The effect of sleep pattern changes on postpartum depressive symptoms.

Background: Research indicates that poor sleep is associated with postpartum depression; however, little is known regarding this relationship among postpartum women who are at high for postpartum depression. This study examined the relationship between changes in self-reported sleep patterns (from six weeks to seven months postpartum) and depressive symptoms at seven months postpartum among women who were at high risk for postpartum depression.

Methods: Participants (n = 122) were postpartum women who were at an increased risk for postpartum depression (personal or maternal history of depression) and had participated in a randomized exercise intervention trial.

A comparison of bivariate, multivariate random-effects, and Poisson correlated gamma-frailty models to meta-analyze individual patient data of ordinal scale diagnostic tests.

Individual patient data (IPD) meta-analyses are increasingly common in the literature. In the context of estimating the diagnostic accuracy of ordinal or semi-continuous scale tests, sensitivity and specificity are often reported for a given threshold or a small set of thresholds, and a meta-analysis is conducted via a bivariate approach to account for their correlation. When IPD are available, sensitivity and specificity can be pooled for every possible threshold.

The relationship between employment status and depression symptomatology among women at risk for postpartum depression.

Approximately 13%-19% of new mothers report depression during the postpartum period. Returning to work after childbirth is associated with depression; however, it is unclear if this finding applies to women who are at high risk for postpartum depression. The purpose of this study was to examine the relationship between employment status and depression symptomatology among women at risk for postpartum depression (defined as personal or maternal history of depression).

Selective Cutoff Reporting in Studies of Diagnostic Test Accuracy: A Comparison of Conventional and Individual-Patient-Data Meta-Analyses of the Patient Health Questionnaire-9 Depression Screening Tool.

In studies of diagnostic test accuracy, authors sometimes report results only for a range of cutoff points around data-driven "optimal" cutoffs. We assessed selective cutoff reporting in studies of the diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) depression screening tool. We compared conventional meta-analysis of published results only with individual-patient-data meta-analysis of results derived from all cutoff points, using data from 13 of 16 studies published during 2004-2009 that were included in a published conventional meta-analysis.

Erratum to: Methods for evaluating medical tests and biomarkers.

[This corrects the article DOI: 10.1186/s41512-016-0001-y.].

Access to Workplace Accommodations to Support Breastfeeding after Passage of the Affordable Care Act.

Objectives: This study examines access to workplace accommodations for breastfeeding, as mandated by the Affordable Care Act, and its associations with breastfeeding initiation and duration. We hypothesize that women with access to reasonable break time and private space to express breast milk would be more likely to breastfeed exclusively at 6 months and to continue breastfeeding for a longer duration.

Methods: Data are from Listening to Mothers III, a national survey of women ages 18 to 45 who gave birth in 2011 and 2012.

The Relationship between Prenatal Antidepressant Use and the Decision to Breastfeed among Women Enrolled in a Randomized Exercise Intervention Trial.

Background: Despite the numerous health benefits associated with breastfeeding, only 49% of postpartum women in the United States breastfeed at 6 months. Therefore, it is important to understand factors that may influence a woman's decision to breastfeed.

Objective: The purpose of this study was to examine the relationship between prenatal antidepressant use and the decision to breastfeed among postpartum women.

Potential benefits of increased access to doula support during childbirth.

Objectives: The annual costs of US maternity-related hospitalizations exceed $27 billion. Continuous labor support from a trained doula is associated with improved outcomes and potential cost savings. This study aimed to document the relationship between doula support, desire for doula support, and cesarean delivery, distinguishing cesarean deliveries without a definitive medical indication.

Employment during pregnancy and obstetric intervention without medical reason: labor induction and cesarean delivery.

Background: Rising rates of labor induction and cesarean delivery, especially when used without a medical reason, have generated concern among clinicians, women, and policymakers. Whether employment status affects pregnant women's childbirth-related care is not known. We estimated the relationship between prenatal employment and obstetric procedures, distinguishing whether women reported that the induction or cesarean was performed for medical reasons.

