Postpartum care - What's new?

Current Opinion in Obstetrics and Gynecology

Volumn 19, Issue 6, 2007, Pages 561-567

  Shaw, Elizabeth ^a   Kaczorowski, Janusz ^b  

^a MCMASTER UNIVERSITY   (Canada)

^b UNIVERSITY OF BRITISH COLUMBIA   (Canada)

Author keywords

Contraception; Depression; Incontinence; Postpartum; Smoking cessation; Support

Indexed keywords

ANTIDEPRESSANT AGENT; DECOSHEXAENOIC ACID DERIVATIVE; EICOSOPENTAENOIC ACID; FLUOXETINE; NORTRIPTYLINE; OMEGA 3 FATTY ACID; SERTRALINE; UNCLASSIFIED DRUG;

BLADDER DYSFUNCTION; CLINICAL TRIAL; COGNITIVE THERAPY; CONTRACEPTION; COUNSELING; DRUG BLOOD LEVEL; FOLLOW UP; HUMAN; INTRAUTERINE CONTRACEPTIVE DEVICE; MENTAL HEALTH; META ANALYSIS; MOTIVATION; OUTCOME ASSESSMENT; PELVIC FLOOR MUSCLE TRAINING; PREVALENCE; PRIORITY JOURNAL; PUERPERAL DEPRESSION; PUERPERIUM; REVIEW; RISK FACTOR; SMOKING CESSATION PROGRAM; SYSTEMATIC REVIEW; URINE INCONTINENCE;

CONTRACEPTION; DEPRESSION, POSTPARTUM; EXERCISE; FATTY ACIDS, OMEGA-3; FEMALE; HUMANS; MENTAL HEALTH; PELVIC FLOOR; POSTNATAL CARE; POSTPARTUM PERIOD; PREGNANCY; PUERPERAL DISORDERS; SMOKING CESSATION; TREATMENT OUTCOME; URINARY INCONTINENCE, STRESS;

EID: 36248968028     PISSN: 1040872X     EISSN: None     Source Type: Journal    
DOI: 10.1097/GCO.0b013e3282f10e44     Document Type: Review

References (52)

