Latest news with #perinatal
Medscape
12-08-2025
- Health
- Medscape
Growth Charts for Twins Improve Perinatal Risk Prediction
TOPLINE: New customised growth charts for twins (GROW-T), adjusted for maternal characteristics, more accurately predicted a small-for-gestational age (SGA)-associated risk for adverse perinatal outcomes than charts for singletons (GROW-S). METHODOLOGY: Researchers developed customised growth charts for twin pregnancies and compared them with singleton charts to evaluate their ability to identify SGA twins who are at an increased risk for adverse perinatal outcomes. They evaluated 8457 twin pregnancies (16,914 foetuses) from 127 NHS hospitals in the UK from January 2015 to February 2025, representing approximately two thirds of all NHS units. A mixed-effects linear regression analysis was performed to determine pregnancy-specific optimal weights at 37 weeks. Researchers compared GROW-T with GROW-S by calculating rates of the SGA-associated risk for stillbirth and adverse neonatal outcomes, such as the need for resuscitation, an Apgar score < 7 at 5 minutes, admission to the NICU, or neonatal death, using generalised estimating equations. TAKEAWAY: At 37 weeks, the average optimal weight of a twin was 389 g less than that of an equivalent singleton foetus. By pregnancy, 24.6% vs 64.9% of twins were classified as those with SGA (< 10th centile) according to GROW-T vs GROW-S; when analysed by individual foetuses, 13.8% vs 44.4% of twins were classified as those with SGA according to GROW-T vs GROW-S. Twins designated as SGA on the basis of GROW-T (odds ratio [OR], 7.2; 95% CI, 4.8-10.8) had a higher risk for stillbirth than those designated as SGA on the basis of GROW-S (OR, 2.8; 95% CI, 1.9-4.1). Twins classified as those with SGA on the basis of GROW-T had an increased need for resuscitation (OR, 1.3; 95% CI, 1.1-1.7), a lower Apgar score (< 7) at 5 minutes (OR, 1.8; 95% CI, 1.2-2.6), higher NICU admissions (OR, 1.3; 95% CI, 1.0-1.6), and an increased risk for neonatal death (OR, 5.4; 95% CI, 1.3-23.5). IN PRACTICE: "Our results add to the increasing evidence for adoption of twin specific charts," the authors wrote. "While adoption of twin specific charts is timely, implementation ought to be accompanied by evaluation in practice to monitor safety in different health service environments," they added. SOURCE: This study was led by Jason Gardosi, MD, Perinatal Institute, Birmingham, England, and was published online on August 01, 2025, in the American Journal of Obstetrics & Gynecology. LIMITATIONS: Ultrasound estimates of foetal weight in twins can be systematically overestimated, potentially affecting the accuracy of growth assessments. Chorionicity was not reported in the study cohort; however, the difference between growth curves of monochorionic and dichorionic twins was considered too small to be clinically relevant. DISCLOSURES: No funding information was provided for the study. All authors reported being employees of the Perinatal Institute, Birmingham, England. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
The Guardian
31-07-2025
- Health
- The Guardian
The five kinds of rest – and why they matter for new mothers
We live in a society that champions individualism, productivity and professional and financial success. At every turn we're encouraged to do it all, which can make us worry that if we're not being productive, what is our purpose? Across two years of research, including interviews with more than 60 perinatal health specialists and hundreds of mothers on the Australian Birth Stories podcast, we learned that most mothers enter postpartum with unrealistic expectations of themselves and their bodies. Some are left feeling purposeless and questioning their worth when the work of caring for a baby doesn't fit with the narrative of a results-driven society. And so it's helpful to flip the narrative and consider rest as the most productive thing you can do after birth. While pregnancy is the most ordinary of experiences, it is also absolutely extraordinary; it's the longest, highest-energy expenditure task the human body performs. After that you deserve rest, you need rest and it's important to remember that your body heals when it's resting. In fact, making a full recovery from childbirth is dependent on rest. When you care for yourself in postpartum, you lay the foundation for your long-term health and wellbeing. When it comes to postpartum, especially if you've got older children, rest is only made possible through intention, preparation and support. There's a lot of privilege associated with the opportunity to rest – access to a support network or the funds to pay for one – but it also requires you to value it and prioritise it. Understanding that there are different ways to rest, even when sleep is not something you