Maternal depressive symptoms, employment, and social support.

Objective: The purpose of this study was to characterize the relationship between maternal depressive symptoms and employment and whether it is mediated by social support.

Methods: We used data from a nationally representative sample of 700 US women who gave birth in 2005 and completed 2 surveys in the Listening to Mothers series, the first in early 2006, an average of 7.3 months postpartum, and the second an average of 13.

Use of nonmedical methods of labor induction and pain management among U.S. women.

Background: There exists limited documentation of nonmedical methods of labor induction and pain management during childbirth in the United States. We estimated the prevalence of nonmedical interventions for induction and pain management and examined the association between medical and nonmedical care during labor.

Methods: We used a nationally representative survey of U.

The impact of prenatal employment on breastfeeding intentions and breastfeeding status at 1 week postpartum.

Background: Postpartum employment is associated with non-initiation and early cessation of breastfeeding, but less is known about the relationship between prenatal employment and breastfeeding intentions and behaviors.

Objective: This study aimed to estimate the relationship between prenatal employment status, a strong predictor of postpartum return to work, and breastfeeding intentions and behaviors.

Methods: Using data from the Listening to Mothers II national survey (N = 1573), we used propensity score matching methods to account for non-random selection into employment patterns and to measure the impact of prenatal employment status on breastfeeding intentions and behaviors.

Postpartum doula and peer telephone support for postpartum depression: a pilot randomized controlled trial.

Objectives: This research provides the first test of feasibility of recruiting postpartum doulas and depressed mothers for a peer support intervention study and begins to evaluate the benefit of postpartum doula support and peer telephone support for at-risk mothers.

Methods: The authors recruited postpartum doulas from national doula organizations, peer telephone supporters from nursing referrals, and mothers with depressive symptoms from 3 local hospitals, local medical practices, Web sites, and community organizations. Participating mothers were randomized to 3 groups--postpartum doula, peer telephone support, and control group.

Reevaluating the relationship between prenatal employment and birth outcomes: a policy-relevant application of propensity score matching.

Background: Prior research shows an association between prenatal employment characteristics and adverse birth outcomes, but suffers methodological challenges in disentangling women's employment choices from birth outcomes, and little U.S.-based prior research compares outcomes for employed women with those not employed.

Examination of a telephone-based exercise intervention for the prevention of postpartum depression: design, methodology, and baseline data from The Healthy Mom study.

Research indicates that exercise is an efficacious intervention for depression among adults; however, little is known regarding its efficacy for preventing postpartum depression. The Healthy Mom study was a randomized controlled trial examining the efficacy of an exercise intervention for the prevention of postpartum depression. Specifically, postpartum women with a history of depression or a maternal family history of depression (n=130) were randomly assigned to a telephone-based exercise intervention or a wellness/support contact control condition each lasting six months.

Postpartum depression and health services expenditures among employed women.

Objective: To investigate the association of postpartum depression with health services expenditures among employed women.

Methods: Women, aged 18 years and older, were recruited from three community hospitals in Minnesota while hospitalized for childbirth in 2001. Using Andersen's Behavioral Model, we regressed the natural log of the price-weighted sum of self-reported health services used from hospital discharge until 11 weeks postpartum on depression status at 5 weeks postpartum (Edinburgh Postnatal Depression Scale).

Prevalence of depressive symptoms in the immediate postpartum period.

Purpose: There is currently little information about rates of positive maternal depression screens immediately after delivery; rather, most studies have assessed the prevalence of major depression between 1 and 6 months postpartum. This study investigated the rate of positive 9-item Patient Health Questionnaire (PHQ-9) surveys within 1 to 2 days after delivery.

Methods: A retrospective chart review of PHQ-9 results obtained within 1 to 2 days after childbirth was performed on 441 women who delivered at 3 St.

