery (P < 0.001). Postpartum distress was directly affected by the presence of depression (P < 0.001). Preventive behaviors at discharge were significantly associated with postpartum distress three months after delivery (P = 0.013). The study also found an association between women's and partner's education, unwanted pregnancy, and cesarean delivery that determined postpartum distress. CONCLUSIONS: Pandemic restrictions did not affect breastfeeding intentions or practices, possibly due to sufficient social and family support during the pandemic. However, robust guidelines are required to increase enable women's access to specializede care to cope with future pandemics, particularly during the first few weeks after childbirth.

Using mobile health in primiparous women: effect on awareness, attitude and choice of delivery type, semi-experimental.

BACKGROUND: One of the reasons for the increase in cesarean section is the lack of knowledge of mothers in choosing the type of delivery. The present study aimed to determine the effect of education through pregnancy application during pregnancy on awareness and attitude and choice of delivery type in primiparous women at Shahid Alavi Specialized Medical Center clinic in Mashhad. METHODS: This study was a semi-experimental type. Seventy primiparous pregnant women who had no restrictions for birth was selected. Sampling was randomized and purpose-based. The data collection tool was a questionnaire. The starting time of the training was considered from the end of the 27th week of pregnancy and continued with regular intervals until the end of the pregnancy. The questionnaires were completed once before the training and once after the training as a pre-test and post-test by the research units. SPSS software (version 26) and MacNemar test and descriptive statistics were used for data analysis. RESULTS: According to the results of the MacNemar test, a significant statistical difference was seen between women's knowledge and attitude after the training compared to before (p-value < 0.01). Choosing the type of birth was preferred before and after the training. But following the performance of women showed that only 62.86% of them chose natural birth. In fact, before the training, 40% and after 72.86% of women had chosen birth. CONCLUSION: Pregnancy education and application during pregnancy is effective in reducing the choice of cesarean section, so this application with the topic of birth and cesarean section has improved the level of attitude and also the positive attitude of pregnant women towards birth. Creation of facilities and promotion of different methods of painless childbirth and training of maternity staff to perform birth is expected.

Effects of parity and week after calving on the metabolic, redox, and immune status of dairy cows.

At the onset of lactation in dairy cows, inflammation and oxidative stress may occur and result in a risk of pathologies and lower milk yield. To propose an innovative management strategy for cows during this period, it is essential to better understand these physiological variations. Our objective was to evaluate the metabolic, redox, and immune status of 7 primiparous and 8 multiparous Holstein cows during late gestation and the first months of lactation. Blood samples were collected between 3 wk before calving until 12 wk postpartum. Milk samples were also collected, but only at the time points after calving. The metabolic (nonesterified fatty acids [NEFA], BHB, glucose, urea, calcium) and redox (reactive oxygen metabolites [ROM], oxidative stress index [OSI], glutathione peroxidase activity, vitamin E) statuses were analyzed in plasma or erythrocytes. The expression of genes related to antioxidant functions was determined in leukocytes collected from milk. For immune status, plasma cytokine levels and the production of reactive oxygen species (ROS) in classical and regulatory neutrophils were measured in 2 whole blood ex vivo challenges. The data were analyzed using a mixed model that included the fixed effects of parity and week and their interaction. Milk yield, plasma NEFA, and BHB in wk 2 and 4 after calving were higher in multiparous cows than in primiparous cows, whereas glucose and calcium tended to be lower. Plasma ROM and OSI levels in wk 8 were higher in multiparous than in primiparous cows. Multiparous cows also displayed higher glutathione peroxidase activity in erythrocytes, and antioxidant transcription factor and superoxide dismutase-1 expression levels in milk leukocytes. Moreover, multiparous cows had higher plasma concentrations of vitamin E but lower plasma levels of cytokines CXCL10, CCL2, IL1Rα, and IFNγ. Following ex vivo whole blood stimulation with Escherichia coli, lower IL1α and TNFα levels were measured in multiparous than in primiparous cows. Intracellular ROS production by neutrophils was lower in multiparous than in primiparous cows. These results thus indicated marked physiological changes in wk 8 compared with wk 2 and 4 of lactation. These differences in the physiological status of primiparous and multiparous cows offer interesting perspectives for potential dietary strategies to prevent pathologies which take account of parity and week relative to calving.