1. World Health Organization, Technical Working Group. Postpartum care of the mother and newborn: A practical guide. Birth 1999; 26:255-258.
2. Levitt C, Shaw E, Wong S, et al. Systematic review of the literature on postpartum care: methodology and literature search results. Birth 2004; 31:196-202.
3. Moran CF, Holt VS, Martin DP. What do women want to know after childbirth? Birth 1997; 24:27-32.
4. Health Canada. Family-Centred Maternity and Newborn Care: National Guidelines. Ottawa, Ontario: Minister of Public Works and Government Services; 2000.
5. American College of Obstetricians and Gynecologists and American Academy of Pediatrics. Guidelines for Perinatal Care. 5th ed. Washington, DC, and Elk Grove Village, IL: American Academy of Pediatrics; 2002.
6. Shaw E, Levitt C, Wong S, Kaczorowski J. Systematic review of the literature on postpartum care: effectiveness of postpartum support to improve maternal parenting, mental health, quality of life and physical health. Birth 2006; 33:210-220. In this systematic review of the literature, 22 trials were identified that examined the impact of postpartum support on maternal parenting, mental health, physical health, and quality of life. The review concluded that there is no evidence to support universal provision of postpartum care to unselected, low-risk women. Women at risk or women who had support provided after detailed needs assessment did have improvements in mental health and/or parenting outcomes.
7. Lumley J, Watson L, Small R, et al. PRISM (Program of Resources, Information and Support for Mothers): a community-randomised trial to reduce depression and improve women's physical health six months after birth. BMC Public Health 2006; 6:37. In this large, community-based, cluster-randomized, controlled trial conducted in Australia, the ability of a multifaceted program with community services and primary care involvement to improve maternal mental health was examined. Over 19 000 women participated. There were no improvements in mental health outcomes (EPDS or SF-36 scores) in the study group as a whole, although subgroup analysis suggested that women without a partner and women born in non-English-speaking countries had improved outcomes.
8. MacArthur C, Winter HR, Bick DE, et al. Effects of redesigned community postnatal care on women's health 4 months after birth: A cluster randomized controlled trial. Lancet 2002; 359:378-385.
9. Gaynes BN, Gavin N,Meltzer-Brody S, et al. Perinatal depression: prevalence, screening accuracy and screening outcomes. Evidence Report/Technology Assessment No. 119. AHRQ Publication No. 05-E006-2. Rockville, MD: Agency for Healthcare Research and Quality; 2005.
10. Grace SL, Evindar A, Stewart DE. The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature. Arch Womens Ment Health 2003; 6:263-274.
11. Wisner KL, Perel JM, Peindl KS, et al. Prevention of postpartum depression: a pilot randomized clinical trial. Am J Psychiatry 2004; 161:1290-1292.
12. Wisner KL, Perel JM, Peindl KS, et al. Prevention of recurrent postpartum depression: a randomized clinical trial. J Clin Psychiatry 2001; 62:82-86.
13. Appleby L, Warner R, Whitton A, et al. A controlled study of fluoxetine and cognitive-behavioural counselling in the treatment of postnatal depression. BMJ 1997; 314:932-936.
14. Misri S, Reebye P, Corral M, et al. The use of paroxetine and cognitive-behavioral therapy in postpartum depression and anxiety: a randomized controlled trial. J Clin Psychiatry 2004; 65:1236-1241.
15. Wisner KL, Hanusa BH, Perel JM, et al. Postpartum depression: a randomized trial of sertraline versus nortriptyline. J Clin Psychopharmacol 2006; 26:353-360. In this randomized, controlled trial, sertraline and nortriptyline were found to be equally effective in the treatment of postpartum depression. Side effects were similar and drug levels were nonquantifiable in breast milk.
16. Hara MW, Stuart S, Gorman L, et al. Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry 2000; 57:1039-1045.
17. Cooper PJ, Murray L, Wilson A, et al. Controlled trial of the short and long-tern effect of psychological treatment of postpartum depression. Br J Psychiatry 2003; 182:412-419.
18. Wickberg B, Hwang CP. Counselling of postnatal depression: a controlled study on a population based Swedish sample. J Affect Disord 1996; 39:209-216.
19. Holden JM, Sagovsky R, Cox JL. Counselling in a general practice setting: controlled study of health visitor intervention in treatment of postnatal depression. BMJ 1989; 289:223-226.
20. Daley AJ, Macarthur C, Winter H. The role of exercise in treating postpartum depression: a review of the literature. J Midwifery Womens Health 2007; 52:56-62. This is a thorough review of both controlled and uncontrolled trials examining the role of exercise in treating postpartum depression. Two randomized, controlled trials in Australia showed some benefits, but the trials were small. The review concluded that there may be a role for exercise, and that there is enough preliminary evidence to warrant larger-scale trials in postpartum women.