A longitudinal analysis of total workload and women's health after childbirth.

Objectives: To examine the association of women's postpartum health with total workload (TWL), work and personal factors in the year after childbirth.

Methods: Employed women from Minneapolis and St Paul, Minnesota, were recruited while hospitalized for childbirth. Longitudinal analyses, using fixed effects regression models, estimated the associations of TWL, job satisfaction and stress, social support, perceived control, breastfeeding and infant characteristics with women's health at 5 weeks, 11 weeks, 6 months, and 12 months postpartum.

Problems with a diagnostic depression interview in a postpartum depression trial.

Background: Diagnostic and Statistical Manual (DSM) IV-based depression interviews, valued for their diagnostic accuracy, are often considered to be essential for depression treatment trials. However, this requirement can be problematic because of participant burden. The purpose of this article is to describe our experience with the depression component of the Structured Clinical Interview for DSM Disorders (SCID) in a postpartum depression treatment trial.

Changes in depressive symptoms over 0-9 months postpartum.

Objective: To investigate mothers' changes in prevalence of postpartum depression (PPD) symptoms over 0-9 months postpartum and determine which symptoms best distinguish depressed from nondepressed women.

Methods: This was a prospective study of English-literate mothers of newborns, recruited from four family medicine clinics and three pediatric clinics. Mothers completed surveys at 0-1, 2, 4, 6, and 9 months postpartum, and surveys included demographic characteristics, a two-question depression screen, the 9-Item Patient Health Questionnaire (PHQ-9), and other health and work characteristics.

Predictors of mothers' postpartum body dissatisfaction.

Purpose: To investigate changes in mothers' body dissatisfaction from delivery to 9 months postpartum, and the relationship of postpartum body dissatisfaction to weight, other health, and social characteristics.

Methods: In this prospective longitudinal study, 506 mothers completed surveys at 0-1 and 9 months postpartum. Postpartum changes in body dissatisfaction and weight were evaluated by paired t-tests, and predictors of postpartum body dissatisfaction were identified by stepwise multiple regression analysis.

Stepped care treatment of postpartum depression: impact on treatment, health, and work outcomes.

Purpose: The purpose of this study was to pilot a stepped collaborative care intervention for women with postpartum depression and evaluate health differences between self-diagnosed depressed and nondepressed women.

Methods: Five hundred six mothers of infants from 7 clinics completed surveys at 0 to 1, 2, 4, 6, and 9 months postpartum and a Structured Clinical Interview for DSM-IV (SCID). SCID-positive depressed women were randomized to stepped collaborative care or usual care.

Postpartum depression screening at well-child visits: validity of a 2-question screen and the PHQ-9.

Purpose: Postpartum depression affects up to 22% of women who have recently given birth. Most mothers are not screened for this condition, and an ideal screening tool has not been identified. This study investigated (1) the validity of a 2-question screen and the 9-item Patient Health Questionnaire (PHQ-9) for identifying postpartum depression and (2) the feasibility of screening for postpartum depression during well-child visits.

Stepped care treatment of postpartum depression: a primary care-based management model.

Background And Purpose: Postpartum depression (PPD), the most prevalent serious postpartum complication, is a devastating illness that negatively impacts not only the mother, but also her infant, other family members, and work performance. There is an extensive body of research addressing systems-based quality improvement efforts for treatment of depression in primary care populations; however, little of this research has been directed toward postpartum populations. This paper presents a health care systems-based quality improvement model for the treatment of PPD derived from research outcomes in general primary care populations.

Mothers' health and work-related factors at 11 weeks postpartum.

Purpose: Many new mothers return to work soon after childbirth. This study examines personal and work-related factors associated with the postpartum health of employed women 11 weeks after childbirth.

Methods: Using a prospective cohort design, we recruited 817 Minnesota mothers into the study while they were hospitalized for childbirth in 2001.