Gender roles as predictive factors on labor pain: a cross-sectional study.

Labor is a complex, subjective experience, and all factors that influence pain should be considered to ensure a comprehensive evaluation. This study aimed to determine whether gender roles were predictive of labor pain. The study has a descriptive and cross-sectional design. It was carried out in a delivery room of a city hospital in Turkey between September 2019 and September 2020. The study sample consisted of 231 primiparous women presenting for labor and delivery. Data were gathered with a descriptive characteristics form, Visual Analogue Scale and The Bem Sex-Role Inventory. Descriptive statistics and simple regression analysis were employed to analyze the obtained data. Regression analysis demonstrated that gender roles were predictive of labor pain in the latent, active, and transitional stages, but not in the second stage. Gender roles were most responsible for labor pain in the latent phase. Results of the study revealed that gender roles may be useful variables to predict women's labor pain, and contributed to the relevant literature. Nurses and midwives offering care for labor pain should consider gender roles as a factor affecting labor pain. It is also necessary to individualize the supporting care given during labor.

The effect of the training provided to primiparous pregnant women based on the model on pregnancy risk perception and health literacy.

The purpose of this study was to assess the impact of health education based on the health belief model (HBM) on the perception of risk in pregnancy and health literacy in primiparous pregnant women to maintain and improve their health. The study was carried out with 82 pregnant women who were in the second trimester. The number of samples was calculated using the G-Power program version 3.1.7. The number of samples was found 44 for the education group and 44 for the control group with a confidence interval of 95 percent, a margin of error of 5 percent, a large Cohen d effect size value (0.5), and a power of 80 percent. Randomization was performed using the envelope method to determine the interventional and control groups. The training prepared in line with the SIM was presented to the participants in the education group. 2 sessions per week, a total of 4 times. "Personal Information Form," Health Literacy Scale (HLS), and Perception of Pregnancy Risk Questionnaire (PPRQ) were used as data collection tools. The mean of the risk perception of the pregnant toward the baby posttest score was 9.95 ± 13.30 in the education group, and 23.35 ± 21.41 in the control group (p = .001). The mean health literacy scale posttest score was 103.52 ± 19.77 in the education group and 93.5 ± 19.02 in the control group, and it was found to be statistically significantly higher in the health literacy education group than in the control group (p = .027). This study found that educating pregnant women using the health belief model reduces their risk perception and boosts their degree of health literacy.

Depression in the Perinatal Period: Course and Outcome of Depression in the Period from the Last Trimester of Pregnancy to One Year after Delivery in Primiparous Mothers.

Background and Objectives: One of the most significant psychiatric problems in women is depression related to the perinatal period. Our study aims to determine the frequency and course of depressive symptomatology in the perinatal period with particular reference to objective rate and outcome of postpartum depression. Materials and Methods: One hundred and eighty-eight pregnant/postnatal women were included in a prospective, longitudinal, observational study during which the depressive symptomatology was estimated at the third trimester of pregnancy, and the first, sixth, and twelfth month' postpartum. All participants completed a semi-structured sociodemographic questionnaire constructed for research purposes, the Edinburgh Postnatal Depression Scale, Toronto Alexithymia Scale, Beck Anxiety Inventory, and The Mood Disorder Questionnaire at each time point. Postpartum depression diagnosis was confirmed by a trained and certified psychiatrist with long-standing experience. For a better understanding of the trajectory of depressive symptomatology and genuine postpartum depression, we classified depression into those with new-onset and those left over from the previous observation period. Results: In general, 48.9% of participants in the study were depressed at some point during the investigation. A total of 10.6% of women were depressed in the third trimester. The highest percentage of new-onset depression (25%) was in the first month after giving birth and was maintained for up to six months, after which the appearance was sporadic. Most of the postpartum depression resolved in the period from the first month to the sixth month after childbirth (20.7%). The episodes mainly had characteristics of unipolar depression. Conclusions: Our results imply that a new onset of depression is most intensive during the first six months, and after that, it is sporadic. Further studies are needed to explore whether all depressive symptomatology in the postnatal period is the same, or perhaps postpartum depression, classified in this way, has specific characteristics, etiology, and consequently different treatment and preventive options.