can count on, can make that easier. This doesn't mean cancelling all plans but rather considering how you feel in social situations and being aware of the effect people have on you. Social rest is choosing to spend time with people who support your intentions and bolster your energy, who fill your soul and make you feel good. Ultimately, you want your social interactions to be positive and meaningful rather than draining and obligatory. This is particularly pertinent in early postpartum when unwanted guests can become a hindrance, tiring you and your baby by overstaying their welcome, which will make you feel depleted and exhausted at an already overwhelming time. The immediate period after birth is a mentally demanding phase of rapid learning. This focus and subsequent exhaustion is exacerbated by birth recovery, fogginess (often referred to as 'baby brain'), sleep deprivation and learning to breastfeed (if you do so). It's imperative to give your brain space to process what you're learning so the lessons have time to sink in. To create this space be mindful of what else you're consuming, especially advice from social media, as information overload can make it hard to be discerning. If you feel as though there are too many thoughts, ideas and questions in your head, write them down in a dot-point list: it helps you to find clarity and empties your head of distractions. Because you're in a physiologically vulnerable and sensitive state, you want to be gentle with your whole self. Any stress, anxiety or concerns will rattle you more than they usually do. Calming music, warm baths, hot tea, cosy clothes and minimal screen time will help you stay grounded. Think of your postpartum bedroom and house as a cocoon; prepare it while you're pregnant and you'll really benefit from its comfort. You'll also benefit from time alone where no one is touching you. Being 'touched out' is a common experience in early motherhood and is particularly relevant if you have older children who can, understandably, need extra touch and reassurance. This may quickly feel sensorially overwhelming, so prioritising breaks – in the shower or bath, in your bedroom with the door closed – goes a long way to creating the physical space you need to feel settled. Beyond the passive physical rest of sleep, active rest such as lying horizontally as much as possible in the first few weeks after birth is a big step towards recovery. This allows your pelvic floor to heal from pregnancy and birth, which is important for your long-term health. Active rest also involves releasing obvious tension in your body. Moving your hips and legs in a way that feels good – yoga, massage – is recommended in postpartum to improve circulation. Likewise, performing gentle stretches of your upper body, neck and shoulders will release the tension you may experience while learning to breastfeed. If you're breastfeeding, it can be really helpful to feed while lying on your side; this prevents your upper body from getting tense and won't place unnecessary pressure on your pelvic floor and perineum. But if you've had a caesarean birth, lying on your side to feed can be painful for the first few weeks, so you may be more comfortable in a supported seated position. Talking to your partner, birth support person or doula/midwife is important. We often have a lot to unpack after birth and it's common to want to share how you felt in labour, the highs and lows of the experience, and how you feel now. This is really healthy: you're letting go of your thoughts, processing them with empathetic listeners and considering how they make you feel. Emotional rest is the calm you feel when you can share your experience in an honest and authentic way. This is an edited extract from The Complete Guide to Postpartum (Murdoch Books; $39.99)
Yahoo
14-07-2025
- Health
- Yahoo
'I needed help with menacing thoughts about my son'
A mother who was diagnosed with postnatal depression after suffering intrusive thoughts about harming her newborn baby is calling for more support for women before and after birth. Karis, 30, from Basingstoke, Hampshire, gave birth to her son Noah two years ago and before she was diagnosed she said felt she "didn't want to be his mum". She now wants her experience to help destigmatise mental illness. She said women "don't get checked on enough" for mental health issues during the perinatal period, before and after birth. NHS England said the use of perinatal mental health services was increasing. Having gone through a traumatic birth experience, Karis recalled how she struggled to connect with Noah and that she hid her feelings for fear he would be taken away from her. "I just didn't feel like I loved him, I didn't want to be his mum, I didn't want him," she said. "In the night while breastfeeding, I had thoughts that he