Feasibility of M-health Version of "What Were We Thinking" Intervention to Promote Maternal Postpartum...
DepressionPostpartum2 moreThe purpose of this study is to assess the feasibility, acceptability and preliminary effectiveness of "What Were We Thinking" (WWWT) a psychoeducational intervention -delivered remotely via communication technologies- to prevent symptoms of postpartum depression and anxiety in new mothers; which has been shown to be effective in primary health settings. WWWT was developed in Australia and has been culturally adapted to be used in Chile. The m-health version of the Chilean adaptation of WWWT for the current study includes: Psychoeducational modules on issues relevant to mothers during the post-partum period; contact with the program facilitator through instant messaging services available on mobile phones and a virtual group meeting. This pilot study will use a mixed design. The quantitative component will consist of a before-after design with control group including 90 adult mothers of child aged 6-8 weeks who receive health care in a primary health centers in Santiago, Chile. Mothers will be randomized into the experimental (EG) or control groups (CG) in a rate of 1:1. Both EG and CG will receive usual treatment provided by primary health centers (TAU), and only de EG will receive the m-health adapted version of the WWWT. The qualitative component considers 12 users semi-structured interviews. The maximum variation sampling strategy will be used according to the completion of m-health version of WWWT. An open coding of Grounded Theory will be used to data analysis. The feasibility of m-health version of WWWT intervention will be evaluated in terms of eligibility rates, recruitment rates and reasons for study refusals, feasibility to deliver the three components of the intervention, data attrition and follow-up rates by treatment condition. Their acceptability considers participant completion of the intervention rates, and a qualitative assessment of the users' acceptability of and satisfaction. Secondary outcomes will include changes on maternal levels of depressive and anxiety symptoms, maternal self-efficacy and perceived social support. And differences in mother-infant quality of interaction between intervention and control groups.
Perinatal Emotion and Relationships Longitudinal Study
DepressionPostpartumThis study, funded by the John Templeton Foundation, will examine birth and the early postpartum period (BEPP) as a transformative life experience that may shift women's experience of emotion in such ways as to a) support enhanced other-oriented emotions and b) underlie risk or resilience from psychopathology.
Follow up of Mothers Suspected of Postpartum Depression
DepressionPostpartumPostpartum depression (PD) is a serious and disabling mental health condition that affects 10-15% of women after childbirth. Low-income minority women are disproportionately affected. Untreated PD can lead to significant negative outcomes for both mother and child. Pediatricians are being asked to routinely screen for PD and while screening rates are improving, little is known about whether mothers actually adhere to pediatrician recommendations to seek additional help after a positive PD screen. The objective of this study is to describe the rate at which mothers seek treatment for suspected PD after a positive screen at the pediatrician office. Additional examination will look at factors that predict whether a mother recalls a recommendation to seek treatment.
The Effect of Magnesium on Maternal Mood, Cognitive Function, and Birth Experience
DepressionPostpartumMagnesium is sometimes used to prevent seizures in the setting of hypertensive disorders of pregnancy. The primary aim of this study is to determine if women who receive magnesium are less likely to experience postpartum depression. Other aims include examining the relationship between receiving magnesium and cognitive function and birth experience.
Effectiveness of a Web-based Nursing Intervention in the Reduction of Postpartum Depression and...
DepressionPostpartumThe purpose of the study is to determine whether a web-based nursing intervention delivered during the postpartum period will decrease symptoms of postpartum depression and parenting stress.