21. Genuis SJ, Schwalfenberg GK. Time for an oil check: the role of essential omega-3 fatty acids and maternal and pediatric health. J Perinatol 2006; 26:359-365. This is an excellent overview of the role of omega-3 fatty acids in both maternal and infant health, with an emphasis on their role in conditions such as hypertensive disorders in pregnancy, pretermbirth, and postpartumdepression. The authormakes a cogent argument for routine supplementation with omega-3 fatty acids in pregnant women.
22. Sontrop J, Campbell MK. Omega-3 polyunsaturated fatty acids and depression: a review of the evidence and a methodological critique. Prev Med 2006; 42:4-13. This is a review of controlled and uncontrolled trials of omega-3 fatty acids in adult depression. It suggests some benefit as either primary treatment or augmentation of other antidepressants.
23. Freeman MP. Omega-3 fatty acids and perinatal depression: a review of the literature and recommendations for future research. Prostaglandins Leukot Essent Fatty Acids 2006; 75:291-297. This nonsystematic review of the literature examining the role of omega-3 fatty acids in perinatal depression identified two randomized, controlled trials in postpartum women. There was some evidence from one trial for the use of omega-3 fatty acids in treatment of postpartum depression.
24. Freeman MP, Hibbeln JR, Wisner KL, et al. Randomized dose-ranging pilot trial of omega-3 fatty acids for postpartum depression. Acta Psychiatr Scand 2006; 113:31-35. In this randomized, controlled trial of three different doses of omega-3 fatty acids in the treatment of postpartum depression, there was a response of approximately 50% across all three groups. There was no placebo arm, however.
25. Truitt ST, Fraser A, Gallo MF, et al. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev 2003; Issue 2. CD003988. DOI: 10.1002/14651858.CD003988.
26. American College of Obstetrics and Gynecology. ACOG Educational Bulletin. No. 258, July 2000. Breast-feeding: maternal and infant aspects. Obstet Gynecol 2000; 96:1-16.
27. Levitt C, Shaw E, Wong S, et al. Systematic review of the literature on the postpartum care: selected contraception methods, postpartum Papanicolau test, and rubella immunization. Birth 2004; 31:203-212.
28. Shaamash AH, Sayed GH, Hussien MM, Shaaban MM. A comparative study of the levonorgestrel-releasing intrauterine system Mirena® versus the Copper T380A intrauterine device during lactation: breast-feeding performance, infant growth and infant development. Contraception 2005; 72:346-351.
29. Centers for Disease Control and Prevention. Monitoring progress toward achieving Healthy People 2010 objectives - 19 states, Pregnancy Risk Assessment System (PRAMS), 2000-2003. Surveillance Summaries, MMWR 2006; 55 (No. SS09):1-11.
30. Edwards NC, Sims-Jones N. A randomized controlled trial of alternative approaches to community follow-up for postpartum women. Can J Public Health 1997; 88:123-128.
31. Women and smoking: a report of the Surgeon General. 2001 (home page on the Internet). US: CDC. 12 May 2006. Available from www.cdc.gov/tobacco/ sgr/sgr_forwomen/index.htm (accessed 3 July 2007).
32. Roske K, Hannover W, Grampler J, et al. Postpartum intention to resume smoking. Health Educ Res 2006; 21:386-392. In this prospective study of 301 postpartum women who had stopped smoking during pregnancy, intention to resume smoking was the strongest predictor of postpartum relapse.
33. Solomen LJ, Higgins ST, Heil SH, et al. Predictors of postpartum relapse to smoking. Drug Alcohol Depend 2007; doi:10.1016/j.drugalcdep.2007.03. 012. In a group of 87 postpartum women who had quit smoking during pregnancy, having more friends/family members who smoke, higher scores on depression scales, and less concern about weight were predictors of relapse. The first cigarette was most often smoked in the presence of another smoker.
34. Ma Y, Goins KV, Pbert L, et al. Predictors of smoking cessation in pregnancy and maintenance postpartum in low income women. Matern Child Health J 2005; 9:393-402.
35. US Department of Health and Human Services. Reducing tobacco use: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2000.
36. Hajek P, Stead LF, West R, et al. Relapse prevention interventions for smoking cessation. Cochrane Database Syst Rev 2005, Issue 1. Art. No.: CD003999. DOI: 10.1002/14651858.CD003999.pub2.
37. Gaffney KF, Baghi H, Zakari NM, Sheehan SE. Postpartum tobacco use: developing evidence for practice. Crit Care Nurs Clin North Am 2006; 18:71-79. Although this is not a systematic review, it does provide an overview of smoking cessation interventions in the prenatal and postpartum periods. Both nonrandomized and randomized, controlled trials are included. The majority of studies show no significant effect on relapse rates at 6 and 12 months postpartum.
38. Dornelas EA, Magnavita J, Beazoglou T, et al. Efficacy and cost effectiveness of a clinic-based counseling intervention tested in an ethnically diverse sample of pregnant smokers. Patient Educ Couns 2006; 64:342-349. This randomized, controlled trial examined the effect of an intensive counseling session plus telephone follow-up to improve smoking quit and relapse rates in a low-income, Hispanic population. Smoking relapse rates were the same in the study and control groups.