Impact of household income and Special Supplemental Nutritional Program for Women, Infants, and Children on feeding decisions for infants in the United States.

BACKGROUND: Despite the known benefits of breastfeeding to infants and mothers, previous studies have demonstrated that underserved women are less likely to exclusively breastfeed. Existing studies on the impact of Special Supplemental Nutritional Program for Women, Infants, and Children enrollment on feeding decisions for infants have conflicting results with low-quality data and metrics. OBJECTIVE: This study aimed to examine infant feeding trends nationally in the first week postpartum over a 10-year period, comparing breastfeeding rates for primiparous women with low income who used Special Supplemental Nutritional Program for Women, Infants, and Children resources with those women who did not enroll. We hypothesized that although the Special Supplemental Nutritional Program for Women, Infants, and Children is an important resource for new mothers, free formula associated with enrollment in the Special Supplemental Nutritional Program for Women, Infants, and Children may disincentivize women to exclusively breastfeed. STUDY DESIGN: This was a retrospective cohort study of primiparous women with singleton gestations who gave birth at term and who responded to the Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System between 2009 and 2018. Data were extracted from phases 6, 7, and 8 of the survey. Women with low income were defined as those with a reported annual household income of $35,000 or less. The primary outcome was exclusive breastfeeding after 1 week postpartum. Secondary outcomes included ever breastfeeding, any breastfeeding after 1 week postpartum, and introduction of other liquids within 1 week postpartum. Multivariable logistic regression was used to refine risk estimates with adjustment for mode of delivery, household size, education level, insurance status, diabetes, hypertension, race, age, and BMI. RESULTS: Among the 42,778 women with low income who were identified, 29,289 (68%) of these women reported receiving Special Supplemental Nutritional Program for Women, Infants, and Children resources. There was no significant difference in the rates of exclusive breastfeeding after 1 week postpartum between those enrolled in the Special Supplemental Nutritional Program for Women, Infants, and Children and those not enrolled (adjusted risk ratio, 1.04; 95% confidence interval, 1.00-1.07; P=.10). However, those enrolled were less likely to ever breastfeed (adjusted risk ratio, 0.95; 95% confidence interval, 0.94-0.95; P<.01) and were more likely to introduce other liquids within 1 week postpartum (adjusted risk ratio, 1.16; 95% confidence interval, 1.11-1.21; P<.01). CONCLUSION: Although exclusive breastfeeding rates after 1 week postpartum were similar, women enrolled in the Special Supplemental Nutritional Program for Women, Infants, and Children were significantly less likely to ever breastfeed and more likely to introduce formula within the first week postpartum. This suggests that Special Supplemental Nutritional Program for Women, Infants, and Children enrollment may impact the decision to initiate breastfeeding and may represent an important window to test future interventions.

Maternal expectations of fetal gender and risk of postpartum depression.

BACKGROUND: Female offspring was associated with a high risk of postpartum depression (PPD) during the one-child policy period in China. However, little is known about the association between maternal expectations on fetal gender and the risk of PPD in the context of the new two children policy implemented in 2016. METHODS: We conducted a hospital-based cohort study of women with singleton pregnancies between 2017 and 2018 (n = 991) to address this concern. Logistic regression was run to estimate the association between unexpected fetal gender and the risk of PPD. RESULTS: A total of 127 women (12.8%) were diagnosed with PPD. Compared with women who achieved fetal gender expectations, the odds ratio (OR) for PPD among those who had an unexpected fetal gender was 2.44 (95% confidence interval (CI): 1.30-4.58) (in the backward method logistic regression model) and 2.25 (95% CI: 1.21-4.18) (in the forward method model), respectively. The disparity of the association was significant among primiparous and pluriparous women (OR, 2.52, 95% CI: 1.32-4.84, P = 0.005 vs. OR, 0.91, 95% CI: 0.09-8.75, P = 0.932). Fetal gender expectations accounted for about 15% of the risk of PPD in the structural equation models. CONCLUSIONS: These results indicated that unexpected fetal gender was associated with an increased risk of PPD among Chinese primiparous women.