was a devil and I had to do something about it. "The thoughts were really menacing. I remember thinking that I wanted to hurt him. That was the point where I knew I needed help." Karis eventually contacted her health visitor and was referred to a perinatal mental health team. She said she was really well cared for after being diagnosed with postnatal depression and obsessive compulsive order, and had since recovered. However, she believes that more needs be done to encourage women to openly talk about how they are feeling. She said: "You're getting checked on but you don't get checked on enough and you don't get checked on enough during pregnancy either. "If someone had asked me at every appointment how I was feeling, I think I might have opened up sooner." A quarter of women experience perinatal mental health problems and 50% are never diagnosed, according to Dr Alain Gregoire, a consultant perinatal psychiatrist and president of the Maternal Mental Health Alliance charity. He said it was "absolutely essential" that health service staff who came into contact with women during pregnancy and postnatally were trained in mental as well as physical health. "Professionals definitely want to look after mental health but they don't have the training and facilities to do that," he said. Karen Sims, perinatal clinical nurse specialist at Hampshire and Isle of Wight Healthcare NHS Foundation Trust, said pregnancy and early parenthood could be "overwhelming" for new mothers. She said: "We want people to know they are not alone. "Our team works closely with midwives, health visitors, primary care and specialist services like the mother and baby unit to make sure support is easy to access." NHS figures show in the year leading up to April 2025, a record 64,805 women in England accessed specialist perinatal mental health services - an 111.7% increase over the past five years. Claire Murdoch, NHS England's national mental health director, said pregnancy and motherhood could bring "significant challenges". She said: "That's why our specialist perinatal mental health teams - made up of psychologists, peer support workers, and midwives - are dedicated to supporting women facing a wide range of difficulties, from prenatal anxiety and birth trauma to severe conditions such as postpartum psychosis." Karis said she was passionate about speaking openly about what she went through in the hope of helping others. "Support is absolutely out there but you have to find it," she explained. "I'm lucky, I've come through it and have a really supportive partner but it's such a lonely time." If you have been affected by the issues in this story, help and information is available on the BBC Advice Line page You can follow BBC Hampshire & Isle of Wight on Facebook, X (Twitter), or Instagram. 'Mums are dying and it's so preventable' 'I wasn't me any more' - a photographer tackles her postnatal depression NHS Hampshire and IOW - Perinatal Community Mental Health Service
CNN
16-06-2025
- Health
- CNN
Fathers' mental health important for child development, study says
EDITOR'S NOTE: Sign up for CNN's Stress, But Less newsletter. Our six-part mindfulness guide will inform and inspire you to reduce stress while learning how to harness it. Mothers bear much of the burden for a child's healthy development, from pregnancy through their teen years. But a large, new study adds to the growing body of evidence saying fathers, too, are responsible for the types of development that help children grow physically, emotionally and cognitively. Fathers' mental distress is slightly associated with subpar child development, including cognitive, social-emotional, language and physical development, according to the study published Monday in the journal JAMA Pediatrics. The researchers defined mental distress as symptoms or a diagnosis of depression, anxiety, a mix of both or stress. The findings were especially true in the perinatal period, which spans from conception to two years postpartum. During this time, the developing fetus, infant then toddler is particularly sensitive to any mental distress parents, especially the mother, experience, according to the study. 'Men are at risk of increased mental distress during the transition to fatherhood, with prevalence rates among men during the perinatal period as high as 8% for clinical depression, 11% for anxiety, and 6% to 9% for elevated stress,' the authors wrote in the study. 'This represents the most comprehensive global review to date on the association between fathers' perinatal mental health and offspring development,' said Dr. Delyse Hutchinson, senior author of the study and associate professor in the SEED Lifespan Research Centre at Deakin University in Australia, via email. 'What stood out was the striking consistency in the trends observed in the results,' Hutchinson, a clinical psychologist, said. 