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      Efecto del contacto piel con piel sobre la presencia de síntomas depresivos post parto en mujeres de bajo riesgo obstétrico Translated title: The effect of Mother/Infant skin-to-skin contact on postpartum depressive symptoms in women with low obstetric risk

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          Abstract

          Antecedentes: La depresión postparto es un problema de alta prevalencia que impacta en la vinculación afectiva de la madre con su hijo(a). El contacto piel con piel se define como el contacto del recién nacido seco y desnudo, en posición prona sobre el pecho desnudo de su madre, cubierto por su espalda con una manta tibia, inmediatamente ocurrido el parto durante al menos una hora. Objetivo: Examinar la relación entre el contacto piel con piel y la incidencia de síntomas depresivos en mujeres con embarazos de bajo riesgo obstétrico. Pacientes y Método: Estudio analítico prospectivo de 393 puérperas de bajo riesgo obstétrico que evaluó sintomatología depresiva puerperal y su asociación con variables bio-sociodemográficas y características del contacto piel con piel como variable en estudio. Los datos se recolectaron a través de un cuestionario a las 24-48 h postparto y un seguimiento telefónico para pesquisar síntomas depresivos a través de la Escala de Depresión de Edimburgo a las 8 sem postparto. Resultados: Se reporta una incidencia de 29% de síntomas depresivos. El análisis mostró que el contacto piel con piel y el inicio precoz del amamantamiento están asociado significativamente con la ausencia de sintomatología depresiva postparto. Conclusión: El contacto piel con piel fue la única variable en este estudio capaz de explicar la ausencia de síntomas depresivos en mujeres que cursaron embarazos de bajo riesgo obstétrico. Se sugiere su implementación como estrategia preventiva.

          Translated abstract

          Background: Postpartum depression can interfere with bonding between the mother and the child. The skin-to-skin contact is defined as the contact of the new-born, dry and naked, prone on the mother's bare chest and with a warm blanket placed across the infant's back; this contact takes place immediately after delivery, for at least an hour. Objective: To examine the relationship between skin-to-skin contact and the incidence of depressive symptoms in women with low risk pregnancies. Patients and Method: A prospective analytical study was performed in 393 postpartum women with low obstetric risk in order to evaluate the postpartum depressive symptomatology and its association with biodemographic and skin-to-skin contact variables. Data were collected through a questionnaire at 24 to 48 hours postpartum and through telephone follow-up, at 8 weeks postpartum, in order to screen depressive symptoms using the Edinburgh Depression Scale. Results: 29% of women reported depressive symptoms. The analysis showed that skin-to-skin contact and early initiation of breastfeeding are significantly associated with the absence of postpartum depressive symptomatology. Conclusion: Skin-to-skin contact was the only variable in this study that can explain the absence of depressive symptoms in women with low risk pregnancies. Skin-to-skin contact implementation is suggested as a preventive strategy.

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          The relationship between infant-feeding outcomes and postpartum depression: a qualitative systematic review.

          The negative health consequences of postpartum depression are well documented, as are the benefits of breastfeeding. Despite the detailed research related to these maternal and infant health outcomes, the relationship between maternal mood and breastfeeding remains equivocal. A qualitative systematic review was conducted to examine the relationship between postpartum depressive symptomatology and infant-feeding outcomes. We performed electronic searchers in Medline (1966-2007), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982-2007), and Embase (1980-2007) by using specific key words. A hand search of selected specialist journals and reference lists of articles obtained was then conducted. Seventy-five articles were reviewed, of which 49 specifically provided data to be extracted related to postpartum depressive symptomatology and infant-feeding outcomes. Both authors independently extracted data including study design, participants (number and characteristics), and results. The results from this review suggest that women with depressive symptomatology in the early postpartum period may be at increased risk for negative infant-feeding outcomes including decreased breastfeeding duration, increased breastfeeding difficulties, and decreased levels of breastfeeding self-efficacy. There is also beginning evidence to suggest that depressed women may be less likely to initiate breastfeeding and do so exclusively. Depressive symptomatology in the postpartum period negatively influences infant-feeding outcomes. These findings have important clinical implications and support the need for early identification and treatment of women with depressive symptomatology. However, strategies to address help-seeking barriers are needed if women are to receive appropriate and timely treatment. Research to determine effective interventions to support depressed breastfeeding women is warranted.
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            Risk of postpartum depressive symptoms with elevated corticotropin-releasing hormone in human pregnancy.

            Postpartum depression (PPD) is common and has serious implications for the mother and her newborn infant. A possible link between placental corticotropin-releasing hormone (pCRH) and PPD incidence has been hypothesized, but empirical evidence is lacking. To determine whether accelerated increases in pCRH throughout pregnancy are associated with PPD symptoms. Pregnant women were recruited into this longitudinal cohort study. Blood samples were obtained at 15, 19, 25, 31, and 37 weeks' gestational age (GA) for assessment of pCRH, cortisol, and adrenocorticotropic hormone (ACTH). Depressive symptoms were assessed with a standardized questionnaire at the last 4 pregnancy visits and post partum. Subjects were recruited from 2 southern California medical centers, and visits were conducted in research laboratories. One hundred adult women with a singleton pregnancy. Main Outcome Measure Symptoms of PPD were assessed at a mean (SD) of 8.7 (2.94) weeks after delivery with the Edinburgh Postnatal Depression Scale. Sixteen women developed PPD symptoms. At 25 weeks' GA, pCRH was a strong predictor of PPD symptoms (R(2) = 0.21; beta = 0.46 [P < .001]), an effect that remained significant after controlling for prenatal depressive symptoms. No significant associations were found for cortisol and ACTH. Receiver operating characteristic curve analyses revealed that pCRH at 25 weeks' GA is a possible diagnostic tool (area under the curve, 0.78 [P = .001]). Sensitivity (0.75) and specificity (0.74) at the ideal cutoff point (pCRH, 56.86 pg/mL) were moderate. Growth curve analyses indicated that the trajectories of pCRH in women with PPD symptoms are significantly accelerated from 23 to 26 weeks' GA. At a critical period in midpregnancy, pCRH is a sensitive and specific early diagnostic test for PPD symptoms. If replicated, these results have implications for the identification and treatment of pregnant women at risk for PPD.
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              Calidad de vida de mujeres deprimidas en el posparto

              Depression is common among women, specially during breeding.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbp
                Revista de la Sociedad Boliviana de Pediatría
                Rev. bol. ped.
                Sociedad Boliviana de Pediatría (La Paz, , Bolivia )
                1024-0675
                2015
                : 54
                : 2
                : 102-109
                Affiliations
                [01] Santiago orgnameUniversidad Católica de Chile orgdiv1Facultad de Medicina orgdiv2Escuela de Enfermería Chile
                [02] Santiago orgnamePontificia Universidad Católica de Chile orgdiv1Facultad de Medicina orgdiv2Departamento de Salud Pública Chile
                Article
                S1024-06752015000200009
                d6dff69b-b886-4718-afbe-249e982f054f

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 8
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                SciELO Bolivia


                síntomas depresivos,post parto,contacto piel con piel,Escala de Depresión de Edimburgo,Depressive symptoms,postpartum,skin-to-skin contact,Edinburgh Depression Scale

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