Association of epidural analgesia during labor and early postpartum urinary incontinence among women delivered vaginally: a propensity score matched retrospective cohort study.

BACKGROUND: Although epidural analgesia is considered the gold standard for pain relief during labor and is safe for maternity and fetus, the association between the epidural analgesia and pelvic floor disorders remains unclear. Thus we estimate the association between epidural analgesia and early postpartum urinary incontinence (UI). METHODS: A propensity score-matched retrospective cohort study was conducted at a university-affiliated hospital in Shanghai, China. Primiparous women with term, singleton, and vaginal delivery between December 2020 and February 2022 were included. UI was self-reported by maternity at 42 to 60 days postpartum and was classified by International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Using logistic regression models, the associations between epidural analgesia and early postpartum UI were assessed. RESULTS: Among 5190 participants, 3709 (71.5%) choose epidural anesthesia during labor. Analysis of the propensity-matched cohort (including 1447 maternal pairs) showed epidural anesthesia during labor was independently associated with UI in early postpartum period (aOR 1.50, 95% CI 1.24-1.81). This association was mainly contributed to stress UI (aOR 1.38, 95% CI 1.12-1.71) rather than urge UI (aOR 1.45, 95% CI 0.99-2.15) and mixed UI (aOR 1.52, 95% CI 0.95-2.45). Furthermore, we observed that the association between epidural anesthesia and UI was more pronounced among older women (≥ 35 y) and women with macrosomia (infant weight ≥ 4000 g), compared with their counterparts (both P for interaction < 0.01). After further analysis excluding the women with UI during pregnancy, the results remained largely consistent with the main analysis. CONCLUSIONS: The findings support that epidural anesthesia was associated with SUI in the early postpartum period.

Evaluation of the effectiveness of a postnatal support education program for husbands in promotion of their primiparous wives' perceived social support: a randomized controlled trial.

BACKGROUND: Primiparous women experience various challenges if not provided with social support in the early postpartum period. Support in form of postpartum education programs is needed to improve mental well-being in primiparous women. The aim of this study was to determine the effect of a postnatal supportive education program for husbands on the perceived social support (primary outcome), and stress and maternal self-efficacy (secondary outcome) of their primiparous wives. METHODS: This randomized clinical trial was performed on pregnant women referring to healthcare centers for routine care from September to November 2021 in Kermanshah, Iran. One hundred pregnant women were randomly divided in to intervention and control groups. Four 45-90 min online training sessions were held weekly for the husbands of the intervention group. The primiparous women completed the Postpartum Partner Support Scale, Perceived Stress Scale, and Postpartum Parental Expectations Survey before (third day after delivery, immediately and one month after completing the intervention. Data were analyzed using Fisher's exact test, Chi-square test, independent t-test, and repeated measures analysis of variance in SPSS version 24, and p < 0.05 was considered statistically significant. RESULTS: In the control and intervention groups before the intervention, socio-demographic characteristics (P > 0.05), the mean scores of perceived social support (P = 0.11), maternal self-efficacy (p = 0.37) and perceived stress (p = 0.19) were not statistically significant. However, in the intervention group compared to the control group the mean scores of perceived social support (79.42 ± 7.17 vs. 37.26 ± 7.99, P < 0.001), maternal self-efficacy (186.22 ± 39.53 vs. 106.3 ± 32.88, P < 0.001) and perceived stress (16.36 ± 6.65 vs. 43.3 ± 7.39, P < 0.001) immediately after the intervention and the mean scores of perceived social support (84.4 ± 5.91 vs. 37.14 ± 6.63, P < 0.001), maternal self-efficacy (191.24 ± 38.92 vs. 112.34 ± 37.12, P < 0.001) and perceived stress (13.98 ± 4.84 vs. 39.06 ± 7.25, P < 0.001) one month after the intervention changed significantly. CONCLUSION: The postpartum supportive education program for husbands was effective in promoting social support for primiparous women. Thus it can be introduced as routine care in the postpartum period. TRIAL REGISTRATION: Clinical trial registration Iranian Registry of Clinical Trials; https://en.irct.ir/user/trial/56451/view (IRCT20160427027633N8), registered (15/06/2021).