'This highlights the importance of supporting fathers if we want to see better outcomes for families.' While previous studies have linked fathers' poor mental health with potential harms on their children's development, the results were limited by the number of forms of development they investigated or the strength of their results. In addition to expanding this kind of research beyond mother-child pairs, the authors also wanted to fill those research gaps. They analyzed ties between paternal depression, anxiety or stress and six types of child development: social-emotional, adaptive, cognitive, language, physical and motor development from birth to age 18. Factors of social-emotional development included a child's ability to form positive relationships with peers, act in ways that benefit others, have healthy relational attachment, self-soothe and have a healthy temperament. Adaptability referred to a child's ability to respond to change and manage daily needs. Cognitive development included the health of a child's executive function skills, decision-making, memory, attention, learning, IQ and academic performance. Physical development factors included preterm birth, gestational growth and childhood height, weight, stunting, abdominal pain and sleep health. Motor development referred to fine motor skills, which involve the use of small muscles for actions such as writing or buttoning, and gross motor skills. Those latter skills use larger muscles for movements including waving your arm, walking or chewing. The findings derive from 84 previous studies totaling thousands of father-child pairs. All studies had followed participants over time, with mental distress measured from pregnancy to two years post birth, Hutchinson said. The authors excluded studies with fathers who had a medical condition, took medication or consumed alcohol or other drugs. There was no evidence for links between paternal mental distress and adaptive and motor development, the study found. But there were negligible to small associations with the other developmental outcomes including social-emotional, cognitive, language and physical maturation. The largest impacts were in early childhood, then infancy, then middle childhood. The associations were also generally stronger for postnatal mental distress than preconception mental distress, 'suggesting that a father's mental state may exert a more direct influence on the developing child after birth,' the authors said. A father's mental distress may affect his sensitivity and responsiveness in interactions with his child and disrupt attachment security, Hutchinson said. 'The timing of this review is excellent,' wrote independent experts Dr. Craig Garfield, Dr. Clarissa Simon and Dr. John James Parker of Ann & Robert H. Lurie Children's Hospital in a commentary on the study. 'Fathers spend more time than ever on childcare and are increasingly recognized as important contributors to family health and well-being.' The results affirm well-established evidence of the importance of supportive parenting on the well-being of children, said Dr. Arwa Nasir, a professor of pediatrics at the University of Nebraska Medical Center in Omaha, Nebraska, via email. Nasir wasn't involved in the study. Research on the role that fathers play in the lives of their children is important,' Nasir added. 'I hope future research will also clarify all the important and wonderful ways that fathers can enrich and support the health and development of their children.' Though the idea of a father's well-being influencing his child could be a natural conclusion, one drawback of the study is its partial reliance on gray literature — unpublished research that, in this case, included doctoral theses and interviews with authors of published studies that met criteria but hadn't reported relevant data. Of the 674 associations found, 286 were from unpublished work. However, the authors of the new study said when they compared their findings based on published research with their results reliant on unpublished studies, the new associations remained similar for most categories of development. Additionally, while the study is 'well-designed,' it doesn't prove a causal relationship and lacks larger context, Nasir said. 'It could simply be that both fathers and children's emotional wellbeing are impacted by the same larger psychosocial factors and socioeconomic pressures, such as poverty, structural racism and health disparities,' Nasir explained. 'Presenting the association between fathers' mental health and children's health outcomes in isolation from the larger societal factors risks presenting the fathers as the cause of children's problems.' This interpretation can also be stigmatizing, Nasir added. 