39. French GM, Groner JA, Wewers ME, Ahijevych K. Staying smoke free: an intervention to prevent postpartum relapse. Nicotine Tob Res 2007; 9:663-670. This pilot nonrandomized study of a brief postpartum counseling intervention with follow-up telephone contact showed an increase in smoking relapse rates at 6 months postpartum (21.5 versus 10.2, OR = 2.5, 95% CI 1.13-5.72).
40. Levine MD, Marcus MD, Kalarchian MA. Weight concerns affect motivation to remain abstinent from smoking postpartum. Ann Behav Med 2006; 32:147-153.
41. Pletsch PK. A model for postpartum smoking resumption prevention for women who stop smoking while pregnant. J Obstet Gynecol Neonatal Nurs 2006; 35:215-222.
42. Thyrian JR, Hannover W, Grampler J, et al. An intervention to support postpartum women to quit smoking or remain smoke-free. J Midwifery Womens Health 2006; 51:45-50. This study describes the structure, strategies, and application of a motivational counseling intervention to reduce smoking relapse rates postpartum. It also contains preliminary 6-month data from the randomized, controlled trial using this technique. There were significant improvements in both abstinence and relapse rates.
43. Haddow G, Watts R, Robertson J. Effectiveness of a pelvic floor muscle exercise program on urinary incontinence following childbirth. Int J Evid Based Healthc 2005; 3:103-146.
44. MacArthur C, Glazener C, Wilson PD, et al. Persistent urinary incontinence and delivery mode history: a six year longitudinal study. BJOG 2006; 113:218-224. This prospective, observational study in Scotland and New Zealand found a 24% prevalence of persistent urinary incontinence at 6 years postpartum. The presence of urinary incontinence at 3 months postpartum was strongly associated with the persistence of symptoms at 6 years.
45. Altman D, Ekstrom A, Gustafsson C, et al. Risk of urinary incontinence after childbirth: a 10 year prospective cohort study. Obstet Gynecol 2006; 108:873-878. In this 10-year follow-up study of 304 primiparous women in Sweden who had delivered vaginally, the prevalence of moderate to severe stress incontinence was 12% at 10 years compared with 2% immediately after birth. The only significant association was the index vaginal delivery.
46. Viktrup L, Rortveit G, Lose G. Risk of stress urinary incontinence twelve years after the first pregnancy and delivery. Obstet Gynecol 2006; 108:248-254. In a 12-year longitudinal study of 305 primiparous women in Norway, the prevalence of any stress incontinence was 42%, with 8.7% severe enough to cause social or hygienic issues. Onset during pregnancy or in the first 3 months postpartum was highly predictive of stress incontinence at 12 years.
47. Harvey MA. Pelvic floor exercises during and after pregnancy: a systematic review of their role in preventing pelvic floor dysfunction. J Obstet Gynaecol Can 2003; 25:487-498.
48. Derbeyshire EM, Davies J, Costarelli V, Dettmar P. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy. Matern Child Nutr 2006; 2:127-134. This was a prospective study with 94 women completing surveys on bowel function, diet and exercise throughout pregnancy. Of the 55 women who completed the survey at 6 weeks postpartum, 17% (95% CI 7-27) complained of constipation.
49. van Brummen HJ, Bruinse HW, van de Pol G, et al. Defecatory symptoms during and after the first pregnancy: prevalences and associated factors. Int Urogynecol Pelvic Floor Dysfunct 2006; 17:224-230. In a prospective study of 487 women, the prevalence of constipation at 3 months postpartum was 46% and at 12 months 42%. The prevalence of painful defecation was 28.7% at 3 months and 22.1% at 12 months. The major risk factor for either symptom at 12 months postpartum was the presence of these symptoms at 12 weeks of pregnancy.
50. Borello-France D, Burgio LK, Richter HE, et al. Fecal and urinary incontinence in primiparous women. Obstet Gyncol 2006; 108:863-872. This was a prospective multicenter study of 921 women in the US evaluating the impact of anal sphincter tear on either fecal or urinary incontinence. At 6 months, the prevalence of fecal incontinence was 17.0% in the women with anal sphincter tears, compared with 8.2% in the vaginal controls and 7.6% in the cesarean section controls (P = 0.01). There was no increased risk of urinary incontinence associated with anal sphincter tear.
51. Mahony F, Behan M, O'Herlihy CO, Connell PR. Randomized clinical trial of bowel confinement vs laxative use after primary repair of a third degree obstetric anal sphincter tear. Dis Colon Rectum 2004; 47:12-17.
52. Eogan M, Daly L, Behan M, et al. Randomized clinical trial of a laxative alone versus a laxative and a bulking agent after primary repair of obstetric anal sphincter injury. BJOG 2007; 114:736-740. This excellent randomized, controlled trial randomized 147 women with a third-degree anal sphincter tear to lactulose alone at a dose of 10 ml three times a day, compared to lactulose plus a bulking agent for 10 days. There were no differences in perineal pain, time to first bowel movement, or pain with first bowel movement, but the group who used the bulking agent had increased episodes of fecal incontinence in the immediate postpartum period.