Risultati per: Linee guida sull’emorragia postpartum

In Reply We agree with Drs Gao and Zhang that understanding the effectiveness of IUDs to prevent pregnancy is important to adequately weigh the risks and benefits of early postpartum IUD placement. Although IUDs are well known to be highly effective, our study was not designed to adequately assess the effectiveness of early postpartum IUDs for pregnancy prevention. We did report all pregnancies in the trial; 2 pregnancies occurred during use of an IUD among the 294 participants who received an IUD and completed 6-month follow-up (1 in the early placement group and 1 in the interval placement group). In addition, the rates of effective contraception were reported as IUD utilization at 6 months and were similar between groups.

To the Editor A recent study found that the risk of complete intrauterine device (IUD) expulsion in individuals who underwent early postpartum IUD placement (2-4 weeks postpartum) was not inferior to that in individuals who underwent interval IUD placement (6-8 weeks postpartum). However, this conclusion must be viewed with cautious for several statistical reasons.

This study examines the association between state public insurance coverage and postpartum care among low-income immigrants and the differences in care received among immigrants relative to nonimmigrants.

Con medici e familiari, nasce da un’analisi neurometrica

New England Journal of Medicine, Volume 389, Issue 1, Page 79-80, July 2023.

Objective
To assess the feasibility of the family paediatrician’s (FP) role in identifying the signs of postpartum depression in parents in time to guarantee child well-being.

Design, setting and participants
Data for this observational prospective study were collected within the NASCITA (NAscere e creSCere in ITAlia) cohort. During the first visit, paediatricians collected sociodemographic data regarding the parents and information about their health status, the pregnancy and the delivery. Whooley questions were administered during the first and second visits (scheduled 60–90 days after childbirth). Moreover, on the third visit (5–7 months after childbirth) the FP was asked to answer ‘yes’ or ‘no’ to a question on the parental postpartum depression, based on his knowledge and on the acquired information.

Results
In 2203 couples who completed the assessment, 529 mothers (19.9%), 141 fathers (6.3%) and 110 (5%) couples reported any depressive symptomatology. Of these, 141 mothers (5.3% of the total sample) and 18 fathers (0.8% of the total sample) were classified as ‘likely depressed’. An association was found between maternal postnatal depressive symptoms and having a diagnosed psychiatric disorder during pregnancy (OR 9.49, 95% CI: 3.20 to 28.17), not exclusively breastfeeding at hospital discharge (OR 1.76, 95% CI: 1.19 to 2.61) and the presence of child sleeping disorders at 3 (OR 2.46, 95% CI: 1.41 to 4.28) and 6 months (OR 2.18, 95% CI: 1.37 to 3.47). Another significant predictor of postpartum depression was being primiparous (OR 1.99, 95% CI: 1.31 to 3.02). Concerning the fathers, a significant association was reported only between likely depressed fathers and child sleeping disorders at 3 months (OR 7.64, 95% CI: 2.92 to 19.97). Moreover, having a likely depressed partner was strongly associated with depressive symptoms in fathers (OR 85.53, 95% CI 26.83 to 272.69).

Conclusions
The findings of this study support the feasibility of an active screening programme for parental postnatal depression during well-child visits as an integral part of postpartum care.

Trial registration number
NCT03894566; Pre-results.