'If the goal is supporting optimal health and development of children, I believe our focus in research and action should be exploring ways that society can support parents through economic security, equity, and justice.' The study emphasizes the importance of assessing and treating the well-being of both parents during health care visits in the perinatal period, experts said. 'Borrowing from the decades-old strategy of perinatal maternal screening for (postpartum depression), clinicians, researchers, and policymakers can build on the existing maternal infrastructure to design father-tailored programs and policies that strive to improve the mental health of fathers and families,' Garfield, Simon and Parker wrote. Parents are the guardians of 'society's future generations,' Nasir added. 'Supporting the well-being of families should be a national priority.' But to receive help, fathers have to speak up and honestly answer questions about mental health concerns, they added. 'It's important for fathers to be aware that becoming a parent can be a challenging period, and that many fathers go through ups and downs during this time,' Hutchinson said. Seeking support early can make a difference, she added, and it's a strength, not a weakness. Fathers can talk with general physicians, therapists or providers at specialized pregnancy or postpartum clinics about mental health symptoms, Hutchinson said. Peer group support and online apps that use mindfulness and cognitive behavioral therapy to help manage moods can also be effective, she added. Even if your children are older, it's still never too late to prioritize your health, Hutchinson said. Every age and stage across child development is important, not just one period in time.
Medscape
16-05-2025
- Health
- Medscape
Postpartum Mental Illness Common in Year 2
A large UK cohort study found that the prevalence of women experiencing moderate to severe mental illness in the second postpartum year increased from 3.1% to 7.4% between 1995 and 2018, supporting extended perinatal mental health (PMH) services. METHODOLOGY: This retrospective cohort study analysed data of 2,132,754 pregnancies from 1,361,497 women registered with a general practitioner between 1995 and 2020 using the UK Primary Care Clinical Practice Research Datalink GOLD database. Women who experienced a stillbirth or termination of pregnancy or had pregnancy durations less than 24 weeks or more than 43 weeks were excluded from the analysis. The primary outcome was the prevalence and incidence of mental illness in the period up to 2 years after birth. TAKEAWAY: The prevalence of mental illness requiring specialist PMH services in the second postpartum year increased from 3.1% in 1995 to 7.4% in 2018, with incident cases rose from 1.9% to 3.8%. The risk for mental illness in the second postpartum year was higher for women of most ages than for those aged 30-34 years. The risk increased with each additional pregnancy (two pregnancies vs one pregnancy: odds ratio [OR], 1.16; 95% CI, 1.13-1.19). Preterm births (OR, 1.21; 95% CI, 1.15-1.27), near-term births (OR, 1.21; 95% CI, 1.17-1.25), and history of mental illness (OR, 2.46; 95% CI, 2.41-2.52) were associated with an increased risk for mental illness. Depression and anxiety had the highest prevalence and incidence in the second postpartum year. IN PRACTICE: "The findings from the study indicate considerable ongoing need for specialist PMH services in the second postpartum year, supporting the extension of UK perinatal services up to two years," the authors wrote. "Further research should explore how to improve equity in access to PMH services in the second postpartum year by facilitating and building upon culturally adapted models for screening and treatment of PMI [perinatal mental illness] for ethnic minority women," they added. SOURCE: This study was led by Ellie Jones, School of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, England. It was published online on May 09 in The Lancet Regional Health - Europe . LIMITATIONS: This study included only women who consulted a general practitioner, possibly missing cases of moderate to severe mental illness. Some pregnancies may have been misclassified or missed due to data constraints, and loss to follow-up could have occurred if women changed practices. The severity of illness could not be precisely assessed, and some second-year cases may have been continuations of earlier illness. Additionally, social factors like support, marital status, and abuse were not included. DISCLOSURES: This study was funded by the National Institute for Health and Care Research Applied Research Collaboration West Midlands. Several authors reported receiving grants from the National Institute for Health and Care Research and having various ties with various organisations. Details are provided in the original article.