Type II Diabetes Mellitus in Patients Exposed to Pravastatin and Paroxetine
DepressionPostpartumType 2 Diabetes (T2DM) is a life-long, chronic condition affecting an individuals' ability to regulate glucose levels in the blood. Diabetes can cause many severe complications if not treated properly. Hyperglycemia is a regular effect of uncontrolled diabetes and can lead to complications such as cardiovascular disease, chronic renal failure, diabetic retinopathy and inability to maintain a healthy body weight. Cardiovascular Disease (CVD) is now the leading cause of death worldwide, affecting millions of people in both developed and non-developed countries. The buildup of cholesterol in the bloodstream may cause the excess to be deposited in the coronary arteries of the heart and the carotid arteries of the brain. The cholesterol deposits are a factor of the plaques that cause blockage of the arteries which can in turn lead to heart disease and stroke. By lowering the blood levels of cholesterol, risks of heart disease, strokes and heart attacks are reduced. Medications such as HMG-CoA reductase inhibitors and fibrates are useful in the prevention of CVD. Pravastatin is a member of the drug class of statins, also known as HMG-CoA reductase inhibitors, and is shown as an adjunctive therapy to diet. It is known to reduce the amount of cholesterol and other fatty substances in the blood. In addition, pravastatin is indicated to reduce the risk of myocardial infarction, revascularization and cardiovascular mortality in hypercholesterolemic patients who do not have clinically apparent coronary heart disease. The recommended starting dose for adults is 40 mg once daily. For patients who do not reach the LDL-C goal with 40 mg, it is recommended to use an 80 mg dose. For persons with significant renal impairment the recommended dose is 10 mg. Children aged 8-13 years have a recommended starting dose of 20 mg daily. Adolescents aged 14 to 18 years have a recommended starting dose of 40 mg daily. Depression is known as the most common mental disorder and most prevalent type of mood disorder today. It can be seen as a state of mood, a symptom, a syndrome or as a clinical diagnosis. Depression is a common disorder, affecting about 121 million people worldwide. Depression is more likely to co-occur with medical illnesses such as stroke, heart disease, cancer and diabetes. Up to one-quarter of people with diabetes are estimated to experience depression which is two times more than those who do not suffer from diabetes. Studies have shown that major depression mainly occurs in 2¬4 percent of people in the community, in 5-10 percent of primary care patients and 10-14 percent of medical inpatients. Also, recent studies have estimated that the symptoms continue over a 6 month to one year period in patients with major depression. The severity of the symptoms and the incidence of medical illness are expected to predict the persistence of depression. Depression can be treated effectively by a variety of antidepressants and/or psychotherapies. If treated appropriately, over 80 percent of people who suffer from depression can be helped. Paroxetine is an orally administered selective serotonin reuptake inhibitor (SSRI) antidepressant. It was the first antidepressant that was formally approved in the United States for the treatment of panic attacks, major depression, post¬traumatic stress disorder, social anxiety, generalized anxiety disorder, panic disorder and obsessive-compulsive disorder. Paroxetine has a well-established safety profile and it shares the common side effects and contraindications of other SSRI's which include nausea and somnolence and is associated with weight gain. This study proposes to conduct a retrospective cohort study to assess the risk of new onset diabetes among patients undergoing treatment with Pravastatin or other statins, and Paroxetine or other SSRI's. This study will compare the risk of co administration of two drug classes versus the use of each agent alone. In addition, the risk among patients prescribed Paroxetine and fibrates in combination, relative to the use of Paroxetine singly, will be examined to determine whether any interaction found between Paroxetine and statins extends to other drugs indicated for hypercholesterolemia. The first primary objective of the study is to estimate the incidence of Type 2 Diabetes (T2DM) among patients newly exposed to pravastatin in combination with paroxetine, or other SSRIs, compared to those newly exposed to pravastatin alone. The second primary objective is to estimate the incidence of Type 2 Diabetes (T2DM) among patients newly exposed to paroxetine in combination with pravastatin, other statins, or fibrates, compared to those newly exposed to paroxetine alone.
Interaction Between Genetic Factors and Maternal Stressors During Pregnancy in the Risk of Postpartum...
Postpartum Depression"The prevalence of postpartum depression (PPD) is approximately 13%. PPD is associated with a higher maternal morbidity and mortality, and also with pervasive effects on the emotional, cognitive and behavioral development of the infant. Stressful life events, socio-demographic and obstetrical risk factors have been associated with the risk of PPD. Genetics risk factors of PPD have also been identified. We are presently studying for the first time how maternal stressors may interact with genetic factors to increase the risk of PPD (Gene x Environment interaction)".
The Effect of a Father Inclusive Psychoeducation Program on Postnatal Depression
PregnancyStudy hypothesis: Childbearing couples who receive the father inclusive psychoeducation program will have: (a) a lower level of depressive symptoms, (b) a higher level of marital relationship, and (c) a higher level of quality of life at 6 weeks, 6 months and one year postpartum than those who receive the usual perinatal care.
The Effect of Early Versus Traditional Follow-Up on Breastfeeding Rates at 6 Months
PregnancyBreastfeeding3 moreThe study's purpose is to determine if early (2-3 week) versus traditional (6-8 week) postpartum follow up is associated with a higher rate of breastfeeding at 6 months. The study's hypothesis is that follow up at 2-3 weeks postpartum is associated with a higher rate of breastfeeding 6 months postpartum.
Postpartum Depression and Cesarean Section
Postpartum DepressionThe purpose of this retrospective study is to determine if there is an increase in postpartum depression (PPD) among women who undergo an emergency cesarean section as opposed to a planned cesarean section. We will analyze the hospital and clinic medical records of postpartum women who delivered by cesarean section (CS) at Tulsa Regional Medical Center between January 1, 2003, and June 1, 2005, and who obtained their postpartum care at the OSU Ob/Gyn Clinic in Tulsa, Oklahoma. We will record whether the cesarean was planned or emergent, and we will note the score they received on the Edinburgh Postnatal Depression Scale when they came to the clinic for their four-week postpartum visit. A score of 12 or lower on the EPDS will be considered "not depressed", and a score of 13 or higher will be considered "depressed." Numbers of depressed patients will be compared among the two types of cesarean sections and analyzed for statistical differences using the chi-squared method of analysis.