Effects of Pilates on inter-recti distance, thickness of rectus abdominis, waist circumference and abdominal muscle endurance in primiparous women.

BACKGROUND: Pilates is expected to have a positive effect on women with weakened abdominal muscles after childbirth. Pilates may have a beneficial effect on the structure and function of the abdominal muscles in pregnant women. Therefore, the objective of this study was to investigate the effects of Pilates on inter-recti distance, thickness of the rectus abdominis, waist circumference, and abdominal muscle endurance in primiparous women. METHODS: Thirty-five primiparous postpartum women were assigned to either the Pilates exercise group (n = 20) or the control group (n = 15). Pilates was undertaken by the exercise group for 50 min/day, 5 days/week, for 4 weeks. The control group maintained their daily activities without any intervention. The inter-recti distance was measured at three locations along the linea alba, and the thickness of the rectus abdominis was measured using ultrasound. Abdominal muscle endurance was measured using a repeated 1-min curl-up test. Waist circumference was also measured. RESULTS: The exercise group showed significant improvements from baseline in inter-recti distance, waist circumference, and abdominal muscle endurance (p < 0.05). The control group showed no significant improvement in these variables. Compared with the control group, the exercise group showed significantly improved performance in terms of inter-recti distance, waist circumference, and abdominal muscle endurance (p < 0.05). CONCLUSIONS: The results of this study demonstrate that Pilates was effective in reducing inter-recti distance and waist circumference and improving abdominal muscle endurance in primiparous postpartum women. Pilates is considered an effective exercise for improving muscle structure and function in primiparous postpartum women, helping in the recovery from, and preventing, diastasis rectus abdominis.

Prenatal Mental Representations in Italian First-Time Mothers Before and During the COVID-19 Pandemic: A Study with Interviews on Maternal Representations During Pregnancy.

INTRODUCTION: Psychosocial risks increase the levels of not-integrated/ambivalent and restricted/disengaged representations during pregnancy, but no study has specifically analysed the impact of the COVID-19 pandemic on maternal representation styles. OBJECTIVES: (1) to compare maternal representation styles in primiparous women who became pregnant before and during the COVID-19 pandemic and (2) to analyse the content of representation styles during the COVID-19 pandemic. METHODS: A total of 37 Italian pregnant women were recruited from 2019 to 2021. The sample was divided into two groups: the pre-COVID-19 group (22 women, mean age = 33.14 years; SD = 3.78) and the COVID-19 group (15 women, mean age = 35.9 years; SD = 4.6). Interviews on maternal representations during pregnancy were administered and analysed for style and content. RESULTS: Women during the COVID-19 pandemic reported more restricted/disengaged and less integrated/balanced representation styles than women pre-COVID-19. Content analysis showed that the COVID-19 pandemic led women to focus more on concrete aspects of pregnancy in lieu of emotional aspects, thus leading them to develop more restricted/disengaged representation styles. CONCLUSIONS FOR PRACTICE: In future pandemics pregnant women should be supported in focusing their attention to emotions, sensations and fantasies about themselves as mothers and their children.

Investigation of intramammary infections in primiparous cows during early lactation on organic dairy farms.

Previous studies have shown that organically raised dairy cows have an increased prevalence of Staphylococcus aureus compared with conventionally raised dairy cows. However, little information exists about the dynamics of intramammary infection (IMI) in primiparous cows during early lactation on organic dairy farms. The objective of this study was to describe the IMI dynamics of primiparous cows on certified organic farms during early lactation. This longitudinal study enrolled 503 primiparous cows from 5 organic dairy farms from February 2019 to January 2020. Quarter-level milk samples were collected aseptically on a weekly basis during the first 5 wk of lactation. Samples were pooled by cow and time point into composite samples inside a sterilized laminar hood and submitted for microbiological culture. For each of the different microorganisms identified, we estimated the prevalence in each postpartum sample, period prevalence (PP), cumulative incidence, and persistence of IMI. Logistic regression models were used to investigate whether the prevalence of IMI differed by farm or sampling time points and whether IMI persistence differed between detected microorganisms. Our findings revealed a high prevalence of Staphylococcus aureus (PP = 18.9%), non-aureus staphylococci and closely related mammaliicoccal species (PP = 52.1%), and Streptococcus spp. and Streptococcus-like organisms (PP = 32.1%) within the study population. The prevalence of these microorganisms varied significantly between farms. Staphylococcus aureus and Staphylococcus chromogenes exhibited significantly higher IMI persistence compared with other detected bacterial taxa, confirming the divergent epidemiological behavior in terms of IMI chronicity across different microorganisms. This study improves our understanding of the epidemiology of mastitis-causing pathogens in organically raised primiparous cows, which can be used to tailor mastitis control plans for this unique yet growing subpopulation of dairy cows.

Impact of parity number, milk production and somatic cell count on the reproduction of Holstein cows.

This research communication describes the reproductive and productive parameters and somatic cell count (SCC) of primiparous and multiparous cows from specialized dairy Holstein herds in South region of Brazil, and correlates these parameters using test-day records. A total of 24 011 records of animals from 75 producers obtained between 2017 and 2018 were used. The variables analyzed included milk production, SCC, milk fat, protein and urea nitrogen contents and reproductive characteristics (number of services per conception, service period and percentage of pregnant cows). Data were analyzed using multivariate logistic regression and the statistical differentiation between the classes of SCC and milk production. Milk production, SCC, number of services per conception and service period were all higher in multiparous cows. The percentage of pregnant cows was higher when the SCC was less than 200 000 cells/ml and was higher in primiparous cows. There was no adverse effect of milk production on reproductive parameters in high producing cows (>40 kg milk/d), however, the percentage of pregnant cows with this production level was significantly higher in multiparous cows. In conclusion, the milk production level need not affect the reproduction of specialized dairy cows if the animals are kept under adequate environmental conditions.

The impact of umbilical cord care education given to Primiparous mothers on cord separation time: A randomized controlled study.

PURPOSE: This study aims to determine the impact of umbilical cord care education given to primiparous mothers on cord separation time. DESIGN AND METHODS: This randomized controlled trial was conducted according to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. The mothers constituting the research sample were divided into two groups, the control group and the education group, and cord care and cord separation times were measured. RESULTS: The mean age of the mothers was 28.72 ± 4.86 years (min. 20 years, max. 40 years). There was no difference in age, gestational week of the baby, birth weight of the baby, gender of the baby and mode of delivery of the mother between the mothers in the control and education groups. While the cord separation time was 10.97 ± 0.320 days in the babies in the control group, it was 6.60 ± 0.177 days in the babies in the education group. A statistically significant difference was found between the duration of cord separation of the babies in the control and education groups. CONCLUSIONS: This study showed that giving umbilical cord care education to primiparous mothers reduces umbilical cord separation time. PRACTICE IMPLICATIONS: It is recommended that pediatric nurses provide education on umbilical cord care and the goals and methods of application of care practices, especially to primiparous mothers. CLINICAL REGISTRATION: This study was registered at the U.S. National Library of Medicine Clinical Trials (code: NCT05573737).